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

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

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

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


Dear Martin,

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



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

Your view would be greatly appreciated.

Joan G (Mrs)

Dear Mrs G,

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



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

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

Daphne G

Dear Daphne G,

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

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

Dear Anon,

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

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

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

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

Have you any views please?

Yours sincerely Paul M B

Dear Paul B,

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

Dear Dr Le Fanu

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

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

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

Kind Regards

Dear Anon,

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

Dear James Fanu,

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

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

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

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

Please please request your readers to help.

Thanking you in advance

Christine W

Dear Christine W,

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

Dear Dr Le Fanu,

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

Yours faithfully,

Dear Anon,

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

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

Dear Anon,

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


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

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

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

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


Dear Anon,

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

Dr James,

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

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

Thank you,

Roy W

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

Dear Roy W,

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

Dear Dr Le Fanu,

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

Ideal Wishes,

John T

Dear John T,

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

Dear Dr Le Fanu,

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

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

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

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

Yours sincerely

Philip Y

Dear Philip Y,

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

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