Mun Li Pang

Yes.

Yes,a GP can definitely diagnose depression, and either refer you for counselling ,start antidepressants or both

Yes, the amount of blood loss from finger prick test is minimal. There is concern if she is losing blood elsewhere like in stools, and iron deficiency, so she needs to be checked further by a GP.

Constipation is often due to lack of water and fibre in the diet. Drinking lots of water (minimum 2L) and having plenty of vegetables and fruits will help. If you've used a lot of laxatives in the past, your gut may become sluggish and less responsive.I would suggest taking probiotics daily, in the form of a fermented drink like filmjolk, kefir or probiotic yoghurt which will help to keep your gut healthy besides fight constipation. Adding ground flaxseed to your meals will also aid against constipation. Check if you have gluten or dairy intolerance which can also cause bloating and constipation.

Antibiotics, see your GP for referral to ent surgeon if frequent recurrence as tonsillectomy may be needed.

Congratulations on your twin pregnancy. Anti D will be important if you are of Rhesus negative blood type. If you have A, B, AB, or O positive blood, then it won't be necessary. With Down syndrome, the risk gets higher with increasing age of the woman at the time of pregnancy, say, late 30s to 40s, but the blood test (MSST screening) is not diagnostic, and neither is the nuchal translucency ultrasound done at 11-12 weeks gestation. The only way to positively confirm Down syndrome is by doing 1 of 2 invasive procedures (amniocentesis or chronic villus sampling), both of which carry a risk of miscarriage. I wouldn't be quick to get a diagnostic test done or worry about your risks of having a Down syndrome child even if you're in the advanced maternal age category, unless there's a family history of Down syndrome. It'll be best to see the results of the next ultrasound at 18-20 weeks gestation, which will give a better clue if there are any organ dysfunctions. Be as happy and positive as you can be and take good care of yourself, as this will be protective for your twins in the womb.

It is quite unlikely to be cancer as, according to you, the lumps have been present and unchanged for 7-8 years. Judging by your description, you could have some benign cysts. With cancer, there would be abnormalities in your full blood examination, and also signs like fatigue and weight loss, etc. Your GP can request an ultrasound to confirm a diagnosis of lumps. Do get them checked again if you note any lumps that are getting bigger and change consistency (hard/rubbery/fixed).

There is no specific diet, but conception will happen quicker if you and partner don't smoke, don't drink alcohol, exercise regularly, are happy, and eat a healthy diet - lots of whole foods, veggies, hydrate well, etc. Obviously, knowing when your ovulation period is (assuming your periods are regular) and having regular sex around that time will speed things up. It is good that you've started on folic acid, as it'll prevent neural tube defects in the fetus once you're pregnant. Do ensure your vitamin D level is adequate, too; most women will be on vitamin D supplements during pregnancy.

Yes, do go see a GP and make sure the infection's not gone into your chest.

2-3 liters of water should suffice for the average person. May need more if you're into extreme sports/strenuous physical activity for long hours in the sun. Water restrictions apply if one has heart failure. Do take necessary precautions to keep safe when out in the sun. UV rays are highest between 10am-3pm.

Yes, you have to be careful not to take aspirin more than twice a week as you could be getting rebound headaches from overuse of aspirin. Do see a GP to get a proper diagnosis and treatment of your headache - if it's migraines, cluster headaches, or tension headaches, etc. Too much aspirin can also aggravate heartburn and cause nausea, vomiting, tinnitus (ringing in ears), etc.

It's best to wait 5-7days after your period is overdue to do a urine pregnancy test, as it takes time for urine bhcg levels to rise and you'll likely get false negatives if you check too soon.

It will not hurt to be on a high-protein, low-carb diet such as diets like Atkins to help improve weight loss, which results in better sugar control for type 2 diabetics. Try to eat as much unprocessed, whole foods that are low GI. Don't fall for gimmicks like low-fat foods as they'll usually contain more sugars, and right fats like virgin coconut oil are actually heart protective. Try to include some cinnamon in your diet, as it naturally helps in regulating sugars.

It is important to get your husband checked out by his GP to rule out any biological causes first. Patient history is important to determine the cause. I recommend you get a routine blood check which includes FBE, UEC, LFT, TSH, and fasting BSL and lipids. Depends on the length of his symptoms, and if he has unexplained weight loss, loss of appetite, etc., cancer has to be ruled out. There is a whole myriad of causes of fatigue, so don't panic, but get him seen by a doctor to get to the root of the problem.

No, steroids are certainly not recommended as a shortcut to bodybuilding. If taken at high doses and for long periods of time, steroids can cause osteoporosis, predispose a person to diabetes, and many other side effects. Besides, a lot of athletes get disqualified if they're found to be using steroids to enhance their performance. Your son can best build up his body with his weight training and eating wholesome foods (minimally processed foods) so his body has the right fuel to function optimally. He'll require a high-protein diet, can add on protein shakes/supplements. See Dr. Josh Axe's website, which provides education on the nutrients our bodies need.