I’m a GP – the medical conditions you MUST report to the DVLA or risk a fine

DRIVING is a lifeline for millions of us, giving us freedom and independence.

But, did you know some common medical conditions must be reported to the DVLA or you risk a fine of up to £1,000?

Dr Zoe Williams answers some common questions sent in by readers

They include things like diabetes, epilepsy, sleep apnoea, strokes, glaucoma and some heart conditions.

If you’ve been diagnosed with a new condition it’s worth checking if you need to report it to the DVLA, at gov.uk/health-conditions-and-driving.

You can also check with your doctor.

Here’s a selection of questions readers asked me this week…

Q: I WILL be 80 in July and I was in hospital in November last year. 

They found a bleed on the brain and I was there for six weeks before I was able to go home. 

Although I recovered quite well I still have a balance problem. Before I consider driving again will this improve?

A: The bleed on the brain you describe could have had several causes, possibly a subdural haematoma, a subarachnoid haemorrhage, or some form of stroke.

Whatever the cause when this injury occurs, you must stop driving immediately and notify the DVLA, which you can do via gov.uk/driving-medical-conditions.

Disabling dizziness on its own is another reason for which you must stop driving and inform the DVLA.

Driving can be really important to people and can support an independent lifestyle, but it is also the most dangerous thing we do in our everyday lives.

You, your family members and health professionals should all be included in the important decision of returning to driving.

If anyone has concerns that driving may put you or others in danger, the health professionals may recommend an independent Driving Mobility Assessment.

This is designed to review your driving and you will be given an honest opinion of your skills and ability.

In addition to this, as you’ll know already, all drivers have to renew their driving licence when they reach the age of 70 and every three years after.

In terms of whether you’ll improve and whether your balance will improve, there are lots of therapies that can help you get better including exercises and you should have been offered some physical therapy before you left hospital, if you haven’t been, please contact your GP who can refer you for extra help.

You say you’ve recovered quite well and it’s important to understand balance is one of the most common lasting issues from stroke or brain injury.

If you’re comfortable walking, that can help improve balance as can sitting on a chair without back support — you can shuffle forward so your back isn’t touching the chair.

Using the back of a chair or kitchen work surface for support, going onto tiptoes and back down again can also help balance and this is something you can do while waiting for the kettle to boil for a cup of tea.

Recovery can take a while after a brain injury and you’re just around six months from when it happened so make sure you continue to take things easy, baby steps will help rather than trying to do too much too soon.

Q: FOR a good few months, I’ve been having lower belly pain, a lot of bloating on and off and a lot of wind. 

I also get very constipated and will be lucky to pass a stool only three times a week.

For the past six months my stools have also been floating. I’ve had blood tests and a stool sample, which came back all clear.

My bowel never seems to be comfortable after I’ve gone either. Is this anything to be worried about as I’ve had it for quite a while?

A: You’ve described symptoms that correlate well with irritable bowel syndrome.

But IBS should only be diagnosed when other conditions have been carefully considered.

It’s usually important to have blood tests for coeliac disease, inflammatory bowel disease, and a full blood count.

Because of the floating stool it would be wise to check liver function, B12, folate and iron.

If you’re female and you have bloating, it is also important to include a CA125, which is a tumour marker for ovarian cancer.

Stool samples can be checked for microscopic blood and evidence of inflammation in the gut.

You mention that you’ve had blood and stool tests already.

If all the tests just mentioned came back as normal, then IBS would be a likely diagnosis in someone with abdominal pain and change in bowel habit.

Strictly speaking, a diagnosis of IBS should only be formally made if the symptoms have persisted for six months, but there is no harm in educating yourself and starting to make lifestyle changes and trying treatments for IBS. 

There is a good resource on the patient.co.uk website, just search IBS. 

More invasive tests such as colonoscopy, where the bowel is examined using a camera is not usually needed.

But in some circumstances they may be advised, such as when IBS symptoms start for the first time after the age of 50.

A floating stool can be a symptom of air trapped in the stool, but it can also occur if your intestines are not absorbing fat properly or sometimes if you have a very high-fat diet.

It is a common side effect of a weight- loss medicine called Orlistat, which works by preventing fat absorption in the gut.

Have you changed anything about the way you eat or started taking any medication?

Sitting down is agonising

Q: WHEN I sit down, the bottom of my spine hurts and it is very uncomfy. I had a fall about a year and a half ago.

I had a fall about a year and a half ago.

I fell flat on my face, then a few months later, this happened. Do you think it’s connected and what can I do?

I have been to the doctor’s but so far nothing has been done about it. It’s really uncomfy to sit and it hurts when I do.

A: This sounds very much like the pain is coming from your coccyx, which is the bone at the very bottom of your spine.

The issue is that you’ve fallen forwards so you wouldn’t necessarily expect your coccyx to be injured as a result.

Combined with the fact that it didn’t start hurting for some time after would suggest the two may not be connected.

Did you have any other falls at another time?

Falling into a seated position, such as slipping when coming downstairs, is more likely to cause a coccyx injury.

Other common causes of coccyx pain include:

Pregnancy and childbirth.
Repeated strain on the coccyx – for example, following driving or cycling.
Poor posture.
Being overweight or underweight.
Joint hypermobility (increased flexibility) of the joint that attaches the coccyx to the bottom of the spine.

You should speak to your GP again and, in the meantime, you can buy coccyx cushions for under £20 online, which can relieve the pressure. Ice packs can help, as can ibuprofen. 

It’s important not to sit for prolonged periods of time, too, so try to keep moving.

Your GP will have the option to send you for further investigation, refer you for physiotherapy or to a specialist who can consider corticosteroid and local anaesthetic injections.

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