Your health questions answered

PRONOUN PROBLEMS

Q. I am a lady of 62. My problem is my personal pronouns. If I talk about a man, I call him her, and a woman, I call her him. Even when I write it down, I get it wrong. If there are theirs, yours, I get them the wrong way round. If there are several in a sentence, I am confused. It used to be now and again, but now I do it all the time. I also find stringing sentences together difficult. At the beginning, I realised I was saying it wrong, but now I don't realise it. I don't want to live my life in dementia. Is there anything I can do?

A. I have consulted two international experts in speech and language disorders. They agree that the problem sounds like a form of progressive aphasia. Aphasia is the technical term for an impairment in the ability to use or comprehend words. Strokes and other brain injuries are the commonest causes of aphasia. But the cause of progressive aphasias is often difficult to define. Because it is such a serious problem which seems to be getting worse, it is important that you see a specialist. Ask your GP for a referral to a neuropsychologist, who specialises in speech disorders, or to a memory clinic that is run by a neurologist. Unfortunately, these problems do seem to get worse with time, and there is no simple cure. But the first step to getting help must be an expert diagnosis.

CANCER WORRY

Q. I have a 20-year history of skin problems on my forehead and temples. Some have been skin cancers that have been surgically removed. I am concerned that most shampoos cause inflammation on my upper forehead and know that most contain sodium lauryl sulphate (SLS) or similar ingredients. Can you please recommend shampoos that do not contain such ingredients.

A. SLS is a detergent found in almost all shampoos and toothpastes. The internet is full of suggestions that SLS causes cancer, but there is no evidence that this is true. SLS can irritate skin, and I'm sure if it is used in industrial quantities your skin will not like it. But I do not think that SLS is the cause of your skin cancers. SLS has been shown to be toxic, but not cancer-causing, in animals. But the amount that a human would need to ingest is enormous. There are some SLS-free shampoos on the market, but I'm not able to give recommendations, because I don't think there is any good reason to buy them.

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.

Readers write

GP from London questions the long-term safety of Livial and other forms of hormone replacement therapy: Women who have strong family histories of breast cancer should think twice before taking any form of hormone replacement therapy for many years. Although the risks are not high, these treatments do increase the risk of developing breast cancer if they are taken for many years.