Yours sincerely
Dear Anon,
Thanks for your query and your interesting account of your self management of your PAR that I look forward to mentioning in the column.
Dear Dr Le Fanu
I am a long time reader of your column which I find most interesting and helpful.
With regard to Mrs. M I from the column of the 21st February; in my searches for migraine remedies, I recently came across the information that the American FDA does not encourage use of ergotamine (Cafergot) for your reader from the 21st February. I refer you to the link
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm154478.htm
I have found that a half plavix (clopidogrel) prevents most of my migraine auras and the frequency of non aura headaches is much reduced too. (I am 51, female, non-smoker and lifelong vegetarian). From suffering 3-4 migraines a week, I now get about 6-7 a year. I know that an UK doctor was performing clinical trials on the use of clopidogrel as a prophylactic for migraine. This may be of interest to you and your readers.
I wish you all the best and would ask that you not use my full name.
Respectfully
Dear Anon,
Thanks for that useful clarification for the current non availability of the ergotamine based drugs.
Dear Doctor
I am a 77 year old female who was diagnosed, in 2001, with inappropriate sinus tachycardia – ablation/pacemaker not recommended, intolerant to medication which would normally improve condition e.g. Beta Blockers etc.
Coped with condition by lifestyle changes, avoiding exertion. Then, two years ago, I began to be woken up several times during the night by episodes of severe palpitations, pulsating in my head and ears and sweating, usually a need to urinate. The palpitations gradually fade away but can last for up to one hour. These show up in electrophysiologic tests, with intermittent left bundle block but no arrhythmia present. I also still continue to have controllable symptoms during the day
Urine tests show normal aldosterone level. One admission to hospital showed potassium levels were low so infusion given.
Medical opinion to date indicates an underlying cause – one doctor suggesting that an endocrinologist might be able to help, but as yet no referral made. I continue to be affected by symptoms every night which is very debilitating.
While not wanting to have invasive or unnecessary treatment I would like to discover the cause so that there could be some resolution of the problem. Any suggestions please?
Many thanks
Dear Anon,
Thanks for your query for which regrettably I have no explanation. The finding of the low potassium clearly warrants further clarification and it would be sensible for you to consult an endocrinologist.
Every morning I suffer badly with catarrh causing coughing and sneezing. Nothing seems to help. Any advice would be greatly appreciated
Ann C
Dear Ann C,
This problem has recently featured in the column please search Telegraph online ‘Le Fanu catarrh erythromycin’.
Dear James, I have for some time been delighted at your comments in the Telegraph,and even read your book on”Why Us “. May I therefore put to you a question, and a comment :
1) Has there ever been a dose/weight related trial on common-a-garden Aspirin? The interest in this is that before I “Retyred” I had significant PAF, put myself on 325mgs Aspirin a day (with milk!) and although the PAF is very much better, and often in Sinus rhythm, I still take 225mgs,without any side effects that I am aware of. I have never had my Cholesterol taken ( I note Haroun Gajraj’s article next to yours today in the TG) and continue to enjoy many hobbies. 2) The Comment-from Voltaire ! (Physicians give Drugs, about which they know little, to Patients about whom they know Less !! ) Any comments for todays Doctors ?
best wishes Graham R (FRCS,RAMC etc !)
Dear Graham R,
Thanks for being in touch and I am delighted of course to hear you have read Why Us (which I hope you enjoyed!). As per the aspirin I am not aware of any study relating dosage to weight but it is reassuring your PAF is much improved. Voltaire also observed ‘The only problem with common sense is it is not very common’ which would seem an appropriate judgement on the current enthusiasm for overtreatment by our colleagues.
Dear Dr. Le Fanu,
Am I the only person becoming more and more perplexed and more than a little troubled by the conflicting advice we are hearing about fats/sugar/cholesterol? (and other stuff!)
I will reach my 70th birthday this summer (if spared!) For some ten years I have followed a relatively low fat diet following surgery to remove my gall bladder because of gallstones. I have been on medication to lower blood pressure since 1996 and on a statin to lower cholesterol for about 5 years – although I did stop them for a while and my level went up again from 4 to its original 6.5. It is presently 4. Two years ago I was diagnosed with malignant melanoma and had right thumb amputation at IP joint. No spread.
My father died of a ruptured left ventricle at age 65. My mother lived till 88 having suffered heart failure, AF, type 2 diabetes, diverticulitis and various other milder complaints for about 20 years before her death.
I have absolutely no idea whether I should continue to take a statin. The article in the Telegraph today adjacent to your column suggests I should opt out. I have no idea at all whether I should return to eating a little butter instead of a cholesterol lowering spread, should I revert to whole milk instead of skimmed, must I give up completely a small glass of wine I sometimes have with my supper and am I not allowed a slice of wholemeal bread with my scrambled egg? Apparently my gp is not specialist enough to know? Who then is one supposed to ask since for any “expert” there will be another with an opposing opinion.
After my thumb surgery, I am advised – nay, threatened- that I must AT ALL COST keep the sun off my skin. I must be virtually shrouded and wear Factor 50+ sunscreen continually. Of course this will mean that I am at risk of my vitamin D level being too low. My gp promised a blood test but has failed to order this. An article in the Telegraph recently warned of the dangers of low Vit D so must I choose to suffer the consequences of that or risk another melanoma if I take a bit of sun? I must remark that the melanoma I had erupted under my thumb nail and i’m told isn’t associated with sun damage but the sun warnings persist.
This letter is only to say…..I am sooo fed up with conflicting advice all around and I am resolved now never to read articles of a medical nature ever again. I am resolved to try to follow a balanced diet, enjoying some carbohydrate, some fat, a little sugar, some fruit, some vegetables and a little bit of alcohol. ….. and just occasionally something supposed to be really bad for me like a great big slice of coffee and walnut cake with a glass of plonk. I may die a bit sooner but Ill die happier.
Yours most sincerely,
Margaret S
Dear Margaret S,
Thanks so much for being in touch. Statins are of miniscule value to women in your age group and I would discontinue them and suggest you eat and drink what you enjoy and ignore all that ‘good advice’. As for the admonishments about ‘covering up’ you are quite right to be sceptical as sun exposure was clearly not responsible for the melanoma at the base of your thumb. It is a sensible precaution to avoid reading articles of about medical matters (other than my own!)
Dear Dr Le Fanu,
I have started to be troubled by aches and pains in my arms (burning sensation in the muscle of the upper arms, shoulder ache, and neck pains on the right side, and pains in the left leg behind the knee and above it.) I went for tests for Polymyalgia, but the blood test came back completely clear, which stumped my GP. I have since heard of someone who suffers from polymyalgia without a positive blood test. Is this possible?
I am 81 otherwise in good health.
John S
Dear John S,
Thanks for your query. It is indeed possible (if rare) to have PMR despite normal blood tests. You might discuss with your doctor having a trial of steroids to see whether this improves the symptoms.
Dear Dr Le Fanu
I am now 61 and my problem started when I was in my early 20s. When I was younger my hands used to shake, but it only seemed to occur when meeting new people. My hands now shake permanently, and at extreme times my head trembles too. I also have palpitations, more so at night, and my insides seem to be in permanent turmoil, a feeling of apprehension. I usually sleep quite badly.
It was once suggested to me that I have a ‘nervous’ nervous system. I have had blood tests in the past which show nothing irregular. I have had acupuncture on several occasions and is briefly relaxing, but not long-lasting. I have tried cutting out coffee, alcohol and various varieties of food, all to no avail.
I keep fit and go to the gym regularly. I don’t eat junk food, other than an occasional half a pizza. I have never smoked and although I used to drink quite heavily for some years in my youth, now I drink probably two medium-sized glasses of white or red wine on average three or four nights a week. I usually drink two small cups of coffee a day.
I have one sister and one brother (who has had a valve replacement in his heart) and I lost a brother six years ago to a heart attack at the age of 60. We all have shaking to some degree. My parents did not suffer from this.
Although I have given you all the downsides, physically it does not stop me doing anything most of the time, since I will force myself to do most things and then normally enjoy them when I do (after a glass of wine to steady my nerves).
I have kept this as brief as I can, but I’m hoping that perhaps you have come across this before or may be able to suggest a next course of action I might take. All suggestions gratefully received – thank you.
Pam A
Dear Ms A,
Thanks for your query. The shaking you describe is known as Benign Essential Tremor which with several of your siblings also affected is clearly genetic. It can be, as you may have noticed, much ameliorated by alcohol but can be more readily controlled by a small dose of a beta blocker such Propranolol.
For several years I have taken a Bonviva Tablet monthly for Osteoporosis. Recently, it was confirmed that my immune system was very weak. It was suggested that the Bonviva Tablets were the likely cause. My G.P. confirmed this, but said that it was important I should continue taking them. I am reluctant to do this, but have been unable to find a suitable alternative. I would very much appreciate your thoughts on this, together with any advice on strengthening my immune system.
Mrs. E. L
Dear Mrs L,
Thanks for your query. There is to my knowledge no evidence implicating Bonviva in weakening the immune system, perhaps you could provide further details.
Dear Doctor,
Sometime ago I seem to recall you explained the reason why having had a normal bowel movement this was sometimes followed, perhaps an hour or two later, by another ‘urgent’ evacuation but this time much looser and almost liquid at times. I would be grateful if you could remind me of the reason behind this and whether this is a natural phenomenon or something to raise with my doctor.
Kind regards and I do enjoy your weekly column in the Telegraph,
Dear Anon,
Thanks for your description of this unusual pattern of bowel movements that I have not encountered before. I will mention this in the column in the hope that someone might clarify what might account for it.
Dear Doctor,
I do find your column interesting and helpful, and now have a query of my own!
Some six weeks ago I strained (I think) my Achilles tendon. After a week hoping it would go away (it didn’t) I saw a nurse practitioner at my GP’s surgery and suspecting DVT she arranged a blood test which was inconclusive and then a trip to my local A&E who fixed an examination which found no DVT problem. At this the NHS lost interest and I have been self-treating with, first three Ibuprofen pills a day, and for the last few days I have substituted massage with Ibuprofen ointment, three times a day (the max permitted on the tube instructions.) I have also been resting as much as possible and the pain eases but as soon as I try and walk one or two hundred yards my condition deteriorates again.
Am I condemned to months more restricted mobility while it cures itself, or is there something I could be doing?
Yours sincerely,
Major Colin R
Dear Major R,
Thanks for being in touch. These achilles tendon problems can be tricky and I am sure you have been doing the right thing treating it with rest and ibuprofen gel. They do tend to resolve within six to eight weeks but it would be sensible to consult a physiotherapist for advice on appropriate exercises.
Dear Dr Le Fanu,
I am in my late 60′s and in general good health.
However for the past 15 months I have been troubled by a persistent, itching skin, particularly bad on my back, chest, shoulders, and head. If scratched, which is incredibly tempting but detrimental, the skin comes up in weals not unlike a nettle rash, which then burn and take ages to heal. It is not eczema or psoriasis. I have seen a Dermatologist who prescribed cream steroids and twice I had intramuscular steroid jabs.None of which stopped or alleviated the problem. A week’s holiday in the sun recently did an amazing amount of good, but it was not long lasting. I am about to undergo ultra heat therapy on the NHS.
If any of your readers have any ideas about cause, or a remedy I would love to hear about it.
Kind Regards
D. W (Mrs)
Dear Mrs W,
Thanks for your query. This is very puzzling as your symptoms are strongly suggestive of Urticaria that usually responds very well to treatment with antihistamines and steroids. It is surprising they have not worked in your case. I hope the ultra heat treatment is of value.
Dear Dr Le Fanu,
Your column today on the toxicity of combined side effects interested me very much.
Five years ago I had a successful operation to remove a colorectal tumour,then another to reverse the ileostomy following. As there was a slight suspicion of malignancy( described as an anomalous test result), I had a brief period of chemotherapy drugs. I abandoned them half way through as my heart was affected even though it was claimed that the drug was not implicated. Then followed several year of a drug regime to try to correct irregular heartbeat, breathlessness, severe tiredness etc. Various combinations were tried, eventually consisting of amlodipine, amiodarone, and finally Pradaxa. Incidentally, it was discovered later that I had a pdf, quite small, which had never caused any noticeable problems before, and it was claimed that the chemotherapy could not have affected this. For three years, in spite of the amiodarone, I still had almost continuous atrial fibrillation , my bp was reasonable but not particularly low, and the Pradaxa to guard against stroke etc was mercifully and obviously much better than Warfarin. However, it has been a miserable couple of years, swollen limbs, painful legs, extreme tiredness, always cold, increase in weight( not gross but very irritating) and general lethargy and feeling under par. Eventually, by personal experiment, my heart beat at last beginning to be more regular, I decided to give up the amiodarone- result- heartbeat OK, but no alleviation of other side effect symptoms. My doctor was very doubtful and urged me to stay on the drugs. Finally I gave up the blood pressure remedy Amlodipine and immediately, within 2 days , felt better……warm hands and feet, swelling subsided, painful limbs gone, more energy, sleeping well. However I have been persuaded to take another “water pill” bp remedy, as, though I felt very well, my bp had increased. I now feel dreadful again. No swelling, but sore legs, permanent indigestion,not sleeping well, very bad tempered( according to husband!).
Left to myself, so long as I do not have a recurrence of the atrial fibrillation, I would just stay on the Pradaxa, which seems not to affect me.
Ever since the possibly unnecessary chemotherapy, my life has been made quite miserable by the side effects of drugs.The thought of another round of appointments for more experimental medical cocktails fills me with dread! Yrs etc
From Julia D
Dear Julia D,
Thanks for being in touch and my great sympathies for these distressing symptoms following your chemotherapy. I note they have recurred (in a slightly different form) with the new ‘water pills’ you have been prescribed so I would agree it would seem sensible to discontinue them and stick with the Pradaxa.
Dear Dr Le Fanu
A belated comment about your article in last Monday’s Telegraph. I experienced the symptoms you mentioned with 3 different statins. I have mild ME and the symptoms were the same as having an ME relapse. I’m curious to know whether there is a link.
Thank you for your column (and in the Lady), it helps my resolve not to be given to many drugs!
yours sincerely
Margaret Anne K
Dear Ms K,
Thanks for your most interesting observation that statins exacerbated your ME. It would be interesting to know whether others have had a similar experience.
I have type 2 diabetes well controlled by metformin. I have underfoot numbness due to peripheral neuropathy. I also have uncomfortably hot knees, due, I understand, also to peripheral neuropathy, and cannot now stand or sit without using my hands and arms in support. It’s probably too late, at nearly 77 to remedy the muscle weakness, but is there anything to reduce the “burning knees” sensation, other than wearing shorts or rolling up my trousers? I also suffer from restless legs syndrome, which is treated with Ropinirole.
Many thanks,
David H
Dear David H,
Thanks for being in touch. Diabetes, as you will know, is well known to cause the symptoms of sensory neuropathy that you describe. There is regrettably no specific treatment though they may be ameliorated by a combination of the drugs Gabapentin and Duloxetine as will be discussed in my next column (28th April). I do wonder, of course, whether you may be taking the cholesterol lowering statin that can be an exacerbating factor.
Hello,
I do hope you can give me some advice on a problem that I have had for some months. When I had a pre op assessment last September, before a knee operation in December, the consultant asked me if I knew I was anaemic, which I didn’t. My GP requested another blood test in January and it was found that my ferritin level was only seven and my haemoglobin about 10.6. Since then I have had a gastroscopy and colonoscopy , which thankfully were both clear and am now waiting to see a consultant at my local hospital. I have been taking Thyroxine for many years and read that sometimes iron is not absorbed properly when the dosage isn’t correct. My GP disagreed, but says she is at a loss as to why I am so anaemic. I had to come off NSAID s several years ago because I did have a stomach bleed then.
I am 69 years old and suffer from fibromyalgia , but have never been anaemic before and have a good diet. Any advice you could give me would be most appreciated.
Many thanks
Mrs Christine P
Dear Mrs P,
Thanks for your most interesting query. This iron deficiency anaemia is almost certainly due to bleeding from the gut. It is not unusual, as in your case, that endoscopies do not identify the source. I would hope the anaemia would respond to those iron supplements and that is all that will be required.
Dear Dr. LeFanu,
I have developed an itch all over my body which seems to coincide with the taking of Creon. The itch frequently erupts into pimples which, aside from being exceedingly uncomfortable, tend to get their heads knocked off with consequent bloodstains on my clothing. I dare not face the consequences of stopping the Creon and would much appreciate any ideas to relieve the itching. Lotions and ointments are not a realistic option.
Yours sincerely,
Antony S C
Dear Antony S C,
My sympathies for this almost certainly Creon induced skin rash. I note that discontinuing it is not an option. It is conceivable this might be an allergic reaction and you might discuss with your doctor a trial of a strong antihistamine such as Telfast.
Dear Dr Le Fanu
Please could you help me I try and give my husband and I a healthy diet he is 81 and I and 76 both in good health.
My question is I make up our breakfast each day with walnuts almonds sunflower seeds and pumpkin seeds mixed with raw porridge.
I have read in this weeks telegraph that the enzyme in porridge for lowering cholesterol is released when the porridge is heated.
Does this mean that you don’t get these benefits when the porridge is uncooked.
I would love to hear from you on this question.
Regards Patricia
Dear Patricia,
Thanks for being in touch. I have not previously encountered this healthy diet of raw porridge and sunflower seeds but would not be concerned about what effect it might have on your cholesterol levels as this should not be an issue at your age.
Dear Dr Le Fanu
I’m sure you mentioned this in one of your articles a few weeks ago, but cannot now remember in what context.
For the past few weeks, on waking, although my distance vision is quite clear I find that I cannot read anything in the newspaper for quite a while, though it often helps if I rinse my eyes in warm water. There is no sign of any discharge such as would indicate conjunctivitis. Most days after that initial trouble my vision is fine, although I have noticed that lately my eyes do feel sore towards the end of the day. I am 84, have regular check-ups at the optician, and have had two successful cataract operations in the last three years. I am taking quite a few tablets to control high blood pressure, but that is now quite stable.
Any suggestions would be very welcome.
Mrs P
Dear Mrs P,
Thanks for your query that I will mention in the column of April 28 in anticipation of eliciting some suggestions as to its cause.
Dear Dr Le Fanu
I would be interested to hear from others regarding the after effects of chemotherapy. I finished a course of Xeloda (tablets) two years ago ( age 68) and still suffer from running eyes, running nose and dry lips. Other less noticeable symptoms include somewhat desensitised fingertips and wrinkled feet. Now considering the alternative these side effects are just an irritation but Oncologists do not seem to have the answers or perhaps sympathise? Neither do the eye specialist or ENT consultants I have seen. Be good to know if others have long term symptoms like these and have some words of comfort or some curative ideas.
Many thanks
Mr S
Ps it must be my age but your column has become a bit addictive – but I don’t need a cure for that thank you!
Dear Mr S,
Thanks for your query and my great sympathies for these post chemotherapy symptoms described. You do not mention the precise regime of drugs but regrettably as you will know their cytotoxic effect also damage healthy tissue resulting in the sort of symptoms you describe. I am sorry not be to able to suggest any curative ideas other than the symptomatic – regular use of vaseline on the dry lips. The nasal spray R,inatec may help reduce the running of the nose.
Dear Dr James, I read in your column about a lady around 60 years of age suffering from leg cramps awaking her in the early morning. This happens to me too and I find that I can get more or less instant relief – usually in about 30 seconds – by applying fairly firm pressure to the base of my nose between the nostrils. It has the advantage that I don’t need to jump out of bed to flail around in prolonged agony!
I too am in my 60′s, am very fit and a regular cyclist. Cramp is usually more likely when I’ve recently done a long hard cycle ride – over 50 miles – and hydration might not have been quite up to scratch.
I also read with interest about another respondent on statins stating that her vitamin D levels were depleted. I understand that statins work by blocking the production of cholesterol in the liver and this process shares a common pathway with the enzyme mechanism for creating vitamin D when the skin when is exposed to sunlight. So in inhibiting production of cholesterol, vitamin D production is also inhibited.
Another topic which has appeared in your column was recurring cystitis. I had a problem with this – cycling probably doesn’t help – but by chance it vanished completely about a week after I had cut added sugar and fruit juice out of my diet. That was about 3 months ago and incidentally, I don’t miss the sugar in the slightest and feel a lot less hungry between meals than I used to.
Susan G
Dear Susan G,
Thanks for being in touch and your account of that cramp treatment a variation of which has featured in the column before and I have used myself to good effect. Cholesterol as you say is indeed a precursor of vitamin D and it is probable this might account for that common side effect causing muscular pains. Thanks too finally for your hint about preventing cystitis I hope to mention this in the column.
Dear Dr Le Fanu
I have been following your articles about needless drug-taking in the elderly with great interest.
Aged 70, my GP decided I needed a DEXA scan. As I left the unit, I was assured that my
results were normal for my age. However, when I saw the print-out of my scores, they were
between T -2.7 and T -3.6.
Now my GP wants to put me on medication (calcium and Vitamin D, which I am happy to take)
and bisphosphonates (which I am very loath to start). I understand that there is also a fairly
recent six-monthly injectable option of a different family to bisphosphonates.
I would be grateful for your views on this. Many thanks in advance.
Kind regards
Sandy H (Mrs)
P.S. I am a regular reader of your column which I find stimulating, interesting and eye-opening.
Long may you continue!
Dear Mrs H,
The results of your DEXA scan certainly fall within the range of osteoporosis for which the six monthly injection of Denosumab is a convenient and well tolerated treatment.
Dear Dr Le Fanu,
This weeks medical query concerns Mrs NA from Rugby.
In my opinion, Mrs NA suffers from Chronic Hyperventilation, also known as Carbon Dioxide Syndrome.
The normal amount of air to breathe is approx 5 litres of air per minute at rest.
I estimate Mrs NA is breathing approximately 3 times as much as normal (approx 15 litres of air per minute at rest), and when she talks on the phone, her breathing rate increases for the duration of the call.
As her breathing increases, (say to 18 litres per min), her carbon dioxide levels fall (The Bohr effect).
Low carbon dioxide levels are an ‘smooth muscle constrictor’.
The smooth muscle that surrounds her nasal passages constrict, blocking her nose.
When she finished her call, her breathing goes back to her ‘normal’ (ie approx 15 litres of air per min).
This decrease in her breathing, increases her carbon dioxide levels.
Higher levels of carbon dioxide is a smooth muscle dilator.
The result is the nose unblocks.
Mrs NA would benefit from learning the Buteyko method, where she would be taught to breathe at a normal rate, ie 5 litres of air per minute at rest.
(Next time she talks on the phone, her breathing rate would increase as before, but only to , say 8 litres of air per minute. Smooth muscle does not constrict at 8 litres of air per minute, and her nose would not block)
This sort of problem is seen on a regular basis by Buteyko Practitioners.
I hope this helps.
Dear Anon,
Thanks for that most interesting suggestion as to the cause of this telephone induced nasal blockage it will feature in the medical column on 28th April.
I had a knee replacement some two years ago and post operation I was told that I had an irregular heartbeat and was prescribed Warfarin tablets. I am 83 years old and have probably had this condition since birth with no ill effects. I have been told that the Warfarin is necessary to lessen the effect of a stroke. There have been no side effects apart from cuts taking a long time to heal and I bruise easily. But, I don’t like taking the tablets and find the ease of bruising and cuts healing time inconvenient. Is the Warfarin necessary?
Barry H
Dear Barry H,
Thanks for being in touch and I sympathise with your reluctance to take Warfarin and indeed there is dissension about its value in those like yourself with long standing (or ‘lone’) AF. You could discuss with your doctor having an echocardiogram and if this shows no abnormality of the structure of the heart you should be able to discontinue it.(see R S More ‘Lone Atrial Fibrillation and Anticoagulant Therapy’ Clinical Cardiology 1993, vol 16, p504-6).
I have been struggling with hypothyroidism for many years. It was finally diagnosed in 2007 after being referred to a leading specialist. I was prescribed thyroxine which did not work and, in fact, made the symptoms worse. When I explained this to my specialist I was told that my blood tests showed that I was now well and the continuation or exacerbation of my symptoms was due to the fact that I was depressed and needed Prozac. If it were not so serious and disappointing I would have found it funny. With help I found an alternative specialist who guided me with natural thyroid replacement, Armour, and T3. With these I have had important improvement in some significant areas but remain very tired with intermittent insomnia and low spirits. The tiredness does not always follow the insomnia! The alternative specialist feels that they cannot help me any further and I am wondering what, if anything, I can do next. I wonder if other readers have managed to sort this out for themselves. I would be very grateful for any ideas. Thank you in advance.
Yours sincerely
Marion P
Dear Marion P,
Thanks for your query and my sympathies for these continuing symptoms of tiredness and low spirits.This would certainly be consistent with a diagnosis of depression and it might be you would be much helped with a trial of Prozac.
Dear Dr.LF
Since March 2013 I have been suffering from nausea and therefore lack of appetite. I have been suffering from anaemia since 2011 which has been diagnosed as NHL for which I have been receiving Chemotherapy for the last 4 months.
I am aware that there are side effects such as nausea and sickness but as you can see the nausea started well before the chemotherapy. I have been prescribed anti nausea tablets by my consultant but they just make me go to sleep.
I am longing to looking forward to enjoying a good meal without forcing myself to eat. Can you help.
Many thanks
Cecily L
Dear Cecily L,
Thanks for your query and my sympathies for this persistent nausea. This problem has featured in the column before and several readers have commented on the benefits of taking an acid suppressant such as Omeprazole even though there are no signs of active inflammation in the stomach on endoscopy. You might discuss this with your doctor.
Dear Doctor,
For the last 13 months I have been suffering from mild nausea for the majority of the time. It started on a skiing holiday in Val D’isere when I caught the ‘flu, and my sense of taste has also changed- with wine in particular losing it’s appeal.
I am aged 56, haven’t lost any weight, and have been endoscoped to no avail!
I would be most grateful for any suggestions.
Yours sincerely,
Peter S
Dear Peter S,
This sense of nausea you describe and the alteration in taste must, I presume, be due to some disturbance of function of the olfactory nerve caused by the episode of flu. This should, with luck, improve with time but it might be – as with the reader above – you would benefit from a trial of Omeprazole.
I would like some advice regarding meniscus tear in my knee joint. Will the tear heal itself, I twisted the knee joint 8 weeks and was in severe pain for 1 week, it was like a knife sticking into the side of my knee, it still hurts all the time discomfort and aching, but not as severe as the first week.
I have been doing physio exercises to strengthen the muscles but the pain never goes.
What is your advice please.
Thanks
K McC
Dear K McC,
Thanks for being in touch. These meniscus tears do not in general heal themselves as they do not have their own blood supply. It is good to hear that the symptoms are improving but it may be, if you have not done so already, you should have a MRI scan with a view to an arthroscopy.
Can you make any suggestions for a rather silly problem I have? My feet feel as if I am wearing socks when I’m not. My GP has done various blood test that all come back OK…and there is no loss of sensitivity when he touches my feet. This has been with me for a year or more …sometimes my feet will go red hot suddenly but only now and then. Could the problem be in the skin do you think? It really is a strange feeling.
Many thanks for your time.
Dear Anon,
Thanks for your query. This sock sensation must be due to impairment of the sensory nerves in the feet even though your doctor’s examination was normal. There is regrettably no specific treatment.
Dear Dr Le Fanu
Two and a half weeks ago I stopped taking the Beta blocker Propranolol after being prescribed it to try to prevent 4 day migraines – the main side effect from taking the contraceptive pill, Yasmin, on a tricyclic basis to counter long term endometriosis. The migraines occur at the end of week 5 and the break week of the pill.
The Propranolol was prescribed last November and after a couple of days of nausea, the main and alarming side effects were pain in the left side of my chest (as if a weight is on that side) and upper arm (a bit like having a loose blood pressure cuff applied), and a feeling of not being able to breathe properly when I was falling asleep at night, which I mentioned to my GP each time I visited. It took about 4 months for the Propranolol to successfully prevent the migraines but by this point, I told my GP that I could no longer tolerate its side effects. Having taken 1 tablet 3 times a day, I went to 2 pills a day for a week, then 1 pill for about 10 days. I then had a period of about 2 weeks of feeling fine, then the 4 day migraine returned last Thursday, followed by the chest pains last Sunday night. I have been under some stress lately but this is starting to pass. Having spoken to my GP, I have been referred for a routine ECG next week and blood tests for underlying conditions.
The theory seems to be that as beta blockers slow the heart rate, mine may not have coped that well and is now having to readjust to getting back to its normal function.
I am in my 40s and generally in good health otherwise.
Do you have any observations on the above and should I be concerned? I’ve read a lot in your column lately about the side effects of statins, but wondered if there was any feedback about beta blockers?
Thank you
Dear Anon,
Thanks for your query Beta blockers are in general well tolerated but can cause the sort of symptoms you describe. It might be that some other form of preventive treatment may be of value.
Dear Dr Le Fanu
My GP discontinued the use of Bendroflumethiazide (2.5mg) on discovering that the salt level in my blood was ‘dangerously low’(I had been feeling unwell for some time). For the past year he has tried to find a drug to control my hypertension minus the devastating side effects. I put the following symptoms down to the side effects of the many ‘hypertension’ tablets I have been on: severe stabbing pains in many parts of my body, no energy, feeling heavily sedated, feeling faint, trembling, bad dreams, tachycardia, palpitations, pulse pausing for several seconds, hot flushes, chest, chin and neck discomfort.
I’m 75 yrs and until this period have had a healthy active life, I now feel like a very old woman. I’ve had an angiogram and a twenty four hour ECG and blood tests, all resulting in no reason for my feeling so unwell.
Please advise.
Thank you.
Dear Anon,
Thanks for your query. There is a tendency to over treat hypertension – as the blood pressure naturally rises with age. I would suggest in view of the side effects you should stop your treatment and see how it goes.
Pain in the jaw 31. March
Could this be a mild form of oesophageal spasm? I began to experience this some ten years ago and have an attack approximately once every two or three months. At first, I thought it was a heart attack but it always began with a pain in the jaw like toothache or earache before becoming a suffocating sensation in the chest. The cure, almost instant, is to sip something like fizzy lemonade or tonic to cause a “burp”. In extremis, I have even swallowed saliva rapidly which clears whatever is causing the spasm.
Yours
Rose C
Dear Rose C,
Thanks for your interesting suggestion I hope to mention in the column of 28th April.
Dear Dr Le Fanu
I look forward to your column every Monday, and never fail to find it interesting. The “statins have no side effects” news item which appeared in the paper on 13th March has prompted comment from you today and previously, but I have been disappointed that you have had nothing to say about the one sentence in the news item which was completely new and startling “news” to me. I refer to the sentence “But of all the symptoms, only the risk of diabetes was found to be slightly raised by the drugs.” I would be very interested to hear any comment you feel able to make on this. Thank you, Irene H
Dear Irene H,
Thanks for being in touch. Statins do indeed predispose to diabetes which – given the numbers taking them in Britain – adds up to an astonishing 5000 new cases a year! Shocking but true.
Doctor’s Diary 31/03/14
Dear Dr Le Fanu
Reading about the pain experienced by Mrs LE of Beds I realised I have had exactly the same thing on a few occasions, most recently a week ago. The pain manifests itself gradually in the teeth/jaw area and spreads across and down as she described, even reaching the nipples, becoming more intense. It’s impossible to pinpoint it and it subsides after, for me, about 15 minutes. In daylight it’s not so bad but at night it’s quite disturbing. I can’t find a pattern relating to anything specific though.
Kind regards
TC
Dear TC,
There has been quite a lot of correspondence on this (see the suggestions from Rose C above and Clare I below) and I will be mentioning them in the column on the 28th April.
I have had mild vertigo for years, particularly when lying down and turning over in bed.
I have noticed the condition to be worse at the time of the equinox and then settling down again.
Do you know anyone else with this problem and could it be linked with changes in our solar system?
Dorothy F
Dear Dorothy F,
Thanks for being in touch and that most interesting conundrum which I hope to mention in the column in the near future.
The ache at night
I had much the same when stressed and found out that it was clenching the jaw which caused the pain. If stressed, it is hard not to in your sleep, but when awake practice keeping your mouth slightly open at all times, without looking too weird, and it is then impossible to clench. Also check your shoulders are down because if they are up, ten to one you are clenching the jaw. Clare I
Dear Clare I,
Thanks for your suggestions please see my response to Rose C above.
Laryngopharyngeal reflux (LRP) – silent reflux
For over two years I have had the feeling of a lump on the left side of my throat. It began the same day I woke up with an ear infection in my right ear. I have had extensive tests via ent and gastroenterology. The silent reflux is my diagnosis, doctors have yet to tell me anything definitive. The only advice I have had is to sip water frequently. I read about LRP in your column on Sunday so looked it up on the internet. The symptoms seem to match. I have some issues with reflux but since chewing sugarless gum regularly this has improved. I would like to know if the feeling of a lump is a symptom of silent reflux and if there is anything that I can do to alleviate it. At first it used to go off, sometimes for a couple of days, now it is relentless and exhausting. I swim regularly and have eliminated foods that are likely to aggravate the reflux.
Regards
Janet T
Dear Janet T,
Thanks for being in touch. I would not have thought this sensation of a lump is attributable to the LRP – which in view of the extensive investigations you have had must be unexplained.
Hi
My lovely daughter had a baby five years and now, age 33 , has been diagnosed with premature ovarian failure .
While she is struggling to come to terms with the news that she will not be able to have any more children, it is astounding that this has happened, out of the blue,
I think if we were able to have an explanation of why or how this happened it would help but that has not happened. Do any of your readers have any experiences or answers ?
Many thanks
Geraldine M
Dear Geraldine M,
Thanks for being in touch and my great sympathies for your daughter’s misfortune. The hormonal control of the reproductive cycle is a very complex business and regrettably it can go wrong without there being an obvious cause. It does sometimes happen that the function of the ovaries recovers. The most useful summary, ‘Premature Ovarian Failure’ produced by Guys and St Thomas’s Hospital, is available on the internet.
31 04 2014 / Mrs LE of Beds
Dear Dr Le Fanu,
Reading this it struck me how similar this lady’s symptoms are to certain bouts of hiatus hernia I have experienced. A feeling like rods of iron running down through the jaw, down the sternum, down the back into the shoulder blades and arms, sometimes all at once.
The preceding anxiety & the fact that it happens on retiring reinforces the possibility. I would be very surprised if I were to be the only person to suggest this.
Strange this query should be followed directly by a remedy for heartburn and reflux? Could it be that this lady benefits from being a little trimmer through the exercising? I certainly have fewer problems of this nature during my slimmer periods.
Regards,
Trevor K
Dear Trevor K,
Thanks for your comments. See my response to Rose C above.
I would be interested in your comments on the following please.
My husband developed a nasty infection of his big toe which caused considerable pain.
Unable to get a Dr appointment he went to our local minor injuries unit. The nurse to a quick look and prescribed a weeks course of antibiotics.
Coincidentally he had a chiropodist appointment the next day. The chiropodist cleaned out the infected area and dressed it. He felt immediate relief of pain.
My question is.
Could antibiotics have been avoided altogether if the nurse had taken the time to do this?
we all worry about the overuse of antibiotics; are they still be prescribed to readily as an easy and quick way out?
Dear Anon,
Thanks for your query. I am sure antibiotics were appropriate treatment for your husband’s infected toe.
I am 88 (male). I suffer from circulation problems feeling extremely cold, alternating with getting too hot and making me feel unwell for about an hour afterwards. I only weigh about 9 stone 10 lbs. I also suffer with hiatus hernia, which I can control, and a leaking heart valve. Your views on my circulation and coldness will be gratefully received. Yours sincerely, Les P
Dear Les P,
Thanks for your query. I wonder if you could possibly provide some more details of your symptoms and I might be able to advise you further.
Evidence Based Practice
Dear Dr Le Fanu
As a nurse who has returned to practice, having been out of nursing for some years, I was interested to read the below comments:-
“Two further tips that may be useful are to rock the pelvis back and fro half a dozen times when sitting on the lavatory, and (commended by a nursing sister from Lincoln) that tickling the base of the spine causes the bladder to contract, thus “discharging the final stream”.
in particular tickling the base of the spine to assist in emptying the bladder. I mentioned it to the ward sister who suggested I check whether there is any evidence to back up this claim as in this day and age this is what is needed prior to sharing anything with our colleagues. However, the only item coming up so far is your Doctor’s Diary. I wonder if the nursing sister is using her experience and good old fashioned common sense or has taken this further, it would be interesting to find out?
Should you have anything further on this or the time to reply I would grateful.
Yours sincerely.
Jane K
Dear Jane K,
Thanks for your query. This is, as you suggest, anecdotal evidence which I find is frequently highly reliable.
Dear Dr Le Fanu
I wonder if either yourself or readers can shed any light on how to resolve my plantar fasciitis, which is severely affecting my ability to walk for any distance, and considering hill walking is one of my main hobbies, this is having quite a severe effect on leisure activities and general fitness.
I have now had this in my left foot for nearly two years, and have a feeling it is developing in the right foot now as well. At about the same time as this developed, I also was developing very stiff neck muscles in particular which no amount of physio or massage has managed to resolve. I have now had some 5 steroid injections into my left foot, have been tested negatively for rheumatoid arthritis, and have given up all forms of gluten (gluten makes my asthma worse, but I used to eat pure rye bread occasionally without it affecting the asthma too adversely). The GP is struggling to suggest any alternative treatments.
I wonder if anyone else can shed any light on possible causes and remedies.
Thanks very much
Regards
Dick M
Dear Dick M,
Thanks for your query. This plantar fasciitis is clearly part of a generalised problem with the tendons that would suggest an underlying inflammatory process. I would have thought you should discuss with your doctor the possibility of a referral for a specialist rheumatological opinion.
Hello,
You recently wrote about a medical query from a Mrs NA from Rugby who develops symptoms of a blocked nose while talking on the phone. I have had similar experiences, not just with a phone but also sometimes with my ipad. I have been tested for allergies and one of the ones I was allergic to was nickel, which can cause similar symptoms. I wonder if perhaps her phone is made of something that has nickel in it (or some other substance she might be allergic to). It is really hard to find out what things are made of, especially phones and other metal gadgets, but something in them might be affecting her. Just a thought…
Regards, Kerry P
Dear Kerry P,
Thanks for that interesting suggest which I hope to mention in the column.
For more than a year now I have suffered from bouts of heavy sweating. They occur at any time (including in bed).They last for only a few minutes but I am soaked!
My various G.P’s offer no advice .Several of my daily drugs refer to increased sweating but as I have been taking most of them for many years, it seems impossible to associate sweating with any one drug in particular.
Can you help? ( I am 87 years old and have a heart problem)
Daily Dosage;
Atenelol 25mg
Candesartan 16mg
Nicorandil10mg
Ranitidine 150mg
Aspirin 75mg
Omega 3 1000mg
Thank you for your advice and look forward to hearing from you.
Robert S
Dear Robert S,
Thanks for your query. This excess sweating is almost certainly due to an age related disturbance of the function of the autonomic nervous system that controls the thermoregulation – for which regrettably there is no specific cure. It is said that the herb drink Bioforce Menosan can be of help.
Please, I would appreciate either explanation/solution …I am 86….. Sweating at night has increased to point that my upper torso is soaking wet, usually in the early hours between 3-5am. It’ s been going on for a long time. I wake up every 2 hrs. Eventually get fragmented sleep. I am an active old lady during the day, but am feeling increasingly exhausted. My GP has no solution.
I have tried giving up my small Brandy,co-codamol, going to bed earlier, changed my duvet, my mattress , wear cotton….nothing makes any difference! I have Cup of Valerian based tea about 10pm. I do have small glass wine with my evening meal at about 7pm.
I would be grateful for any suggestion/ help.
The only medication (apart from paracetamol) is Amlodipine and Vit. D.( Co-codamol at night).
Thank you.
Miriam S
Dear Miriam S,
My sympathies for this problem which regrettably is not unusual in your age group. Please see my response to Robert S above.
Good morning Dr Le Fanu
I am 78 yrs and have an enlarged prostate. Every 6 months I have my PSA checked and so far everything is ok.
Can you tell me why my urine flow, which is good during the day, but very much reduced at night. I visit the toilet about 3 times most nights.
Sometimes I find, when I go to the toilet in the early part of the night, that I have the slightest hint of an erection, inspite of not having errotic dreams.
Years ago, I was on some tablets to reduce the number of trips to the toilet. They were ineffective.
Your advice would be appreciated.
Sincerely
Paul J S
Dear Paul J S,
Thanks for your query. I can only suppose this change in pattern of urinary flow is ‘anatomic’ with the narrowing of the urethra by the prostate being more marked when supine than when standing.
Dr. James
I am a 67 year old Grandfather on statins for over 20 years diagnosed with hypercholesterolemia. One of my two son’s has inherited this condition, as have both his daughters, aged 9 & 12.
My concern relates to problems of treatment for my Grandchildren, especially as my son could only attract the attention of his GP by brandishing a piece from the D T reporting the initially unexplained death of a fit 13 year old girl who was found to have acute levels of cholesterol.
In the light of the article by Dr. Haroun Gajraj, (and as I have no medical skills) it is very difficult / impossible to make any reasoned judgement on the action any of the three generations should take. Any comments would be most interesting.
For your information neither daughters have been offered treatment due to their ages. I am prescribed Rosuvastatin 20mg (no blood brain exchange) and Ezetimibe 10mg. My ‘natural’ level 10.5 approx, current 4.8, strict diet pre-treatment reduced it to low 7. My son is on same drugs and dosage, originally 12.5 now 5.5.
Sincerely,
Dick M
Dear Dick M,
Thanks for your query. The situation is quite straightforward, statins are very useful drugs for those like yourself and your family with markedly raised cholesterol levels. The problem is prescribing them to everyone else!
Statins re DT Mon 24 Mar 2014
Dear Dr Le Fanu,
I read with interest your colleague, Haroun Gajraj’s piece and your own in today’s DT and am left confused. I am male 74 years old and a largely retired academic.
I was diagnosed with coronary heart disease in 2008 after an angiogram which indicated a jammed up RH coronary artery, 10% atheroma in the LH and nothing elsewhere. I was and am symptomless. I also have “mild Type 2 diabetes”.
A possible coronary bypass operation was suggested, by me, but after further consultations with a cardiac specialist, he proposed that medication would be a better solution. It is suggested that the condition was of long standing and that I had developed collateral circulation.
The medication is –
-Rosuvastatin at max dosage, i.e. 40 mg daily. According to the studies of this drug, when taken at this level, atheroma will regress in most people (ASTEROID, JUPITER and other studies).
-Atenolol at 25mg twice a day.
-Ramipril at 10mg dailly.
-Clopidogrel at 75mg dailly.
And for Type 2 diabetes, Gliclazide at 80mg daily which I also control by diet and exercise.
My blood pressure is 130/70 and my Cholesterol, 2.7. My father died at 101 and my mother 93 neither from a specific disease. I wonder if the problem is chemical then the solution should be chemical?
I feel fitter now the I felt 25 years ago and have no problems and am disinclined to go chasing any but wonder if I should slack off on the drugs. Your thoughts would be of value.
Best wishes,
Dugald C
Dear Dugald C,
Thanks for your query. I would be guided by your cardiologist’s advice. My only concern would be whether or not your diabetes is a side effect of the Rosuvastatin. You might discuss this with your doctor.
A bitter pill to swallow
Dear Dr. Le Fanu, Further to today’s column, can I ask your advice.
A former driving examiner,now 83 yrs. of age and retired for 23 years, I am prescribed the following medication for high blood pressure.
2.5mg Bendroflumethiazide
Doxazosin 1mg
Adizem 240 mg
Losartan 2/ 50mg
A reading taken this evening was initially 144/66 and after 2mns, 133/64
I have asked my GP, about whom I have the greatest regard, whether it would be possible to reduce the number of tablets, but she doesn’t seem to think this is possible. I would be very grateful for any advice.
George T
Dear George T,
Thanks for your query. That is quite a cocktail of drugs but they seem to be doing the job and if they are not causing any side effects I would have thought it sensible to continue with them.
Hello Doctor James, I have been diagnosed with osteoporosis following a bone scan. I have been taking Risedronate sodium once a week, and Ad-cal chewable tablets on the other days. I started them at the beginning of January and soon noticed an unpleasant taste disturbance. Everything I eat or drink tastes metallic, salty and I have constant catarrh which I am unable to stop. I spoke to my GP, who said he had never heard of bad taste being a symptom of either of my medications. I am really miserable at not enjoying food or drink, but I understand the importance of treating osteoporosis, even though I have had no symptoms yet – I was tested because my mother has it, and has broken her femur.
I am wondering if you have heard of nasty taste being a side effect of risedronate, and if so, is there anything I can do to lessen the side effects of risedronate/ad-cal, or is there anything else I can take instead?
Many thanks,
Jennifer G
Dear Jennifer G,
Thanks for your query. It must be that this unpleasant taste is caused by your osteoporosis medication – though I could find no report of this in the medical literature. I would have thought you should discontinue them and review the situation when, with luck, your taste has recovered.
Dear Dr Le Fanu,
From the age of five or less until the age of 66 – about 60 years – I had frequent trouble with constipation. My gut was always biased towards hard stools and often I had to take laxatives. After reading a slightly Alternative book about IBS, I realised that my gut flora might be at fault. I started taking natural yoghurt in the mornings and this helped a bit.
The problem disappeared as soon as I started taking Azithromycin about a year ago for Bronchiectasis and it has not returned since the end of the course – my only course of this drug. It seems to me that the constipation was related to the flora in my gut and this particular antibiotic removed whichever bacteria were causing the problem. There must be something unusual about how Azithromycin works in the gut or which gut flora it attacks.
I have taken many other antibiotics in my time but none of them had more than a very short-term effect on my bowels. It has to be mentioned that this antibiotic course was for six weeks. That may have been part of the reason for the effect. On the other hand this is the only time that I have used this particular drug and the effect of it did not change noticeably during the later weeks of the course so a shorter course might have been just as useful.
Since many people have chronic constipation problems I wonder whether this observation would be worth following up scientifically and clinically to see whether the effect can be reproduced with a normal dosing period. For me it would definitely have been worth taking a short course of Azithromycin in my youth, if it had been possible, to save me a lot of problems.
Yours sincerely,
David B
Dear David B,
Thanks for that most interesting account of the miracle cure of your constipation with the Azithromycin. I look forward to mentioning in in the column.
Some years ago I started suffering severe night sweats. Blood and urine test revealed nothing and eventually both the GP and I lost interest and I learnt to manage them by sleeping on a big fluffy towel and having a change of PJs and bedding half way through the night! Workable at home (divorced and sleeping alone) but not so easy when travelling or staying with relatives.
Fast forward a couple of years and a couple of weeks of not feeling up to scratch resulted in the removal of my gall bladder. No more night sweats!
Dear Anon,
Thanks for that most interesting observation that I will mention in the column in the near future.
In confidence
Hello Dr Le Fanu,
I am seventy years of age. Two years ago I was diagnosed with Parkinson’s and have a regular review with a neurologist.
At my review a few weeks ago I completed a questionnaire which drew our attention to frequent nocturnal micturition.
I was advised to consult my G.P which I did. The PSA result was 2. A urine test (amongst others) was carried out which showed an infection and I was prescribed a course of Trimethoprim which I have just completed. I think the frequency of nocturnal micturition is less now.
The GP referred me for a pre and post ultrasound to see if the bladder was emptying fully. This has yet to be carried out.
Before beginning the medication I had noticed a few minor blemishes on the left side of my face. These have developed into whiteheads. I have never had spots before.
Any ideas and recommendations ?
Bill
Dear Bill,
Thanks for being in touch and I would hope that the Trimethoprim will markedly improve these urinary problems.
Dear Dr Le Fanu
I have been advised by my consultant in Nottingham that I need a total knee replacement because of osteoarthritis where the X-rays show bone on bone. I have read about custom made knee replacement so contacted CircleBath who as you can see from the link below appear to offer this treatment.
http://www.circlepartnership.co.uk/about-circle/media/circlebath-pioneers-new-knee-replacement-technology-sep-11
I was told that they no longer offer this and they believe that it is now not offered nationally. I wonder if you know if this is the case? It seems a preferable solution to the one size fits all offered by most hospitals.
Yours sincerely
Mary B
Dear Mary B,
Thanks for your query regrettably I have no experience of this type of replacement.
I read your column with great interest, but have yet to see another letter reporting a similar reaction to the stopping of Warfarin that I have had. I had a right coronary artery graft in August 1991 which proved very successful for 6 – 8 months, but I then suffered varying degrees of mild angina and breathlessness for which no cause could be found. In 1999 I moved to another area and another cardiac department took on trying to find an answer to an increasing debilitating problem. Ten years ago at a clinic visit during a bad spell I was put onto Warfarin ‘as a prophylactic’ – nothing in notes to indicated reason. I had no problems while taking the Warfarin, but at a pre-angio hospital visit last December the cardiac nurse took my notes to the boss and basically demanded to know why I had been taking it for so long. The result was that it was stopped immediately and I’m back on the old 75mg of aspirin. I went home with strong warnings that I might become breathless. Instead of which I ceased to be breathless every morning and am able to walk for 1/2 hour daily at a reasonably brisk rate which included the hilly roads in our area. Hills and steps have been a no-no for many years, but so far only lifting or carrying anything slightly heavy gives me any problems now and I do get very tired.
Five angiograms plus the 2 most recent failed due to a blocked subclavian artery in one case and inability to get into either femoral artery in the other, 2 stress MRI tests and several scans of varying sorts later everyone is somewhat frustrated. The next try is to be a stress-echocardiogram which is a new one on me. As there is a 4 months waiting list and only one consultant doing them in our area, I rather think it may be new for everyone. Meantime life goes on and there really isn’t time to be ill!
Keep up the Sherlock act.
Best wishes
Dear Anon,
Thanks for your observations that your Warfarin might have been contributing to your breathlessness. I have not encountered this before and I am not quite sure of the purpose of all the investigations you describe – perhaps you could clarify further.
Dear Dr. Le Fanu. I was much struck by the paragraph on blood thinning drugs in today’s article. My late husband was always on the outside edge of normal blood clotting time but was prescribed Warfarin when diagnosed with heart rhythm atrial.fibrillation as well as tablets for hypertension. After 3 or 4 years I did notice personality changes, but thought it was just ageing. In 2006, on holiday in Norway, he fell and banged his head, but did not seem to suffer any discomfort. However, 2 days later my daughter found him on the floor with no response to any stimulant. The doctors in Norway worked very hard with him, but a scan showed that he had had a massive brain bleed and would not recover. I hope the findings you report will stop this happening to other people.
I enjoy reading your column each week Thank you for common sense medical advice.
Yours sincerely, Patricia C
Dear Patricia C,
Thanks for your query and your cautionary account of this most serious hazard of Warfarin – particularly for the older age group who are more vulnerable to falls. Thanks for your kind comments about the column.
Dear Dr Le Fanu,
For more than five years my 49 year old son has been unable to work or lead a normal life because of severe migraines, neck pains and loss of balance. He has seen audiologists, neurologists, psychologists, physiologists and had a CT scan and xrays, all to no avail. He appears to have the condition recognised in Sweden, Austria (and gaining acceptance in France at Cochin Hospital) of hypersensitivity to electromagnetic emissions.
The National Health Service seems totally unable to provide him with any help and clearly does not want to recognise his very debilitating condition. Can you or any of your readers give any advice?
Yours sincerely,
Brian A
Dear Brian A,
Thanks for your query and my great sympathies for your son’s medical problems. There is, as you will know, a lot of information on electromagnetic sensitivity available on the internet. But I regret I do not have any experience of dealing with this type of problem. I am sorry not to be of more help.
Enquiry re recurrent Cystitis
Dear Dr Le Fanu,
I read your article in the Telegraph on 7 April with interest.
I am 72, have had Cystitis intermittently all my life. This year I have already had 3 bouts of it. I know my problem is emptying my bladder. I have tried Pot cit on many occasions, but to no avail. I wonder if you have any other suggestions?
I look forward to a reply
Yours sincerely
Anne Le C (Mrs)
Dear Mrs Le C,
There has been a lot of comment on this problem of recurrent cystitis in the column recently. Please search Telegraph online for ‘Le Fanu cystitis bladder ‘.Welcome to the latest online clinic for 2014 with the usual mixture of the intriguing and instructive. This week’s clinic is exceptionally large so with regrets I have not been able to respond to all the queries and for the brevity of some of the replies. The next clinic will on Friday 2nd May
Dr Le Fanu"s on-line health clinic, Friday 11th April 2014
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