Whirlpool Responsible For Rash

Q. I have developed an itchy, burning rash on my bottom. It sometimes becomes red and inflamed. I trace this to the whirlpool facility at our spa, which I use every day after exercising.
I have tried Aveeno soaks but they don’t help. The dermatologist prescribed cortisone creams that didn’t work either. I am at a total loss as to what I should do to get some relief. Is it possible that this rash could be caused by the whirlpool and what can be done about it?
A. Hot tub folliculitis may result from improperly maintained whirlpools or hot tubs. Organisms such as Pseudomonas can cause the symptoms you describe.
Check with your dermatologist to see if an antibiotic is appropriate and let the spa management know about your outbreak. Both the pH and chlorine control may need improvement. Do not use the whirlpool until you recover completely to avoid transmitting the infection to others.
Q. I have taken Prilosec and then Prevacid for years to treat severe heartburn. When I began to suffer weakness and confusion I started taking 1000 mg of vitamin B12 daily. Within a relatively short time the horrible symptoms began to subside.
My doctor does not really see the relationship but I sure do! What can you tell me about this interaction?
A. Long-term suppression of stomach acid can sometimes interfere with efficient absorption of vitamin B12. This nutritional deficiency can cause nervous system problems, which may show up as insomnia, memory problems, depression and tingling or numbness in feet or fingers.
One reader reported a conversation with a nurse who noticed “a remarkable improvement in a female patient with dementia after a vitamin B12 deficiency was discovered.”
Q. I began taking Paxil after I had severe anxiety attacks due to a frightening diagnosis. I was told Paxil was non-addicting. After my condition was successfully treated, I tried to go off Paxil. I experienced severe withdrawal symptoms that felt like a stroke. My speech was affected, and I had nightmares whenever I slept as well as a constant migraine-like headache.
I called my doctor and was weaned off Paxil slowly over the next two months. My doctor seemed unaware that withdrawal could occur with Paxil, which seems to be recommended for all sorts of conditions.
Is the medical community aware of such reactions from stopping antidepressants? One Internet search led me to scores of other people who had similar problems.
A. The maker of Paxil has just changed its patient labeling in England. Instead of claiming that the medicine is not addictive, no mention of this issue will be made. According to the company, the term confuses patients.
Paxil and other antidepressants like Zoloft or Effexor may cause withdrawal symptoms if discontinued abruptly. Dizziness, nausea, agitation and shock-like sensations are extremely disconcerting.
A surprising number of medicines can cause unanticipated psychological reactions or withdrawal and physicians don’t always warn patients about this possibility. We are sending you our Guides to Antidepressant Pros and Cons and Psychological Side Effects. Anyone who would like copies, please send $2 in check or money order with a long (no. 10) stamped (60 cents), self-addressed envelope: Graedons’ People’s Pharmacy, No. MX-23, P. O. Box 52027, Durham, NC 27717-2027.