I was diagnosed with atrial fibrillation last September and have been taking Warfarin ever since. My dosage is 4.5 and my INR is 2.7. The aim is between 2 and 3 so now my blood tests have been reduced to every 70 days. It just so happened I was due at the Surgery yesterday afternoon for a blood test so I took your article with me.
Why did I bother? The Nurse looked down her nose and said it was scaremongering and if I wanted any information I should consult the internet!! As a retired Civil Servant I can remember that if we saw any relevant piece in the press, it was cut out, circulated to those officers concerned and then filed!
I have never been told how my AF came about only that my heart has to work harder because I am tall (5ft 11ins). Nor has any side effects of Warfarin been discussed with me. But, according to the nurse yesterday, my condition is being monitored!!
I just thought you might find my experiences interesting and whilst I think the NHS is a wonderful organisation there are people, unfortunately, who show so little interest
Regards,
Jill M G (Miss)
Dear Miss G,
Thanks for being in touch. Warfarin certainly does reduce the risk of stroke in those with atrial fibrillation but it is scarcely ‘scaremongering’ to draw attention to the potential hazards – as mentioned in the column – that they increase the risk of brain haemorrhage following a minor head injury. I would hope that you have had the TSH blood test to assess your thyroid function as its overactivity (hyperthyroidism) is a well recognised (and treatable) cause of AF.
Dear Dr Le Fanu.
6 weeks ago I was hit on the left eyebrow by the full blast of a tennis ball at point blank range by a mishit ball from an over enthusiastic opponent.The immediate result was numerous floaters in both eyes and partial blurring of sight in the left eye. An immediate visit to the doctor suggested a visit to an optician/opthalmologist. They suggested referral to a specialist which the doctor did. The waiting time is 6 to 10 weeks. Optical assessment now seems almost normal apart from the left eye being ultra sensitive to light necessitating dark glasses to avoid pain and strain. There is continual pain and feeling of pressure behind the eye especially at night and first thing in the morning. In the morning at the side of the left eye well away from the point of contact there has been some bruising or slight signs of internal bleeding which disappear during the day when I am upright. Talking to the local hospital eye department suggested visiting an eye hospital where they examined me under protest because of the time elapsed since the incident and said that optically my eyes were fine as I could read and the go home take painkillers and relax. The doctor implied that I was stupid to be wearing dark glasses and then kept telling me to stop blinking during the examination which was impossible!!!! They stated that a tennis ball blow would not cause much damage. My estimate is that at the level at which I play the ball would have been travelling at over 100mph and was a firm new ball.
Your comments today about subdural haematoma were of interest as this has been discounted by doctor and hospital.
What could cause my eye to be so sensitive to light so long after the initial injury?
What could be causing the feeling of pressure and pain behind the eye?
Dear Anon,
Thanks for your query. These ‘blunt’ injuries can cause tearing and contusion of the tissues of the eye – though it is obviously reassuring that the optician found no evidence of severe structural damage. I can only suggest that as with most soft tissue injuries they usually take six to eight weeks to recover fully.
Dear Dr James: In the recent correspondence re cystitis, I am surprised that no-one has mentioned what I consider to be the best preventative, which is to pass water within 10 minutes of having sexual intercourse. This tip was contained in an excellent book Understanding Cystitis by Angela Kilmartin, which was recommended to me in the 1960’s. I believe it is now out of print, but is still available on Kindle.
(Apologies if you have already mentioned this).
Yours sincerely
Mrs Audrey R
Dear Mrs R,
Thanks for drawing attention to that most useful tip for preventing cystitis and Angela Kilmartin’s excellent book on the subject.
Dear Doctor Le Fanu
My 12 year old Grandson (who is a type one diabetic) has suffered with constant stomach ache for several months. His schooling has been severely affected in that he is continually exhausted through sleep interruption and when he does attend school his parents are requested to collect him because of this stomach ache.
He has had an x-ray and scan which have not shown any physical problem. The hospital diagnosis is ‘Chronic non-organic abdominal pain’ which is not much comfort to his parents.
Is his problem shared by others and what is the likely outcome?
Regards
John H
Dear Mr H,
Thanks for being in touch. There is an extended discussion on the website www.medhelp.org on stomach pain and diabetes with parents describing the same problem as your grandson where thorough investigations have failed to identify the reason for these persistent abdominal pains. Thus the cause is clearly not ‘non-organic (ie psychological). It could be, speculatively, due to some disturbed functioning of the sensory nerves or blood supply to the gut or perhaps inflammatory process in the pancreas. I would hope it might improve with time but the only therapeutic option would be to control the pain with appropriate analgesic.
Hello,
I am writing further to an earlier email I sent regarding Mrs NA from Rugby who experiences a blocked nose when on the phone. I suggested that the cause might be an allergy to nickel. I have such an allergy and also experience the same symptoms on the phone and also when I use my iPad. I wondered if the phones themselves or something about the iPad cover contained nickel—there is no list of “ingredients” in the making of a phone. I went to John Lewis to see if their computer and phone dept. might have some ideas. They said that cell phones and iPads usually have batteries made of nickel. You can get batteries made of titanium but very few of these small gadgets have them.
It is surprising as one is not in direct contact with the battery, but it is a possible explanation.
Regards, Kerry P
Dear Kerry P,
Thank for that further clarification of the potential contributory role of nickel sensitivity in causing that ‘blocked nose conundrum’.
Dear Dr Le Fanu
I read your article concerning Warfarin and I was diagnosed with atrial fibrillation last year following a couple of very mild dizzy spells caused by very low blood pressure. I am 68 and otherwise slim, fit and healthy. About 6 weeks after diagnosis I had a heart scan and was told it was ‘back’ and functioning completely normally. However, I am prescribed 8 mgs of Warfarin every day for 6 days and 9 mgs on one day each week. This seems high to me and my GP said it was because my blood was such that a high dosage was necessary. I really don’t like taking this drug and have particularly noticed a deterioration in the condition of my hair which is fine enough as it is and which I find very worrying.
My questions:
Is it really necessary?
Is there an alternative e.g. Aspirin?
What would happen if I didn’t take it?
I wondered if I could have a regular heart scan (which I would pay for) or am I just being ridiculous and should put up, shut up and be grateful!
Dear Anon,
Thanks for your query. It is advised that those whose atrial fibrillation responds to ‘electric shock treatment’ or cardioversion can discontinue their Warfarin after four weeks. I would have thought the same applies in your case now that you are spontaneously back in sinus rhythm and your heart scan is normal. You should discuss this with your family doctor or cardiologist.
Dear Dr. LeFanu,
Whenever my wife catches a head cold or chest infection, the usual nasal/bronchial/chest symptoms associated with such infections generally clear within a few days. However she is invariably left with chronic head pain. She describes this variously as “congestion” or “the bones in my head ache” or “my sinuses are bad”. Steam inhaling can sometimes give relief but it is often days before she is rid of the pain.
To complete the picture she has the condition Bronchiectasis and chronic cough and over the years, has seen two or three eminent ENT specialists. None has ever diagnosed/achieved very much.
Whilst she is coping with infections, paradoxically the coughing reduces to what could be described as a normal level…indeed, it’s often the case that she can anticipate the onset of infection by reduced coughing!
Given the disappointing lack of diagnosis for this head pain, this enquiry is more to seek assistance for the best form of pain control. Neither paracetamol nor ibuprofen seem to give any relief…what more could she try?
Many thanks,
Trevor C
Dear Trevor C,
Thanks for being in touch and your account of your wife’s puzzling head pain following a chest infection. This certainly sounds like some form of sinusitis – especially as steam inhalations provide symptomatic relief. It might be that she might benefit from the ‘keyhole procedure’ or endoscopic sinus surgery. Meanwhile I would hope that Co-codamol 30/500 (30mgs of codeine and 500mgs of paracetamol) would relieve the head pains.
Dear Dr James Le Fanu
At the very least re; your possible electro-sensitive Anon patient, you should at least have mentioned the charity ES-UK, www.es-uk.info.
This charity does sterling work in providing serious and helpful information about the symptoms and causes of electro-sensitivity. This is on the rise as we continue to increase our exposure to Wifi/EMFs/EFs. One thing is known that anything in excess is a problem, and that is the point we are at now. More and more people have become electro-sensitive, (or should it be – victims of electro-pollution), since the growth of the use of wifi more widely since 2000, and now being used by nearly everyone 24/7 in their constantly on mobile phones. Every device should come with a health warning as large as those on cigarette packets…….the means the internet is accessed needs to be as safe for the body as possible. Mobiles should be an emergency tool. The advertising revenues from the telecommunications industry maybe one reason the newspapers are comparatively quiet on this subject. GPs need to educate themselves on it in a more serious manner, and have the current ES leaflet in there surgeries so that people can consider the issue more deeply for themselves.
Dear Anon,
Thanks for being to my attention that most information website.
Dear Dr. Le Fanu, I am a white, English male, aged 77 years and have suffered for years from an itchy back. Since consulting a specialist some 35 years ago I have used aqueous cream daily whenever the problem became a real irritant. However the itch now is ever present during waking hours, ie. I am free of it in bed. Strangely, it is most troublesome from arising and eases somewhat through the day. Aqueous cream is not as effective as it has been in the past and Cetraben, from my GP., is no better. The increase in irritation seems coincident with my being diagnosed with Rosacea which affects scalp and face, evidenced by papules and pustules and minor red patches on the face. Itching and red blotches on scalp and face were treated by my GP. as dermatitis and can be controlled by daily use of Canestan with hydrocortizone, but the problem returns if treatment is stopped. I have started taking one capsule daily of Lymecycline 408 mg. but am told it takes about six weeks to take effect.
I mention the dermatitis and Rosacea and their treatment only because the increased back itch has been coincident with them and I thought it might be relevant; I await the six week period ending to see what happens to the Rosacea. My reason for writing is to see if you can suggest a solution to the itchy back problem.
Yours sincerely, A.K.L
Dear Mr L,
Thanks for your query. It is possible that this persistent itchiness of the back might be the (not uncommon) syndrome of Notalgia Paresthetica caused by disturbed functioning of the sensory nerves arising from the spine. Treatment is not very satisfactory but Transcutaneous Electrical Nerve Stimulation (TENS) is said to be of value. (see E Savk, Journal of Dermatology 2007 vol 31 pp 315-9)
What are the best exercises to combat sciatic nerve sharp pains
Dear Anon,
There is a useful series of exercises (with illustrations) on the NHS Choices website (search exercises and lower back pain).
Dear Dr Le Fanu
I have read recently that a test is available to establish levels of copper in the body, which could be a cause of early dementia. While I am not anxious to have a test, I wondered about the effects of wearing a copper bracelet, as I have done for many years, to great effect. I wondered what your thoughts are on this subject.
Sheila J
Dear Sheila J,
I would have thought it most unlikely that copper toxicity is implicated in Alzheimers. The evidence is certainly contradictory, with researchers at Keele University claiming recently that copper protects against the condition. It is good to hear you have benefitted so much from the copper bracelet and you should carry on wearing it!
In our seventies, my wife and I still have intercourse three or four times a month. Unfortunately, despite taking 100mg Viagra tablets to prolong my erection, I fail to ejaculate on about half of these occasions. My GP seems puzzled. Any suggestions?
Dave N
Dear Dave N,
Thanks for your query. The two possibilities here are first retrograde ejaculation where the semen passes back up into the bladder rather than down the urethra and second ‘retarded organism’ – ie failure to achieve ejaculation. There is regrettably no straightforward treatment for either condition though it can be the side effect of certainly drugs – notably anti depressants.
Dear Dr James,
As a former smoker, I now use electronic cigarettes (known as ‘vaping’) and I found I enjoy the experience much more than the effects of tobacco. My wife, too, gave up after 43 years in favour of vaping and says she would never return to cigarettes. There is no smell, no stink of stale smoke in the house or on clothes and we feel very much better physically.
We are careful to use nicotine liquid made either in the UK or the USA under laboratory conditions and are now very happy with our change of lifestyle. And I understand that the chemical producing the vapour is also used in inhalers prescribed for asthma sufferers and those with breathing difficulties, so my assumption is that this cannot be harmful (certainly when compared with all the toxic substances involved when smoking ordinary cigarettes).
There seems to be support for the health benefits of vaping from many doctors, including heart and lung specialists, although there are obviously differing views within the medical profession.
I enjoy the effects of nicotine consumption in much the same way as I enjoy good wine or whisky; nothing to excess but enough to provide an extra pleasure in life.
In view of what seems to be an increasing controversy over the use of electronic cigarettes and their apparent health benefits over smoking tobacco, I would be grateful if you felt able to give your views on the situation.
Many thanks for your regular columns in the Daily Telegraph. Not to be missed in this household!
Dear Anon,
Thanks for being in touch on your account of the joys of vaping. It would certainly seem to be (self evidently) vastly safer than smoking and to be welcomed as a highly effective means of minimising the harms of tobacco.
Pain in face/neck/upper chest relieved by drinking glass of cold water
((I am sending this “letter” for my mother for my elderly, vibrant mother. Strangely enough I have a similar situation where I suddenly have a feeling of what feels like a tight metal, painful band around my neck which also is relieved by drinking cold water quickly.))
Dear Dr Le Fanu,
For several years I have been experiencing the symptoms of awakening with severe pain down one side of my face and going down into my neck and upper chest. Quite by accident I discovered that by drinking (quickly) a glass of cold water this discomfort rapidly subsided. I wonder what it could be?
One of your correspondents reported similar symptoms recently (possibly 7th April or 31st May).
Yours sincerely
Kathleen G
Dear Kathleen G,
Thanks for being in touch. These pains, as I mentioned in the column on Monday are almost certainly due to spasm of the oesophageal muscles. As both you and your vibrant mother have discovered this is usually relieved by taking sips of cold water, though a slug of alcohol is also an effective remedy. The spasm itself is often precipitated by acid reflux that can be prevented with an acid suppressant drug such as Omeprazole
Dear Dr Le Fanu
Up until recently I had been an active 68 year old woman – walking a reasonable distance each day alongside the chores of living alone. But quite suddenly my legs now feel almost ‘wooden’ – and I’m wondering if this is a normal at my age and what steps I might take to alleviate the problem.
Your thoughts would be much appreciated.Many thanks Lin B
Dear Lin B,
Thanks for your query. This heaviness of the legs could be due to either pressure on the nerves at the base of the spine or a peripheral sensory neuropathy. I would hope that your family doctor will be able to clarify which is responsible and advice appropriately.
Dear Doctor Le Fanu,
Some time ago you published an article on post nasal drip which involved treatment with a low dose of an antibiotic for an extended period. I wonder if you could provide me with details of this treatment as I have suffered with this condition for many years.
Many thanks
Best regards
Dear Anon,
Please see my response Anon on the subject above.
Dear Dr James
My son ,who will be 18 at the end of May , has been suffering from pain in his left testicle for the last 4 years .The pain is at its worst after a prolonged period of standing .He has seen his GP and two consultant urologists , and save for a condition of bell clapper testicle , they can find nothing wrong with him . He has had a CT scan and a doppler test , all showed normal .No reason has been found for his pain . We are struggling to help him and would welcome any information which may help .
Hoping to hear from you ,
Dear Anon,
Thanks for your query. I would have thought this dull ache must be due to the testes not being properly ‘anchored’ in the scrotum as occurs in so called ‘bell clapper deformity’. It might be minimised, I suppose, by wearing tight supportive pants though as the defect can predispose to torsion of the testes, an operation is often recommended.
Dear Dr Le Fanu,
I am a 62 year old male and in the late 1970s or early 1980s I was treated for an over-active thyroid condition with radioactive iodine. For 10 or so years thereafter I did not require medication, but for the last 10-15 years I have been taking Levothyroxine Sodium tablets (100 micrograms per day) for an underactive thyroid. Since my treatment for the over-active thyroid I have tried to keep all medication and supplements to a minimum and I am concerned about the proposed introduction of Folic Acid into bread, and that I might find some adverse reaction with my medication.
Can you offer any advice, please? I realise that Folic Acid is present in some cereals, but as I don’t eat breakfast cereals this has not worried me until now. Also, is the proposal just to put Folic Acid into bread, or in to all commercially available flour? My wife currently makes 80% of the bread we eat.
Thank you.
Yours sincerely
H F W
Dear Mr W,
Thanks for your query. I would not have thought that folic acid would interfere with the management of your thyroid condition.
Dear Dr James,
Could Mrs PB be suffering from Blepharitis?
Warm after baths are supposed to help unblock the oil glands around eyes, which, with blepharitis, become blocked. Eyes sometimes water involuntarily, too. I suffered from this, and tried the suggested treatments of warm washes/massage, baby shampoo and bicarbonate soda. I subsequently discovered through years of observation, that it is caused by the water in my area (Thames valley). By using bottled French water on my face(and travelling abroad!), it is manageable.
I do hope you are able to share this, as I was surprised by the lack of information I received, and a little keen to share my discovery lest there are others that suffer.
Sincerely,
Laurie
Dear Laurie,
Thanks for those interesting observations that I will be mentioning in the column of the 12th May.
Dr LeFanu,
I read your article on neuropathic pain with interest. I’ve suffered from a small patch of this since an operation last summer. The GP had prescribed gabapentin for me, which I only took one dose in the evening and stopped within a fortnight because the side effects were worse than the pain (I dislike any additional sensations of dizziness as I figure skate and prefer to maintain good balance – less bruises that way!).
My consultant however recommended placing a plaster of Opsite (polyurethane sheet) across the area. The plaster doesn’t aggravate the nerves and provides sufficient barrier than the touch sensation is removed from the area which is being covered. Having looked for some literature to explain how this works, I can’t find any. And given that my GP hadn’t heard of this, I thought it’s obviously a lesser known treatment option.
I hope this idea might be of benefit to someone else.
Regards,
Dear Anon,
Thanks for that most useful tip on the value of Opsite in controlling your neuropathic pain. I look forward to mentioning it the column for the benefit of others.
Dear Dr Le Fanu
I have suffered from peripheral neuropathy for a number of years. I am 69. Initially it took the form of a deep “sparking” within my heel of other parts of my feet. At that stage I was advised to try the homeopathic tablet Aconite which, without doubt, reduced the pain. As the symptoms became more acute, however, (at night I would experience the feeling of a sparkler exploding under the toes of my foot) I was forced to seek medical help. My consultant, having tried all avenues to seek the cause (thyroid, diabetes, and many others have been rules out) decided that my condition was of unknown cause – as around 70% of cases are, I am told.
He prescribed Carbamazepine which has brought the condition under control in most circumstances. However, when the condition “flares up” I return to Aconite (2 X Aconite 30 every 2 hours or so) in addition to the medicine and the condition is generally brought under control.
I have never believed in homeopathic remedies but I am absolutely certain there is no placebo effect at play here. I hope this is helpful. Until recently there was a Neuropathy Trust which produced a very informative quarterly magazine but the Trust has now folded. They have promised to send all ex-members a copy of a book which is being produced with a number of useful articles on the subject.
Yours sincerely
Geoff R
Dear Geoff R,
Thanks for those interesting observations on the value of the homeopathic remedy Aconite in controlling your neuropathic pain. I will mention in the column shortly.
Sores Eyes – Monday 28/4/14
Re today’s letter on the above. If I read my 6.30am delivered Telegraph, sometimes in bed, after some 30 minutes or so my eyes become really sore, red and teary and it becomes impossible to continue to read. This doesn’t happen when reading a book this early in the morning, or the Telegraph later in the day. I have surmised the soreness is due to the chemical smell (vapour?) from the still dampish print that irritates my eyes. Certainly my fingers become dirtier reading the newspaper this early in the day rather than later. Just a thought !
D.J. G
Dear Mr G,
Thanks for being in touch. Several readers over the years have described a similar allergic response to reading the Telegraph. This can apparently be minimised by ironing it beforehand!
I was intrigued by your first item today for treatment of nerve sensitivity. I am 71, a non-smoker, acceptable BMI and in good health. Three months ago I had decompression surgery between L1/2 and L3/4, because I had begun to feel ‘heavy legged’, unable to easily get out of a chair or from a kneeling position, and then started to have numbness in my feet. Scans showed the vertebrae virtually sitting on top of each other.
This was all probably the consequence of a fusion in the lower spine 28 years ago putting pressure further up, and it was felt I had been quite lucky to get so far without further problems.
I am now well over the op, but continue to have a constant feeling of ‘defrosting’ in my feet, which spreads to my lower legs after standing and walking for even a short time. The really painful burning sensation which I was having at night shortly before the op has eased, but I am told the damaged nerves can take a long time to regenerate, months or even years. I still have to use my arms to get up from a chair. I have become a useless grandmother!
Meanwhile my doctor has prescribed Amitriptyline, 10mg at night, to try to enable me to walk more comfortably, which after two weeks seems to be having no effect. I realise it may take longer.
I was intrigued that it said it was for depression, but your article explains this. However, it also says to avoid alcohol which might soon make me depressed! I have experimented with an occasional glass and have no side effects but on a stronger dose it might do.
Do you have any suggestions, or would it be worth my while contacting the pain research unit at Oxford? My surgeon has more or less told me just to wait for as long as it takes, and should the nerves not come back feels there is nothing else he can do for me.
I am sorry this is rather long but am trying to put the full picture.
Yours in hope, Georgina C
Dear Georgina C,
Thanks for being in touch. I would have thought that your symptoms following the decompression operation should continue to improve gradually. In the meantime there is no reason to abstain from alcohol on that modest dose of Amitriptyline.
Dear Dr James
I am on a very low dose (50mg) of Levothyroxine for hypothyroidism – originally my thyroid was fast and by the time I was referred to an Endocrinologist it had swung to slow. The Dr I saw believed it was likely to be caused by a virus. I was weaned off the Levothyroxine successfully but my thyroid slowed again a couple of years ago, as I was warned might happen.
I am now experiencing symptoms (I’ve never had any before) where I have periods of being so extremely fatigued and exhausted I collapse at the top of the stairs and have to sleep all day: these episodes last 2-4 days and are becoming more frequent. I am also approximately 5kg heavier than my usual weight: I am hyper-aware of these because I am an olympic weightlifter competing at a National level and train 6 days a week and obviously compete in a weight category (63kg).
My GP tested my iron levels on my request when the episodes of exhaustion started to occur more often (last couple of months they have quickened considerably to being spaced approximately a fortnight apart) and these were normal. My last thyroid function test was in January so she has agreed to retest this but when I went for my blood test today I asked the nurses what specifically is being tested, they said just my TSH – surely if I am experiencing symptoms I need T4 and T3 levels as well at a minimum?
In addition, I have Ehlers-Danlos Type III and have just been diagnosed with Systemic Scleroderma and am struggling with gastrointestinal issues previously thought to be crohns but now believed to be SIBO (apparently common in both of these conditions; Ciprofloxacin taken for ear infections has effectively “cured” my gut issues for weeks at a time).
My questions are: should there be other tests/blood tests run to determine the cause of the severe fatigue and weight gain? (T4, T3, vitamin/mineral levels etc) and if my blood test for TSH comes back within normal ranges, am I justified in requesting to be referred to an endocrinologist?
These symptoms are severely impacting on my life and training; I have missed work and training on more than one occasion. I am otherwise (!) a very fit and healthy individual: non-smoker, non-drinker, very healthy diet, 30 year old woman.
Your advice and guidance would very much be appreciated,
Kind Regards
E B
Dear E B,
Thanks for being in touch and my sympathies for these various medical problems. This episodic exhaustion you describe is, I would presume, related to the recent diagnosis of Scleroderma and associated gut problems. I would not have thought that further tests of vitamin or mineral levels would reveal any other treatable underlying cause.
Dear Anon,
Please can anyone tell me why when i eat even a small amount of chocolate i start sneezing
Mrs Audrey J
Dear Mrs Audrey J,
You are obviously allergic to chocolate!
Joan H
Dear Dr Fanu
Regarding the eye problem being experienced by Mrs P B from Suffolk as reported in the Telegraph 28th April, perhaps she should be tested for Fuch’s corneal endothelial dystrophy, as my husband found, not all opticians seem to be able to recognise/diagnose it.
Sincerely
V D
Dear Mrs D,
Thanks for drawing attention to Fuch’s dystrophy as a possible explanation. I will mention this in the column next week.
Mrs PB of Suffolk and eye problem
Dear Doctor Le Fanu,
I experienced the same condition morning and evening for about a year before I was introduced to a solution by a GP.
I apply morning and evening Optrex Multi Action Eye Wash which can be bought in any chemist (Ł6.50approx) A small drop is poured into the eye bath (supplied) and applied with Iseree Soft Cotton Pads (59p for 120x from Lidl)which are folded in half, dipped into the eye bath. The lower eye lid is pulled down to apply the wet pad; the nose corner of the eye is also massaged with the wet eye pad. Repeat on the other eye with a freshly wet cotton pad.
After some weeks of doing this I find that I need now only do so once a day. I trust that this will be of some help.
Yours sincerely, Ken H
Dear Ken H,
Thanks for your contribution concerning Mrs PB’s eye symptoms and I will be mentioning it in the column shortly.
Dear Dr Lefanu,
Mrs PB
Mrs PB may be suffering from blepharitis. The glands at the base of the eyelashes become clogged and according to my optician the result is like looking through a greasy windscreen. I use Blephasol to help remove the clogging and at night I use Blephagel which helps stop the eyelids sticking together while asleep. Like Mrs PB I find that vision clears during the day.
I also suffer from mild cataracts and have been using drops that (allegedly) treat cataracts. I am not to sure whether they do or not, but I find they do help to get rid of the blurriness in the morning.
Dear Anon
See above.
Hello Dr Le Fanu
With regard to the lady who has difficulty in reading in the first hour after waking, the explanation is not primarily ocular as it is to much of a coincidence for a symptom such as this to affect both eyes simultaneously.
At this time she will become more longsighted owing to lowered blood glucose levels from the relative overnight fasting.
It would be prudent to investigate her glucose metabolism.
Yours sincerely
Mr A P, M.D., F.R.C.Ophth., (rtd).
Dear Mr A P.
Thanks for that observation that I will mention in the column next week.
Dear Dr Le Fanu,
I have heard that a person who is left handed (as I am) is perhaps the surviving infant of twins, the other having been
absorbed by the mother.
Next to your own recent piece in the Telegraph there is an article about a surviving twin. Is she left handed? Or is it too early to say?
Robin E
Dear Robin E,
Thanks for being in touch. Lefthandness is indeed commoner in twins (17%) than the general population (10%) but the single ‘survival’ theory as to why this should be so is scarcely convincing.
Dr Le Fanu"s online overall health clinic, Friday 2nd May 2014
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