A Question of Health

I AM a primary school teacher who has never had chickenpox. I have heard that it is a serious disease in adults and I would prefer not to get it. Is there a vaccine I could have?

There is a vaccine that is 70-90 per cent effective, but it is not licensed for use in the UK. It sounds as though you are already immune, but ask your doctor for a blood test to check this. If you are not immune, you could ask him if he will prescribe the vaccine for you on a "named patient basis".

MY OLDER brother was born with spina bifida and I developed epilepsy in my late teens (I am now "seizure-free" and no longer on medication). I was wondering whether my and my brother's conditions could have been connected with folic acid deficiency in my mother? I hope to get pregnant this year; should I be taking more folic acid than other women?

There is good evidence that taking folic acid reduces a woman's risk of having a baby with spina bifida. You should take 400 micrograms daily from the time you stop using contraception until the 12th week of pregnancy. I do not think there is any link between your epilepsy and your mother's folic acid intake. Some drugs used to treat epilepsy interfere with folic acid; women taking anti-epileptic drugs may need extra folic acid before conception and during pregnancy. But this does not apply to you.

I AM a 28-year-old man who developed chronic juvenile rheumatoid arthritis at age 14. I now have quite badly deformed elbow and knee joints. I stopped taking my prescribed drugs (Voltarol, penicillamine and chloroquine) owing to stomach pains and skin problems. My blood samples show no signs of rheumatoid arthritis, but my flexibility is so bad that I wonder how long it will be before I am in a wheelchair. Would surgery combat this?

Most rheumatologists work with orthopaedic surgeons. You can get good advice and help from Arthritis Care (freephone 0800 289170), or the Arthritis Research Campaign (01246 558033, or www.arc.org. uk).

Write to A Question of Health, `The Independent', 1 Canada Square, Canary Wharf, London E14 5DL; fax 0171-293 2182; or e-mail to health@independ ent.co.uk. Dr Kavalier regrets he cannot respond personally