From itchy skin to extreme fatigue and toe pain – Dr Zoe Williams answers your health questions

ANYONE who cares for someone with dementia will know the power of nostalgia.

An old TV programme, a childhood sweet or a favourite song can light up the eyes of those with the condition.

Dr Zoe Williams helps a reader suffering from severe toe pain

It is lovely to see someone singing the correct lyrics despite their memory difficulties.

To help carers, Nestlé introduced a “reminiscence package” featuring reproductions of vintage chocolate wrappers and boardgames.

On the Nestlé website you can download packs including Easter Egg boxes from the 60s, 70s and 80s.

Print the items and assemble them if needed.

For help downloading the pack, contact customer service on 0800 58 57 59.

It is important to keep those living with dementia engaged and connected with others.

The progression of the condition can have a huge effect on relatives and carers.

Get in touch with any queries you have regarding a diagnosis or otherwise.

Here’s a selection of what readers have been asking me this week…

I LOVE SPORT BUT TOE PAIN STOPS ME

Q) FOR a couple of years now, I have had severe pain in my right big toe, which has stopped me from playing sports and doing exercise.

I am 65. My GP had a brief look and said it was probably arthritis.

A private specialist said it was sports-related arthritis from 40 years of playing netball and provided shoe inserts.

But there is no improvement after many months.

What can I do? I want to carry on with some sort of sport and running.

A) Firstly, it’s great to hear that you are keen to continue sport and be active.

My advice is to ask for a referral to the musculoskeletal team, or sometimes they are called MCATS.

This is a team of advanced physiotherapists who work alongside orthopaedic surgeons and rheumatology specialists.

They will be able to assess you thoroughly, arrange any necessary X-rays or scans, and be able to talk you through the various options, including surgical and non-surgical treatment.

It sounds as though you may have hallux rigidus, which is the medical term for arthritis of the big toe joint, but this has not been confirmed on an X-ray.

For a couple of years now, I have had severe pain in my right big toe, which has stopped me from playing sports and doing exercise

If this does turn out to be the case, then there is an operation, called a cheilectomy, which I would advise you to ask about.

It’s a surgical procedure to remove extra bits of bone that can result from hallux rigidus, and it aims to give the big toe more space to bend and move, while alleviating pain.

The most extreme treatment is to fuse the joint.

This converts a painful stiff joint with little movement to a painless and permanently stiff joint with no movement.

Be sure to discuss the pros and cons, as a fused joint may not get you back to playing sports like netball, and will likely stop you from wearing heeled shoes, but it may enable you to walk, run, swim and cycle without discomfort.

ILLNESS DEFIES MEDICS

Q) I AM a 64-year-old female and several years ago I had a gastric band which was removed as it wasn’t helping me lose weight and was making me sick.

Since then, I have had shortness of breath, a cough, excessive phlegm, frequent sore throat, hoarseness and throat clearing, bloating after eating, burping, occasional diarrhoea and fatigue.

I struggle to eat or swallow my medication due to choking.

I have requested a referral to a gastroenterology specialist, as I believe my issues stem from scar tissue caused by the band.

It still feels as though it is in place. F

rom X-rays and scans, the only potential issue found was that I have a raised right diaphragm.

I am at my wit’s end with this illness that appears a mystery to the health professionals.

Several years ago I had a gastric band which was removed as it wasn’t helping me lose weight and was making me sick

A) The diaphragm is a big muscle with important functions: It’s essential in breathing, helps protect your organs and helps in digestion.

It should sit like a dome at the bottom of your chest.

In your case, the right side is raised a little higher than normal, but I wouldn’t expect this to be causing the problem.

Scar tissue from the gastric band surgery could indeed be contributing to your symptoms. In particular, your difficulty swallowing, digestive issues and the feeling that there is something still there.

It may be worthwhile requesting to be seen by the team that did the gastric band procedure.

It is also certainly important to rule out any lung or heart issues.

In the meantime, it is a good idea to discuss your struggles with eating and taking your medications with your GP.

There may be alternative medicine forms, like liquids, that are easier for you to swallow.

It is so important to be consistent with your medications to effectively manage your conditions long-term.

There are over-the-counter medicines that may help with diarrhoea, burping and flatulence, e.g. antacids, probiotics, fibre supplements, and gas relief medications.

Lifestyle changes can also be very effective.

A food diary can identify trigger foods, like spicy or fatty foods, caffeine, alcohol or carbonated drinks.

Eating smaller, more frequent meals and drinking plenty of water throughout the day will support digestion and bowel movements.

Regular physical activity can also improve digestion, reduce bloating and relieve stress.

Tip of the week

IT takes effort to track how much salt is in our food, which should be limited to one teaspoon per day.

Buy “reduced salt” versions of foods like sweetcorn and pasta sauce, tinned fish in water, not brine, and slowly cut down how much you use in cooking – you will adjust to the taste over time.

Q) I AM suffering from itchiness on both shins, each hip and at the bottom of my spine but there is no visible rash or pain.

I have to apply a prescribed cream four times a day.

GettyDr Zoe helps a reader suffering from itchiness on both shins[/caption]

It is irritating and wakes me up during the night.

I am 85 and have never experienced this before.

The itchiness has been regular for about two months.

I was diagnosed with type 2 diabetes two years ago and lost 4st in weight by walking every day.

But I struggle to keep my sugars low despite being careful with what I eat, and I am reluctant to go on injections.

A) Itching can have many causes and it’s important to have it properly checked by your GP who will likely do a comprehensive set of blood tests called a “pruritus screen”, which can look for underlying causes.

Diabetes is one possible cause and I want to say well done for losing weight and walking every day.

Despite your efforts, it is not uncommon to still struggle with high blood sugar levels, but please keep going as these changes are so beneficial.

Insulin is a hormone produced by the pancreas.

When you eat, the carbohydrates in food get broken down into glucose (a type of sugar), which your cells use for energy. Insulin allows glucose to enter into the cells.

In type 2 diabetes, the body struggles to produce and/or use insulin properly.

As a result, glucose stays in the blood instead of entering the cells.

Losing weight and increasing your physical activity can massively help to control blood glucose levels.

However, there are several reasons why it may still be high, including diet, stress, other health conditions and genetic factors.

Stress can trigger the release of hormones like cortisol, which increases blood sugar levels.

Stress on the body can come in many forms from poor diet and/or sleep, chronic illness or injury, traumatic experiences and even daily irritations.

Do not lose hope as there are still many lifestyle changes you can try.

It can help to opt for foods with a low glycaemic index (GI), which are digested more slowly.

Foods high in fibre also help slow digestion and absorption of glucose leading to more stable blood sugar levels.

Talk to your nurse or doctor to identify what specific lifestyle changes may benefit you alongside optimal diabetes medication and make sure you get that pruritus screen.

   

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