Bed wetting and DDAVP

I am a 28-year-old female and often wet my bed at night. Is there anything I can take to correct this problem? Is DDAVP effective?

I think what you have is nocturnal enuresis. It is not a rare problem by any means but because people do not brag about it, the exact incidence is not known. In any case, you have several options when it comes to medications. You may want to ask your doctor for DDAVP, which is available as an inhaler. In some people, it does reduce nighttime urine production. However, it does not work in everyone and it is also an expensive medication. I would say try it for a week and see what happens, if it fails to work in 7-14 days, it is unlikely to work at all. DDAVP seems to work much better in children compared to adults. You should know that as soon as the medication is stopped, the enuresis will return. Good luck.

Lost condom in the butt

 I recently had anal sex with my boyfriend and it appears that the condom came loose and is lost in my rectum. Should I do something?

No, I would not worry at all. In most cases, the condom will just pass out with the feces. It is very unlikely that it will remain in your rectum. During my younger days as a surgeon, we used condoms as tubes when doing colonic surgery. The condoms were stitched on the inside of the bowel so that the fecal material would not come into contact with the bowel lumen, giving the sutures time to heal. After 5-8 days, the condoms then spontaneously fell out. There were never any problems. However, I should warn you- losing a condom in the butt is one thing, but if you were to loose a sex toy or a dildo, that will require removal either with a scope or surgery.

Incomplete colonoscopy

I has just underwent a colonoscopy and the doctor tell me it was incomplete and now recommends a barium enema

Polyps can occur anywhere in the colon but are most common in the left or sigmoid colon. Some polyps tend to grow and eventually turn cancerous. Thus, colonoscopy is a useful tool to screen for polyps and remove them if possible. However, all consumers should understand that in nearly 30% of patients, colonoscopy cannot assess the whole colon. The reason for this failure may be technical (incompetent doctor) or poor bowel preparation. When the doctor is unable to visualize the entire colon, the options are to repeat the colonoscopy or undergo a barium enema. Barium enema is an imaging study whereby contrast is inserted into the rectum and picture of the colon are obtained. Barium enema unlike colonoscopy does not always visualize polyps less than 5 mm. Moreover, during a barium enema one cannot even do a biopsy or remove the polyp. Therefore, if your colonoscopy is unsuccessful, you should discuss the topic with your doctor and find out why it was unsuccessful and perhaps be referred to another doctor who is more proficient at the technique

Arm Acne

I have severe acne on my upper arms. What is the best way to treat it?

Upper arm acne is just as common as acne on the face. Many people have upper arm acne but often do not notice it. The only difference between arm and facial acne, is that the former is usually concealed with garments. Arm acne is common in young people and tends to be slightly more common in men than women.

The treatment of arm acne is the same as for facial acne. There are non prescription and prescription medications that can be used to treat arm acne. The best advice is to first try an over the counter product. If that fails you can see a doctor for a prescription medication.  Unfortunately over the counter products like salicylic acid, clindamycin or benzyl peroxide suck.

In addition, you need to know that arm acne is often made worse by excess sweating, tight clothing and wearing damp sweaty clothes (eg after exercise) 

The first object should be to maintain good skin hygiene. Shower regularly, wear loose cotton garments and change clothes if they are damp after exercise. When showering do not scrub the acne lesions- Scrubbing is not a treatment of acne and can cause scarring. If you have long hair that falls on your arms, trim your hair.

There are 100s of herbs, lotions, potions, solutions, creams, ointments, enemas, solutions, etc etc for acne- the only thing they have in common is none of them work-so avoid wasting your money on BS products. If you have acne, go and see a decent skin doctor. Avoid GPs because they know very little about the skin and will probably prescribe an antibiotic without even examining you.

The good thing about arm acne is that unlike the face, it can be concealed by clothing.

Renova for Acne

Recently my doctor gave me a prescription of Refissa (Renova) for my acne. Is this a good medication?

If you look at all my posts, I provide honest opinions without any bias. I do not work for any drug company, i do not own any shares in any pharmaceutical products and i never associate myself with pharmaceutical reps. I provide information for patients which is useful, practical and honest.

Renova is a great medication for mild to moderate acne. Refissa (Tretinoin emollient) also known as Renova is used for the treatment of severe acne. The drug is also known as accutane, claravis and amnesteem. Refissa is usually prescribed when other treatments have failed.

Refissa belongs to a class of drugs known as retinoids. The drug works by decreasing skin oil production and increasing the peeling action. This leads to thinning action of skin and resolving of acne. If acne is untreated, it can lead to scar formation. The drug is also used to erase fine line and wrinkles.

Trust me, you will not be disappointed. However, it is relatively expensive. Most general practitioners do not prescribe this drug because they are clueless about skin disorders. You need to speak to a skin doctor, but it is worth the money.

Refissa for acne

I am a 23-year-old female and have terrible acne, but my doctor will not prescribe me Refissa. Why?

Refissa is known to cause damage to the fetus and all women of childbearing age should not take this drug. One has to sign a consent before approval can be given to use of Tretin in young women. Once you take Refissa, you should not get pregnant at least one year after stopping the drug. Most doctors are afraid to prescribe this medication to women, because if anything happens during the pregnancy, the doctor is most likely going to be sued. Instead of the pill, you may want to try the topical ointment. However. it also comes with similar restrictions.

Birth defects and pregnancy

Are birth defects common? This is my first pregnancy and I am worried? 

Birth defects continue to occur despite good prenatal care. It is estimated that one in every 33 infants born in North America has some type of birth defect. Birth defects can affect almost any part of the body. Birth defects also vary in severity. Some infants may have a simple cleft lip but others may have serious heart and limb defects. Birth defects of the heart can often be life threatening but most of these can be corrected with surgery within the first year of life. Unfortunately, in other parts of the world the majority of babies born with even the most simplest of heart defects die because of lack of surgeons. If you eat right, do not smoke, do not drink, and do not ingest medications during pregnancy, i would not worry about it. Most things in medicine happen because of bad luck rather than any specific factor.