Dr Le Fanu"s on-line overall health clinic, Friday 14th March 2014

My father died in his 80s and my mother who is 93 is still alive but very decrepit. I am not aware of any history of bowel cancer or indeed any cancer in my household. I am in typically good wellness [I weigh the same as I did when I was aged 24 – 9.5 stone – 5’ 8” tall] and have quick run each day. I take Benecol to counter supposed higher cholesterol considering that I will not consider medication for this I haven’t had it checked for a whilst but I am primarily pretty rigorous about a reduced fat diet regime.

My concern is that if I provide a sample for the programme they will practically undoubtedly detect blood but that may just come up from my haemorrhoids. If they do detect blood then I imagine I will be named in for a retest and further examinations.

It genuinely would be helpful if the leaflet from the NHS could offer some advice to haemorrhoid sufferers, considering that they really do not and obtaining a medical doctors appointment for a decent length of time to chat about this topic is not practicable perhaps you could use your column to supply some advice.

Martin

Dear Martin,

Thanks for our query. The dilemma you describe is not uncommon and accounts for several of the ‘false positives’ related with the Bowel Cancer Screening programme. It can be minimised by taking a laxative (such as Lactulose) to decrease the probability of bleeding from the haemorrhoids triggered by difficult stool and producing the sample on the day when there is no proof of frank bleeding. You may want to get in touch with the screening programme’s helpline on 08007 976060 for more tips.

ALAMY

Ptosis

Dear Dr Lefanu, I am to undergo cataract surgical procedure in May/June of this yr, and realize that the eyelid might droop following this. Are there any workout routines that I could do to avoid this, as my eyelid has a tendency to droop somewhat at the finish of the day anyway.

Your view would be greatly appreciated.

Joan G (Mrs)

Dear Mrs G,

Thanks for your query. This drooping of the eyelid (or ptosis) following cataract surgical treatment is due to temporary faulty working of the nerves induced by either the trauma of the procedure or the prolonged effects of the anaesthetic. There are as a result just no preventive measures and it must resolve inside of a couple of days.

ALAMY

Sir,

I am 80 many years old and have had osteoporosis for about 4 many years. I accept the unpleasant reduce back and decreased mobility, but discover other symptoms (if they are connected to the osteoporosis or not) extremely hard to put up with. I am on medication for RLS (restless leg syndrome) but can get no relief in spite of taking three ropinirole and one amitriptyline at bedtime. In truth I do not believe the issue stems from my legs, but from my reduced back. Sitting of an evening, watching Television, studying, making use of my Nintendo to perform scrabble, doing my tapestry or just speaking to friends and household, I cannot sit nevertheless for extended, due to the peculiar sensation in my back (cured by getting up and walking about) at evening as quickly as I lie down in bed, my reduce limbs take on a lifestyle of their very own ,creating fantastic jerks each number of seconds which make me distressed and sleep not possible. For considerably of the night I stand hunting out of the window or stroll round the area or touch my toes as a implies of short-term relief but as soon as I get back into bed it begins once again! My beautiful GP can throw no light on the subject other than to up my medication which has not worked. I am also on eye drops for glaucoma, adcal and alendronic for the bones, soluble aspirin and statins (the two unnecessary in my book but I do as the health care occupation decrees!) and emosil for prolonged standing reflux problems. I check out the osteopath after a month for ‘maintenance’ work on my back. I also have B12 injections each and every 12 weeks as apparently I am anaemic and not too long ago had blood taken for a suspected DVT (proved not there) and now am going to the hospital for treatment method for lymphoedema simply because my ankles are swollen.

I ought to be most grateful for any advice you can give me as I am fed up with the situation. I might be 80 but I am even now 45 in my head with plenty I want to do and I need my rest !!! It is a positive factor that “Old age ain’t for sissies” !

Daphne G

Dear Daphne G,

Thanks for being in touch and my sympathies for these distressing signs and symptoms which do not match the normal pattern of RLS being a lot more of a mixture of ‘restless’ and ‘jumpy’ (as in Periodic Limb Motion Disorder). It is also significant it does not reply to Ropinirole. I note that the United States based mostly Rowe Neurology Institute (RNI) reviews that this mixture of signs can be due to disc difficulties at the base of the lumbar spine that would definitely be consistent with your connected back troubles (see: Vernon Rowe: ‘RNI Discovered connection among restless legs syndrome and bulging disc in lumbar spine’ – offered on the web). You might wish to discuss with your medical professional whether or not this may warrant even more investigation with, for example, an MRI scan. My two other recommendations would be that you discontinue the statins that can induce or exacerbate the symptoms of RLS and take into account taking clonazepam that is of worth the two in RLS and for PLMD.

I have been more and more unable to taste or smell something for two many years. Now I have neither taste nor smell. A number of health care opinions from my superb medical professionals at the surgical treatment, and a couple of hospital consultants have agreed that absolutely nothing can be completed about it. Is there any hope? I am male and 80.

Dear Anon,

Thanks for your query. I presume you do not have a persistent nasal/sinus dilemma that is the only readily treatable lead to for loss of taste and smell. Your signs and symptoms are as a result most likely to be due to an age associated reduction of function of the olfactory nerve for which there is no certain remedy.

Some time ago my wife suffered a minor stroke /heart attack accompanied by atrial fibrillation.

She has recovered well with typical medicine but we have wondered regardless of whether the fact that she had had a extremely massive abscess on a tooth which had burst of its very own accord before it impacted her breathing (which her medical professional had feared may possibly happen)had been a contributory factor to the heart problems.

We have heard that it is suspected that this can take place but it sounds like an “old folk’s tale”

Have you any views please?

Yours sincerely Paul M B

Dear Paul B,

Thanks for your query and I am glad to hear your wife has recovered effectively from her current health-related difficulties. I would not have believed they were connected to the tooth abscess.

Dear Dr Le Fanu

Following a severe fall at residence triggered by sudden vertigo or dizziness, I was at some point referred by means of the ‘Falls Clinic’ to an ENT consultant who carried out the Epley manoeuvre on me following hearing that I had suffered shingles of the inner ear and scalp some five years previously (he known as it by a syndrome identify which I have now forgotten). Result: one hundred% cure! I told him I had go through about it in your column and suggested it to many GPs simply because I have had recurrences of shingles ever since, but each and every single 1 of them dismissed the thought out of hand.

Just to say ‘thank you’ – I study your column with fantastic interest.

I have a peculiar symptom which somebody might be ready to come up with a resolution for. I get a blocked up nose anytime I talk, particularly on the cellphone. It goes away as swiftly as it comes on when the conversation is above. It is fairly noticeable and a lot of men and women have remarked on it.

Kind Regards

Dear Anon,

Thanks for currently being in touch and I am delighted (if perhaps, like your household physician, a bit surprised) that the Epley manoeuvre must have cured your vertigo/dizziness if it was brought on by the attack of shingles. I have not encountered this puzzling ‘telephone conversation induced blocked nose’ syndrome you describe. I will mention it in the column in the close to long term in the anticipation someone will be ready to offer you an explanation.

Dear James Fanu,

I would like you to attempt and reply a problem that I have had for over a 12 months now. The medical professionals cannot get to the root of the problem, not with out trying!

I have (which can only be described as) a tingling nervy tight sensation down the outside of both legs. It is considerably worse at evening when laying down or when resting. It keeps me awake at night continuously. It is genuinely uncomfortable and quite agonizing at instances

I have been taking Anastrozole for breast cancer for two.50 years now and did think it was a side effect. I stopped taking the Anastrozole for 3 months and there was no adjust.

The doctor has prescribed Pregabalin and Oxerutins (Paroven). I have seen a vein professional, a neurologist and had osteopathy, all with no help or conclusion.

Please please request your readers to help.

Thanking you in advance

Christine W

Dear Christine W,

Thanks for being in touch and my sympathies for the puzzling signs and symptoms. The reality that they are position associated (being worse when lying down) may well recommend they are due to sciatica but no doubt the a variety of physicians you have consulted have deemed and excluded this probability. I can only presume then that this have to be some type of neuropathy for which I note you are taking the proper therapy I am sorry not to have been of more assist on this matter.

Dear Dr Le Fanu,

I read with interest all the recent correspondence on recurrent cystitis, having much sympathy with the sufferers – it is miserable. One particular tip given to me that I hope may prove beneficial is to consider d-mannose, a kind of sugar that I realize attracts e-coli in the bladder to itself and prevents the bacteria sticking to the bladder wall. A teaspoon of the powder taken twice a day in water appears to have assisted several individuals. Might I also recommend a book by Angela Kilmartin named ‘The Patient’s Encyclopedia of Cystitis, Sexual Cystitis and Interstitial Cystitis’ (not as formidable to go through as it sounds!), which explains a washing approach which may also help some readers. Each of these things can be readily identified on Amazon.

Yours faithfully,

Dear Anon,

Thanks for getting in touch and drawing interest to d-mannose and Angela Kilmartin’s excellent guide which I hope to mention in the column in the close to future.

I study your comments about medical doctors carrying out tests for dementia screening. My encounter is various. The medical doctor asked for a psychiatric nurse to check out our home and she held the exams, which to my mind have been derisory and in no way found what I believe to be the situation with my husband’s memory. They had been as you describe. He did not get a diagnosis, but the a lot more I appear into the problem the more I think that nothing is obtainable anyway so truly I am not certain what the stage in screening is. If someone like Prunella Scales can not be assisted who can? Just placing a label on anything doesn’t do something.

Dear Anon,

Thanks for currently being in touch and your account of your encounter of dementia screening. I could not be in higher agreement about the pointlessness of labelling memory issues in this way with no their getting something to provide in the way of remedy.

ALAMY

I am not confident if post nasal drip is the correct term but I am sure you will know what I refer to.

A couple of weeks in the past you had someone ask suggestions about this. I have had a problem for years and no one could aid. I am also a hearing aid wearer and as such usually have problems with my ears (too enclosed an environment). For the ears I was sent to an ENT advisor. He took recognize of all the difficulties in the region and not being in a position to discover anything incorrect with my ears mentioned it may well be best to try out and resolve the dilemma from the nose side of the ear drum. He recommended, in the first instance, Sterimar nasal spray – starting with the stronger one particular and then making use of the milder one particular.

The Sterimar has worked wonders. Possibly this could help other people. This kind of a easy reply.

The advisor did give me a recipe for creating the contents of the spray at home but I decided against this for two reasons. 1. It would be challenging to discover a spray bottle to get the spray in the proper place. two. I was worried about contamination if I made it at home.

Regards

Dear Anon,

Thanks for becoming in touch. I am so pleased to hear your catarrh enhanced with the Sterimar spray. I look forward to mentioning it, as you propose, in anticipation that it will also be of support to other individuals.

Dr James,

I have suffered for several many years with tingling sensations in each feet. It commenced in my right foot and above the many years has spread gradually to halfway up my calf. While the dilemma with my correct foot progressed, I began obtaining tingling sensations in my left which has spread to most of the foot now. An MRI of my reduce spine exhibits no problems and I have experimented with a handful of medication (amitriptyline and gabapentin) with no achievement.

Any tips on any achievable following actions and who I could seek the advice of ?

Thank you,

Roy W

PS: A curious incident occurred prior to the difficulty started out. Although abroad I walked barefoot into the bathroom soon after it had been cleaned utilizing family liquid chemicals and a burning sensation spread nearly instantaneously from the bottom of both feet up to my ankles – could this be the trigger of nerve harm?

Dear Roy W,

Thanks for currently being in touch. These tingling sensations are induced, as you will know, by a peripheral sensory neuropathy. It is definitely really intriguing that they seem to be to have been brought on by the exposure to those chemicals in the bathroom as you describe- very challenging to picture how they may well be responsible. There can be in some situations an underlying remediable result in this kind of as diabetes but regrettable there is no distinct remedy.

Dear Dr Le Fanu,

About 50 many years ago my Wife had element of an overactive thyroid removed. Each few years she has the standard thyroid check. The final results are constantly the exact same – thyroid function regular. Even so she study that the final results of this test are not constantly reliable and so she believes that any lack of energy is the consequence of lack of thyroid. Is there a far better check available?

Ideal Wishes,

John T

Dear John T,

Thanks for currently being in touch. I am sure your wife can be reassured that her reduction of energy is unlikely to be due to an underactive thyroid if the exams are within the standard selection.

Dear Dr Le Fanu,

I recognize that due to the fact of the wide feedback from the several folks who make contact with you, you can provide, throw light on health care circumstances that have proved hard to diagnose. I have this kind of a situation.

It started all of a sudden in May possibly 2013 and I feel coincided with when I was prescribed Beconase nasal spray for regular colds. The situation will take the kind of a permanent sour taste at the back of my mouth, rather related to the feeling when vomiting is about to arise, but it goes no additional than that. I also have a feeling of moderate discomfort in the stomach area and an enhanced feeling of hunger. I create an abnormally massive amount of wind (burping), specifically after becoming even now for a period. My appetite and bowel functions are typical. The above signs are least obvious after a meal but build prior to the following meal and in the course of the evening. They are least noticeable when I am actively engaged in some thing, most obvious when I’m nevertheless. My GP are not able to explain the problem, nor can the ENT specialist or the Gastro-intestinal professional I have consulted. I have experimented with Gaviscon and Omeprazole but neither had any impact.

I am aged 74 and otherwise healthier, even though I did have a kidney stone final September which passed naturally.

I would be really grateful if you have any idea what might be leading to these signs and symptoms.

Yours sincerely

Philip Y

Dear Philip Y,

Thanks for currently being in touch with this most intriguing query. Your signs and symptoms are undoubtedly typical of – and almost surely due – to acid reflux, The acid suppressant Omeprazole is for most a highly effective remedy though for a considerable minority – like your self – it does not relieve the signs at normal dosage. Some will respond to a doubling of the dose and if this does not work more investigation is necessary with a see perhaps to obtaining anti reflux surgical procedure. There is a most comprehensive account of this on the web (Herschovici and Fass, The Recent Opinion in Gastroenterology, 2010 vol 26, pp367-378) that you must examine with your medical professional.

Dr Le Fanu"s on-line overall health clinic, Friday 14th March 2014

Dr Le Fanu"s online health clinic, Friday 14th February 2014

Dear Dr Le Fanu

I wonder if you can solve a total mystery?

Before I gave up smoking, I thoroughly enjoyed drinking red, rose and white wine and port. After I gave up smoking I found that every glass of red wine I tried tasted like the very worst corked wine you have ever encountered, which was a blow to morale as you can imagine.

After a death in the family I resumed smoking for a period. I thought this would allow me to enjoy red wine again, but alas not! Curiously my taste for rose and white wine (and port, interestingly given the colour) were unchanged. No other forms of drink (alcoholic and non-alcoholic) were affected, nor were my food tastes.

What is going on? Everyone I know is speechless. I am even more speechless as I have some delicious red wine laid down and their drinking spans will soon be up unless I can regain my taste for red wine. It really does taste disgusting, although I can still appreciate any bouquet, which is now doubly enticing!!!

Can you help?

With best wishes

Andrew

Dear Andrew,

Thanks for that most intriguing query. I have not encountered this selective dysgeusia for red wine nor can I readily imagine what might explain it. I will mention this in the column in the hope of eliciting some answers.

Sadly, I missed the “Doctor’s Diary” when the question of treatment for prostate cancer was first raised and only picked up the discussion in your most recent column. It may be too late to express any views.

I read what the Edinburgh lawyer says about the relief he feels at not having to go for annual check-ups but from my own experience, having taken the surgery option, I feel that the downsides of this decision should not be under emphasised. It is true that sporadic impotence was the reason I first went to the doctor on a visit that eventually led to the prostate cancer diagnosis and it is true that I was warned of the possible side effects but I was unprepared for the impact on me as man of both full impotence and a degree of incontinence. The effects of the operation have left me with on-going serious depression which is certainly not alleviated by the thought of living another 35 years!

I cannot remember whether the alternatives of chemotherapy or radiotherapy in various forms were predicted to have the same effects to the same degree. I was hugely influenced by my consultant who said that if chemotherapy did not work the patient could not then go back to surgery. I wish I had not listened!

I would only urge any man with this disease be advised to consider the impact of impotence and incontinence.

I M D

Dear I M D,

Thanks for being in touch and your account of the unfortunate consequences of your prostate operation – which I suspect may reflect the experience of many. The problem with surgeons is that they tend to recommend surgery and it is indeed possible that radiotherapy might have been the better option.

Hereditary haemochromatosis

I have recently been diagnosed with the above condition as a result of a blood test. I thought I had no other symptoms, but have discovered that burning tongue syndrome, which I have had for several years, can be associated with this condition. This also causes altered taste, including sensitivity to salt and acid fruits etc. I wonder if this would help your correspondent of 29th November whose son has haemochromatosis?

Dear Anon,

Thanks for your query. It may be that Haemochromatosis is associated with Burning Tongue Syndrome but I was unable to find any reference to this in the ‘medical literature.’

Dear Dr. James,

What are your views on osteoporosis medication? I suffer from IBS and other, related digestive problems. Just the thought of swallowing a pill makes me panicky. The intravenous method comes with a whole host of possible side effects as well. What to do?

Kind Regards,

Pia A

Dear Pia A,

Thanks for your query. You do not mention your age or how you came to be diagnosed with osteoporosis – the only preventative medication that does not involve taking pills/injections is HRT.

It would be worth Mrs SD from York’s daughter who has returned from backpacking in Africa and suffering headache, paralysis etc to have thorough tests for Schistosomiasis . This parasite, often known as Bilharzia is endemic in many areas and rarely can affect the brain and spinal column causing neurological symptoms. Sometimes brain lesions are small and hard to detect.

Yours

A C G

Dear A C G,

Thanks for being in touch. Several readers have raised the possibility of Bilharzia as a cause for this unfortunate young woman’s misfortunates which I mention in the column this Monday.

I have found Questran to be a miracle cure for my irritable bowel freeing me up to Travel more but it seems it is no longer available. Is there an alternative product out there?

Dear Anon,

Thanks for being in touch and I am of course delighted to hear that Cholestyramine has proved to be a miracle cure. The alternative (if more costly) is Colesevelam.

Hi,

I was wondering if you could advise if you have heard of glucosamine sulphate giving people skin rashes?

My partner has been suffering with a rash since November and the only thing we can think of that has changed is the brand of glucosamine sulphate he has been taking. He changed from using the Aldi version to the Lidl version!

The rash started in his groin and on his forehead. It has gone from his groin, but is still on his face and now on his neck and behind his ears too.

Hope you can help.

Thank you,

Mrs Alison G,

Dear Mrs Alison G,

Thanks for your query. It is possible, but unlikely that your partner’s rash is due to glucosamine. It sounds as if he needs to see his doctor to establish the correct diagnosis.

Insomnia, epilepsy, asperger’s, and seemingly underweight (or recently told so!).

Dear Dr Le Fanu,

Insomnia is the current problem:

Have you come across any research papers linking daily ingestion -100 grams of various garlic mixes to epilepsy control?

Seems to be working for me at least.

Factor in the carrot and coriander soups.

Not taking the BNF medications, useless in respect of efficacy and side effects.

As for the weight, goes back to climbing in the era of Cubby, Pritchard and Dawes.

I am 5’8″ and about 8.0 stones, give or take a full bladder and lower bowel.

BP 93/60, ECG 53 but normal P QRS ST/T and U waveform, was 42 when my academic mother pulsed me in 1983.

Cross the ticker off the possibles, thank gosh.

Best Regards.

P.S. Consume ~2000 kcal’s per day.

Dear Anon,

Thanks for your query. I gather that garlic is claimed to be ‘a natural remedy’ for epilepsy but there is no scientific evidence for this.

Dear Dr. LeFanu,

From Holland I follow you on the website and already had many advantages from your advice over the years.

Maybe this info is helpful for some of you readers.

Age 66. Arthritis pubic bone and feet.

I felt that all the medicine I was taking was not doing me any good; at intake my mind protested. My bones and muscles hurt so much that I wanted to ‘test my gut feeling’ i.a. to stop medication.

Having had restless legs (and very bad sleeping) for over 4 years and tried everything, I eventually ended up with Neupro plasters.

I was on high blood pressure pills Losartan 50 for three years. I discussed my wish with my GP to not take bp pills for a while.

So I stopped Losartan and quite soon after the Neupro plasters.

The combination of stopping the medicine made my restless legs stop being restless nearly immediately.

My blood pressure came down a quite a lot without medication and I felt much less pain in my body.

I now take 400 Magnesium before bedtime (don’t know if I need calcium as well?) and I sleep well!

I am trying to find a non-chemical to keep my blood pressure going down.

Eat no wheat and dairy since 4 months. Lots of vegetables and raw food. And no sugars.

What did the trick I don’t really know, but this time maybe ‘my body knew best for the time being’.

Thank you for your time and advice given over all these years,

With kind regards,

Carol O

Dear Carol O,

Thanks for being in touch – and I am pleased, of course, to hear that the column has been ‘advantageous’ to you over the years. I would concur that medicines are an important cause of many different, and often unusual, symptoms – and where the diagnosis is unclear it is only sensible to give them a rest to see whether this can improve matters.

It was interesting, as always, to read your column today.

You may not remember that you published a very similar tip some years back, in response to a complaint about having to go many times during the night. Then, you advised standing up after passing urine once, and then trying again, upright, which always yields an appreciable amount. I passed this on to my middle-aged and over friends, and received lots of grateful thanks.

I haven’t tried walking round the bathroom, as I am always anxious to get back to bed and sleep.

Mrs. C. D

Dear Mrs C D,

Thanks for being in touch and well remembered(!) – the reason for mentioning it this time (recurrent cystitis)is different.

Hello

I wonder if you can help?

About five years ago my mum had a heart valve operation. A fortnight after that her feet became hot, itchy and sore.They haven’t changed since then. She has to hang them out of the bed at night to keep them cool. Often she has to put them in cold water during the day and night. They are so irritable that she never has a full nights sleep. Also she cannot wear socks, even in winter. Her feet go so red and tight they turn nearly purple.

Mum has been to the doctors but no-one seems to know what the problem is!

I don’t know if her operation would of had anything to do with her feet ?

Look forward to your reply

Rachel McL

Dear Rachel McL,

Thanks for being in touch and my great sympathies for your mother’s distressing symptoms. I suspect her red burning feet are likely to be a circulatory problem caused by reduced blood flow which can be readily diagnosed by the absence of pulses below the knee. This can be improved by a small operation known as a Sympathectomy. The further possibility would be a condition known as Erythromelalgia for which the preferred treatment is a beta blocker. She needs to discuss this further with her doctor.

Dear Dr Le FAnu

In 2011 i had an aortic valve replacement and single by-pass. in 2012 and 2013 followed several A+E emergency admissions with atrial fibrillation. The Sotalol did not control the AF. At the beginning of December I suffered a stroke affecting the parietal lobe, left side affected. Now I am in a wheelchair. Guess why the drug did not work – thyrotoxicosis – nobody ever checked my thyroid hormones..not the GPs not the cardiologists, not A+E doctors. Surely doctors learn about the thyroid at medical school?

Perhaps an article about the thyroid in the DT might enlighten them? I recall seeing a book – Could it be my Thyroid?

People with AF need to know about thyrotoxicosis

Likewise, their GPs and cardiologists and A+E doctors

The only reason this was diagnosed was that I still had AF in hospital after my stroke – it showed on echocardiogram. They called in an endocrinologist to look at me. He looked at my eyes and throat and did test for T3,T4, TSH.

Regards,

Margaret W

Dear Margaret W,

Thanks for being in touch and I am very sorry to hear of the unfortunate outcome of this delayed diagnosis of Thyrotoxicosis. I suspect this may not be unusual and will mention your experience in the medical column for the benefit of others.

Dear Dr James

I am 83, a year ago I developed food intolerances to all foods containing sulphites, additives and preservatives.

I am seeing an allergist/immunologist and am due to see a dietician.

It has been a miserable year and I am struggling to come to terms with it.

I was ok in the morning but in the afternoon my face and nose and eyes were affected, I can’t understand how my life was turned upside down in a matter of hours.

As you probably know, the list is never ending of the things I can’t eat or drink, I had been ill 3 years previously with chest infections and was continually on antibiotics and steroids, eventually I had a double hiatus hernia operation which had pierced the chest wall.

Three months after the op my chest infections stopped but 5 months after the op I started my food intolerance.

I had also lost 3.5st in the period before/after the op as had trouble swallowing.

Surely there must be some connection between my previous health problems and this food intolerance?

Any tips would be gratefully appreciated.

I have started taking vitamin c and d.

Regards

Elaine T

Ps – my tests show I am allergic to shellfish, coffee, cheese, nuts, leaf spore pectin, coconut, vinegars/sauces, purees, chocolate, sweets and much more

Dear Elaine T,

Thanks for being in touch. It must be most unusual to develop all these food allergies at your time of life. I would be interested to know where they were diagnosed.

PA

Dear Dr Le Fanu,

It does make me rather fed-up and cross when I read sweeping statements such as the banner over Emily Gosden’s article “Older women dying from ignorance of breast cancer”. If one was to ask any woman on any street in the UK in the said age bracket (50-70+) about breast cancer, I am sure she would say that she personally knows of someone who has died from, or is suffering from, this disease. I am still mourning a dear friend and know several work colleagues who have died in this way (they were all under 70). So it’s a bit silly to say that we are ‘ignorant’ when, for over 20 years. this particular age-bracket has been attending faithfully and obediently the call for a mammogram. So I cannot see how Age UK can say that “older women are less aware of symptoms”, (also their newsletter often has an article on the subject); nor, I think, can Professor Dame Sally Davies say, similarly,”..awareness of symptoms and risk are low among this age group”, this is simply shifting the onus onto the ‘patient’. We mature ladies do not need to be led by the hand to get a mammograph, and if we find changes we will go for an investigation – but we would like it to be easier and simpler as we grow older. However, we appear to be being treated differently to our younger sisters.

Take my experience as an example of some mystifying logic. I live in a rural area, about 10 minutes’ car-drive from the nearest town where a very nice mobile/static breast cancer screening unit is sited, close to the local hospital (no A&E) and my doctors’ surgery. It is private, feminine and the radiographers are delightful. So on appointment day, I could take a day off work, drive the 10 minutes there and be home again well within the hour. Now I have reached the magic age of seven-zero (I am 73), I am not allowed to go there. Instead, I have to go to a main hospital which is a 60+mile return car journey (time-consuming and expensive), or take a two-bus journey which would take at least 2/4 hours return – very time-consuming and tiring. Can you see why the take-up might be down? When I phoned to ask the reason why I had to do this I was given the reason as being about ‘record-keeping’. Yes, I’m baffled, too. So I ask the question: ‘ Why make it more difficult for this age-group? Why can’t I continue to use the lovely little unit that has been provided?’

“No Answer”, came back the stern reply.

Yours faithfully,

S N

Dear S N,

Thanks for being in touch and for those observations with which I could not be in greater agreement. I presume the local breast screening unit is part of the national programme which, as you will know, is not available to those over the age of 70 – hence the onerous requirement for you to take that long journey to and from hospital.

Dear Doctor,

For the last nine months I have suffered with tingling and weakness in my arms and legs, this is a random thing and I have not been able to associate it with anything particular that I have eaten or done. Sometimes it will last all day and can make walking seem ‘drunken’ but does seem to get a little easier in the evening after a meal. Recently I have developed a numbness in my left buttock which spreads into my leg and causes cramping on the outside of the leg. Again random but getting more often. Like a previous correspondent I get the odd sharp pain in my legs.

I get headaches mainly in the right hand side of my head which seem to start in my neck, and some lightheadedness.

I have had MRI and CT scans on my head, numerous blood tests and physio examinations all showing normal. Because these symptoms are random it makes life quite miserable not knowing how I am going to feel from one day to the next.

I am 73 years old, never smoked, drink in moderation and keep active.

Hoping for a solution!

Mrs J D

Dear Mrs J D,

Thanks for being in touch. These syndromes you describe are certainly consistent with the Migrating Sensory Neuritis as recently featured in the column. There is regrettably no specific treatment though it does not have any long term adverse complications.

Dear Dr Le Fanu

I had a total hip replacement 3 months ago and have been left with Trendelenburg gait, symptoms of which I have never had before. Apparently this is quite rare so wonder how I have been left with it and is there a time frame for walking straight and without pain. I seem to have been given many explanations none of which satisfy me can you give me any hope.

Regards

Dear Anon,

Thanks for your query and I am sorry to hear about this painful gait following your hip operation. The only treatment of which I am aware is physiotherapy and exercises to strengthen the abductor muscles.

Hello James

Mystery ache to lower legs and arms for 20 years

41 year old male – never smoked, very good diet, swims and runs daily.

Since I was 21 I have suffered from a heavy/weary ache to both lower legs. The ache came on suddenly – I can even remember the exact moment when my legs suddenly felt heavy. Since then any form of exercise has brought on the ache. The symptoms worsened for several years to a point when even walking or getting up was tiring to my legs. Then around 1999 the ache eased slightly. I have had bilateral fasciotomy to treat compartment syndrome with no success. I have had back scans, lower leg scans, neuro-muscular tests – all negative. Doctors long since gave up. I have seen podiatrists, acupuncturists, osteopaths etc… although my osteopath can bring on similar symptoms with a minor contortion of my limbs.

The ache can be felt 24/7 but at rest it is very faint. Upon exercise it gets increasingly more debilitating. Once I stop, the ache immediately subsides. To give you an analogy of how it feels when I run, it is like running through water or treacle, or perhaps running in concrete boots. There is never any pain. It gets to a point when my legs feel like they are nailed to the floor and have to stop.

The same thing happened in my arms about 12 years ago – again all of a sudden during a swim I felt this heaviness in my arm muscles. Since then exercise to my arms such as press ups brings on the same heaviness. I can do about 26 press ups before arms just get so heavy I have to stop. As when I run, I am never out of breathe.

The symptoms also vary with temperature. Both my arms and legs ache worse in hot weather. I can swim OK in the sea but not very far indoors. I can run further and faster in the cold but considerably less in the summer. Running in bare feet is easier than wearing trainers.

Whilst there is no pain and I am able to exercise, I am emailing you because I am completely frustrated that I am unable to realise my potential. I am a good runner who can be an exceptional runner. I am competing against runners with no lower leg ache and it hurts me mentally that I fade away in every race I compete because my legs just get more and more weary.

But my overall fitness levels are fine. I can run 8 miles in under one hour, albeit a lot slower than I want to. I can swim a mile in the sea very easily.

Any ideas – hope this isn’t too complicated. Anything I have missed trying?

James

Dear James,

Thanks for your query. It certainly sounds as if your doctors have been very assiduous in trying to sort out what might be responsible for these unusual symptoms. I will mention it in the column in the near future in anticipation it might generate some suggestions from readers.

Dear Dr. Le Fanu,

A few weeks ago you wrote about someone who had numb legs and was taking magnesium, hoping it would help.

Is there any way you could get them to contact me, to let me know if it was successful?

Yours truly,

Susan S

Dear Susan S,

Thanks for your query. The correspondent reported that since taking the magnesium tablets the difficulties she had had with her ‘jelly legs’ had not recurred.

Dr Le Fanu"s online health clinic, Friday 14th February 2014