Dr Le Fanu"s on-line wellness clinic, Friday 28th February 2014

It seems the hearing loss is permanent.

Dear Anon,

Thanks for being in touch and my sympathies for this serious, if rare, side effect of Erythromycin of which I must confess I was unaware. Your experience is a cautionary reminder of the potential hazards of even commonly prescribed drugs.

ALAMY

Dear Dr Le Fanu

I’m a widow of 80 years with severe back pain due to a very damaged spine, (scans).

My pain consultant is going to try more injections, but a new condition has been disturbing my sleep for the last week. It is only at night, when I have a continuous mild headache, back of the head. When I get up in the morning and move around it disappears. I’ve tried different number of pillows, warm or cold bed, nothing works. Could there be any connection between my other problem, irritable throat, which makes me sneeze and sometime gag? (My GP advised stopping Ramipril, but not enough time yet to see whether that works.)

At the moment he can’t suggest anything to help the headaches. Please Help!

Florence S

Dear Mrs S,

Thanks for your query. The location of these nocturnal headaches at the back of the skull would suggest they might be due to muscle spasm from pressure on the nerve of the neck which speculatively might be related to jarring of the vertebrae from the coughing and sneezing associated with the Ramipril. If so then a small dose (2mg) of the muscle relaxant Diazepam might be a useful preventive measure.

Dear Dr Le Fanu

Re your medical query in last Saturday’s Telegraph re Mr & Mrs HM from Bolton, I suffered with exactly those symptoms, plus a fear of being near large expanses of water, notably walking along the canal towpath. I suffered for over a year before going to my doctor. She promptly performed the Epley Manoeuvre, and I was fully recovered by the next morning.

Wikipedia describes it thus:

The Epley maneuver or repositioning maneuver is a maneuver used to treat benign paroxysmal positional vertigo (BPPV) of the posterior or anterior canals. Free floating particles from the affected semicircular canal are relocated, using gravity, back into the utricle, where they can no longer stimulate the cupula, therefore relieving the patient of bothersome vertigo.

And it is demonstrated on UTube via the following link:

http://www.youtube.com/watch?v=hq-IQWSrAtM

It will change their lives!

Best wishes

Trish M

Dear Trish M,

Thanks for being in touch and your personal experience of the benefits of the Epley Manoeuvre in countering your symptoms of vertigo. There has been a lot of correspondence on this matter which I will be summarising in the column of the 10th March.

REUTERS

Dr. Le Fanu,

I have two grandchildren (ages 11 and 8) who will visit Japan this coming summer for about 5 weeks. I am very concerned about radiation exposure data. Both the Abe government and Tepco have been caught at manipulating the data, so, finding accurate numbers has become problematic. I operate under the assumption that there is no safe level of exposure, even more so for children than adults. Yet, there are record levels of ionized hydrogen, cesium 134, 137, strontium 90 being released and now spread across the globe. Would you send children to that nation when there has been three core meltdowns, nearly three years of continual emissions and continuing dangers for an explosion at reactor #4? Would you allow your children/grandchildren to go?

Thanks for your time,

R J M

California, USA

Dear R J M,

Thanks for your query and I appreciate your concerns though I would not concur that there is ‘no safe level of exposure’ – as we are all exposed to background levels of natural radiation of around 2m/sev a year without it causing any harm. This, I gather, is on a par with the additional exposure of those in close proximity of Fukushima incident in 2011 but is well within the limit established for those in the radiation industry of 50m/sev a year. This is clearly reassuring and I would not have thought there is any reason why your grandchildren should not travel to Japan this summer.

In your last column there were three patients with what sounds very like Meniere Spectrum Disorder, a very common but widely misunderstood complaint. For a start, MSD is an otological disorder, not a neurological or psychiatric one. Thus the young woman with hearing problems and vertigo almost certainly had endolymphatic hydrops, a known otological side-effect from quinine-like drugs. While her facial numbness could have been of neurological origin, a quick check on Google confirms that this is also not uncommon among patients with Meniere’s disease. In the husband and wife with nausea and vertigo, either of these are of inner ear origin unless proven otherwise, and MSD is the likeliest diagnosis. Here vestibular function and balance fluctuate widely, probably as a result of a changing inner ear pressure, from dehydration for example. This lack of body and space stability can usually be compensated for by use of the eyes, except in the circumstances described where visual fixation is impossible — on cliff tops; descending a staircase with a central void; large cathedrals; and open spaces in general, which is likely to cause agoraphobia.

A G G

Dear A G G ,

Thanks for being in touch and drawing attention to Meniere Spectrum Disorder as a possible cause of vertigo. This, as you say, is an otological problem that is usually associated with other hearing related symptoms such as tinnitus or deafness. I will mention this in the column in the near future.

ALAMY

Hi doctor I hope you can help me I read in the telegraph a letter to you about the trouble a lady was having with taking lansoprazole tablets as I am having the same problem I wondered if the lady said what she was taking in place of them if not could you recommend another i’m 76 years of age thank you very much . Len H

Dear Len H,

Thanks for being in touch and it is interesting to learn that, like the lady featured in this column recently, your restless leg syndrome resolved after discontinuing Lansoprazole. I would advise that you take instead an acid neutralising medication such as Gaviscon.

I am 71 and eighteen years ago I was diagnosed with eczema on my lower legs. This was never a great problem, controlled by diprobase and betnovate, until last 0ctober when it spread all over my body almost driving me crazy with constant itching, especially at night, when excessive scratching caused cellulitis. No treatment, including steroids and antibiotics, has made the slightest difference to the eczema and the various creams only give a very temporary relief. An appointment with a dermatologist takes. Four months though my g.p. is trying to hasten things. No one seems to have any idea what has caused this sudden flare up nor what can effectively relieve the symptoms let alone cure it. Any ideas? R.G.M

Dear R G M,

Thanks for being in touch and my sympathies for this sudden severe exacerbation of your eczema. There are, as you will know, several recognised trigger factors such as infection, a viral illness and stress – but given that for most the underlying cause of eczema is not known the same probably applies to the fluctuations in its severity. I am sure the skin specialist can advise further but in the meantime you might discuss with your doctor taking a low dose of oral steroids to bring it under control.

ALAMY

Dear Dr. James, I have been meaning to write to you for years but have only now got round to doing so. I was first prescribed anti-depressants forty-four years ago for a chronic depressive illness and noticed some unusual side effects with different types of antidepressant drugs. They all made me thirsty and some produced unusual sexual effects: Clomipramine prevented me from ejaculating-an effect that is put to useful effect in its being prescribed for young men with premature ejaculation problems, I understand. Mianserin markedly enhanced the intensity of sexual orgasm when I was on this drug and this interesting side-effect occurred even when I was prescribed low doses of 20mg per day. More recently I have been prescribed Dosulepin at 150 mg per day and this produces considerably delayed orgasm. I think the most interesting side-effect was that of Mianserin and I wonder whether this has any useful role in treating sexual dysfunction. I never drew any of these side-effects to the attention of my GP as I had other things on my mind-my illness. Jeffrey J

Dear Jeffrey J,

Thanks for being in touch and your fascinating personal account of the diverse effects of antidepressant drugs on your sex life. The value of drugs such as Clomipramine for those with premature ejaculation is well recognised but I had not previously come across the orgasm intensifying effect of Mianserin – which I gather has been used to counter the reduced libido associated with SSRIs (see D Aizenberg, Clinical Neuropharmacology 1997 vol 20 pp 210 – 4).

Dear Dr Le Fanu,

I have been very interested to read in your column of others who have facial paralysis hearing problems and one eye closing when one is looking down – there must be a lot of us about! Mine arrived suddenly just over three years ago and was diagnosed as Ramsay Hunt Syndrome. Whilst I am lots better it is the synkinesis which makes my eye flutter. I seem to be winking when I talk, especially when I get animated, which I feel is the most tiresome. I had physiotherapy with the Lindens Clinic in Sale for some time.

My balance is not very good either, which I attribute to the lack of nerve activity in my left ear. Do you have any recommendations or helpful advice to offer? I would love to feel like myself again.

Yours hopefully,

Jillian C

Dear Jillian C,

Thanks for being in touch and it is good to hear that those unusual symptoms you describe seem to be improving. This winking while talking must be most disconcerting for yourself and others. As for the balance problems, several hospitals (such as St Thomas’ in London, Addenbrooke’s in Cambridge) now run special clinics offering ‘vestibular rehabilitation’ for those with chronic vertigo and it might be worthwhile discussing with your doctor whether a referral might be appropriate.

Dear Dr James

I hope you can help me with a very distressing problem that has cropped up about 5-6 years back. Every few months I suddenly wake in the night and find I have voided my bladder. It is so random and I have not been able to find a trigger. I have very good bladder control at all other times, no leakage nothing. I am 63 years old, active, slim, had a hysterectomy around 16 years back. I was told that following the menopause one can get low grade urinary tract infections, and if I feel at all like I might be getting one ( any change in frequency, odour) I take cranberry concentrate for a few days.

This problem is causing me such distress that I am worried to go on holiday, to stay with friends and almost to fall asleep! Please suggest something to help?

Thank you.

Kind regards

S V

Dear S V,

Thanks for being in touch. The random episodic nature of your nocturnal enuresis, as it known, without any other urinary symptoms would suggest this is likely to be due to spontaneous contraction of the detrusor muscle that empties the bladder. This is probably related to the altered state of consciousness and brain activity when asleep. It is, for example, of interest that enuresis is also a feature of epileptic attacks and may be a side effect of some psychiatric drugs. The fact that this occurs only every few months would rule out any preventive drug treatment – and the only option would seem to be to wear some sort of waterproof pants when visiting friends or on holiday.

Your correspondent Carol G might be interested in the (rather ancient) Dr. Hay diet, which actually enabled me to give up Omeprazole for my constant reflux problems.

Since the problems of acidity and reflux are a constant in your columns, may I also warn nut eaters of my own experience: following an attempt to peel some almonds by boiling them briefly, the whole house became permeated with the smell of bleach – thus identifying yet another cause of acid reflux! Since raw cashew nuts had a similar effect, I assume that some sort of acid bath is used to ensure there is no fungal/bacterial growth before packing. I now only buy nuts in their shells.

Kind regards (and keep up the good work!)

Dear Anon,

Thanks for being in touch and it is interesting, as several readers have observed over the years, that The Hay Diet has cured your reflux problems. Thanks too for the nut warning!

Please, please help! We are desperate! Eight months after lithotripsy for a 7 mm kidney stone my daughter (32) is still in severe pain, for which she is taking large amounts of temgesic and diclofenac prescribed by her GP.

All investigations by the kidney consultant – ct scans, blood tests for infection, etc. have proved negative, and no other cause has been suggested: could it be nerve damage, and if so, what can be done? We wonder if you, or your readers have any suggestions.

Thanks for taking the time to read this and hope you can help.

Dear Anon,

Thanks for your query. I am not sure when you say your daughter is ‘still’ in severe pain whether this is the same or a different pain from that associated with the kidney stone. If it is the same this would suggest that the original diagnosis attributing the pain to the kidney stone must have been in error – now that the stone is no longer present. There is, for example, a condition known as Loin pain/Haematuria Syndrome that can cause the symptoms of severe pain and bleeding similar to those caused by a kidney stone. If, on the other hand, the pain is different then this might suggest the Lithotripsy procedure itself might be responsible, by for example causing soft tissue damage to the kidney or other organs in close proximity such as the pancreas. I hope these comments are helpful.

Dear Dr Le Fanu

I would like to say how grateful my daughter and I are to your readers for the many kind and helpful replies to my letter to the online health clinic of 17 Jan 2014. Also thank you for featuring the letter (wrongly attributed, I think, to Mrs S D of York) in your column of 10 February. We will be investigating some of the suggestions made and will let you know the outcome when we have any news.

Thank you again

Barbara S

Dear Barbara S,

Thanks for being in touch again. I would be more than interested to hear the outcome of investigating the various suggestions made by readers.

Dear Sir,

I am recently experiencing cold numbness to right hand side of face and in right arm, it is as though the dentist has given me a minor injection to carry out a filling.

On Friday went to Neville Hall Hospital Abergavenny, had a head scan, throat scan (TIA) and everything appeared to be normal. 9 blood tests taken, all ok, except still waiting on the cholesterol result to come back. Brilliant service.

Have been put onto Aspirin and Statins would rather not be dependant on either. The cold experience seems to last a few minutes to 10 minutes.

The only “big” change in my lifestyle, is that I decided in mid January not to drink anymore at home, used to have a few glasses of wine most evenings, (cost and to lose weight), only drink now, when out socially, not to open up a bottle when I get home, to continue the partying. The first experience was, I had a steroid injection in my knee for a cartilage pain, then had the face numbness in the evening may not be connected in any way, although at the time of injection my blood pressure was extremely high.

I do keep fit and next Saturday have booked to go skiing, it was mentioned that they would prefer me to drive rather than fly? The flight is a very short one Bristol to Geneva at a low altitude, but of course skiing will be at high altitude. Any suggestions, or other avenues help or advice would be much appreciated.

Bye for now Patricia W

Dear Patricia W,

Thanks for being in touch. This numbness in the face and arm would certainly fit with a TIA or stroke – so it is reassuring (if a bit surprising) that the various tests and brain scans have all been reported as normal,. This pattern of symptoms can sometimes be due to migraine but beyond that it is difficult to know what might be responsible I would not have thought that either your changing drinking habits or the knee injection are implicated. It would certainly be sensible to be cautious about flying until this is sorted out.

Good afternoon, Doctor

In 2011 I experienced a sudden total deafness in my left ear

The condition was explored extensively after the usual suspects were eliminated

Eventually, from extensive blood tests, it was established that I had a gene mutation affecting the MTHFR gene, resulting in an excess of Homocysteine (HC) in my bloodstream. This was diagnosed to be the cause of a mini stroke on the nerves taking sound signals to the brain

Folic Acid and Aspirin were prescribed, but after four months the (HC) level had risen further to 16.

The consultant recommended a change to Megafolinic Acid from folic acid but this did nothing to the HC level.

My wife searched the Internet for any information related to the problem and uncovered a report by The Life Extension Foundation in the USA which recommended high levels of Tri Methyl Glycine (TMG) to counteract the HC level

This report was also insistent that the HC level should be below 7 whereas our local Path laboratory is saying that 5 to 15 is “normal”

The Life Extension Foundation report also insists that anything above 7 significantly increases the risk of heart attack and strokes

For three months I took 4.5 grammes of TMG and my HC level fell to 8. I then reduced the TMG to 0.5 g (a suggested ‘maintenance dose’) and my most recent HC reading is 10

Should I be happy to keep my HC level below 15 or should I be aiming for below 7?

Is The Life Extension Foundation a respected authority or just another pseudo-scientific commercial organisation?

Finally I would add that while seeking a local supplier of TMG, our Health Food Shop commented that we (Britain) were way behind the Americans on this topic – which itself gave me cause for concern

Should you require more info I would be very happy to provide a copy of my Consultant’s letters together with a copy of the Life Extension Foundation report

I would be grateful for your thoughts on this matter

Regards

Ian B

Dear Ian B,

Thanks for being in touch. There is, it would appear, an increased risk of stroke and circulatory disorders in those with an elevated level of homocysteine- where any reading above 13 is considered to be ‘raised’ But the benefits of lowering it to within the normal range appears equivocal. I am sure you are best guided by the advice of your specialist about this. There is a most useful summary of the condition by Elizabeth Varga ‘Homocysteine and MTHFR mutations’( Circulation 2005 vol 111 pp 289-293) that can be downloaded from the internet.

Dr Le Fanu"s on-line wellness clinic, Friday 28th February 2014

Right now in healthcare: Friday 28 February

Good morning and welcome to the daily blog from the Guardian’s local community for healthcare professionals, giving a roundup of the important news stories across the sector.

If there’s a story, report or event you’d like to highlight – or you would like to share your thoughts on any of the healthcare concerns in the news nowadays – you can get in touch by leaving a comment below the line or tweeting us at @GdnHealthcare.

The Guardian reviews that up to 240 prosecutions a yr alleging wilful neglect or sick-treatment of patients could take area below a new criminal offence to be launched in England following the Mid Staffordshire hospital scandal. James Meikle reviews:

People could face up to five many years imprisonment and/or £5,000 in fines, says a consultation paper and impact assessment on proposed new legislation. The organisations that use them could encounter far stiffer monetary penalties.

Such a law would act as a deterrent and match penalties that previously exist for these who unwell-treat people with out mental capacity, says the Department of Well being.

There’s also information that the health secretary, Jeremy Hunt, has pledged considerably more rapidly diagnosis occasions for folks with suspected dementia.

Today’s other healthcare headlines:

• Guardian: NHS ombudsman delivers scathing verdict on Furness hospital believe in

• Nursing Occasions: Third of NHS workers have noticed patient security ‘near miss’

• HSJ: NHS England’s HR director to depart

• Telegraph: Minister launches evaluation of harmful new ‘legal high’

Writing for the network right now, Mohammad Al’Ubaydli, chief executive and founder of Sufferers Know Best, says individuals need to have control more than their personal data if care.information is to perform. He writes:

The case the government helps make for care.data, that permitting health care researchers entry to patient data will end result in new cures, is a difficult one particular to oppose. If the case were so easy then most folks, which includes me, would welcome it.

The question that the care.data hard work brings to light is a simple one particular – why has the NHS moved so speedily to give patient medical records to third events and so slowly to provide information to the patient themselves? For me, this is totally the wrong way round.

In an examination piece for GP on the internet, Graham Clews asks: What following for care.information?

We’ve a live discussion from noon today on the position of technology in integrating health and social care. Publish a question for our panel now or join the debate as is transpires.

Elsewhere, Jennifer Dixon writes for the Overall health Basis weblog on the NHS funding challenge and Candace Imison asks on the King’s Fund site whether hospital chains are a recipe for success and the Economist has a piece on what other countries are copying from the NHS.

That is all for these days, we’ll be back on Monday reporting dwell from NHS Expo in Manchester. And really do not overlook, there is nonetheless time to consider part in our newest health experts survey – share your views on how your functioning lifestyle has altered more than the final year.

Right now in healthcare: Friday 28 February

Right now in healthcare: Thursday 27 February

Good morning and welcome to the day-to-day blog from the Guardian’s neighborhood for healthcare professionals, giving a roundup of the essential information stories across the sector.

If there’s a story, report or event you’d like to highlight – or you would like to share your thoughts on any of the healthcare problems in the news right now – you can get in touch by leaving a comment under the line or tweeting us at @GdnHealthcare.

Health reporter Denis Campbell writes for the Guardian that mothers and fathers ‘spend hundreds of lbs a week’ to go to babies in neonatal care.

And, following on from Jeremy Hunt’s announcement yesterday, the Telegraph reports that Mid Staffordshire hospital trust, in which up to one,200 a lot more individuals died than would be anticipated, is to be dissolved.

Other healthcare stories:

• BBC: Will eldercare be as frequent as childcare?

• Guardian: Youngsters of older men at greater chance of mental sickness, study suggests

• Guardian: Nearly 11,000 admissions to hospital for obesity recorded in 2012-13

• HSJ: Dismay above moratorium on psychological health commissioning

On the network nowadays, journalist Vivien Goldsmith has written a piece explaining how NHS Modify Day became the largest movement in the well being service’s history.

And, Guardian columnist Jackie Ashley has written for Comment is free saying that folks power can alter the NHS from inside. She writes:

… whilst it’s simple to mock some of the 217,000 public pledges produced so far: to “communicate in a a lot more trustworthy and compassionate way” or to greater control a patient’s hospital discharge or to work to combat patients’ suicidal thoughts in the aggregate they include up to the distinction amongst a popular NHS and an unpopular, as a result politically vulnerable NHS.

As the motion itself puts it, “No matter how big or little the pledges have been – from a clinician making an attempt a child’s medicine to understand how it tasted, to a receptionist promising to smile a lot more, they gave us all a focus and reinforced our belief in the values of the NHS.”

But the second issue we need to recognize is that this is genuinely a bottom-up movement, and a massive component of its goal is to challenge petty authority. It has already empowered and liberated a lot of NHS personnel, encouraging them to speak out publicly, utilizing Twitter and other social media to express themselves.

Healthcare commentator Roy Lilley has written about NHS culture. He writes:

3 strands of NHS existence 3 cultures. We only require look up to see in which alter is needed initial and seem down to see the place it is necessary most. The newest staff survey final results are horrific virtually a third of personnel wouldn’t be content for their relatives to be handled in which they function.

It is not possible to collapse these cultures into one. They are different worlds with diverse languages. The trick to modifying this is to generate an overarching, enveloping climate of protection and secure haven where individuals can join in a single objective. That would change the culture from a world where performance is pursued by aggressive fanatics, to a planet that is graceful, thoughtful and due to the fact of it… delivers with out a functionality.

Only then does the the NHS discover its only business is to be in the peace of mind business.

And, the Conversation has a piece by David Springate, a biostatistician at the University of Manchester, that says overall health database, Care.information, could help keep away from an additional pharma scandal.

Systems need to be place in location to properly monitor users of this data and tougher penalties need to be introduced if the principles are breached. But patients are getting harmed every single day because of a lack of information sharing that could detect harmful side results and drug reactions that would never be picked up by clinical trials. It is genuinely this that we ought to all be doing work towards.

That is all for nowadays, we’ll be back tomorrow with our digest of the day’s healthcare information.

Right now in healthcare: Thursday 27 February

Today in healthcare: Wednesday 26 February

Good morning and welcome to the day-to-day site from the Guardian’s neighborhood for healthcare pros, offering a roundup of the important news stories across the sector.

If there’s a story, report or occasion you’d like to highlight – or you would like to share your thoughts on any of the healthcare issues in the news today – you can get in touch by leaving a comment below the line or tweeting us at @GdnHealthcare.

A selection is due right now on whether or not the Mid Staffordshire NHS basis believe in must be dissolved, reports the Guardian. The Press Association story says Jeremy Hunt, the wellness secretary, has the final say on programs to dissolve the trust and move important providers to neighbouring hospitals.

There’s also information of research findings that nursing cutbacks are right linked to larger patient death prices in hospitals.

And a essential report by the Commons health pick committee says Public Overall health England is failing in its process and is far as well near to the government

Today’s other healthcare stories:

• Telegraph: Atos awarded contract for NHS data

• Guardian: MPs’ anger at missing information on who has patient records

• eHealth Insider: ‘Exciting’ care.data data strategy promised

• BBC: ‘Wake-up call’ on domestic violence

• Independent: Teenage pregnancies in England and Wales are at the lowest level given that information began

• GP on the web: Lack of cancer expertise hazards setting back care by a decade, CCGs informed

• Pulse: GPC holds NHS England to ransom more than premises payments

Writing for the network, Sue Ward, head of enterprise growth and marketplace at Central and North West London NHS foundation believe in, calls for reform of the tendering approach. She writes:

Above the many years there has been much speak about improving the bid process although retaining robust governance and intelligent commissioning. Even so, talk has not translated into alter and charges carry on to rise year on year. Now should absolutely be the time to get decisive and urgent action to streamline the approach and conserve the NHS hundreds of thousands of pounds.

Esther Addley’s politics sketch covers the postponement of the care.data undertaking, although a Guardian editorial says what should be an extraordinary asset to patient care and to the United kingdom science base may possibly have been misplaced for the foreseeable long term.

Elsewhere, Jonathan Hammond, a PhD candidate at the University of Manchester, says the care.data undertaking has not got off to a very good start off. Writing for the Conversation web site, he adds:

There is clear cross party assistance for care.data in principle, which is encouraging offered the prospective advantages of a database of this variety. Utilizing the information of the NHS patient body to enhance healthcare is a laudable perfect that is done a disservice by the impression of liberties taken and assumptions created about the use of our personalized health-related data.

The reality that NHS England only circulated a leaflet created to inform absolutely everyone about the scheme right after an purchase from the Info Commissioners Workplace is a case in point. Guardianship of our well being information is a huge privilege – and the particulars of care.data, and the manner in which they are communicated to the public, should reflect the magnitude of it.

Andy McKeown seems to be ahead to following week’s Nuffield annual Wellness Policy Summit next week, and says it will give an indication of parties’ NHS policies ahead of next year’s standard election, although he predicts:

One can not help considering that the election concern will be ‘the economy stupid’ and regardless of whether we are all beginning to truly feel much better off. Overall health will probably be beneath immigration in the public’s pecking order.

But there is a vital situation that all events want to tackle. How are we going to make sure that wellness and social care are adequately funded more than the next 5 to 10 many years?

David Buck writes for the King’s Fund on health inequalities, calling for a national conversation and George Eaton, for the New Statesman, seems to be at Labour’s plan to “declutter” public companies.

That is all for today, we’ll be back tomorrow with our digest of the day’s healthcare news.

Today in healthcare: Wednesday 26 February

Today in healthcare: Tuesday 25 February

Good morning and welcome to the day-to-day website from the Guardian’s community for healthcare specialists, providing a roundup of the key news stories across the sector.

If there is a story, report or event you’d like to highlight – or you would like to share your ideas on any of the healthcare issues in the news nowadays – you can get in touch by leaving a comment beneath the line or tweeting us at @GdnHealthcare.

The Guardian reviews that a company doing work to entry NHS prescription data on behalf of pharmaceutical firms attempted to indicator a gentlemen’s agreement final year for entry to the new central database of health care information on each patient in England.

There’s also information of a warning by the World Overall health Organisation that getting overweight is in danger of becoming the new norm for youngsters as nicely as grownups in Europe as it issued figures displaying that up to a third of eleven-12 months-olds across the area are as well hefty.

Today’s other healthcare headlines:

• BBC: NHS death costs ‘should be ignored’

• Telegraph: NHS health-related information database could assist prevent condition, senior medical doctors say

• eHealth Insider: Care.data ought to be opt-in – Jarman

• Nursing Instances: Shortage of Belfast nurses sparks emergency summit with minister

• HSJ: Foundation trusts overspend on company staff

• GP on the web: Flu vaccine campaign set for growth in September

Chris Hopson, chief executive of the Foundation Believe in Network these days on parity of esteem for psychological overall health, calling for it to become “a truth rather than a fig leaf”. He writes:

… mental well being treatment performs, it’s cost efficient, and it even saves the NHS and the exchequer cash. It is also important that we seem after the critically psychological unwell, properly to handle the danger to the two wider society and people who have mental well being troubles.

But the most scandalous statistic of all is that only 26% of adults with psychological illness receive care, in contrast, for illustration, with 92% of men and women with diabetes.

Creating for the Guardian’s new cities task, Leo Benedictus explains why urban residing can be negative for your mental health and Patrick Strudwick, for Comment is free of charge, says we cannot leave mentally unwell men and women at the mercy of unregulated therapists.

Hazel Davis reviews for the network on Born in Bradford, a task examine set up as a longitudinal research of 13,500 youngsters born in the city, which is assisting to shape NHS solutions. Davis explains:

So far the data has resulted in a number of modifications in the NHS in the city, such as the introduction of universal testing for gestational diabetes, growing detection and treatment method from 2% to 7% and program vitamin D dietary supplements in antenatal care. The Content (Wholesome and Energetic Parenting Programme For Early Many years) teaches women how to reduce their BMI and make sure their kids are growing up with healthy diet plans. The programme, which is in pilot phase, consists of group sessions just before and following birth, led by early years workers.

Ideas for the Bib data utilization “on the ground” are immense and dependent on a lot more funding. The team hopes to do much more lectures (the two in schools and for the Bib participants) and integrate some of the data into the college curriculum.

Born in Bradford was launched in 2007 to find out why the city’s infant mortality rate is twice the British common.

Elsewhere, contributor Dr Chris Lancelot writes for GP online calling for key modifications to the care.data project. NHS England, he says, “seems to have no insight into the mess that it alone has created”, and he adds:

If NHS England thinks that among now and October all it needs is a slicker PR campaign, then it is sorely mistaken. With out massive changes to the way care.data is structured and organised, by the autumn the opposition to it will have grown exponentially right up until the complete country knows the true truth — and by then the huge bulk will have opted out, possibly permanently, from any NHS data-sharing agreement of any type.

So I have a clear and basic message to NHS England: unless of course you pay attention to what the public is saying, and make major alterations to the programme, care.information is dead in the water.

That is all for right now, we’ll be back tomorrow with our digest of the day’s healthcare news.

Today in healthcare: Tuesday 25 February

Right now in healthcare: Monday 24 February

Excellent morning and welcome back to the day-to-day website from the Guardian’s community for healthcare experts, offering a roundup of the important news stories across the sector. In case you missed it, here’s our digest of final week’s prime healthcare stories.

If there’s a story, report or event you’d like to highlight – or you would like to share your ideas on any of the healthcare issues in the information nowadays – you can get in touch by leaving a comment under the line or tweeting us at @GdnHealthcare.

The Guardian reviews on a warning that sufferers will fail to get a GP appointment when they are unwell on more than 34m occasions in England this 12 months due to the fact funding cuts are affecting companies. The Royal University of GPs says practices are getting brought to their knees by an unprecedented fall in funds for healthcare in the community and increasing demand for their companies. The college’s chairman, Dr Maureen Baker, explained:

GPs and practice nurses can not maintain undertaking much more for significantly less and now that funding for standard practice in England has slumped to just eight.5% of the NHS price range the support we give is in crisis.

All three political parties say they want to see much more individuals currently being treated in the local community, the place care can be supplied to sufferers far more economically, in their own surroundings, and but assets are increasingly getting diverted away from communities and into hospitals.

By continually diverting resources into hospitals, we have fuelled a real and increasing crisis in common practice.

Elsewhere, the Telegraph says the healthcare records of every single NHS hospital patient in the country have been offered for insurance purposes.

A lot more healthcare information:

• Nursing Times: Employers moot move to ‘living wage’ shell out strategy

• GP online: CCGs push for NHS England collaboration to decommission underperforming GPs

• eHealth Insider: Birmingham invests £7m in e-prescribing

A review by watchdog Monitor found the quantity of NHS foundation trusts in England in financial problems has virtually doubled in a 12 months from 21 to 39, the Guardian reported.

In other information:

• Independent: Drinking alcohol even though pregnant could grow to be a crime

• Telegraph: Worst hospitals price NHS £300m

• Independent: 1000′s of HIV individuals go hungry as benefit cuts hit

• BBC: Councils want social networks to introduce Neknominate warnings

The BMA has compiled a guide to what’s occurring in Westminster this week, like a well being committee session on the care.information project.

That is all for these days, we’ll be back tomorrow with our digest of the day’s healthcare information.

Right now in healthcare: Monday 24 February

This week in healthcare: Monday 17 - Friday 21 February

The NHS has admitted that patient confidentiality could be undermined by the new healthcare records database. Photograph: Phil Mccarten/Reuters

Our live website is on hold this week, so here’s a summary of what’s been occurring across the healthcare sector this week.

The ongoing care.data saga continued to hit the headlines. The Telegraph reported that the NHS’s very own danger evaluation warned patient confidentiality could be undermined by the new healthcare data database. The database could be vulnerable to hackers or could be utilised to determine patients “maliciously”.

Nick Triggle, the BBC’s health correspondant, wrote a piece asking how care.data could go so incorrect? He wrote:

The idea with Care.information is to expand this database to incorporate what transpires to individuals when they are underneath the care of GPs.

The belief is this could support researchers create new remedies and improve the monitoring of overall performance.

But most would argue none of this was communicated by NHS England.

And the Telegraph ran an editorial about data issues in the NHS.

The sheer size of the undertaking, even so, has provided numerous pause for imagined – not least due to the state’s longstanding inability to keep the data that it collects safe, from the reduction of 25 million child benefit information in 2007 through to a catalogue of smaller sized-scale incidents. This is especially worrying since the scheme’s ensures of anonymity have proved inadequate for critics, who have argued (convincingly) that it will still be reasonably simple for customers of the database to recognize person patients.

Meanwhile, in response to the news last week that former Marks &amp Spencer chief executive Sir Stuart Rose is to advise well being secretary Jeremy Hunt on how to develop up a new generation of managers to transform failing hospitals, Chris Ham, chief executive of the King’s Fund, wrote about what the NHS can learn from the department keep. He lists three insights he acquired from going to Marks &amp Spencer 25 many years ago and explains how they are even now pertinent to the NHS these days.

The Guardian, meanwhile, exposed that a King’s Fund report stated that GP practices need to commence doing work together in federations and delivering far a lot more solutions in a restructuring of healthcare that is vital to hold the NHS sustainable. In one more blogpost for the King’s Fund, Ham wrote about producing general practice match for the long term. He concludes:

The registered checklist of sufferers means that practices are uniquely properly positioned to take the lead in establishing revolutionary versions of care underneath the proposed approach. But if they are unable or unwilling to do so, then NHS trusts offering neighborhood providers and acute companies should be offered the chance of taking the lead, preferably in partnership with practices. At a time when the want for innovation in the NHS has never ever been higher, encouraging a range of approaches to be examined and evaluated has apparent points of interest, not least in unfreezing techniques of doing work that appear increasingly anachronistic.

The Guardian also ran a story saying that a funding adjust could force rural GP practices to near. Massive areas of rural England could be left with no any GP services for local residents as a consequence of cuts in national funding.

Journalist Mary O’Hara wrote a piece for Comment is cost-free explaining why we require the online presence of MentalHealthCop whose Twitter account and award-winning weblog was suspended by West Midlands police. She explained that psychological sickness and policing is an very sensitive location, and social media can play a constructive part.

The Telegraph unveiled that physicians are becoming paid as considerably as £3,000 per shift by NHS hospitals to fill “endemic” personnel shortages in Accident &amp Emergency units. In an editorial, the paper wrote that higher wages for locum medical doctors and bad determination-making in hospitals could be costing lives.

The good news is that there is a expanding push for transparency in the NHS. For instance, the Government is working to release league tables of performance that ought to not only highlight failures, but also motivate study of ideal practice. The health services wants to search at itself truthfully and rigorously. It can not continue to fall back on comforting myths about it being “the envy of the planet”. Failure to get issues appropriate – to keep adequate amounts of staffing and to control that personnel nicely – can be a matter of life and death.

Here is a quick run by way of some of the leading stories from elsewhere this week:

• BBC: Romanian medical professionals tempted abroad by a far better lifestyle
• BBC: Ambulance ‘postcode lottery could price two,500 lives a year’
• The Guardian: Use of police cells in the course of psychological health crises to be halved
• The Telegraph: Bristol Children’s Hospital ‘still in denial’ about deaths, say parents
• HSJ (subscription): Employers chief moots end to spend restraint
• HSJ: Three groups set to join in initial CCG merger

And right here are the best five stories on the network:

• ‘More sources to the frontline’ slogan damages the NHS
• Struggle to recruit managers will include to cycle of failure in the NHS
• Could bedside TVs be utilised to give patients access to medical records?
• Could stroppy sufferers be the dynamo behind the future NHS?
• Potential of the health service: the era of neighborhood care has arrived

This week in healthcare: Monday 17 - Friday 21 February

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

Right now in healthcare: Friday 14 February

Great morning and welcome to the everyday weblog from the Guardian’s community for healthcare professionals, giving a roundup of the essential information stories across the sector.

If there is a story, report or occasion you’d like to highlight – or you would like to share your thoughts on any of the healthcare troubles in the information right now – you can get in touch by leaving a comment below the line or tweeting us at @GdnHealthcare.

The Guardian reports that the amount of people waiting for NHS hospital remedy has risen by much more than 300,000 below the coalition, amid concern that NHS rationing is forcing patients to wait longer for operations. NHS data exhibits that two.88 million men and women in England had been waiting for consultant-led therapy in December 2013, up by 310,000 or twelve% on May possibly 2010. Katherine Murphy, chief executive of the Patients Association, mentioned:

It’s worrying that the amount of extra folks waiting is that higher. That 310,000 is a enormous amount of individuals who are waiting for what is quite usually existence-modifying surgery

There’s also information that Sir Stuart Rose, who was credited with rejuvenating Marks &amp Spencer in the course of a turbulent 6 years as chief executive, has been employed to assist revive the fortunes of failing hospitals in England. Chief political correspondent Nicholas Watt reviews:

In a move dubbed in Whitehall as “M&ampS meets NHS“, Rose will advise the health secretary Jeremy Hunt on how to create up a new generation of managers to transform failing hospitals. There will be a distinct focus on the 14 NHS trusts placed in “special measures” last yr.

Hunt will also announce that Sir David Dalton, the chief executive of the Salford Royal NHS Foundation, is to advise him on how effective trusts can take charge of failing hospitals. This will be modelled on Michael Gove’s “superheads” programme, in which profitable headteachers take in excess of failing schools, and follows the introduction of Ofsted-fashion inspections for hospitals.

Roy Lilley tweets in response to the information:

In other information nowadays:

• Nursing Instances: Try to introduce law on minimal staffing amounts

• GP on-line: GPs encounter delay above IT deal

• Pulse: Stopping smoking ‘as successful as antidepressants’ at strengthening mood

• Telegraph: Men are thirty per cent more likely than females to die from cancer

• HSJ: Spend outstanding managers much more than PM, says Hunt

• eHealth Insider: 220 applications to Nursing Tech Fund

Dr Maureen Baker, the chair of the Royal University of GPs, will be taking component in a Twitter chat between one and 2pm to go over the College’s campaign Put patients initial: Back general practice. You can follow it through the hashtag #putpatientsfirst.

And patients are getting encouraged to join the NHS Change Day motion. Members of the public are becoming motivate to either thank a member of NHS personnel, join 1 of 3 public pledges, or share their personal suggestions for personnel pledges.

On the network today, Scott Greer, a senior visiting fellow of LSE Health, asks who runs the NHS in England. He writes:

Margaret Thatcher’s governments developed the NHS management executive and even moved it to Leeds in another try to distance the operating of the well being service from politics, a technique that ended in failure as the management executive was abolished and energy taken back into the DH in which New Labour ministers could much better assert their manage. Why? As
Jeremy Hunt is discovering out, voters and the media will usually direct their anger at the politicians rather than the bureaucrats if A&ampE companies fail to provide in the middle of winter, no matter what is written down in a mandate. And, as the current confusion reveals, this present division of roles and responsibilities is unlikely to continue to be steady for extremely long.

But what the existing reforms have also completed is to develop new sources of power inside of the technique, partly due to the dispersal of power away from ministers to NHS England and regulators such as Monitor and the CQC, but also due to the fact of the personalities and backgrounds of those in charge.

Nigel Edwards has blogged for the King’s Fund on transforming local community solutions. Many years of initiatives, policy suggestions and fads have left a legacy of highly complicated, narrowly targeted and frequently poorly co-ordinated services, he writes, producing the system hard to understand and navigate.

Writing for Comment is free, Ranjana Srivastava calls for mammograms to be utilized with more care although Daniel Hannan says drug laws are not functioning in a piece for the Telegraph.

That’s all for right now. The website will consider a break up coming week and return on Monday 24 Feburary.

Right now in healthcare: Friday 14 February

Today in healthcare: Thursday 13 February

Excellent morning and welcome to the everyday website from the Guardian’s local community for healthcare pros, supplying a roundup of the crucial information stories across the sector.

If there is a story, report or occasion you’d like to highlight – or you would like to share your thoughts on any of the healthcare troubles in the news nowadays – you can get in touch by leaving a comment under the line or tweeting us at @GdnHealthcare.

The Guardian these days reviews a warning by GP leaders of a “crisis of public confidence” in an NHS scheme set up to share specifics from people’s health-related information.

RCGP honorary secretary Professor Nigel Mathers explained:

We urgently need to have a renewed national push by the authorities to guarantee that patients are totally informed, in clear terms, about the benefits of the scheme, what their rights are, and what their rights to opt out are.

There is also information of Alder Hey children’s hospital failing 4 in 5 standards checks.

Today’s other healthcare headlines:

• Guardian: Signs of lung disease frequently ignored, study finds

• BBC: South Wales wellness boards think about specialist care shake-up

• HSJ: £10m of Healthwatch income ‘goes missing’

• Telegraph: New breast cancer drug ‘huge step forward’

• Independent: £1bn could be saved by NHS in excess of next decade if medical doctors diagnosed continual lung diseases earlier

• Nursing Occasions: Understanding disability nurses threaten to strike

• Pulse: CQC inspections will lead to ‘deluge’ of premise claims, says NHS England director

On the network nowadays SA Mathieson examines how the NHS workforce has transformed considering that the coalition took energy. Mathieson reviews:

What has altered significantly is the combine of workers. The quantity of physicians employed by NHS trusts rose by six.9% above the four many years to last October, to 105,056. Within this group, the variety of consultants rose virtually twice as quick, up 13.two% to 40,709. Numbers of competent ambulance and technical employees rose somewhat. Meanwhile, nursing numbers initially fell, leading to criticism from Labour leader Ed Miliband. But numbers have since recovered to 310,924, up 994 (.3%) over the 4 many years, with clinical assistance workers following a similar pattern.

But there have been massive NHS work cuts in 1 region: infrastructure help employees, down ten.two% more than the period. Within this group, the folks suffering the largest cuts have been non-senior managers, down 18.5% to 24,349, and senior managers, down 22.one% to ten,197. Numerous left as the outcome of the government’s phasing out of primary care trusts and strategic well being authorities, finished last April.

Writng for our sister Voluntary Sector Network, Ali Stunt, chief executive of the charity Pancreatic Cancer Action, explains why despite widespread criticism, its controversial ad campaign accomplished its aim.

Photograph: Pancreatic Cancer Action

Elsewhere, BBC healthcare correspondent Fergus Walsh writes about the opposing views to proposals from well being watchdog the Nationwide Institute for Wellness and Care Excellence to drastically boost the numbers provided statins Andrew M Brown also writes in the Telegraph about statins and mass medication and Andrew Jones in the Mental Elf blog writes about smoking cessation.

That’s all for right now, we’ll be back tomorrow with our digest of the day’s healthcare news.

Today in healthcare: Thursday 13 February

Nowadays in healthcare: Wednesday 12 February

Excellent morning and welcome to the everyday blog from the Guardian’s neighborhood for healthcare specialists, supplying a roundup of the key news stories across the sector.

If there’s a story, report or event you’d like to highlight – or you would like to share your thoughts on any of the healthcare problems in the information today – you can get in touch by leaving a comment below the line or tweeting us at @GdnHealthcare.

The Commons health committe has published a report following its annual inquiry into public expenditure on wellness and social care. Richard Humphries summarises the findings on Twitter:

Guardian well being correspondent Denis Campbell writes that the committee has named for some hospitals to end delivering specified services or even shut altogether if the NHS is to remain viable, even although such adjustments are “notoriously controversial”. Campbell reports:

The Commons well being pick committee said in a report that a dramatic expansion of the centralisation of hospital solutions was required to aid the NHS cope with the growing pressures on its budget.

… the MPs say that integrating the presently separate providers, which ministers and NHS leaders say is crucial for the NHS to remain sustainable in the encounter of rising demand induced by ageing, “will also need reconfiguration”.

The BBC says the committee found a lack of clarity over what the money saved in the NHS in England has been spent on, although the Mirror reports that the re-organisation of the NHS is producing it harder to offer decent social care.

In other news this morning, Sir David Nicholson, the outgoing NHS England chief executive, has written for the Telegraph, calling for a programme of transformational modify to frontline care. He says:

… this government’s Health and Social Care Act focused, with excellent cause, on administrative structures. These subsequent changes have to target on the sensible ways we provide front-line care in our communities, and they should be advised, led and built by clinicians on behalf of patients, from the bottom up rather than the top down.

Nicholson is due to give evidence to the public accounts committee this afternoon.

Far more of today’s healthcare headlines:

• Guardian: Cholesterol drug statins must be provided to millions much more, NHS guidance says

• eHealth Insider: Hunt predicts US-Uk ‘single market’

• BBC: Colchester Hospital – Head to get ‘grip’ after cancer scandal

• Pulse: LMC leaders phone for longer patient consultations

• Nursing Occasions: Ward pressures hit pupil placements

• Telegraph: Half of folks with dementia endure malnutrition, report warns

Regular contributor Kailash Chand writes for the network right now, warning that austerity is pushing the NHS into unprecedented territory. He writes:

The NHS has not faced this level of challenge in its historical past. The universal healthcare presented by the NHS is in critical danger of getting to be unsustainable.

To deal with the rising demand on the wellness services, the government have to allow NHS personnel to use their very own clinical judgment in purchase to make workable enhancements. It’s about medical doctors having the freedom to make change for the benefit of the well being support away from politically motivated interference.

Denis Campbell reports for the SocietyGuardian segment on a survey of workers at Public Wellness England, which uncovered “it is not a satisfied organisation”. The survey, Campbell writes, found:

Just 27% feel a strong personal attachment to PHE, only 32% say it inspires them to do the very best in their work and only 36% would recommend it as a excellent location to perform. Probably even far more worrying is that only
34% “believe that [its] nationwide executive has a clear vision for the potential of PHE”, just 31% have self-confidence in the decisions manufactured by senior managers and thirty% really feel the organisation is managed effectively. Several of the
final results – primarily based on questionnaires returned by three,073 people, 61% of the five,000-powerful workforce – recommend a widespread disillusionment.

Columnist Zara Aziz asks no matter whether the NHS wants to ration cancer treatment options.

Elsewhere, Jamie Reed writes for the New Statesman about care.data, warning that government incompetence hazards undermining the project and Richard Murphy writes on the Tax Analysis blog that putting VAT on personal overall health care would increase £2bn for the NHS.

Gemma Finnegan has tweeted about a Twitter chat this evening on social media tips for overall health and wellbeing boards:

That is all for these days, we’ll be back tomorrow with our digest of the day’s healthcare information.

Nowadays in healthcare: Wednesday 12 February

Today in healthcare: Tuesday 11 February

Very good morning and welcome to the every day site from the Guardian’s neighborhood for healthcare specialists, providing a roundup of the important news stories across the sector.

If there’s a story, report or occasion you’d like to highlight – or you would like to share your thoughts on any of the healthcare concerns in the news today – you can get in touch by leaving a comment below the line or tweeting us at @GdnHealthcare.

The Guardian reports on a declare by scientists that possibly daily life-conserving medicines are getting denied to young children with cancer since they are not currently being put by way of the needed clinical trials.

There’s also news of Ed Miliband’s pledge that a long term Labour government would give sufferers a formal function overseeing alterations to regional NHS companies.

And an OECD study has discovered that psychological wellness issues are costing Britain £70bn a 12 months.

Today’s other healthcare headlines:

• Telegraph: Jeremy Hunt says thank you to NHS employees

• Independent: Revealed – Large Pharma’s hidden back links to NHS policy

• eHealth Insider: Two thirds opt out of care.information – survey

• Guardian: MPs overwhelmingly back ban on smoking in automobiles carrying children

• Nursing Times: Chaplain spreads ‘good news’ about the NHS

• Pulse: NHS England imposes GP premises freeze as it carries out funding evaluation

On the network today, Gill Hitchcock reviews on a funding threat to a distinctive mental well being programme that aims to get sufferers back to operate.

And Roger Kline meets Delilah Hesling, appointed as the country’s 1st patient safety ombudswoman, who says:

The factor that drives me to stand up so strongly for sufferers and workers is the memory of my own personalized painful experiences. The shocking realisation of how bad a culture can get in a caring organisation gave me two possibilities. I could avert my gaze and depart or consider to be portion of altering things. I stayed.

Delilah Hesling sees herself as ‘someone who speaks truth to energy and whose loyalty is very first and foremost to [her] patients in partnership’.

Suzi Gage blogs for the Guardian about how minimal alcohol pricing might reduce well being inequalities, whilst Polly Toynbee, writing for Comment is totally free, asks why the government will not let a new process to prevent the birth of young children with incurable genetic diseases.

Elsewhere, Isabel Hardman blogs for the Spectator about what Ed Miliband unveiled about Labour’s NHS policy in his Hugo Younger lecture Geordan Shannon writes for the Conversation web site about the wellness influence of climate modify and Martin Bromiley writes for the Wellness Foundation blog on patient safety.

That’s all for nowadays, we’ll be back tomorrow with our digest of the day’s healthcare news.

Today in healthcare: Tuesday 11 February

These days in healthcare: Monday 10 February

Great morning and welcome to the every day website from the Guardian’s neighborhood for healthcare experts, providing a roundup of the essential news stories across the sector.

If there’s a story, report or occasion you’d like to highlight – or you would like to share your thoughts on any of the healthcare concerns in the news these days – you can get in touch by leaving a comment below the line or tweeting us at @GdnHealthcare.

The Guardian reports these days on investigation findings that introducing minimum pricing for alcohol would lead to 860 fewer deaths a 12 months and 29,900 fewer hospital admissions among hefty-drinkers while getting only a slight impact on reasonable drinkers.

A separate examine suggests that the NHS would conserve £250m a 12 months if a single in 10 journeys had been created by bicycle.

In other healthcare information:

• Guardian: Smoking ban in vehicles carrying youngsters anticipated to be passed

• Telegraph: Employees off sick for a month to obtain health assessments

• Independent: Gastric surgical procedure increases chance of alcoholism

• BBC: Strokes – Women sufferers ‘have poorer daily life good quality than men’

• Nursing Occasions: CNO urges NHS to give nurses time to innovate

• eHealth Insider: Davies departure leaves ‘clinical hole’

On the network right now, Richard Vize asks what clinical commissioning groups can understand from Oxfordshire. Oxfordshire CCG’s encounter, he writes, demonstrates that although commissioners handle the finances, suppliers are even now in charge:

Several providers and CCGs are beginning to create strong and trusting relationships, on which they are developing a shared vision of the need to alter. But in which the relationship is less constructive, CCGs basically do not have the clout to batter via change in the encounter of concerted opposition. If pushing by way of change entails getting a scrap with the incumbent provider it will need political guile, and lots of it. Commissioners can not permit providers to be observed as possessing the exclusive correct to represent patients’ interests.

Amelia Gentleman reviews for the Guardian’s G2 part on the story of a kidney donation. She writes:

Following the journey of a transplant is a uniquely demanding journalistic physical exercise, not least since the timing of an operation is unattainable to predict in advance and depends on human tragedy. There are quite stringent principles governing confidentiality, to stop the family of the donor and the recipient obtaining out also significantly about every other. Make contact with in between the two is uncommon, and only takes place at the finish of a quite supervised procedure. To adhere to these principles, all names, spots and dates have been removed from this account, generating this an uncomfortably detail-cost-free post.

But there is a parallel want from NHSBT to target consideration on the need to indicator up new organ donors and to highlight the extraordinary daily life-prolonging effect of a productive transplant. Though there has been a thirty.five% increase in transplants in the past 5 many years, there are still far more than seven,000 on the transplant record, and last yr much more than one,300 men and women either died while on the waiting listing or grew to become also sick to receive a transplant. The process of signing up to donate is straightforward and takes only a couple of minutes on the web.

‘We are asking folks to do one thing for other people at a time that is so devastating for them.’ Photograph: Sean Smith for the Guardian

In an accompanying piece, transplant recipient Sharon Brennan describes her expertise. “It is only just sinking in that my donor actually did save my existence,” she writes. “My gratitude is immeasurable.”

Elsewhere, Eerke Boiten writes for the Conversation web site about care.data and anonymity.

That’s all for nowadays, we’ll be back tomorrow with our digest of the day’s healthcare news.

These days in healthcare: Monday 10 February