HAPPY Boxing Day. I hope you all had a lovely Christmas and got to spend precious time with your loved ones.
As you tuck into leftovers and settle down to watch a festive film, just spare a thought for those who may be spending this time by themselves.
Olivia WestDr Zoe Williams helps a reader who fears they have caught a STI[/caption]
Around three million people in England say they feel lonely often or always.
Loneliness can occur when someone is experiencing grief, a limiting health problem or a mental health issue.
Gently remind anyone feeling isolated that you are there if they need any help or a simple chat. Maybe consider how you can help lonely strangers too.
Volunteers can search for projects nationwide on Befriending Network (befriending.co.uk/directory), which includes Age UK’s befriending service.
Sign up for From Me To You, in which you write letters to people living with cancer.
Or encourage your kids to visit Lonely Not Alone (lonelynotalone.org), where stories and messages of support for young people are compiled by the Co-op Foundation.
Here are my responses to readers’ questions . . .
Q: I’M a 53-year-old woman and, every so often, I get a really bad swollen lip, which gets huge.
The doctor said it’s an allergy and asked me to write down things I eat, but my diet is always the same.
I can go for months without this happening and then, all of a sudden, it comes out of nowhere. It is worse in the summer. The flare-up starts with an itch. If I take an antihistamine it goes within 12 hours.
A: From the picture you sent me of your swollen lips, and what you’ve said, it looks and sounds to me very much like you’re dealing with angioedema – a sudden swelling caused by an allergic reaction, which also fits with what your GP said.
The NHS website has some good advice on when you may need to call 999 if you have this type of reaction, so please do have a read.
It might have only occurred in your lips, but there is a risk that angioedema could cause swelling of your tongue and throat, deemed a medical emergency.
As you’re already taking antihistamines and they help the swelling go down, I wonder whether it’s worth you taking them daily for a month or two and seeing if they can prevent the swelling rather than just treat it?
This is something to discuss with your GP.
You say you eat the same things all the time, but allergic reactions don’t always come from the things that we eat.
It could be down to cosmetics, the detergent you’re using to wash your clothes or even a response to extreme cold, heat or stress.
Your doctor’s advice of keeping a diary could be extended to include these other potential triggers.
Does it happen at a certain time of day, is there a certain weather type? You said it is worse in the summer.
The more detail you can put into the diary, the better, and if you can take pictures to show your GP too, that should help.
Q: I HAD symptoms of an STI after visiting a sex worker and having unprotected oral sex.
After receiving some cream, the GP advised me to get a sexual health check at a clinic. The clinic said that because my symptoms had cleared up I shouldn’t have attended and instead should have got a home test kit.
I tried to explain that I live with someone and would rather not do a home test, as it would be very awkward. Can you now not visit a sexual health clinic for a routine check-up?
A: As with many NHS services, they do vary depending on your location.
While most sexual health clinics will offer face-to-face appointments for people who are currently experiencing symptoms, many do have alternative methods in place such as utilising something called SH24, which sends discreetly packaged test kits, usually a plain letterbox-sized parcel, to people’s homes.
It involves taking a small sample of blood and a sample of urine in private, whether that be at home, work or the gym.
You can then send it back by popping it in the post box and the results are texted or emailed to you.
It’s designed as a means to increase testing in a way that’s simple, easy and discreet.
In places where they don’t offer this, it may be that there are separate clinics for people with symptoms and people who aren’t experiencing symptoms but want a check-up.
The best way to find out what range of services are available in your area is to go to the NHS website, search ‘sexual health clinics’ and type in your postcode.
There may be multiple clinics you can contact by email or telephone to see what services are available.
Or if you can afford them privately you can seek private consultations and sexual health checks.
Q: SINCE May this year, my wife, 73, has suffered with shingles nerve pain around her belly and lower back.
Unfortunately she didn’t have the vaccine. She was prescribed amitriptyline and then gabapentin (three doses of 300mg daily).
But there is still no improvement in the electric shock-type pain. It’s really getting her down.
GettyPeople are often left with lingering pain in areas where they had shingles[/caption]
A: Your wife is fortunate that she has someone in her corner who is looking after her so well.
It sounds very much like she’s dealing with post-herpetic neuralgia, a condition where people are left with lingering pain in areas of skin where they had shingles.
The shingles vaccine, which is offered to people aged 70-79, can prevent this painful complication. Gabapentin can be effective at treating nerve pain and the maximum dose is 1200mg, three times a day.
The dose is usually increased gradually to find the lowest amount that is effective at easing the pain.
This way, you face the lowest risk of side effects.
So if her symptoms are not well controlled at the current dose, in the first instance she should chat to her GP to get advice on titrating up the gabapentin.
If that is still not effective, or if she has side effects from the medication, then other options for treatment include lidocaine patches – which allow local anaesthetic to seep into the affected skin – or capsaicin cream.
Capsaicin is thought to work by blocking the pain messages that are sent to the brain by nerves. In the meantime, there are a few other things that your wife could try to ease her symptoms.
Synthetic fibres such as polyester could agitate her, so if it’s an option to use cotton or bamboo, it’s worth considering some new garments.
Some people find that the area is less painful when it’s covered in cling film or maybe a plastic wound dressing.
You could also try some ice packs. They are not for everyone, but it might be worth a shot.
Hopefully your wife will find that something I’ve mentioned here helps her.
Often, the symptoms resolve with time.
However, sometimes people with this condition need to be referred to a specialist pain management clinic, which your wife could explore with her GP.