Stop pretending we can’t afford the NHS: that’s the message of our march today | Larry Sanders

We are living in a world in which the politics of the leaders of two of the world’s great nations – America and Britain – is built on broken promises. During Donald Trump’s election campaign he promised to “take on Wall Street”. So when just weeks later the president announced a cabinet full of banker billionaires, my brother, Senator Bernie Sanders, said: “With all due respect, Donald Trump is a fraud.”

Meanwhile, here in the UK Theresa May took up her post as prime minister on the commitment to “work for all, not just the privileged few”. Well, it is just weeks since our NHS descended into a humanitarian crisis, and we are already looking at another round of privatisation and cuts. Which is why at midday today we will be marching on parliament in support of the NHS.

We don’t need reminding of the horrors we saw over the winter, with people dying on trolleys and turned away from hospitals, and the British Medical Association warning our most cherished institution has been pushed to breaking point. The NHS is facing a £22bn funding gap, with the demand for care set to rise 4% a year while the health service’s budget will go up by only 0.2% every year between now and 2020.

This crisis in healthcare has been exacerbated by the current Tory government – but its foundations were laid by New Labour and further strengthened by the coalition with the Health and Social Care Act of 2012. The creeping privatisation of the past quarter of a century has introduced vast fragmentation and inefficiency into our health service, and, combined with chronic underfunding, has left the NHS on the brink. Anyone who has visited a hospital recently knows how hard doctors, nurses and all the staff are working to make sure patients are cared for with dignity and compassion, despite the strain on the system. It is time we listened to their concerns.

Prime minister Theresa May pledges to build a ‘better Britain’

Adding to the pressure facing hospitals across the country is the financial crisis in social care. We’re living longer, and that’s a great thing – last year, aged 81, I stood in the Witney byelection after David Cameron resigned. But while there are currently one-third more over-85s than 10 years ago, adult social care budgets have been cut by one third in the same time. And the care funded by local authorities accounts for just a small proportion of the care elderly people in the UK currently receive. Every year family, friends and neighbours provide £55bn of unpaid care, four in 10 people in care homes pay for themselves, and a staggering 1.2 million people over 65 with care needs receive no help at all.

We are simply not providing enough care and support for people in the community, at home and close to where they live. This means elderly people are more likely to end up in hospital, and when they get there it is more difficult to get them home again. People who are medically well are stuck in hospital because there is nowhere suitable for them to go and too little support for them at home. The system is failing these people who could be living at home or in supported accommodation instead of being isolated from their communities on a hospital ward. But it also fails those who desperately need the hospital beds these elderly people occupy.

The government’s response has been to engage in a cruel con where local councils were told there was “new” funding for social care, only to find much-needed funding cut from elsewhere. It is little wonder the system is on its knees – and the prime minister’s insistence on ending free movement as part of Brexit risks starving the NHS and care services of the staff they so desperately need.

Today thousands of people will march in support of the NHS, unwilling to stand by and watch while this government dismantles public healthcare – and I’m proud to be among their number. The government tells us there isn’t enough money but this isn’t true. We are the fifth richest country in the world – we have the money to stop our health service turning into a humanitarian crisis, and to care for people when they grow old: in hospitals, the community and homes. We have the money for a fully funded public health service. If Theresa May is to keep her promise to “work for all, not just the privileged few”, she must not let the NHS and social care crumble on her watch.

Stop pretending we can’t afford the NHS: that’s the message of our march today | Larry Sanders

New recruiting drive for more nurses – 3 March archive, 1970

The Government is today launching a major recruiting drive for nurses, to combat what is now officially recognised as a grave national shortage.

At the same time, an independent committee is being set up to look at the future role and training of the nurse, so that her scarce skills can be used to best advantage.

Mr Crossman’s announcement of these plans in the Commons yesterday came a fortnight after nurses had won pay increases of up to 20 per cent but, as he said, wages are not the only problem.

He has already tackled regional hospital boards on two more of the outstanding grievances: they are being asked to ensure that their senior nursing staff have a clear part in management, and told that it is essential for nurses to be relieved of the domestic chores which now take up so much of their time.

Boards have also been firmly told that although there is to be no extra money, they must not use lack of funds as an excuse for not recruiting. Cutting down on nursing staff, Mr Crossman said earlier yesterday, was not an economy that the National Health Service could afford.

The recruiting campaign, whatever Mr Crossman’s plans for improving the nurses’ conditions, still relies heavily on the traditional vocational pull: “You’re someone special when you’re a nurse,” the advertisements will say, but at least they can add: “And now you’ll be better off too!”

The campaign will cost £250,000 over the next year and the Department is not sure what it is aiming at. It has set no target for its recruitment because it actually has no figures on the gap between need and the present situation and therefore assumes that recruitment can be unlimited.

The last time the Department spent a lot of money on this sort of programme, it had something like 200,000 inquiries but has no idea how many of these turned into signed contracts. This campaign will at least have a follow-up element.

The shortage of nurses at least is incontestable in many parts of the country. Even London teaching hospitals now have to rely heavily on agencies to get staff, and intake has been dropping. The national wastage from training schemes is around 35 per cent of all who start a course.

Cheap labour
The chaos of the present system of treating young nurses as an uneasy cross between student, apprentice, and cheap labour is one of the problems that the new committee will be looking at.

It will be chaired by Professor Asa Briggs, Vice-Chancellor of Sussex University and a historian. He said yesterday that he hoped the inquiry would take about 18 months, and he was anxious to tap current feelings among nurses rather than rely on published reports.

He wants to look at the education of nurses in relation to the whole development of educational patterns, as well as trying to rationalise manpower for a future where hospital and community work will be much more closely linked.

New recruiting drive for more nurses – 3 March archive, 1970

Polish abortion law protesters march against proposed restrictions

Polish women have gathered in cities across the country to protest against a proposal to ban abortions in cases where foetuses are badly damaged or have no chance of survival after birth.

Many wore black, a symbol of mourning for the feared loss of reproductive rights, as they took to the streets of Warsaw, Gdańsk, Łódź, Wroclaw, Poznań and other cities and towns across the predominantly Roman Catholic nation of 38 million.

“Girls just want to have fundamental rights,” one banner proclaimed.

The protests on Monday follow a similar round of street demonstrations in early October, a reaction to a proposal for an even more restrictive law which would have banned abortion in all cases, including rape, and imposed prison sentences of up to five years on women and doctors involved in terminating pregnancies.

Massive so-called “black protests” forced lawmakers to abandon that proposal.

The women, joined by many men, have returned to the streets in response to a new proposal by Jarosław Kaczyński, the head of the ruling Law and Justice party. Earlier this month, he said his party wants to ensure that even pregnancies involving a child “certain to die, very deformed, still end up in a birth, so that the child can be baptised, buried, have a name”.

In the weeks since the first round of protests, the grassroots movement advocating abortion rights has increased its demands. Those who turned out on Monday also called for better sex education and easier access to birth control while also demanding that the influential Roman Catholic church end its “interference” in political life and public education.

Clashes broke out between abortion rights supporters and anti-abortion activists outside a metro station in central Warsaw where demands were laid out in a petition that a steady stream of people lined up to sign.

“We want to live in a secular society,” said Agata Rybka, a 24-year-old student of biotechnology at Warsaw University who had volunteered to oversee the petition signing. “Right now religious issues dominate public discourse and we don’t like it.”

Poland already has one of the most restrictive abortion laws in Europe, with terminations only allowed in cases of rape, when the foetus is irreparably damaged and when the woman’s life or health is in peril.

The new proposal would not amount to a total ban, and would still allow abortion in cases of rape or if the woman’s life or health is in danger.

Dorota Szumilak, a 44-year-old financial analyst, signed the petition, explaining that she did so because she saw in the abortion ban proposal an attempt to restrict women’s rights more broadly. A Lutheran, she said she feels discriminated against in a society where the Catholic church runs religion classes in the schools and is now supporting further restrictions on abortion.

“The role of the church is now too strong,” she said.

She was with a friend, Malgorzata Brendel, 53, who said the attempts to tighten the abortion law had prompted her to become one of a growing number of Poles who are now formally leaving the Catholic church.

Polish abortion law protesters march against proposed restrictions

Well being Care"s March Madness: Buzzer Sounds On Exchanges Deadline

The fourth anniversary of the signing of the Reasonably priced Care Act (ACA) passed on March 23 with out significantly notice or fanfare.

As an alternative, all eyes were on March 31, the final deadline for purchasing well being insurance by means of state and federal well being care exchanges – and the day that fines for non-participation kicked in.

Supporters and opponents of the ACA are on the edge of their seats, anxious to know the final result: Specifically how numerous individuals signed up, will they pay out their premiums and for how extended will they do so?

In contrast to March Madness, we won’t know how this dance ends for months to come. But like the NCAA tournament, the ACA has presently had its share of victories and significant upsets.

The Victories

As a end result of well being care reform, the number of uninsured or underneath-insured Americans will be decrease in 2014 than in the current previous.

By April one, the White Property estimated it was on track to attain seven million enrollees through the state and federal exchanges. An estimated 9 million more enrolled in Medicaid.

Open enrollment is above for 2014 whilst many inquiries stay open-ended. (Picture courtesy of HealthCare.gov)

The vast majority of the newly enrolled will receive subsidies to assist shell out for coverage. Their coverage will consist of totally free preventive screenings, which should boost their overall nicely-currently being and contribute to lower well being care charges in the long term.

In addition, health care reform allowed far more than three million otherwise uninsured young grownups to obtain entry to coverage underneath their parent’s policy right up until age 26.

One more victory in government’s eyes is that people with “pre-existing conditions” – these who had been unable to buy individual insurance in the previous – can no longer be denied coverage. Meanwhile, tens of thousands of ladies whose plans previously excluded maternity coverage can now receive the prenatal care and delivery solutions they require.

And lastly, individuals who after identified it tough to navigate the arcane personal overall health insurance coverage market place, and had been frustrated by their restricted alternatives, can now go to an on the web exchange and choose from a broad set of alternatives.  

The “Upsets”

For all the victories, other outcomes have left several ACA fans upset and disappointed.

In spite of the large push by supporters, it is estimated that only 15 percent of Americans eligible to enroll through the exchanges signed up.

In the 17 states that constructed their very own exchanges, 20 percent of eligible individuals enrolled on average. Vermont led the pack at 54 %. In contrast, the 27 states that defaulted to the federal exchange saw an typical enrollment of only 12 percent.

And a mere 25 percent of folks in between 18 and 34 many years of age decided to enroll, compared to the government’s target of 40 percent.

Well being Care"s March Madness: Buzzer Sounds On Exchanges Deadline

No April Fool: People "In Line" For Obamacare Can Nonetheless Get Coverage Right after March 31 Deadline

Like voters in line as the  polls close on Election Day, the Obama administration said it will nevertheless accept applications for private coverage beneath the Affordable Care Act soon after next Monday’s deadline of March 31.

The administration this afternoon explained people who could “attest” that they had been “in line” on Monday of following week will nevertheless have their applications accepted, evaluating the ultimate signup to voters who are in line to vote when polls closeon election day. The administration is expecting an unprecedented surge of enrollment over the up coming five days.

“We are not going to shut the door,” stated Julie Bataille, director of the Office of Communications for the Centers for Medicare &amp Medicaid Solutions, a division of the U.S. Division of Well being and Human Providers that is charged with rolling out the overall health law.

Hoping not to see a repeat of technical concerns that dogged the healthcare.gov web site in which customers can indicator up for coverage, the Obama administration this afternoon stated, for the duration of a call to supply an “operational update” that the web site is successfully managing a lot more than a single million visits a day and is preparing for what is currently an unprecedented surge of Americans searching for coverage.

With just five days left for eligible uninsured Americans to indicator up for a personal wellness program below the overall health law, officials from U.S. Secretary of Health and Human Companies Kathleen Sebelius workplace stated they are prepared for an unprecedented final minute rush.

“We have observed only minor concerns,” stated Kurt DelBene, senior advisor to U.S. Secretary of Well being and Human Companies said in a conference get in touch with this afternoon. “We believe the site (can handle) a hundred,000 concurrent end users. We know men and women will wait until the final minute.”

Tuesday alone, there have been 1.2 million visits to healthcare.gov and consumers to the internet site have been at their highest amounts because signup began. “That’s just in 1 day,” Bataille stated, including that the contact center received more than a half million calls on Monday and Tuesday of this week.

Buyers can choose from an array of plans sold by the likes of Aetna Aetna (AET), Cigna Cigna (CI), Humana Humana (HUM), UnitedHealth Group (UNH) and a variety of Blue Cross and Blue Shield programs. These eligible can get subsidies to purchase this coverage by way of marketplaces recognized as exchanges through healthcare.gov.

No April Fool: People "In Line" For Obamacare Can Nonetheless Get Coverage Right after March 31 Deadline

Dr Le Fanu"s on-line wellness clinic, Friday 21st March 2014

Reading with interest your column, and recent letters to the editor, about side effects of statins, I bring to your attention an on-going localised reaction I am still having to a Shingles vaccination which I had in the middle of October last. You may/may not be aware that the NHS is offering this new vaccine to all 70 year olds, which age I attained last July: hence when offered it by my GP I took it up, although I’ve never suffered from Shingles. A few days after the vaccination I developed a localised reaction around the site of it which is still ongoing and which my GP has now referred me twice to hospital for tests.

The reaction ranges from a stinging sensation to an ache: not disabling in any way but certainly irritating! I first was referred to the local musculoskeletal clinic who thought I might have water on the site: an MRI scan showed this was not so. I’ve now been referred to a Neurologist next month. My GP has reported this to the Yellow Card Scheme, but I do wonder whether others have had this side effect from what is a new vaccine?

I don’t expect a reply but thought you might like to know!

Andrew M

Dear Andrew M,

Thanks for drawing attention to the side-effects of the shingles vaccine. This can, as you will know, cause an inflammatory reaction with pain and redness at the site of the injection – and yours seems to be a more serious variant of this. Perhaps a short course of ibuprofen may be of value.

ALAMY

Migril availability

Hello

For years I have found migril to be the only thing that worked for my migraines. Have been unable to obtain it for the last month and chemist just saying there is a manufacturing problem. Do you know if it has been withdrawn? Thank you for your help.

Regards Mrs M I

Dear Mrs I,

Thanks for your query to which I do not know the answer but I notice a similar preparation to Migril, Cafergot, was discontinued in 2012. It is possible this might be a marketing ploy by the drug companies to promote the sale of newer more expensive anti-migraine drugs.

Dear James

I have an unusual conundrum for you. I am a physiotherapist and a patient of mine, BS, a lady in her early 70s gets a bitter ‘metallic’ taste in her mouth on effort-usually involved with large arm movements, but it can also occur following more strenuous body activity.

She has a history of cerebral haemorrhage secondary to cerebral cavernous malformation, and right hemiparesis. She has reduced use of her right arm and has balance problems , but she can walk distances reasonably well with some assistance.

None of her medical consultants have been able to explain this.

(Ms) Gill S MCSP

Dear Ms S,

Thanks for your most interesting query. I would suspect this bitter taste in the mouth might be exertion induced acid reflux. This can be prevented with an acid-suppressant drug such as Omeprazole.

ALAMY

Dear Dr Le Fanu,

I would like to ask your advice on my lower back pain please. I am 35 years old. I have had very bad lower back pain since about spring 2008. It is on my lower central and right hand side and the nerve that goes from this region into my leg and foot is also affected (sciatica). It gets very bad at times and I can barely move without pain. It then will ease off for a while and I can manage again but then return.

I used to be very active – running and swimming and cycling a lot. I did run a marathon just before the pain started and fear I may have damaged my back permanently from this. I can do no sport now. I find just sitting at my work desk very painful and have to stand a lot of the time rather than sit. I have had a lying down mri scan. Which uncovered two bulging discs. Also an xray I had when I was 16 said I had marked lumbar scoliosis.

I have been doing core stability exercises religiously since the pain began, but this does not seem to help much.

I have seen various consultants but with no way forward. Do you think I should try and get a weight bearing mri scan as I have heard these can reveal the back and any issues more clearly. Also would you recommend a consultant or specialist I can see to help me with a way forward to try and reduce the pain? I have heard of caudal epidurals but I am very scared of injections as I have heard these have risks of paralysis and nerve damage and may only just mask the pain for a while.

Any advice would be greatly appreciated, many thanks

Dear Anon,

Thanks for your query and my sympathies for this severe chronic back pain that has so impaired your mobility and is, I gather, related to a series of problems in your lumbar spine . I would not have thought that a weight bearing MRI scan is likely to clarify matters further. I would suggest you contact Dr Clifford Harley (07810620058) who is an orthopaedic physician based in London with a lot of experience in dealing with this type of problem. Alternatively Mr Jeremy Hucker (01895 628891) specialises in the sort of minimally invasive procedures such as facet joint injections and caudal epidurals than can be very helpful.

Dear Doctor

I have been suffering with Interstitial Cystitis for nearly five years (although it was only diagnosed in the last eighteen months). It is extremely painful having a chronically inflamed bladder and my life is ruled by how I can manage the daily pain. I have given up alcohol, caffeine, smoking, chocolate and many other foods and am trying a wheat/gluten free diet, I have also had to retire from work as a Teaching Assistant.

The pain can be relieved for a short time if I urinate (this in itself can be painful), because my bladder is so small now. I am not incontinent but have to

empty my bladder quite frequently (I am 57), particularly during the night (between 10pm and 6am) it can be up to 13 times. Constipation also adds to the

discomfort. Sitting and walking are most uncomfortable although I am trying to get to a yoga class twice a week as exercise is supposed to be good.

I have had cystate installations which I believe have helped slightly and am still taking anti acid…is Milk of Magnesia any good? I and many others need help

our lives are dominated by this condition and the constant pain for which no one seems to be able to offer any suggestions or relief. I dream of having one pain free normal day a week. I believe recently there was a Health drink mentioned in one of your articles perhaps I could try it! Any suggestions please.

Very best Regards

Dear Anon,

Thanks for being in touch and your account of the distressing symptoms caused by your interstitial cystitis. I note you have consulted a urologist who has organised some appropriate treatment. My only suggestion, if you have not tried it already, is you should discuss with your doctor a trial of the acid-suppressant drug Cimetidine which, it is claimed, can be of considerable value in some patients.

ALAMY

Dear Doctor LeFanu,

Having read a recent DT headline and your frequent comments on statins and their effects I can no longer resist reporting the following experience which may interest you.

Some years ago I was prescribed Atorvastatin, 40 mg. to be taken once a day, which from time to time I would forget to take.

As it happens I also play chess competitively to at least average club standard. When I forgot to take the tablets I gained the impression that I could see things over the board more clearly. Now chess players are graded by a process which, while not perfect, gives a pretty good idea of a player’s strength so it naturally occurred to me to wonder if stopping the tablets altogether would bring about an improvement in my playing standard.

A consultant cardiologist who I see regularly assured me that not taking Atorvastatin for a couple of months would be unlikely to have any harmful effects. I accepted his advice when within a year my grading shot up be nearly thirty points to a standard I was last at about thirty years ago, some way above the average of club players in the UK. I also came equal first or second in three successive tournament, an achievement which I have never before managed to accomplish.

It would clearly be rash to draw the obvious conclusion. For a start I had been at the lower standard for some years before I began taking Atorvastatin. Also there is no obvious explanation for the improvement. Clearly I did not become brainier but I did notice that my opponents for some reason reason would often not take advantage of clearly superior positions, clearly won games in one or two cases. That could be because I was evaluating positions more clearly than I had before though I do have two explanations of my own, one of them rather odd and relating to opponents not taking advantage of superior positions..

None the less the experience does seem suggestive and naturally one wonders if chess players could contribute to an assessment of the effects of statins on cognitive achievement.

Anon

Dear Anon,

Thanks for your fascinating account of the subtle cognitive effect of statins on your chess playing. I will mention this in the column of the 31st March.

Good Afternoon

About 5½ years ago I had a parathyroid gland removed. A biopsy of the gland revealed that it was malignant. As a result, half of my thyroid was removed as a precaution. Although I have had no further problems with my remaining parathyroid glands, I am increasingly getting erratic heartbeats, tremors in my hands and upper torso, and severe tiredness. Various GPs and the Consultant Endocrinologist have requested T4 blood tests from time to time. All the blood tests have come back more or less normal, and generally with a request that they be repeated 6 months later.

The question that I have, and which the Consultant seems to unwilling to answer, is whether the remaining part of my thyroid is struggling to maintain my thyroxin levels, thereby causing the symptoms that I am getting. Would a low dose of thyroxine relieve the thyroid and remove the symptoms?

I would be interested to know if any of your readers have experienced similar problems following removal of part of the thyroid.

Best Regards

John G

Dear John G,

Thanks for your most interesting query. The symptoms you describe are certainly suggestive of an overactive thyroid – though I do not think this is related, in the way you propose, to the operation on your parathyroid gland. You should discuss further with your doctor the significance of those ‘more or less’ normal thyroid function tests as a low normal TSH is still compatible with an overactive thyroid.

Dear Dr. James,

I’m 71 years old, reasonably fit & active for my age. I take Amlodipine 5mg & Valsartan 80mg, for high blood pressure. Also, I take Qvar 100, twice a day for my asthma. I enjoy a few pints of beer, two/three times a week at the local pub. Last week, I had four pints of beer one evening & walked home. On the way home, I called to visit a friend, for a cup of tea & a chat. Shortly after arriving, whilst sitting down in the chair, I got a fit of coughing. Next thing I slumped back in the chair, with my eyes closed. My friend rushed over to me, calling my name & was preparing to ring for an ambulance. After about four seconds, I opened my eyes & was OK. I had clearly “blacked-out” for some reason?

What could be the cause of this?

Do I need any tests?

Thanks.

Mike

Dear Mike,

Thanks for your query. This fainting episode you describe is known as Cough Syncope and is due to the fall in blood pressure caused by pressure changes within the chest cavity brought on by a severe bout of coughing. It is a benign condition and does not warrant further investigation.

My partner is a 58 male and has just started on warfarin a week ago as he has irregular heartbeat he has started to get hot sweats fluttering in his chest, giddiness, headache please can you advise on what to do many thanks

Theresa

Dear Theresa,

Thanks for your query. The symptoms you describe are certainly not typical of the side effects of Warfarin so there could be some other explanation such a viral illness. Still their onset so soon after starting the medication is clearly suspicious and were these symptoms to persist you might need to take a different form of blood thinning drug.

Dear Dr Le Fanu

I do hope that you or your readers can explain my medical query.

Having always had cold feet at night I now have the opposite but the right foot, above the instep, is worse and heats up until it feels as if is burning yet it is just normal temperature to the touch. The right foot feels swollen but it isn’t and it burns with heat all day and going to bed the leg gets hot with it and often keeps me from getting to sleep. During the evening I can sit with my feet up and right shoe off which helps and I often sit with a cold pack on it but I can’t do that at night in bed.

I am 77 years old and have walking difficulties due to osteoarthritis. I take paracetamol and occasional ibuprofen for the pain but it doesn’t seem to make much difference. I have been to my doctor about this but she says it must be my age. Is it just poor circulation?

Yours sincerely

V. H

Dear V H,

Thanks for your query. It sounds from the description of your symptoms that they are due to ‘burning foot syndrome’ caused by the disturbed functioning of the sensory nerves to the leg known as a Peripheral Neuropathy. There is regrettably no specific treatment but the drug Gabapentin is said to be of value.

I refer to the recent comments in your column.

I have had excess mucus since Nov 2012 but since March last year this has resulted in a mucous drip which seems to go down my Trachea and causes a wheeze which requires repeated coughs to release. This is usually 3-4 periods each day, there has not been a free mucous cough day in one year now.

I have had chest x-ray and recent nose scope which saw no polyps etc.

I am on steroid nose spray which has improved my breathing and the mucous a little the wheeze/cough remains.

I am told in my area (East Grinstead) 1 in 4 people suffer from rhinitis?! But I know of no other person that has coughed for a full year.

Is this usual?

I assume the Erythromycin is for the non-allergic and the other antihistamine for the allergic rhinitis ? How do I find out which I am? And is there any hope for the cough or is that it for the rest of my life (I am 63)

Yours

John W

Dear John W,

Thanks for your query. It is possible you may have become sensitive to, for example, the house dust mite or other allergens to account for your symptoms. This is best clarified by patch testing at an allergy clinic I would have thought it probable you would benefit from a course of Erythromycin as described in the column.

Hello,

I am sure you must have been inundated with emails on this subject but I would like to briefly tell you of my experience. I was prescribed these when all GP s were trawling through their patients and blanket prescribing.

I too suffered horrendous muscular pain, could hardly get out of a chair, had CT scans and full body MRI. All showed nothing. I read your article of a few years ago and immediately stopped taking them. However I still experience numbness in my feet and I have learned to live with this. I can still play golf and walk 18 holes,but I am sure as I get older this will get worse.C’est la vie!!

You are so right to warn people,

Thank you

Sincerely

Jenny H

Dear Jenny H,

Thanks for being in touch. Regrettably – as in your situation – the statins can have long term adverse side-effects. It is encouraging that you are still managing to get round the golf course!

ALAMY

I am 70 years old and have for many many years taken Statins as I have a raised familial cholesterol level. I too have all the aches and pains; however recently I was found to have a very low vitamin D levels and at the moment I am taking 20,000 bio Vitamin D3 capsules – 3 once a week for 14 weeks. The aches and pain are greatly reduced.

Janet D

Dear Janet D,

Thanks for that most interesting observation and drawing attention to the causes other than statins for these muscular aches and pains.

Dear Dr. Lefanu,

Regarding the report on adverse reactions to statins, have you thought that the reason the people on placebos had the same side effects was because it is the constituents put in tablets that cause the problems. I take thyroxine and had to change brands because of the ingredients. Eltroxin was mysteriously removed and I had taken it for some time with some energy sapping side effects.

Yours sincerely

Priscilla C

Dear Priscilla C,

Thanks for your query. It is certainly the case that the relative effectiveness of different brands of the same drug can be influenced by their formulation. This is not however the explanation for the supposedly low level of statin side effects which is due rather to under-reporting by the pharmaceutical companies.

I have been following the statins thread with interest if only because I do NOT take them. However, as I am on the border for type 2 diabetes I have been told quite often that I should have high cholesterol but do not.

Many years ago I had bouts of constipation but before I got to the GP I realised, courtesy of the Reader’s Digest, that I had probably been eating too much Raisin Bran in hotel for breakfast. A blood test showed elevated blood sugar and off I was sent. My GP told ne to make sure that WHEN I collapse in the street I must tell people I am diabetic. 10 years later and I am still waiting for that collapse. My diet is low in all the things that are supposed to be bad though I still imbibe.

I also have raised BP and for 5 years I was given a string of tablets none of which did any good. The contraries I could get but not reduced BP. In May 2013, I was allowed onto the ‘expensive’ list and now take Valsartan. It has already started to stop working leaving with only the one cure. 2 glasses of Red Wine!!!! That drops my BP 25 sys in about 20 minutes and keeps it there for hours. I have resveratrol tablets but at the suggested 250mg I do not think they are as good as the wine. I am a regular booze cruiser but even so the cost is quite high albeit rather pleasant. Bitter is nearly as good, lager is middling as is rose but white wine, of which I have 2 favourites, is useless.

The question in this is why if BP so important that I was allowed to have high BP for 5 years before being given proper treatment? Personally, I much more favour Pulse as that better indicates how the pump is actually working. In Florida last December I was running 250 sys while calmly sending emails. I never worked out out who was the real patient as the nurses could not understand why I was not having a heart attack! [My BP rarely got above 140/90 which the US has now suggested is OK!]

Which now takes me back to the Diabetes and drug reactions.

June 2012, I climbed out of a canyon in the Languedoc and then walked over a mile to get the car because I felt my grandchildren would be tired. My daughter has said that she, my son and their families only did the climb because ‘granddad had done it’!

June 2012, one week later, I started on Metformin.

Late August 2012, I was taking antibiotics and corticosteroids for a severely blocked nose and had 3 further courses that year.

February 2013, I was diagnosed with Nasal Polyps.

April 2013, I spent 2 days in a Florida hospital with breathing problems that I feel may have been a panic attack. I had a number when I returned home starting the day after my insurers tried to avoid payment of my $ 24,000 bill for 2 nights in hospital; plus ambulance services!!!!! The agreement to pay the bill and no more attacks!!!

July 2013, I became aware that I had been taking Metformin since my blockage had started, or from 1 week before. I stopped the drug and to date my diabetic status has not changed above the 7.2 level.

October 2013, December 2013 and February 2014, I have had 3 chronic breathing attacks that lead to 2 short hospital stays. Each has treated me for Asthma though in Florida in December that was quickly dismissed.

March 2014, I had a consultant here insist I am asthmatic. He insists that I am an asthmatic whose polyps come from that and would not understand the timeline above. He actually dismissed my evidence as irrelevant which begs the question as to where the asthma came from and why so suddenly. I will try for another opinion with a Consultant who is more scientifically minded! I await my operation and a return to see this man with relish.

On the other hand I suggest I am having asthma type symptoms brought on by the blockage dripping from the polyps ‘gumming’ up my airways and hence my lungs that started soon after I first took Metformin. When my nose is ‘clearish’ then what I blow out is not unlike what I cough up when blocked. And very nasty and thick it is, too! I have only one thing to keep even partially free and that is an OTC spray Oxymetazoline Hydrochloride which has a regular 2 day failure every few weeks. And very oddly the improved and sunny weather!!!!!!

A Google search last week – why did I never do that earlier? – supplied FDA evidence of a small number of people with polyps who took Metformin, and I mean small. But like the statin ‘conclusion’ it requires cause and effect to be seen. How many statin sufferers have had their reactions logged officially? And in my defence I cite the peculiar fact that Metformin helps deal with Polycystic Ovary Syndrome. As a man that worries me on a number of levels!! It also makes me question drug testing standards when drugs created for one reason help totally different ones. Are we being pushed drugs that actually no-one really knows about? After all Metformin could just as easily have killed women with that syndrome and would any one have noticed quickly?

I hope my GP will check his records as his Metformin patients come in to see whether there is even 1 extra sufferer. If even one more patient has it in a small surgery that would have amazing and far reaching consequences. My ENT consultant who will ‘do’ my polyps, if my lungs even get clear enough for an anaesthetic, I hope to also get checking. In the meanwhile ……… ?

Richard F,

Dear Richard F,

Thanks for being in touch. I would have thought it most unlikely that the Metformin you are taking for your diabetes is implicated in causing your nasal polyps.

Dr Le Fanu"s on-line wellness clinic, Friday 21st March 2014

eight Causes Why In March N.C.A.A. Stands For "Not Caring About Athletes"

1.  This month, the NCAA will make $ 770 Million in tv revenues from internet hosting its yearly men’s basketball tournament.  NCAA members will hold all of this cash for themselves.  The pupil-athletes will be paid nothing.

two.  If school athletes had been allowed to unionize, men’s university basketball gamers could reasonably assume to earn a number of hundred thousand bucks for enjoying in the NCAA men’s basketball tournament.  Therefore, the NCAA has petitioned the Nationwide Labor Relations Board to deny pupil-athletes’ right to unionize.

3.  Nevertheless even though the NCAA has argued that its athletes are foremost college students and not ‘employees,’ the NCAA still schedules its early round men’s tournament basketball games on Thursdays and Fridays during the day– days that conflict with traditional students’ academic obligations.

four.  Even a lot more disturbingly, this year the NCAA once once more scheduled its national championship game on a Monday night.  This maximizes the association’s television revenues, but needlessly can make the finalist teams miss two extra days of class.

School sports activities announcers such as Dick Vitale tend to search at the NCAA’s business practices through rose colored glasses.   (Photograph credit: Dave Hogg)

five.  In numerous instances, over the program the an total season the journey to the NCAA men’s basketball championship calls for student-athletes to miss one particular-quarter of all spring class days fully for basketball purposes.

6.  The 2014 NCAA Tournament schedule even calls for further missed class days purely for seeding motives.  For example, even even though Harvard University is based on the East Coast, the crew is currently being asked to travel to Spokane, WA for its 1st-round game — a game that will force that group to miss Wednesday, Thursday and perhaps Friday classes of this week.

seven.  Even although NCAA member schools regularly preach the dangers of pupil-athletes utilizing alcohol, they are so ‘drunk’ for income that they even let beer companies to market for the duration of the NCAA tournament.  Dry campus, so what?  Utilizing pupil-athletes to indirectly peddle beer is extremely profitable.

eight.  And worst of all …. the NCAA utilizes our loyal viewership of the tournament to preach its unique vision of “amateurism” and to lull several of us into the false belief that the NCAA’s several practices that restrain wage in the market for college athlete labor providers actually are in place for the pupil-athletes’ own benefit, and not as a way to maximize individual member schools’ income.

____________________________

Marc Edelman is an Associate Professor of Law at the City University of New York’s Baruch College, Zicklin College of Enterprise, where he has published a lot more than 25 law evaluation articles on sports activities law issues.  His most latest posts such as “A Brief Treatise on Amateurism and Antitrust Law” and “The Long term of Amateurism after Antitrust Scrutiny.”

eight Causes Why In March N.C.A.A. Stands For "Not Caring About Athletes"

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

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

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

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

Martin

Dear Martin,

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

ALAMY

Ptosis

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

Your view would be greatly appreciated.

Joan G (Mrs)

Dear Mrs G,

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

ALAMY

Sir,

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

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

Daphne G

Dear Daphne G,

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

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

Dear Anon,

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

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

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

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

Have you any views please?

Yours sincerely Paul M B

Dear Paul B,

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

Dear Dr Le Fanu

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

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

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

Kind Regards

Dear Anon,

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

Dear James Fanu,

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

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

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

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

Please please request your readers to help.

Thanking you in advance

Christine W

Dear Christine W,

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

Dear Dr Le Fanu,

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

Yours faithfully,

Dear Anon,

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

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

Dear Anon,

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

ALAMY

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

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

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

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

Regards

Dear Anon,

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

Dr James,

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

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

Thank you,

Roy W

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

Dear Roy W,

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

Dear Dr Le Fanu,

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

Ideal Wishes,

John T

Dear John T,

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

Dear Dr Le Fanu,

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

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

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

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

Yours sincerely

Philip Y

Dear Philip Y,

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

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

Dr Le Fanu"s on the web health clinic, Friday 7th March 2014

In addition to paralysis, l have chronic pain, due to the severe nerve damage and or a stroke during the surgery. l now take Tramadol 100SR x 2, Oxycontin 20mg x 2 and OxyNorm for breakthrough pain management, l also take a Statin, Omeprazole and Zomig. Is this dangerous?

Rob S

Dear Rob S,

Thanks for being in touch and your account of the devastating effect of this illness and the heroic surgical procedure to correct it. I would have not have that the medicines you are taking to minimise the pain due to nerve damage are ‘dangerous’. I do, however, wonder whether the statins that are well known to cause musculoskeletal pains are necessary.

ALAMY

Dear Dr Le Fanu,

I should be grateful for any advice on curing (not simply relieving) flatulence, from which I’ve suffered for nearly two years, after (successful) radiotherapy for prostate cancer.

I was also left with bleeding blood vessels (radiation proctitis) which have not been totally eliminated. The combination is unpleasant!

No nurse, doctor or specialist has been able to suggest a cure for my flatulence. Can you or any reader help?

Thank you,

GH J

Dear G H J,

Thanks for your query. I note from an excellent review of the gut symptoms following radiotherapy for prostate cancer that ‘distressing’ flatulence in surprisingly frequent (J Andreyev, Lancet Oncology 2007, vol 8, pp 1007-17) -though why this should be so is not clear. You will know no doubt that so called ‘healthy’ foods (beans, pulses etc etc) are an exacerbating factor and best avoided. Dr Andreyev also notes that antibiotics ‘might help’ presumably through their effects on the composition of the gas producing bacteria in the colon. Several readers over the years have commented on how a course has markedly reduced the amount of flatus. You may wish to discuss this with your doctor.

Dear Dr James

I had an echocardiogram last March which showed mild aortic regurgitation which is a central jet and trivial mitral regurgitation. I am sure it is due to my hypertension. I started on 2.5mg Ramipril, last March and for the past 8 months the dosage has increased to 10mg Ramipril plus 5mg amlodipine.

Almost every night when in bed I experience a sensation of pulsation in the neck and chest. I can also feel the heartbeat in my left ear. My doctor referred me to the ENT doctor, but she could not find anything and said that the noise I can hear could be related to the blood pressure.

Fortunately my blood pressure is under control it varies 135/78 to 146/88.

I also had a ultrasound of carotid and vertebral vessels with no evidence of atheroma or stenosis.

My questions are:

Can the regurgitation of the valve return to normal if blood pressure is controlled?

What can I do to get rid of the noise in my left ear, as it is not a ringing or whistling noise like tinnitus, so it must be to do with heart/blood pressure.

If the blood pressure is normal, why do I still from time to time feel the pulsation on the neck and sometimes in the chest?

I would very much appreciate your good advice.

many Thanks

Mrs N

Dear Mrs N,

Thanks for your query. This is a tricky one. Hypertension can (if severe) cause aortic regurgitation through its effects in dilating the musculature of the heart – but both conditions are common and can thus occur independently of each other. Hence treatment of hypertension may indeed improve AR – but clearly if they are ‘independent’ it will not.

Next the pulsating sensation in the neck can indeed be due to the increased haemodynamic flow associated with AR – but again only when severe which I gather is not the case. Put another way your symptoms do not really ‘fit’ – but I would favour the positive that your blood pressure is now well controlled and your AR is ‘mild’ – and thus unlikely to cause any serious problems in the future.

PA

Dear Dr Le Fanu

May I report what appears to be a fairly simple treatment for heartburn and acid reflux? These had been giving me some problems for a number of months, but I noticed the problems were less in the summer. One difference in my lifestyle in the summer is that I go swimming most days, breaststroke. This of course exercises certain muscles which would not normally be used much. Since Christmas (when this idea occurred to me), I have been doing (dry) the sort of arm exercises that roughly simulate the breast stroke action (such as I recall from school PT), and since I started I have not been troubled by heartburn or acid reflux. I can only imagine the exercises strengthen the diaphragm, giving it a stronger grip on the gullet. I don’t do much, maybe three or four minutes a day at most. Worth a try.

Regards

MS

Dear MS,

Thanks for being in touch with that most interesting account of the value of breaststroke type exercises in reducing the symptoms of acid reflux. I will mentioning this in the column in the near future.

Dear Dr. James LeFanu

I have recently come out of hospital where I spent 8 days recovering from a condition called Guillain-Barre Syndrome, this unusual condition puzzled the doctors for a while because of its rarity. I have not been ill prior to this occurrence. My question is, is it likely to return or is it a ‘one-off’?

Yours

Neil G

Dear Neil G,

Thanks for being in touch – and it is good to hear you have recovered from Guillain-Barre Syndrome. This can indeed recur, but gratifyingly only very rarely, in around 1% of those affected which, by the laws of probability, is obviously very reassuring.

ALAMY

Dear Dr James,

Having read your column this week, due to the ‘editors pick’ recommendation, I would suggest that Primary (AL) Amyloidosis is a cause of changes in taste, along with an enlarged or inflexible tongue. If picked up early, Amyloidosis can be successfully treated, especially by the NAC (National Amyloidosis Centre) at the Royal Free Hosp. A rare but overlooked disease, due to the difficulty in diagnosing it.

http://www.ucl.ac.uk/amyloidosis/nac/amyloidosis-overview

With best wishes,

Jean

Jean R

Dear Jean R,

Thanks for being in touch and drawing attention to Primary Amyloidosis as a cause of taste disturbance. I hope to mention this and the NAC in the near future.

Dear Colleague,

Your column today touched on this subject. It reminded me of a previous writer who reported to you that “lifting his scrotum” helped empty his bladder and solved his tendency to recurrent UTIs. I wrote to you at that time pointing out that what he was probably doing was massaging, or milking, his spongeosus urethra. though I haven’t suffered UTIs myself, such a manoeuvre succeeds in preventing embarrassing leaks down ones trouser legs having put everything away and “adjusted one’s dress” in the mistaken impression that one had finished urinating! Perhaps you recall this correspondence?

Dear Anon,

Thanks for being in touch I do indeed recall that correspondence and will be mentioning it again in the Monday column in the near future.

Regarding the medical query from AN from Aberdeen who suffers a transient loss of taste after cooking the family supper.

I used to suffer a bad headache after cooking the Sunday dinner until I realised that this was caused by keeping my head bent forward as I prepared the food (more preparation that a weekday meal).

I also suffered headaches on holiday until it was suggested that this was caused by tilting my head backwards as I swam the breaststroke (to keep my glasses and hair dry!!!).

His head position may be a cause of the problem suffered by AN.

Also, regarding overlooking the rarer causes of common conditions, I suffered body and head itching and also a tremor in my leg which caused problems when driving. As I have a history of depression these problems were dismissed as being psychosomatic. Some time later I developed palpitations and by chance saw a different doctor to my regular one. Without the pre-knowledge of my mental illness (although it is in my notes) she immediately suspected an overactive thyroid and this subsequently proved to be the case. The previous symptoms were a precursor of hyperthyroidism.

Regards

Gillian C

Dear Gillian C,

Thanks for being in touch and your interesting account of this cooking related headache – an interesting phenomenon I had not previously encountered. I was intrigued too by the unusual presentation of your overactive thyroid and will mention this in the column shortly.

Maybe this is too late for inclusion, but I’ve found that pushing gently upwards on the perineum helps too. (Only works for 50% of the population, I suppose.)

Dear Anon,

Thanks for that further hint on promoting urine flow.

Dear Dr Le Fanu

In your piece in the DT on Monday 10th February you referred to a neurological condition that readers had experienced whilst being on holiday. Amongst the symptoms were; a severe sore throat, leading to deafness, loss of balance, difficulty in swallowing, facial palsy on the left side and the closing of the left eye.

I thought you might be interested to hear that I have all of those symptoms but from a totally different set of circumstances.

Having been a Trigeminal Neuralgia sufferer for a very long time I underwent the Glycerol Injection procedure for the relief of that condition in January of 2011 at the Princess Elizabeth Hospital in Birmingham as a NHS patient. Following this procedure I immediately developed a severe sore throat which persists to this day and deafness in the left ear. Although the latter was a known possible side effect of the procedure all the other symptoms seem to have arisen from the procedure too. When I mentioned them at the subsequent check ups the Consultant’s ignored them.

Your mention of Dr John Boughey’s opinion on the likely cause, a herpes simplex virus, is most interesting and is something I would dearly like to discuss with my GP and the Consultant’s at Birmingham as I am also experiencing what seems to be a never ending cold, itching to the eye lids, headaches, migraines and sweating at present. But that is unlikely to happen as it is considered poor form by them when referring to another clinician’s views or experiences.

Incidentally, is Dr Boughey an American by any chance?.

In conclusion may I thank you for your most interesting column which you produce with great compassion and humour.

Thanks and regards.

Peter

Dear Peter,

Thanks for being in touch and your kind comments about the column. It would appear from the description of your symptoms that the treatment of your trigeminal neuralgia must have damaged the glossopharyngeal nerve in close proximity to cause this deafness and sore throat. I would not have thought the herpes simplex virus is implicated.

Sir,

I was most interested in the final point in your print column this week suggesting gentle tickling of the base of the spine to encourage passing of the last drops during urination.

This has been a tip in my family for many years and I found it invaluable when caring for my adored mother in her final months, whilst supporting her on the commode. Avoiding that annoying feeling of not having finished is especially useful when getting out of bed is such a difficult enterprise.

I can also confirm from my own experience that it is equally useful when putting tinies on the pot last thing at night. It has probably helped to save me many disturbed nights, and my dear parents many a wet nappy!

Yours faithfully,

C.P. B

Dear C P B,

Thanks for being in touch and I am so interested to hear of your family tradition on the value of tickling the base of the spine – and particularly for the ‘tinies on the pot’. I will be mentioning this shortly.

ALAMY

I am 80 years old and I am having trouble sleeping. I go to sleep quickly but I then wake up between 2/3am and cannot get back to sleep. Any suggestions?

Regards Brian D

Dear Brian D,

Thanks for being in touch. This type of insomnia is, I suspect, not unusual for those in your age group for which there is no specific remedy other than perhaps a small dose of a sleeping pill such as Zopiclone.

I am male aged 85 and have taken 10mg amlodipine, 1mg doxazosin, 10mg enalapril & 2.5mg bendroflumethiazide daily for 18 years the water tablets instead of speeding up the excretion of water i.e a tin of beer taken mid-day Sunday would be removed 2am Monday. does this matter?

Jack

Dear Jack,

Thanks for being in touch I cannot begin to imagine why your medication should have the paradoxical effect you describe.

Dear Dr Le Fanu,

Further to your Doctor’s Diary in The Telegraph of March 3rd, I thought it might be helpful to remind you of the physiology behind Taste and Smell. The former responds to fluids only, is subdivided into 4 parts (sweet, sour, salt and bitter), and is appreciated by “buds” at the back of the tongue. The latter is activated only by gaseous substances drawn past olfactory receptors at the back of the nasal septum, and can be lost as the result of catarrh or a head cold. I suspect that your Mr AN from Aberdeen is suffering from chronic catarrh affecting his sense of smell, and this is aggravated by the heat of the kitchen cooker! But your oenophile may have a neurological problem involving his sense of taste, which might require a neurological second opinion. I am not an expert in such matters, but just happen to remember my Primary FRCS physiology from the distant past !!

J.B – FRCS

Dear J B,

Thanks for your most interesting suggestions both as to the cause of the cooking related anosmia and the selective wine dysgeusia – that I will feature in next week’s column (Monday 10th March).

Dr Le Fanu"s on the web health clinic, Friday 7th March 2014

Today in healthcare: Wednesday five March

Great morning and welcome to the every day weblog from the Guardian’s community for healthcare professionals, offering a roundup of the crucial 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 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.

If you missed our coverage of the Health and Care Innovation Expo yesterday, including David Nicholson on his largest regret, Tim Kelsey on care.information and Jeremy Hunt’s conference speech, pay a visit to Tuesday’s blog.

The Guardian reports on Nicholson’s interview at Expo, in which he combined a belated public admission of his problems above the Mid Staffs scandal with a warning that the support should undergo agonizing changes if it is to continue to be viable.

In other news nowadays:

• HSJ: Labour evaluation – councils need to show “readiness” to consider on care of “frail” patients

• Pulse: Burnham contemplating permanent 48-hour appointment target

• Independent: Blood-stained walls amid a litany of ills at ‘crisis’ hospital

• BBC: Welsh hospital death rates ‘to be clearer’

• Guardian: Animal protein-wealthy diet plans could be as dangerous to health as smoking

• Guardian: Sugar ‘could be addictive’

• Telegraph: Warning for binge drinkers more than-fifty five

• GP on the web:NHS England bid to strengthen organization support for GP practices

• Nursing Instances: Recipients of £30m fund for nursing technological innovation unveiled

A new video for the Guardian shows how the busiest A&ampE division in the United kingdom, at Queen’s hospital in Romford, east London, relies on locums, portion-time doctors and on recruiting employees from abroad.

Within Britain’s busiest A&ampE – video

Saleyha Ahsan, a medical professional at Queen’s, explains why she decided to make the movie, which depicts the true-existence drama of targets and staff pushed to the restrict. She writes:

The Tv stories of George Clooney and the ER cast don’t come shut to reality. My analysis into the speciality obviously went past viewing health-related dramas but nothing ready me for what it was in fact like.

… I went through a time period of possessing palpitations throughout a stretch of incredibly difficult shifts last winter. It was when I had a palpitation and nearly passed out even though driving that I made the decision to step down my intensity of function. I had additional investigations but the remedy was apparent. I reduced my shifts and the palpitations have stopped.

Above the previous 3 years I have worked harder than in my previous life in the army. I went via the Sandhurst commissioning course, renowned for its hard routine, but in accident and emergency medicine at its peak, the intensity is tougher.

This week is Nationwide Apprenticeship Week Candace Miller, director of the Nationwide Capabilities Academy for Health, writes for the network describing what she learned when she invested a day on the frontline with an award-winning 17-12 months-old recruit.

Our columnist Richard Vize has interviewed Keith McNeil, chief executive of Cambridge University hospitals NHS foundation believe in, for the SocietyGuardian section.

Keith McNeil, chief executive of Cambridge University Hospitals NHS Basis Believe in, tries to imbue his employees with the self-belief to act rather than be informed. Photograph: Graham Turner for the Guardian

And Anna Bawden reports for SocietyGuardian on a new project in which patients and NHS staff perform with each other to boost providers.

Elsewhere, Alan Wilson asks on the Overall health Basis blog: how can we produce a ripple result of good quality improvement in the NHS? and Alex Baylis blogs for the Nuffield Trust on responding to the Francis Inquiry.

That’s all for right now, we’ll be back tomorrow, reporting dwell from the Nuffield Trust Wellness Policy Summit. And really do not overlook, there is nevertheless time to take portion in our most current health pros survey – share your views on how your operating daily life has altered over the last yr, how the well being service should be financed, and the care.information project.

Today in healthcare: Wednesday five March

Today in healthcare: Tuesday 4 March

Excellent morning and welcome to the daily weblog from the Guardian’s community for healthcare professionals, we’re reporting from the Health and Care Innovation Expo in Manchester. To catch up with yesterday’s speeches and debates, see yesterday’s weblog, and you can follow it on Twitter by means of the hashtag #Expo14NHS.

The health secretary, Jeremy Hunt, is due to communicate at the conference right now and David Brindle, the Guardian’s public solutions editor, will be interviewing Sir David Nicholson. But initial, here’s a run by way of this morning’s healthcare headlines.

The Guardian reviews on a call by the public accounts committee to supply pay out increases to consultants functioning in struggling accident and emergency departments to halt a chronic shortage in certified and knowledgeable workers. Responding to the report, wellness minister Dan Poulter said:

It will take 6 many years to train an A&ampE advisor, and there is no easy resolve – but our prolonged-phrase plans are robust, escalating the quantity of training locations by 75 subsequent year, and planning for all trainee physicians to spend time in A&ampE. We are also seeking at generating an A&ampE job far more eye-catching as portion of our negotiations on the advisor contract.

Well being minister Dan Poulter says the government is seeking at creating a profession in A&ampE much more appealing to consultants. Photograph: Felix Clay for the Guardian

There is also news that a prominent Tory MP on the wellness choose committee has questioned how the complete NHS hospital patient database for England was handed more than to management consultants who uploaded it to Google servers primarily based outside the Uk.

And NHS figures reveal that record numbers of critically ill individuals had their lives saved or extended final year after the biggest ever variety of people donated their organs right after death.

Today’s other healthcare headlines:

• BBC: A single in 5 ‘admits misusing A&ampE’

• Pulse: One in three GP requests to near their practice checklist blocked by NHS England

• Guardian: Fears of patient information leak prompt inquiry into mapping internet site

• Telegraph: Labour – support people deal with themselves

• Nursing Instances: Nursing directors need to ‘over-recruit’ by 10%, says best manager

• HSJ: Contact for investigation into ‘bullying’ at cancer trust

Today in healthcare: Tuesday 4 March

Today in healthcare: Monday 3 March

Excellent morning and welcome to the every day blog from the Guardian’s neighborhood for healthcare pros, we’re reporting from the Wellness and Care Innovation Expo in Manchester.

But prior to the occasion begins, here’s a roundup of this morning’s healthcare headlines.

The Guardian reviews on a warning that the prevalence of poverty–stricken families who can not afford to acquire ample foods is overtaking unhealthy consuming as the most pressing public overall health concern. The declare, reports Patrick Butler, is made in a BBC Panorama documentary to be broadcast on Monday evening which discovered that more than a third of regional authorities in England and Wales had been now supplying funding for food banks, regardless of government claims that charity foods is not a element of the social safety method.

Panorama has discovered that above a third of regional authorities in England and Wales had been now providing funding for meals banks. Photograph: Christopher Thomond for the Guardian

Today’s other top stories:

• Telegraph: Targeted treatment offers hope to cancer individuals

• Guardian: Smoking breaks at operate expense British businesses £8.4bn a yr, examine finds

• Independent: Terminally unwell guy deprived of right to die at home due to healthcare failings

• eHealth Insider: Open supply strategies revealed

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

Today in healthcare: Monday 3 March