August 11, 2022

Q. Three years in the past whereas on vacation I began struggling what felt like electrical shocks in my mouth. Once I received again I visited the dentist, who identified me with trigeminal neuralgia. My GP agreed, however couldn’t provide me any recommendation or therapy. Fortunately the ache disappeared over time, however a number of weeks in the past it began once more. My physician prescribed pregabalin, however it hasn’t helped. Can the rest be finished?

A. Trigeminal neuralgia causes assaults of sudden, extreme facial ache, often on one facet of the face. Sufferers usually describe it as like electrical shocks or sharp, capturing pains within the jaw, tooth or gums. The assaults are often brief, lasting from a number of seconds to some minutes, however in critical circumstances this will occur as much as 100 instances a day. They are often triggered by contact, speaking and even brushing the tooth.

Understandably, it’s a distressing situation and may be disabling.

The ache is attributable to an issue with the trigeminal nerve, which runs from the temple and branches across the eyes and brow, in addition to sending alerts to the jaw muscle tissues.

In some folks there’s an underlying trigger, akin to injury attributable to dental issues, a blood vessel or tumour urgent on the nerve, or a situation like a number of sclerosis which causes nerve degeneration. If there are different worrying signs akin to imaginative and prescient or balancing issues, a GP may order a scan to rule out something sinister.

However trigeminal neuralgia in itself is a big situation. Sufferers can discover they’re unable to eat, so shed extra pounds, and undergo despair and even job loss as they’re unable to proceed regular each day actions.

It actually is just not one thing that medical doctors needs to be ignoring.

The epilepsy remedy known as carbamazepine is licensed to be used on this situation and GPs are in a position to prescribe it to resolve the ache. NHS tips counsel that if this drug doesn’t work or can’t be used then a specialist needs to be concerned to handle the ache and provide therapies, together with different epilepsy medicines in addition to particular neurology painkillers. Ask for a referral to a neurology or ache specialist staff.

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Trigeminal neuralgia causes assaults of sudden, extreme facial ache, often on one facet of the face (file picture)

Q. My husband has been suggested to file his blood strain twice each day as he has had very excessive readings. On the NHS web site it says readings needs to be taken thrice at one-minute intervals, and that we must always ignore the primary studying as it is going to all the time be larger. The factor is, the GP took it solely as soon as after which began him on remedy. Might they’ve it fallacious?

A. Blood strain naturally varies all through the day relying on all kinds of things, together with what time of day it’s, what we’ve eaten and drunk, and the way burdened we’re.

Being nervous additionally pushes up blood strain, which is why it’s usually larger when the GP takes it – this can be a phenomenon known as white-coat syndrome. So repeated readings, not one-off measurements, are the one actual strategy to inform if an individual has hypertension.

Taking it thrice is about enhancing the accuracy – taking it 5 or ten instances could be even higher, however after all we have now to go along with what’s handy. That stated, very excessive readings in clinic can clearly point out an issue, and may lead to a prescription for blood strain remedy. We’d nonetheless ask for studying to be finished at dwelling, to substantiate the prognosis and provides us a transparent image of a affected person’s blood strain.

We usually ask for per week’s price of measurements.

Among the finest methods to check blood strain, particularly if there’s uncertainty or massive variations in readings, is to have a blood strain monitor known as an ABPM. This can be a digital monitor fitted to the affected person’s waist and connected to an arm cuff. It’s worn for a 24-hour interval and takes at the least 14 readings throughout waking hours. It’s thought-about an correct strategy to verify a hypertension prognosis.

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Q. I’ve lately been identified with osteopenia. I’ve heard that train may also help enhance bone density, and I’m eager to strive, however I’m apprehensive about fracturing a hip or one thing. Shall I steer clear altogether simply in case?

A. Osteopenia is a prognosis we give when bone density is decrease than common however not low sufficient to be thought-about full-blown osteoporosis – when the bones turn out to be fragile and liable to breaking. Usually, folks with osteopenia should not placed on to osteoporosis remedy however could be really useful to make way of life modifications in an effort to enhance issues.

And sure, train is vital. Even folks with osteoporosis are suggested to do train as it’s unlikely to trigger a damaged bone. In reality, it’s fairly the alternative: train boosts bone density, improves muscle energy and reduces the chance of fractures. Strolling and climbing stairs, skipping, tennis and star jumps are all good choices, as a little bit of influence helps stimulate bone progress. Muscle-building train can also be really useful. This might be lifting weights, utilizing resistance bands or doing body-weight workout routines akin to wall push-ups two to a few days per week.

Sufferers with osteopenia would often be suggested to have sufficient Vitamin D from a each day complement in addition to satisfactory consumption within the weight loss plan of calcium – the Royal Osteoporosis Society has good recommendation on its web site about how to decide on calcium-rich meals (theros.org.uk)

Why your leaky waterworks might not imply prostate most cancers

Would you see the indicators of prostate most cancers? OK, that’s a little bit of a trick query.

Leaky waterworks might not be a sign of cancer

Leaky waterworks may not be an indication of most cancers

The reality is, for an enormous variety of sufferers there aren’t apparent signs. So I used to be happy to see Cambridge College consultants voicing issues about NHS public well being campaigns that inform males to pay attention to urine issues, akin to going extra usually than traditional, as a possible signal. Nevertheless, there’s little proof to hyperlink these issues to the illness, and they’re extra more likely to be attributable to an enlarged prostate.

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Confusion about the actual indicators could also be one purpose why about half of all prostate cancers aren’t picked up till later phases.

So what must you search for? It’s all about danger elements – being over 50, of African or Caribbean descent, or having a father or brother with a historical past of the illness. If all three are true, common GP check-ups are essential. Should you tick two containers, attend all well being checks and look ahead to something totally different from regular.

I sense Covid troubles once more

Covid-related anosmia – the lack of sense of scent – is again with a vengeance, if my sufferers are something to go by.

This curious symptom grew to become synonymous with the virus within the first few waves.

DO YOU HAVE A QUESTION FOR DR ELLIE? 

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

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

If in case you have a well being concern, all the time seek the advice of your personal GP.  

However then Covid mutated, folks received vaccinated and developed immunity, and it appeared to vanish considerably.

Properly, not any extra. The newest wave of Covid has thrown up a complete heap of circumstances.

One other commentary: simply who will get dreadful Covid signs, and who brushes it off, appears fairly random as of late. I do know older folks who’ve stated their an infection was nothing greater than a foul chilly, whereas younger, sporty sorts have been struck with ‘the worst flu ever’.

I’m eager to listen to your tales – how has Covid affected you? Did you get a stinker, or barely discover it? Write and let me know.