You health questions answered

LIVING WITH LUMPS

Q. I have several lumps on my lower arms, one on the base of my back and several on my thighs. Previously I've been told these were lipomas. Now three more small lumps have come up in a row along the middle of my inside forearm and my doctor has brought up the possibility that they could be an autoimmune disease that affects the connective tissue. I also have permanent hypothyroidism. Do you think this diagnosis is possible, and if it is, what kind of disease?

A. Lipomas are benign fatty lumps that grow in various parts of the body. When they grow under the skin they feel like soft rubbery lumps. They can be as small as a pea, or as big as a plum. The commonest places for them are around the neck, the back and the upper arms and upper legs. The lumps are usually painless, although they can be uncomfortable if they appear in awkward places. Occasionally they can press on nerves and cause pain or numbness.

If you remove a lipoma and look at it under a microscope, it is composed of fat cells that have grown and spread. Lipomas usually appear for no apparent reason. Very rarely they run in families (familial multiple lipomatosis). When this occurs it is probably due to a gene that is passed from parent to child, but the actual gene that causes this has not yet been identified.

I can't quite imagine what autoimmune disease your doctor is referring to. There is no recognised link between an underactive thyroid and lipomas. There is a very rare condition called Dercum's Disease that causes an unusual type of painful fatty lumps, and there is some suggestion that people who have this disease sometimes have underactive thyroid glands. But the condition is so rare that there is hardly any medical literature written about it. I don't think you should worry that you are beginning to show signs of some rare autoimmune disease. The likelihood is simply that you are someone who has a tendency to produce lipomas for no good reason.

LEAKS IN THE NIGHT

Q. I need some help with a delicate subject. My husband, who is nearly 50, has begun to leak urine in the night. He is embarrassed and doesn't know what to do. He now sleeps on a towel to protect the sheets and mattress. Is there anywhere he can get help without going to the GP, who is a social acquaintance of ours in quite a small rural community?

A. Urinary incontinence is rarely talked about, but incredibly common. The Continence Foundation, a charity that helps people with bladder and bowel problems, estimates that nearly 10 million women and more than a million men in the UK have bladder problems. It is important to find out why your husband has suddenly begun to have urinary problems. It could be something as simple as a urine infection, or it could be his prostate gland or even something related to his bowels, such as severe constipation. Most areas have confidential NHS continence clinics. If you contact the Continence Foundation's specialist nurse on 08453 450 165 you will be able to get personal advice and the address of your nearest clinic. You can get a copy of their new leaflet Bladder or Bowel Problems? by sending an SAE to: Continence Foundation, 307 Hatton Square, 16 Baldwins Gardens, London EC1N 7RJ.

LICE WORK

Q. I have five daughters between the ages of 4 and 12 and I've found myself in a constant battle against head lice. I have tried pretty much everything but the treatments I am using don't seem to be doing the job anymore. I read in the newspapers recently that chemicals are now regarded as ineffective, and I am also quite concerned about putting chemicals on my children's hair and skin, especially the little ones. Is there an effective natural remedy I could try?

A. This question appears in the postbag with painful regularity. Head lice seem to be an integral part of school life these days, and there are no treatments - chemical or otherwise - that are guaranteed to succeed. I have always been impressed by the results of the bug-busting technique, which does not use any chemicals. It relies on stubborn determination and an understanding of the life cycle of head lice.

If you can prevent the head lice from reproducing, they disappear. In order to do this you have to remove all live lice before they lay their eggs (the eggs are the tiny grey droplets that stick to the hair shafts). Get a big bottle of ordinary hair conditioner and a very fine comb. Wet the hair with conditioner and comb through the hair right down to the roots, removing live insects and as many eggs as possible. If you do this every three days for three weeks, you will prevent any new eggs being laid. If your children come into contact with other children, there is always the risk that they will become reinfected. If this happens, you need to start again. With five young girls, you have your work cut out.

Readers write

DB from Bristol lowered his cholesterol without doing anything different:

"I would advise your healthy correspondents with high cholesterol levels to take the test again, this time avoiding eating up to 14 hours before the test. I did and my cholesterol level fell significantly."

A range of treatments for verrucas, from MO of Cheshire:

"I had a verruca for around 10 years, which kept coming back, despite a variety of treatments over six years.

"I swim regularly and am sure that was where I picked it up, whatever you say. Eventually, I treated the verruca successfully using a combination of banana skin plasters (taped to the foot day and night), calendula tincture and Wartner cryo treatment (used far more frequently than instructed). The key to beating them is constant treatment."

Please send your questions and suggestions to A Question of Health, 'The Independent', Independent House, 191 Marsh Wall, London E14 9RS; fax 020-7005 2182 or e-mail to health@independent.co.uk. Dr Kavalier regrets that he is unable to respond personally to questions