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

Dr Le Fanu"s on the web wellness clinic, Friday 21st February 2014

Best wishes. Barbara C

Dear Barbara C,

Thanks for that further useful tip on how to ensure the bladder is properly emptied. I will be mentioning this in the Monday column on the 3rd March for the benefit of others. Best wishes.

A simpler and very effective answer to emptying one’s bladder, thus preventing frequent nightly trips to the loo, and, more importantly, avoiding infection, is to rock one’s pelvis back and forth whilst sitting on the lavatory. Just 1/2 dozen of these movements then a pause and repeat as necessary, has worked perfectly for me these last 10 years or so.

I also had an ultrascan. The urologist told me to take a low dose of antibiotics permanently! Luckily a friend gave me this invaluable tip.

Ruth,

Dear Ruth,

See above

Sir

Rather than walking around the bathroom between “sessions” on the loo, the advice from a Nursing Sister in Lincoln, after my colposuspension op. about 25 years ago, may be of interest.

When I couldn’t produce the amount of urine required before I was discharged, she suggested I “tickle” the base of my spine until the bladder reopened and discharged the final stream.

It worked then – and has gone on working since – and doesn’t require moving from the loo between streams!

Yours

Jane K

Dear Jane K,

See above

I read your advice about how to cope with repeated attacks of Cystitis which I have found helps enormously. In addition I also ensure that there is no constipation which also adds to the build up of urine residue in the bladder. I eat bran for breakfast together with two prunes in juice and this works like magic. As a result I also have avoided repeated attacks which lasted on and off for several years. Yours sincerely, Sheila Z

Dear Sheila Z,

See above

Dear Dr Le Fanu,

I’m a 60-year-old female in good health except for the following. I have very painful leg cramps, which wake me up, beginning at about 6-6:30 AM, when either the furnace or the air-conditioning switch on. They run from the point of the hip down the outside of the leg to the knee. They never go below the knee and only occur in the right leg (the side I sleep on) and when I am in bed. The pain is excruciating and no amount of massage or stretching makes it go away. They last about 20 minutes. My doctor is baffled, although she wondered if a shift in air-pressure from the furnace could be triggering it. But what precisely is it triggering? I have had sciatica, but only in the left hip and this does not feel the same, as well as not extending to the calf and foot. Any suggestions?

Many thanks,

Chris W.

Dear Chris W,

Thanks for your query about these agonising muscle cramps which I too suffer from. From personal experience I find they are best relieved with a small dose (2mgs) of the muscle relaxant Diazepam. There is no obvious explanation for why they should wake you in the early morning though I would doubt it is related to the boiler/air conditioning.

Dear Dr James

I am 84, have very recently had a heart attack and have been diagnosed with severe aortic stenosis. My daughter is adamant that because I have now been put on statins, I should be taking CoQ10 to counteract the depletion of this from my body by the statins.

I have asked both my GP and the coronary nurse about CoQ10 and neither of them seem to know much about it. Do you think it will be beneficial for me?

I am taking the following medication and have reserves about taking any supplementation without knowing whether it may affect what I have been prescribed:

Amlodipine 5mg daily

Levothyroxine 125 micrograms daily.

Valsartan 80mg daily

Aspirin 75mg daily

Atorvastatin 80mg daily

Ticagrelor 90mg twice daily

Lansoprazole 15mg twice daily

Bisoprolol 3.75mg daily

Glyceryl trinitrate 400 microgram S/L spray (75-dose) as needed

Thank you advance for your advice.

Best regards

Jean T

Dear Jean T,

Thanks for being in touch my and sympathies for your recent heart problems. I note you are already taking a long list of medications and appreciate your reluctance to take yet another. Nonetheless there is an obvious rationale for those on statins to take CoQ10 as they block the production of this important enzyme in the liver. A recent review suggests this is likely to be of particular benefit for those like yourself over the age of 65.

Dear Dr Le Fanu

Thank you so much for your brilliant column and regular online clinic.

I have read that waist to height ratio is a better indicator than Body Mass Index for various serious future health problems.

Dr Michael Mosley’s Fast Diet book for one advises that your waist measurement should be no more than half your height. For the former he says to measure around your belly button.

I am 1m74 tall and weigh 66 kg. I am fit with good muscle tone and usually described as slim but if I don´t hold my stomach in and measure round my belly button, I am in the at risk category (92cm). However, my actual waist is a good 5cm above my belly button and if you measure this waist, I am well within the parameters of safety (79cm).

Should I be concerned?

Thank you

Dear Anon,

Thanks for your query. The appropriate measurement is ‘the smallest circumference of the natural waist’ – so you are indeed within the ‘safety parameters’.

Good Evening Doctor

I am a perfectly well 70 year old male with one strange and intermittent problem. I cook for the family every night and on average three times a week I lose 80% of my sense of taste during cooking. It only happens when I cook – never ever at any other time. And it doesn’t happen every time. And it returns to normal about an hour after I’ve cooked (and enjoyed the (tasteless) fruits of my labours.

Have you come across this before?

Dear Anon,

Thanks for that most puzzling query that I have never encountered before. I will mention it in the column for the 3rd March and it will be intriguing to find out whether others describe a similar experience.

Dear Dr. Le Fanu,

I am a 59 year old woman, who encountered during a snorkelling holiday in Minorca last October, the exact same pattern of neurological symptoms as the retired RAF Group Captain who had holidayed there (he replied to the back-packing lady on holiday in West Africa).

In the last few weeks my symptoms have been reduced to the ear-clicking deafness, a twitching of the left eye whenever a headache resumes and a red, spotty rash around my mouth.

My holiday was at Punta Prima on the south-east tip of Minorca and I would very much like to know if the RAF gentleman was on holiday in this part of the island, as perhaps the water quality was not as it should be for a Blue Flag quality area.

Best regards,

Linda B

Dear Linda B,

Thanks for being in touch and how fascinating that when on holiday in Minorca you should have experienced the same neurological syndrome as Group Captain G. If you want to get in touch we can pass on his email address.

ALAMY

Dear Dr Le Fanu,

I have been very interested in the recent debates about statins.

I have rheumatoid arthritis and my cholesterol readings have always been high at around 7.9.

I cannot tolerate statins have tried them all.

Recently I had to see a cardiologist on another matter took with me the results of a recent blood test,he looked at this and said you need not worry as you have lots of good cholesterol.

This made me think and wonder how many other people are like me without ever being told?

Yours sincerely Mrs Iona A

Dear Mrs Iona A,

Thanks for being in touch. I could not agree more that doctors prescribing statins should take into account the good/bad (HTL/LDL) cholesterol ratio. My impression is they rarely do.

Dear Dr Le Fanu,

A question to ask Mr H M and his wife might be: had they both contracted strep infections/sore throats before the emergence of these new fears? There is increasing evidence that the infections can cause anxiety and obsessive behaviours in children. Perhaps the same might occur in adults.

http://www.scientificamerican.com/article/from-throat-to-mind/

Many thanks for your excellent columns and online clinics.

Dear Anon,

Thanks for being in touch and for drawing my attention to that most interesting article in Scientific American. I do not know of this link between ‘throat and mind’ and will pass it on to Mr H M.

Dear Dr Le Fanu,

I was interested to read (in the Telegraph) of the lady who was given the dementia test. I had a similar experience a few weeks ago. I am 81. Completely out of the blue I had a phone call asking me to attend the surgery for a blood pressure test. I was rather bemused about it (even though within the last year I have had cancer operations and radiotherapy which has taken a bit of a toll), but I attended. After the BP test I was asked to draw a clock face in a circle on a sheet of paper. I asked if it were a dementia test and the doctor declined to reply. Other memory and cognitive tests followed e.g. a random name and address, reciting numbers backwards, etc. etc. I asked the doctor if she could recite the alphabet backwards (as I can at speed) but she declined. In retrospect I felt I should have walked out. The blood test was so blatantly a devious ruse to get me to the surgery to do the test. And when she refused to confirm what the test was for, that was so rude. I felt I was treated like an ignorant “specimen” to achieve the practice quota. If she had explained what she wanted I would have found the tests of some interest. Instead it got my back up and I shall feel suspicious of any further unsolicited requests from the practice.

I felt like writing a strong letter of disapproval to the practice manager / senior doctor but desisted as I was afraid that if I rubbed them up the wrong way they could make things difficult for me when I need their help.

Yours sincerely,

David C

Dear David C,

Thanks for being in touch with your most disturbing account of your experience of dementia screening. I have summarised this in the medical column of the 3rd March to warn others of this devious (and unethical) ploy.

Dear Dr James,

I have read all the recent letters about prostate issues and feel my experience may help others. I am 69 years of age and was diagnosed with prostate cancer 5 years ago, (PSA 10.5) . The tumour was Gleason score 7. It was contained within the prostate although very close to the nerves likely to affect incontinence and impotence. I took the option of radiotherapy and it was the best solution without doubt. In the last 5 years I have not experienced any erectile dysfunction or incontinence. My 6 monthly PSA checks have constantly remained below 1.0. The radiotherapy treatment was high density modulated treatment spread over 38 sessions. Having read much about diet and prostate health I cut out all dairy products. Drink soya milk, avoid all red meat, eat lots of fruit and vegetables and take regular exercise. For many years before my diagnosis I ate 500g of natural yogurt every day and strongly suspect this contributed to my prostate cancer.

I now feel very positive about the future and intend to maintain my healthy lifestyle. I hope my experience help others.

Best regards

B. W

Dear B W,

Thanks for being in touch and I would certainly concur that for those with your type of prostate cancer, radiotherapy is a much better option than surgery.

Dear Dr Le Fanu,

I always enjoy your informative Friday column, and am wondering if you can offer any help to alleviate my embarrassing problem, namely, over-salivation. I am 84 and have no health problems other than an underactive thyroid. This is dealt with by 100mg thyroxine daily, and has never caused me any trouble. But as I have grown older my saliva flow seems to have increased. The problem is not helped by the deep creases that run from the corners of my mouth, providing channels down my chin! I have not had a stroke, and my teeth are well maintained. I wonder if there is something astringent I could suck?

Yours hopefully

Dear Anon,

Thanks for your query and my sympathies about this embarrassing drooling problem. This can certainly be due to over salivation but in your age group is more likely to be related to a defect in the mechanism for swallowing saliva. Hence the rationale for the (paradoxical) treatment of chewing gum that increases the volume of saliva which is then more readily swallowed. I would be more than interested to hear if this works for you.

Dear Dr Le Fanu

It was interest that I read your article in today’s DT about the effect of Omeprazole on iron levels. A couple of years ago I was diagnosed with the hereditary form of Hemochromatosis and after scans to ensure that iron hadn’t built up in my heart, liver, stomach and lungs and regular venesections, the iron levels are under control but are monitored.

As I have acid reflux due to a hiatus hernia, I take one Omeprazole before breakfast which solves the problem for the day. My consultant knows that I take Omeprazole. Does this medicine have any effects on my Hemochromatosis?

Yours sincerely

GW (aged 75)

Dear G W,

Thanks for your query. The reduced iron absorption with Omeprazole should theoretically be of value in patients with hemochromatosis though it is unlikely to confer any benefit over and above that of regular venesection.

I was 90 yrs.old last December and am in excellent health (apart from a few arthritic joints) but I have had a very tiresome tickly throat for at least 30 years – which I have not been able to ease or cure by cough mixtures etc – & which produces phlegm after taking food.

Have you any suggestions to help my tiresome & long-standing problem?

I do enjoy reading your very helpful advice on minor problems every Monday! Do hope to find some helpful suggestions in your Medical column on Mondays!

Regards from Mrs.Barbara C

Dear Mrs Barbara C,

Thanks for being in touch and my sympathies for this long standing tickly throat/chronic catarrh throat problem. It certainly sounds as if this could be due to chronic rhinosinusitis in which case it might respond to a three month course of low dose Erythromycin as mentioned in the column last week. Alternatively you might discuss with your doctor a trial with the nasal spray Rhinolast (see my response to Simon P below).

I have for some years developed quite severe muscle pain overnight. This does not happen every night but seems to go in phases.

Rather difficult to describe. It occurs mainly in my thighs and forearms but increasingly seems to affect other muscles. Around my neck and shoulders. Cumulatively it is extremely uncomfortable – possibly waking me and forcing me to get up in the night. It is more than just stiffness; possibly like extreme muscle tiredness. At times my muscles seem on the edge of cramp. Lately I feel as though I am vibrating when it is at its worst. There is no movement however; just an impression. I feel shattered in the mornings but it subsides within an hour or so.

I have the Rheumatoid factor and have attended clinics for quite a long time. I have been told that I do not fit into any pattern and have not received any treatment as such. I do have arthritis in wrists and hands but my strength is pretty good.

The nearest I have come to a diagnosis was from a neurologist who after electrical muscle tests tentatively suggested Myositis. This was dismissed by rheumatology but they did send me for an MRI of my muscles but I do not yet know the result of that.

I am 75 years old.

I do hope you may have some idea what is wrong. I cannot believe that it is all in my imagination.

Regards

Brian H

Dear Brian H,

Thanks for being in touch with your description of these unusual muscle symptoms at night. I have not encountered this before and will mention this in the column in the hope that someone will be able to clarify what is amiss.

Dear Dr James

Last year my 47 year old son-in-law fell ill with viral encephalitis, and after two months in hospital he is at home, slowly making a good recovery while suffering short term memory loss. A few years previously my other son-in-law, then aged 35, was suddenly taken seriously ill with a very high temperature and severe pain in his groin, which was diagnosed as a bacterial streptococcus infection and from which he thankfully recovered after five weeks in hospital.

Both were very fit, high achieving young men who took care of their health and exercised frequently. I have been wondering what could be the common denominator that caused them to be susceptible to these rare and life threatening illnesses. They had not been overseas in the preceding months. The only thing that comes to mind is that both had become weight conscious and were on an Atkins type diet, following the rules impeccably. Might it be that the sudden complete change to their diets, which excluded fruit, potatoes and bread, could result in a reaction affecting the immune system? Their families, who were eating as usual, did not show any signs of illness.

I would be interested to know if you have any views on the subject.

Kind regards

Anita

Dear Anita,

Thanks for being in touch and your account of those serious infectious illnesses experienced by both your sons in law. This is almost certainly one of those unfortunate consequences and I would not have thought there is likely to be a ‘common denominator’ of the sort you mention.

Fear of heights (Mr HM Bolton)

As a Clinical Hypnotherapist, I have helped very many people suffering with this problem. I strongly urge him and his wife to find a reputable Clinical Hypnotherapist.

Kind regards

Enid H

Clinical Hypnotherapist

Dear Enid H,

Thanks for being in touch. Several other readers have mentioned the value of hypnotherapy in this situation and I will mention it in the column shortly.

Our close friend was put on Statins by his doctor. Although he complained several times to his doctor about the side effects he was suffering he was not listened to. After talking his brother in America he was made aware of many complaints in the USA about some side effects. He gave statins up, started taking more exercise and had a better diet with a self regulating 2 days off things. After a few weeks he was free of the side effects felt better and his cholesterol was much lower. We noticed the difference while he was on statins to when he came off and it was quite noticeable.

A story about experts in WW1. Some experts stated that if the body went over 100 mph they would die. Other experts said rubbish. Pilots soon were over the 100 mph mark and survived.

Dear Anon,

Thanks for your account of your close friend’s statin experience. Might you perhaps have a reference for the claim about the dangers of travelling at 100 miles an hour?

Retracting penis

About 15 years ago when I was working and could afford private insurance I consulted a urinary specialist because I felt that something was wrong with my scrotum and testicles. He told me that fatty tissue had descended into my scrotum, no cause for alarm, not cancerous, an operation not necessary and would in fact do more harm than good.

Now many years later the old sensations have returned: one testicle is sore to touch and the scrotum has acquired a lot more fatty tissue which causes an unpleasant feeling of being over-filled.

It has wrapped itself around the shaft of the penis which, in turn, now looks as if it has virtually retracted into the abdomen. Its visible length is now around one inch which means that to urinate I have to push the fatty tissue out of the way as I tug it into the outside world. At home I just drop my trousers .. But this is not possible when using public, theatre or restaurant urinals. Inevitably there’s often a small amount of urine left which then trickles into my trousers, announcing the fact that I have “wet myself”.

I have tentatively sought some help and advice from the local hospital departments but whereas the private sector was helpful, the NHS seems to think it’s an hilarious situation and refuse to take me seriously – I’m the silly old fool who reckons he’s the real live Little Willie.

Must I accept it as simply being a good anecdote when doctors get together to swap funny patient stories ?

Dear Anon,

Thanks for being in touch. The problem you describe is known, for obvious reasons, as Buried Penis Syndrome. It certainly sounds as if you might benefit from some sort of surgical repair as described by Dr Miroslav Djordjevic on the informative website of the Belgrade Centre for Reconstructive Surgery. I am dismayed the urologists at your local hospital have been so unhelpful and you should discuss with your doctor being referred elsewhere.

ALAMY

Reading your item on catarrh, might I suggest another possible cause.

For probably 20 years I had a great supply of mucus, but because it increased so very gradually I did not even realise I had a problem. Only when I found that I could inhale through my left nostril but NOT exhale did I consult a specialist who said I had a large polyp there. It took 3 operations to get all of the thing out, but at last I now have a dry nose !

Hamish G

Dear Hamish G,

Thanks for being in touch. Nasal polyps, as you say, are an important and treatable cause of excess catarrh.

Dear Dr James,

I am emailing for advice on behalf of my mum.

In September 2011 she went into hospital to have a full knee replacement on her left leg and drastically my dad died suddenly at home on her first night in hospital. She just needed to be home and so came out of hospital the day after her operation. As well as the huge pain in her heart she started suffering with pain in the back of her legs (like sciatica) – being worse in her right leg. She has had this pain constantly since then. Her new left knee is working well and isn’t painful. In September 2012 she had a big operation to her lower back to release trapped nerves from collapsed discs to help with the pain in her legs. Unfortunately this has made no difference to the pain in her legs.

This January she had to have a full knee replacement on her right leg as it was bone on bone. The operation went well and she is doing well with it. However she is still In the same pain down the back of her leg.

She is continually using a tens machine to help with the pain and sleeps all night with a hot water bottle and an electric blanket. She has tried tablets that dull nerve pain and although they give her a small bit of relief the side effects far outweighed the benefits. She has also had trigger point injections in her thigh and buttocks.

A physiotherapist has told her that she finds it hard to believe it is sciatica as she can sit up ok with her legs out in front of her.

She is a young 70 year old and if her knees and legs hadn’t been bad she would be very active. She has two dogs and loves to go on long walks.

We are at our wits end as to what to do for the best. She hasn’t been able to move on since my dad died as she is continually in pain and can’t enjoy life like she would love to. She is naturally a very positive happy person but when it has got really bad she has said that she wants to end her life.

Back in 2008 she was diagnosed with non-Hodgkin’s lymphoma and underwent 6 months of chemotherapy. She was given the all clear and now goes for check ups every 8 months. Could the chemotherapy have affected her bones, joints, nerves etc? She has already been told that she will have to have new hips in the future.

Any advice would be gratefully received.

Many thanks

Dear Anon,

Thanks for being in touch and my sympathies for your mother’s persistent pain following her knee replacement which I would doubt is related to her past treatment for non-Hodgkin’s Lymphoma. It certainly sounds as if she has severe generalised arthritis and this pain could well be referred from the arthritis in her hips and will hopefully resolve once they are replaced.

ALAMY

I read Monday’s column about chronic catarrh and I will study the download.

When I was young at and for years I had chronic catarrh, and could never breath through my nose and always had my mouth open. When I was at prep school I was taken to an ENT specialist in London called Dr Robin. He numbed the bone at the back of my nose and then pushed a syringe needle through the bone into the sinus. He then attached the needle to a small vacuum machine and sucked out whatever was in the cavity; I remember ti tickled. The result was miraculous, and I was able to breath through that nostril for the first time in my life. a year later they did the other nostril, and I have not had trouble since.

What is this procedure called and is it still done as my son also has similar symptoms and seems to have a constant cold and I wonder if this technique would work for him.

I look forward to hearing from you.

Regards

Dear Anon,

Thanks for being in touch. My impression is that this method of draining the sinuses you describe has now been replaced by a procedure known as Endoscopic Sinus Surgery (ESS). I would suggest your son discuss with your doctor the possibility of being referred to an ENT specialist to consider whether this would be an appropriate treatment for his symptoms.

Dear Doctor

I am an 82 year old man in generally good health. I try to swim (very slowly!) two or three times a week. Before I enter the pool I empty my bladder as a matter of routine. Within 15/20 minutes I am “dying to go” again so I have to come out of the pool to go to the toilet again. At that stage the bladder seems to be full again. Two GPs cannot offer any advice on the cause or treatment of this condition. Can you please?

Dear Anon,

Thanks for your query. This excess urination following swimming is known as Immersion Diuresis, an interesting physiological phenomenon caused by the combined effects of the temperature and pressure of water in increasing the blood flow to the kidneys. It can be prevented with the drug Desmopressin – but I would not have thought this is indicated in your case.

ALAMY

Following your ‘doctor’s diary’ comments yesterday on statins you may find this useful for your file

I am a fit, 77, tall, lean, gentleman of a professional background

Two years ago, after a routine health check blood samples etc., it was told that clinically it had been shown that for persons of my age, regardless of the state of health, a, from then, lifetime intake of statins would be beneficial from the point of view of health protection

So I started taking them every day, within six months, little by little, decrepitude overtook me with muscle aches and pains and overall ennui

This was attributed to ‘old age’ it seemed and as it was so gradual there was no obvious link to the statins

I read an article referring to possible side effects and stopped toking the statins, within a week I was, and remain, in a state of vibrating high level wellness

I hope this is interesting and useful

James G

Dear James G,

Thanks for your interesting account of your statin induced decrepitude that I will mention in the column on 3rd March.

With reference to your correspondent who is concerned about osteoporosis medication, I also have fairly advanced osteoporosis and IBS. I have tried 3 kinds of tablets, all of which caused inflammation of the gullet, and then a powder taken in water, which caused severe IBS symptoms. There appears to be no alternative and I am now just taking the Vitamin A, C & D tablets and crossing my fingers that I don’t fall over.

Another correspondent mentioned restless leg and Esomeprazole, as result of which I left out my evening Esomeprazole tablet with a view to moving on to another antacid. However 10 hours later I was struck with agonising pains in the oesophagus which lasted for 4 hours, so I decided to try to live with the restless legs and take iron supplements instead!

J. W

Dear J W,

Thanks for being in touch and your account of the side effects caused by these treatments for osteoporosis which I suspect are not unusual.

Dear Dr. le Fanu,

I read the piece with interest. I have been plagued by catarrh, secondary to allergies since my chemotherapy with Pentostatin for Hairy Cell Leukaemia in 1996. My immune system is, to use a well known non medical term, shot! I have allergies to all sorts of things, but they are not even consistent. One day I will have rhinitis with conjunctivitis and within hours it might be just the one or the other. I have been using Rhinolast (as well as the other regimes you describe including saline nose washes – Sterimar) for the last 2 to 3 years. It keeps my catarrh under good control. Before that I had maxillary sinusitis at least once or twice a year, whereas I have not had it once since regular use. I have even had the long term erythromycin regime on a couple of occasions. It certainly works, but not forever, in contrast to the Rhinolast.

For your amusement I enclose a letter I wrote to the DT in 1996. At least it shows I am a consistent reader!

I hope this information about Rhinolast might be helpful to your readers. Keep up the good work on resistance to mass medicalisation.

Best wishes,

Simon P

Dear Simon P,

Thanks for being in touch and your account of the benefits of Rhinolast in controlling your symptoms of Rhinitis. I will mention this in the column in the near future for the benefit of the many troubled by this common complaint.

Hello Dr Le Fanu

I have been diagnosed with gastroesophageal reflux disease. My doctor has prescribed 20mg of omeprazole twice daily and gaviscon after my evening meal and at bedtime.

However I read in your column that omeprazole interferes with the absorption of iron.

Could you comment on whether it is appropriate to take omeprazole and if not what are the alternatives? I am retired and aged 65 years and in good health.

Regards

Carol G

Dear Carol G,

Thanks for being in touch and I am sure the benefits of taking Omeprazole for your severe acid reflux more than outweigh its effects in reducing iron absorption.

Dear Dr. Le Fanu,

My 90 year old father is now suffering from the debilitating condition lymphoedema, though is otherwise very well.

Though he has regular clinic appointments and daily performs his exercises, lymph drainage massage and wears his compression stockings, the condition does not appear to be improving.

Could Daily Telegraph readers come up with any suggestions that they have found relieves the symptoms of this very uncomfortable condition?

With best wishes and many thanks for your very interesting column.

Lesley W

Dear Lesley W,

Thanks for being in touch. It certainly sounds as if your father is receiving the best possible treatment for his lymphoedema. There is a most informative website about this condition run by Lymphoedema Support Network.

Dr Le Fanu"s on the web wellness clinic, Friday 21st February 2014

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