A Question of Health

How can I stop my faithless husband making me ill? What is this purple swelling on my leg?

His sex is not safe

His sex is not safe

Q. I've been married for nearly 27 years. My husband is an intelligent and loving man and a fantastic father, but he's unable to be faithful. When I first found out, I wanted to leave him. After much discussion, I decided that his weakness did not make him less of a husband and father. We came to an agreement: I would overlook his occasional infidelities and he would make sure that that side of his life never interfered with the family. I've now had a shock. Not only have his infidelities been much more frequent than I thought, but since his vasectomy 15 years ago he has not used condoms. He says that there is nothing to worry about because he only has affairs with "nice" women - but these "nice" women might have husbands who are just as "nice" as mine. He thinks I am being silly and melodramatic. I am considering divorce because I think my health and even my life are dependent on his choice of partners. Could you please spell out to him how inconsiderate and stupid he is being?

A. I somehow doubt that your husband is going to change his behaviour because I ask him to. But, just for the record, in case he doesn't know, unprotected sex, even with "nice" people, carries the risk of contracting sexually transmitted infections. Some, such as chlamydia, may have few if any symptoms, but can lead to complications such as female infertility. Other infections, such as genital herpes, can be painful and unpleasant lifelong afflictions. Infection with HIV, which causes Aids, is most likely to be fatal, although drug treatment now helps people to live much longer. Cervical cancer is also linked to infection with the human papilloma virus, which is sexually transmitted. Your husband should also be aware that vasectomies can occasionally fail. I don't suppose you and he would be keen on sitting down with a marriage guidance counsellor, but it's worth considering. A few sessions of honest talking in the presence of a trained outsider can sometimes help couples whose situation seems pretty hopeless. You can find a local counsellor through the Relate website: www.relate.org.uk. Let me know what transpires.

Purple swelling

Q. About three weeks ago I knocked my leg against the side of a bed and a purplish swelling appeared within a few minutes. The initial pain has gone, but the swelling remains as it was. It is directly over the middle of the shin bone. I have been advised to simply wait for it to go, but I am tempted to pierce it with a sterilised needle, as I'm sure some blood would come out and the swelling would go down.

A. The swelling on your leg is probably a subperiosteal haematoma. When you hit your leg, a small blood vessel burst. The blood that escaped from the vessel is trapped under a layer of tissue known as the periosteum, which normally provides a tight covering to the bone. The periosteum is quite tough, and the blood is unable to get out. Eventually the body will absorb the blood naturally, and the swelling will disappear. This may take many many weeks, because of where the blood is trapped. I would strongly advise you against sticking a needle into the swelling for two reasons. First, the blood is probably thick and clotted, and it will not flow out through a tiny needle hole. Second, there is a chance that you will introduce some infection which could spread into the bone. This would be a serious problem that would be difficult to treat. Let nature take its course.

In the genes?

Q. A first cousin of mine (my mother's sister's son) and his partner have just had a baby with Edwards' syndrome, which is caused by an extra chromosome. Can this run in families?

A. Edwards' syndrome, like the more common Down's syndrome, is caused by the presence of an extra chromosome. In Edwards' it is number 18 (in Down's it's number 21). Babies with Edwards' syndrome usually die in the first month of life, although occasionally they can survive for a year or more. They are invariably severely handicapped. Edwards' syndrome does not run in families, except in a few, very rare cases. If your cousin's baby has what is known as primary Edwards' syndrome, there is no extra risk for you.

Have your say: readers write

Another report of measles occurring after vaccination, from LR of Leamington Spa:

My oldest son, now in his early thirties, had all the available jabs at the time, including the measles one. At the age of four, when we were living in Tanzania, he had a shortened bout of measles, diagnosed by a doctor who was well acquainted with the symptoms and so was unlikely to make a mistake. At the age of 13, he again presented with a rash, high fever and inability to keep his eyes open in bright light. Our GP, then in her fifties, was also acquainted with the symptoms of measles, which was once again diagnosed. This time it was the full works. Having said that, we were very grateful that he had had the injection. Children in Tanzania were dying every day from the disease and, had it not been for the jab, instead of having a mild bout of measles at age four, he could well have died.

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 health@independent.co.uk. Dr Kavalier is unable to respond personally to questions