WINTER is still with us, which means rates of the “winter vomiting bug” norovirus are higher than at other times of year.
It can be nasty, with the main symptoms being nausea, vomiting and diarrhoea, but while unpleasant, you will very likely feel better within two to three days.
Dr Zoe Williams answers questions sent in by readers
If you do catch it, drink lots of fluids, stay off school or work until you have not been sick or had diarrhoea for two days, and maintain good hygiene – wash your hands regularly, especially after using the toilet and before prepping food.
Here is what readers have been asking me this week.
Q) I AM a 78-year-old woman on medication for high blood pressure and an underactive thyroid – both of which are under control.
A couple of years ago I went to hospital with an ache on the left side of my chest. It felt like my heart was aching and on occasion the pain got stronger and travelled to my back, but not my neck or arm. I was sent for tests, which found nothing sinister.
I was given a spray to use under my tongue if I experienced another strong ache or pain.
I’ve had two strongish aches since then, the last being the strongest with my chest feeling a little tight. I’ve had no other symptoms.
My mother suffered from angina. Last week, I woke up with a severe cramp on the whole left side of my chest, mainly down my back. It lasted at least 20 minutes and it was hard to breathe.
Could this be related to my heart? I nearly phoned 111 but didn’t, I just waited for it to subside.
I’ve had this cramp before, but not as strong as this. It was so painful I thought my lung had collapsed, silly me.
A) Well, there’s nothing silly about this at all and if your symptoms, especially the chest ache or tightness, are getting worse, it’s a good idea to have a routine review appointment with your GP, who may wish to do further blood tests or an ECG.
I’d be interested to know if the spray helps when you have symptoms. If it does, this would make angina more probable as the cause.
Angina symptoms are due to the heart muscle not getting enough oxygen, which can lead to breathlessness and chest pain or tightness.
The pain can radiate to the jaw or the arm. You can think of it as the heart muscle getting cramp.
The spray can alleviate angina symptoms because it allows the arteries that provide oxygenated blood to the heart muscle itself (the coronary arteries) to open wider (dilate) and this helps the blood to flow better.
Now on to the severe cramp. While I cannot completely reassure you that this isn’t related to your heart, it doesn’t fit with the classical symptoms of angina.
It sounds more like the muscles of the chest wall are cramping, or it could be the muscles between the ribs.
Stretches and exercises for the upper body could prevent further episodes of these types of musculoskeletal pain, but it’s important to be properly assessed by your doctor to rule out anything more serious.
Q)I AM always sleeping. I go to bed at about 9.30pm and get up around 7.45am. I go to the toilet two or three times in the night.
Some days I have an afternoon nap as well. I have been to the doctor and my bloods are OK. I’ve also had a heart scan which was fine and I’ve had all my Covid and flu injections.
I’m on venlafaxine, atorvastatin and levothyroxine. Do you have any ideas for what might help?
A) Of the three medications you’ve listed, venlafaxine is an antidepressant and has sleepiness and lethargy as potential side- effects, so if starting this medication coincides with the start of your symptoms, it could be the cause.
As you will likely know, depression itself can cause excessive tiredness too.
Levothyroxine is used to treat an underactive thyroid, a condition that commonly causes lethargy and tiredness.
So if this was not appropriately treated, it could be the cause — but I expect your GP will have checked this with the blood test. You are sleeping a lot of hours a day and as this is not your norm it requires medical assessment, including when it started, what else has been going on and your full medical history, to attempt to pinpoint why.
It’s good your GP is aware of it and has ruled out some conditions by doing bloods and a heart scan.
Bloods have obviously ruled out anaemia which can cause tiredness and the need to sleep a lot and I wonder about your gender and age — could perimenopause or menopause be a factor?
You don’t mention anything about your lifestyle and what you get up to during your waking hours, but regular movement and physical activity can be energising and often combat feelings of tiredness.
If the opposite is true, then this is important for your GP to know. Limiting alcohol is important too.
It sounds like your GP is on the case to discover the root cause of your symptoms.
Some people need more sleep than others, but if this is a sudden change for you and you used to have a lot of energy, make sure they continue to pursue it clinically while you look at any lifestyle changes you can make.
Two-year-old can’t see doc
Q) MY grandson is just over two and a half years old and has a returning chesty cough. He has also had a rash around his mouth for six weeks now and we have tried different creams without success.
My daughter says she can’t get a face-to-face appointment with a doctor although she has had a phone appointment. We think he should be checked over because he just doesn’t seem well and we are concerned. How can we insist on an appointment as it seems extreme to take him to A&E?
A) Even with the best will in the world, a child turning up to A&E with a chesty cough could be in for a very long wait, so you’re right to pursue another solution.
It’s important to let the GP know how worried you are.
While chesty coughs in children are usually not too concerning, if your daughter genuinely feels there might be something more serious than a simple infection going on, then this should be taken seriously.
It’s rare that practices refuse to give a face-to-face appointment. More likely it is due to lack of availability and the GP workforce crisis, but if they really refuse then they have to give you a reasonable reason why and have to provide it in writing.
If there is a long wait for an appointment, consider requesting a pharmacist consultation in the meantime.
And, of course, if there is deterioration in your grandson’s condition it’s important you call 111 or use the emergency services.