I suffer from dizziness – sometimes extreme – and blurred vision. I also find that I slur my words. The GP ordered blood tests last year but I haven’t heard anything since. Based on my own research, I believe I have ataxia, which seems to be getting worse every day. What do I need to do to get an official diagnosis?
Ataxia is the name given to a number of serious brain disorders that affect balance, speech and coordination. Making a diagnosis with a neurologist can be a long process, requiring many tests, including MRI scans.
Certain species run in families, so genetic testing is also important.
Some tests are not common and are only offered at certain large hospitals across the country, which also require a referral.
The most common form of genetic ataxia is called Friedreich’s ataxia, which is inherited from parents. Typically, people notice that their symptoms develop very slowly over time before the age of 25, although not always. People can also develop ataxia as a result of other illnesses, such as multiple sclerosis or after a stroke.
Ataxia is the name given to a number of serious brain disorders that affect balance, speech and coordination. Getting a diagnosis can be a long process
Treatment for ataxia is usually not possible, but relief of symptoms may be possible. This may include speech therapy, physical therapy and occupational therapy. Medication is also available for muscle spasms and pain.
Because ataxia is a rare and difficult condition to treat, the charity Ataxia UK has accredited specialist ataxia centers for treatment and research. You can ask your family doctor or neurologist for a referral.
Ataxia UK is an excellent source of support (ataxia.org.uk).
I had my baby in March and then had a smear test in June which showed I had the HPV virus – but the doctor said I didn’t have any abnormal cells. I have to come back in June for another swab to check the situation. My problem is that we would like to try for baby number two. I’m in my late 30s, so time is of the essence. Is it safe to do this before my next test?
There are many different types of HPV – more than 100. It is a very common virus that does not cause problems in most people, but some types can cause genital warts or cervical cancer.
While up to 80 percent of adults are affected by HPV at some point, this proportion will undoubtedly decline over the years as teenagers are now vaccinated against it.
However, because HPV is linked to cervical cancer, smear tests look for HPV. People who don’t have it are very unlikely to develop the disease.
If someone has the virus, the cells at the cervix – the entrance to the uterus – are checked for abnormal changes. It is reassuring when none are found, and then women undergo closer monitoring with annual screening rather than every three years. For most people, the virus goes away and does not cause cancer: nine out of ten HPV infections go away within two years.
Balancing the desire to have another baby is a very personal decision, weighing the risks and benefits. I would advise patients to prioritize understanding the HPV process for both practical and emotional reasons.
There are excellent charities offering advice. The Eve Appeal offers the Ask Eve service on 0808 802 0019, providing nurse-led expert information online or over the phone.
My right big toe joint hurts a lot and I often can’t move it. I was told years ago that I had a hallux limitus that would eventually develop into a hallux rigidus. I was also told that the only treatment other than surgery, which I was reluctant to have, was painkillers. Is there anything else out there that I don’t know that you could suggest?
Surgery can seem daunting, but compared to not being able to walk or put on shoes, it might be worth it.
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Hallux limitus is osteoarthritis of the big toe that occurs due to wear and tear. The surfaces of the bones become damaged and rub against each other, restricting movement until the toe can no longer move at all. Some people claim that alternative remedies, including turmeric, chondroitin and glucosamine, can help. However, these are not recognized treatments, which is why I would not recommend them.
Anti-inflammatory tablets or gels such as ibuprofen and other painkillers are helpful. It is recommended to wear stiff-soled shoes or shoes with arched soles during activities.
You may be referred for podiatry or orthotic treatment – specially made shoe inserts. Doctors may also offer a steroid injection into the joint – this would reduce the inflammation in the joint and provide relief for months.
There are a number of operations and an orthopedic surgeon will advise you on which is most suitable as this depends on the condition of the joint. The operations either protect the joints or immobilize them, which can sound pretty scary.
However, the aim in all cases is to relieve pain – studies show that the load on the foot improves with surgery, even if the joint is stiff. This can be a worthwhile price to pay for pain-free action and walking.
Sometimes a GP needs to see you – please don’t say no!
You might think it’s hardly necessary to say it, but if your doctor asks you to come to an appointment, please say “yes.”
Data published last week in the British Medical Journal looked at the safety of remote consultations and, contrary to some reports, showed how safe they can be. However, researchers note that they are not the right choice in some situations, such as skin rashes or in the elderly. In these cases, doctors need to actually see the patient in person to properly evaluate them, just in case the case is serious.
I’m aware that in some areas it’s still difficult to get face-to-face advice, but I’m running into another problem. Quite often I ask a patient to come in for an examination and they insist that they would prefer to be treated remotely.
There are things we just can’t sort out over the phone, and that kind of resistance worries me.
My question is: now that the dust has settled on the major change that Covid has brought, how do you feel about telephone advice versus face-to-face advice? Please write to me and let me know.
Will your A&E survive the winter?
As we approach winter, there is understandable fear in the healthcare community about the impending surge of viral infections, insects, coughs, colds and other ailments.
Most of us shake them off or spend a few days feeling lazy. But vulnerable people — babies, pregnant women, the elderly and infirm, people undergoing cancer treatment or suffering from conditions that affect the immune system — can end up being admitted to the emergency room. What will they find when they arrive?
An analysis by the Care Quality Commission published last week found that half of England’s emergency departments were failing to meet basic standards.
I would like to know how your local unit is doing? Have you had difficulty getting treatment, had to wait for an ambulance, or found yourself in limbo without a care package? Write and let me know.