August 11, 2022

Q. Slightly lump has developed on my proper wrist which my GP says is a ganglion. It’s inflicting lots of ache and weak point in that hand. I’m informed it can’t be eliminated as a result of there’s a vein operating throughout it. Can the rest be accomplished?

A. Ganglion cysts are the most typical sort of swelling GPs see on the hand or wrist. They’re normally discovered on the again of the hand, the wrist or on the backside of the thumb, and are innocent.

We don’t know what causes them, however they often develop after an damage and are extra frequent in arthritis victims.

Some individuals don’t discover them, however others do as a result of they will trigger ache or discomfort with sure actions.

If a ganglion shouldn’t be inflicting any hassle, it’s higher to go away it alone as the bulk disappear spontaneously. As a result of they’re fluid-filled cysts, and never stable lumps, there isn’t a menace of them turning into something nasty in the event you do ignore them.

Years in the past, docs believed one of the best therapy was bashing them with a heavy ebook (which in most properties was a Bible, therefore their nickname of Bible cysts), which was thought to redistribute the fluid and eliminate the swelling.

Fortunately, now we have now moved on considerably.

Relying the place the ganglion is, it may be surgically eliminated or the liquid may be sucked out with a needle. The success of such approaches is determined by the place of the cyst and if there are close by blood vessels.

Some well being chiefs don’t fund these procedures as they’re thought-about beauty, but when the cyst is interfering together with your every day life, therapy needs to be obtainable on the NHS.

If sufferers have questions on a process to take away a ganglion, GPs can refer them to an NHS hand surgeon who can present further element.

One reader has been left in ache after a ganglion cyst developed on their wrist and is asking what may be accomplished to deal with it (inventory picture)

Q. Are you able to assist with my erectile dysfunction drawback? I used to take Cialis or Viagra tablets they usually labored very effectively, however now neither appears to have any impact. I’m 82 and it looks like my docs don’t take the issue significantly as they assume I’m too previous. Do you have got any recommendation?

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A. Any well being drawback that impacts your high quality of life is worthy of an in depth investigation by a GP, regardless of your age.

Cialis and Viagra each deal with erectile dysfunction, but when neither works, a physician may initially surprise if the dose must be elevated or whether or not they’re being taken accurately.

These medicine usually need to be taken at particular occasions and never too near meals.

There are different medicines obtainable – vardenafil and avanafil are value a strive.

Erectile dysfunction is handled as a symptom of one other situation, as there’s usually an underlying trigger. GPs ought to carry out blood exams to verify for diabetes and low testosterone, whereas additionally desirous about medicines as a possible trigger. An enormous variety of medicines can result in issues with sexual operate, together with antidepressants and tablets for hypertension.

In aged individuals, erectile dysfunction generally is a signal of Parkinson’s illness or coronary heart well being issues. If the issue develops all of the sudden – alongside different weaknesses or adjustments within the physique – it might point out a stroke. Sexual operate can also be very carefully linked to emotional wellbeing, and issues can usually be related to melancholy, anxiousness and stress.

Drugs aren’t the one therapy. If medicine are ineffective, males needs to be supplied therapies that may be prescribed by a specialist reminiscent of vacuum pump gadgets, injections and lotions.

Q. 5 years in the past I used to be recognized with an issue with my bicuspid coronary heart valve. However additional exams of my coronary heart operate got here again regular, so the physician stated no motion was required. Is it prone to keep that means, or can the issue trigger hassle?

A. The valves within the coronary heart are essential for ensuring blood flows in the appropriate path. As an example, oxygen-rich blood has to journey away from the center to the remainder of the physique, to ensure it will get the vitamins it wants.

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The primary valve within the artery leaving the center – the aortic valve – usually has three flapping components which open when the center beats and pumps out blood, guaranteeing blood travels by means of in a single path solely and might’t stream again into the center.

About one particular person in 50 is born with an aortic valve with solely two flaps. We name this a bicuspid valve. In most individuals, it doesn’t trigger any issues, they usually discover out they’ve it solely throughout a coronary heart scan that’s carried out for an additional purpose. Generally docs will search for it through a scan in the event that they hear a coronary heart murmur.

DO YOU HAVE A QUESTION FOR DR ELLIE? 

Electronic mail [email protected] or write to Well being, The Mail on Sunday, 2 Derry Avenue, London, W8 5TT. 

Dr Ellie can solely reply in a basic context and can’t reply to particular person instances, or give private replies. 

You probably have a well being concern, at all times seek the advice of your personal GP.  

If it isn’t inflicting any issues when recognized by a physician, they received’t do far more than monitor the affected person repeatedly.

Most individuals is not going to want any additional therapy. Nevertheless, a bicuspid valve also can trigger severe points as a result of it’s extra susceptible to put on and tear than a traditional valve. It will probably turn out to be stiff and slender or too floppy, permitting blood to leak again into the center.

These issues cease the center working correctly and result in breathlessness, chest pains, dizziness and even blackouts.

If there are indicators the valve is degenerating, a specialist will enhance the frequency of scans and, finally, could counsel a process to switch it. However which means complicated coronary heart surgical procedure, so it might be accomplished provided that deemed completely important.

Why you mustn’t overdo HRT 

I used to be alarmed by a letter from a reader final week who stated she’d been given ‘an excessive amount of’ HRT by her non-public GP.

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When the dose she had been prescribed didn’t sort out her sizzling flushes and insomnia, the doc informed her to make use of twice the quantity of treatment. This nonetheless didn’t work, so the physician added one other treatment after which upped the dose of that.

By this level the affected person was struggling breast ache, cramps, bloating, nausea and complications.

‘I felt poisoned,’ she wrote.

I’m not stunned. Excessive doses of feminine hormones can set off a spread of significant uncomfortable side effects, and it’s not advisable to take larger-than-normal quantities.

She lowered her dose, discovered all the pieces improved, and by no means went again to that physician.

Has anybody else had an identical expertise? Write to me and let me know.

Dr Ellie Cannon was contacted by one reader who claimed she had been given 'too much HRT' by a doctor (stock image)

Dr Ellie Cannon was contacted by one reader who claimed she had been given ‘an excessive amount of HRT’ by a physician (inventory picture)

Let me know in the event you can’t contact your GP on-line

Does the seemingly unstoppable drive to maneuver all GP companies on-line make you anxious? Do you are feeling that with out a smartphone, you’ll find yourself not with the ability to entry important healthcare companies? I do know there are lots of of you on the market – as a result of I persistently obtain letters from readers saying so.

It’s estimated that one in ten Britons battle with internet-based companies, so GP surgical procedures lately generally is a entire new world for some sufferers, with apps, texts and web sites used for all the pieces from prescriptions to appointment reminders.

I worry it will turn out to be more and more troublesome for individuals who can’t log on.

Your GP ought to have the ability to give recommendation, assist and assist with studying the way to get on-line, in the event you say you’re fighting entry. However I do fear some individuals are lacking out.

If that is you, write to me and let me know – I need to attempt to assist discover a answer.