Christmas bug warning and worrying cancer checks – Dr Zoe Williams on your top health issues

IT’S just under two weeks until Christmas and no one wants a nasty bug to ruin their festive fun.

There are reports of the “worst cold ever” circulating, and cases of other winter viruses, particularly flu, RSV and norovirus, are rising.

NHS GP Dr Zoe Williams answers health questions sent in by readers

But don’t be alarmed by that. Just take precautions by looking after yourself and practising good hygiene measures.

Colds can last up to two weeks and symptoms can linger longer, especially a post-viral cough or fatigue.

Your risk of catching a cold is largely down to who you come into contact with, and if the virus gets the chance to spread to you from an infected person.

By looking after yourself and your immune system, you can create a stronger defence against bugs.

At this time of year, it can be hard to stay on top of healthy habits.

Between all the festivities, get an early night, cook nutritious meals in batches and freeze for easy dinners, and carry a water bottle with you to stay hydrated.

If you’re struggling for time to exercise, take brisk walks during lunch breaks.

Plus, wash your hands regularly and catch sneezes in tissues!

Here’s a selection of what readers asked this week…

Q: I WENT to see my doctor as I have been suffering from an ache on the right-hand side of my chest.

A scan showed I’ve got a non-alcoholic fatty liver.

I’m 61, have type 2 diabetes, diagnosed in 1994, and have been on medication since 2005. What should I be doing to ensure it doesn’t get worse?

A: Non-alcoholic fatty liver disease is a range of conditions caused by a build-up of fat in the liver, which is not related to the consumption of alcohol.

It’s related mostly to carrying excess body fat but other factors – like type 2 diabetes and age – can make someone more prone to having it.

A healthy liver should contain little or no fat. It’s estimated up to one in three people in the UK has early stages of NAFLD, where there are small amounts of fat in their liver.

The good news is, if it’s caught early, there’s a lot you can do, by way of lifestyle changes, that will reduce the risk of it getting worse and even reverse the inflammation and build-up of fat.

If left to get worse it can cause long-term damage and eventually lead to fibrosis and cirrhosis (scarring).

Other factors that raise NAFLD risk are high blood pressure, high cholesterol, being over 50, smoking and having an underactive thyroid.

There’s no specific medication to treat it so lifestyle changes are the best option.

The recommendations are to lose weight and aim for a healthy BMI. Search for the NHS BMI calculator at nhs.uk.

A healthy balanced diet with plenty of fruit, vegetables and lean protein helps. Limit fat, sugar and salt.

Exercise helps treat it too – build up to 150 minutes a week of moderate intensity, such as brisk walking or cycling.

While it’s not caused by alcohol at all, drinking can make it worse so it’s worth trying to cut down or stop.

It can be a scary diagnosis but lifestyle changes can make it completely manageable so try not to worry

Q: I AM 83 and in generally good health. In February I had a mammogram and was told there was nothing to worry about.

But since then I have found that my ­nipple goes inverted, although not permanently, and I now get ­irritation around it.

GettyA reader gets ­irritation around their nipple[/caption]

Last month, I had an appointment with a practice nurse who said she couldn’t feel any lumps in my breast or anything around my nipple.

She’s speaking to my doctor and seeing if it’s necessary to send me to a consultant.

Would you recommend I take this further and see a con­sultant privately?

A: Thank you so much for writing in with your question. It allows me to give an important explanation of the differences bet­ween screening and investigations.

Screening mammograms are designed to identify early-stage breast cancer before a person has experienced any symptoms.

Screening is incredibly important because detecting cancer at an early stage gives medics the best chance of treating it successfully, which also means the types of treatment required are likely to be less invasive.

However, investigations are also incredibly important.

They’re different to screening in that these are tests that are carried out if there is a symptom or sign suggestive of abnormality.

So, while your screening tests in February were normal, since then you have developed symptoms and therefore your nurse and doctor will need to decide whether it’s required to refer you for investigations.

An inverted nipple that is new is a potential sign of breast cancer.

However, it is not inevitable.

I would recommend making an appointment to see your GP within the next week or two so they can examine you and likely refer you for further investigation.

Q: MY GP has referred me to a dermatologist at the local hospital after I showed her a small dark blemish on my back.

My husband had noticed it and I wasn’t too concerned about it. It had been a small dry patch of skin for ages. In the summer, I scratched it and it bled.

suppliedA reader was referred to a dermatologist after showing a small dark blemish on their back[/caption]

The GP didn’t mention what she thought it was, just said it should be checked.

I Googled it and it looked exactly like seborrheic keratosis.

I read the referral letter in my medical records online and was horrified that she suspected this. It ticked all the boxes and it is 4mm x 1cm. I have been fast-tracked.

Now I can’t think of anything else and having to wait another week for my appointment is awful.

I suppose I just need some reassuring words, especially after seeing a box ticked on the referral form for counselling.

I didn’t ask enough questions but I wasn’t told she suspected skin cancer of the worst kind. I am 69.

A: Realising that you have been referred on a two-week-wait suspected cancer pathway can be very worrying if this was not carefully explained to you by the referring nurse or doctor at the time.

The counselling question on the form usually refers to whether the referring clinician has counselled the patient about the type of referral so they don’t get a shock when they arrive at a clinic where the aim is to check for, and in most cases rule out, a cancer.

It would seem this was incorrectly ticked in your case.

The majority of skin lesions that are referred via the skin cancer two-week-wait pathway turn out not to be concerning, with only approximately six per cent being melanoma or squamous cell skin cancers.

Seborrhoeic keratoses are one of the most common types of lesions that are found when dermatologists check patients who are referred this way.

I would advise getting in touch with the practice and sharing your concerns.

It may be that the referring GP can offer some reassurance that their suspicion of this being a cancer is actually low, or at least speak to you to give a full explanation of this referral.

Q: FOLLOWING a PSA test, I have been sent the result of 0.52μg/L. I am 62.

All the prostate tables online read in ng/mL so I’m no wiser as to my results’ meaning.

A: I understand your confusion about the PSA test results.

Prostate-specific antigen (PSA) is a protein produced by the prostate gland that is commonly used as a marker for prostate health.

The measurement units for PSA ­levels can vary. In your case, your result of 0.52 μg/L is actually the same as 0.52 ng/mL.

Typically, normal PSA levels vary by age, and the interpretation of results usually involves considering your age, medical history, and any symptoms you might have.

A PSA level of 0.52 ng/mL is generally considered low.

Got a question for Dr Zoe?

Email her at [email protected]

   

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