STI: Ask the experts

April 9, 2009

Ask the experts

 

PAIN WITH EVERY BREATH I TAKE

 

Q: I had septoplasty surgery a year ago. It involved the shearing off of a portion of my nose bone to clear the air flow through my left nostril. Everything proceeded smoothly until four or five months after the surgery.

 

I began to feel lethargic regardless of whether I was engaged in sports, reading or just sitting and doing nothing. I also yawn often regardless of the amount of sleep I get.

 

Almost every breath I take causes severe pain in my nose and the pain spreads to the back of my head and eyes. Sometimes, part of my cheeks and eyelids twitch. I am also unable to detect certain scents.

 

In addition, my speech is occasionally slurred. This is a torture as I cannot concentrate, especially on my university studies. I have been to see specialists several times but they have found nothing wrong with my bone structure and prescribed only nasal sprays which aggravate my condition.

 

A: It is necessary to evaluate the nose and sinuses to diagnose the problem.

 

Sinusitis should be considered a cause for the pain in the nose and eyes. I would query whether any sinus surgery was performed in addition to septoplasty. You could check with your original surgeon or it could be assessed with an endoscope and CT scan of the sinuses. This would also tell you if sinusitis is the problem. If it is confirmed to be the cause, then there are methods to solve it.

 

The other possibility is that you might have sleep apnoea. This could cause the lethargy and your difficulty in concentrating. Again, a good assessment of the airway would be informative. If it is thought that sleep apnoea is probable, then it would be worthwhile to take a sleep test.

 

Dr Stephen Lee, a specialist in ENT surgery at Raffles Hospital

 

NUTRITIONAL VALUE OF IKAN BILIS

 

Q: Do ikan bilis (anchovies) have nutritional value?

 

I have been told that if eaten with bones intact, they especially good for pregnant women.

 

But there has been a recent trend in many shops in the market to sell ikan bilis with the bones removed.

 

When asked why, the sellers say it is because people do not like the bones. I wonder if this is true or is it because the current generation of sellers and consumers of ikan bilis do not know about its nutritional value.

 

Is the dried and salted variety (easier to buy and largely eaten here) or the fresh variety better? How much of it should we eat?

 

A: Anchovies with bones intact are a good source of calcium. They have two to three times more calcium than those with the bones removed. However, the entrails and head of anchovies contribute to a much higher cholesterol content, so it is better to have them removed but to leave the bones intact.

 

Some shops do sell split anchovies with the bones intact. Alternatively, purchase whole anchovies and remove just the head and entrails.

 

The fresh variety is better due to the much lower salt content. However, even if you do buy the fresh variety, it is best to remove the entrails.

 

There is no recommended amount of anchovies that one should consume. As the dried variety has high salt content, you may want to soak and wash them before cooking. Three tablespoons of anchovies will give you about 180mg of calcium, which is about one-fifth of an adult's daily calcium requirement.

 

Other good sources of calcium are milk, cheese, beancurd and dhal (a dish prepared with lentils or other pulses).

 

Ms Lim Su Lin is the chief dietitian and manager at the dietetics department at National University Hospital