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 recognized me with trigeminal neuralgia. My GP agreed, however couldn’t supply me any recommendation or remedy. Fortunately the ache disappeared over time, however a number of weeks in the past it began once more. My physician prescribed pregabalin, but it surely hasn’t helped. Can anything be completed?

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

Understandably, it’s a distressing situation and might 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 tissue.

In some individuals there may be an underlying trigger, reminiscent of harm 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 reminiscent of imaginative and prescient or balancing issues, a GP would possibly 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 pounds, and endure melancholy and even job loss as they’re unable to proceed regular day by day actions.

It definitely just isn’t one thing that docs needs to be ignoring.

The epilepsy medicine known as carbamazepine is licensed to be used on this situation and GPs are capable of 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 supply remedies, 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, normally on one aspect of the face (file picture)

Q. My husband has been suggested to file his blood stress twice day by day as he has had very excessive readings. On the NHS web site it says readings needs to be taken 3 times at one-minute intervals, and that we should always ignore the primary studying as it is going to at all times be greater. The factor is, the GP took it solely as soon as after which began him on medicine. Might they’ve it improper?

A. Blood stress 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 confused we’re.

Being nervous additionally pushes up blood stress, which is why it’s typically greater 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 option to inform if an individual has hypertension.

Taking it 3 times is about bettering the accuracy – taking it 5 or ten occasions can be even higher, however in fact we have now to go together with what’s handy. That mentioned, very excessive readings in clinic can clearly point out an issue, and would possibly lead to a prescription for blood stress medicine. We might nonetheless ask for studying to be completed at residence, to substantiate the analysis and provides us a transparent image of a affected person’s blood stress.

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

Top-of-the-line methods to check blood stress, particularly if there may be uncertainty or massive variations in readings, is to have a blood stress monitor known as an ABPM. It is 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 not less than 14 readings throughout waking hours. It’s thought-about an correct option to verify a hypertension analysis.

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

A. Osteopenia is a analysis we give when bone density is decrease than common however not low sufficient to be thought-about full-blown osteoporosis – when the bones change into fragile and susceptible to breaking. Usually, individuals with osteopenia aren’t placed on to osteoporosis medicine however can be really helpful to make life-style adjustments in an effort to enhance issues.

And sure, train is vital. Even individuals with osteoporosis are suggested to do train as it’s unlikely to trigger a damaged bone. In reality, it’s fairly the other: train boosts bone density, improves muscle energy and reduces the danger of fractures. Strolling and climbing stairs, skipping, tennis and star jumps are all good choices, as a little bit of influence helps stimulate bone development. Muscle-building train can also be really helpful. This might be lifting weights, utilizing resistance bands or doing body-weight workout routines reminiscent of wall push-ups two to 3 days every week.

Sufferers with osteopenia would normally be suggested to have sufficient Vitamin D from a day by day complement in addition to sufficient 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 could 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 unlimited variety of sufferers there aren’t apparent signs. So I used to be happy to see Cambridge College specialists voicing issues about NHS public well being campaigns that inform males to pay attention to urine issues, reminiscent of going extra typically than regular, as a possible signal. Nevertheless, there may be 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 true indicators could also be one motive why about half of all prostate cancers aren’t picked up till later levels.

So what must you search for? It’s all about threat 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. In the event you tick two bins, attend all well being checks and look ahead to something completely different from regular.

I sense Covid troubles once more

Covid-related anosmia – the lack of sense of odor – 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? 

E 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. 

When you have a well being concern, at all times seek the advice of your individual GP.  

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

Nicely, not any extra. The most recent wave of Covid has thrown up a complete heap of instances.

One other remark: simply who will get dreadful Covid signs, and who brushes it off, appears fairly random lately. I do know older folks who’ve mentioned their an infection was nothing greater than a foul chilly, whereas younger, sporty varieties 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.