Q: My wife suffers from ice pick headaches. She’s had scans done and she’s visited doctors, but no one seems to know why they happen. I am writing to you out of desperation. What can we do to help her?
Ice pick headaches, also known as primary stabbing headaches, cause severe pain around the eye or on the side of the head that comes on suddenly.
The sensation lasts only a few seconds, but can occur up to 50 times a day. It is not known what causes them, but they may be triggered by bright lights or stress. They are more common in people who suffer from similar conditions, including migraines.
See a doctor for scans and tests when they first occur so you can make sure nothing more serious is happening.
It is also advisable to have an evaluation with a neurologist who specializes in this area, as ice pick headaches can be confused with cluster headaches, which have similar characteristics; a neurologist could detect the difference between the two.
Ice pick headaches can be disabling because they cause a lot of pain, and for this reason, pain clinics often recommend psychological support, says Dr. Ellie Cannon.
Medications such as the pain reliever indomethacin may be used to prevent attacks.
Because ice pick headaches are so temporary, despite being so severe, they are difficult to treat at the time. However, medications such as indomethacin can be used to prevent attacks. Indomethacin is a pain reliever that is also used as an anti-inflammatory for conditions such as arthritis.
Ice pick headaches can be disabling because they cause a lot of pain, and for this reason, pain clinics often recommend psychological support.
Q: A few years ago I had a scan to see if I had multiple sclerosis (MS), but nothing was found. I have had extreme fatigue for a decade and my legs often feel sluggish and heavy. Recently I felt slight numbness and tingling on one side of my body. Is it still possible that I have MS?
MS is a neurological disease that can affect the brain, nerves and spinal cord and affects around 130,000 people in the UK. It occurs when the immune system attacks the body and attacks the protective layer surrounding the nerves called the myelin sheath.
The damage this causes can cause numbness or tingling in the face and body, extreme tiredness, blurred vision, problems walking, and even difficulty controlling the bladder.
There are different types of the disease, although most people find that their symptoms come and go. Unfortunately, some people’s MS gets worse as they age, with no period in which it gets better.
Anyone who has had unexplained symptoms of nerve damage for a long time would be worth seeing a neurologist for examination, despite the long wait to see an NHS specialist.
When diagnosing a patient with MS, the doctor would first rule out other causes of nerve damage, such as vitamin B12 deficiency. Another test would be a nervous system exam to see how well your reflexes are working, which may involve hitting your knee or bicep with a reflex hammer.
In some cases, an MRI can detect MS by detecting damage to the myelin sheath of nerves in the brain and spinal cord.
But someone can still have MS even if a scan doesn’t detect this, as it may not appear in all areas of the brain or may be less visible if they are small or in an early stage. A neurologist may order other tests to help diagnose MS, including a lumbar puncture, also known as a lumbar puncture. This involves using a needle and syringe to remove some fluid from around the spinal cord, which is then tested. A person’s eyes may also be examined to see if there is damage to the optic nerve, which can be an early sign of MS.
Q: In August they found a huge 3-inch cyst on one of my ovaries and put me on the emergency list for surgery. But doctors also discovered that I have long QT syndrome, which causes an irregular heartbeat, and there now seems to be a suggestion that I will not be suitable for surgery. That I have to do?
The important thing is not to panic. Having to wait until surgery can be a good sign: Ovarian tumors can be aggressive, so you’ll usually be called quickly for surgery if doctors think the cyst is cancerous.
Still, noncancerous ovarian cysts can be unbearable. The pressure from the cyst can also cause swelling and pain in the pelvis, as well as constipation or problems emptying the bladder.
Long QT syndrome is a rare condition in which the heart’s electrical system takes too long to recharge between heartbeats, which can cause fainting, palpitations, and seizures. It’s usually something people have no idea about until they have an ECG, a simple test that records the electrical activity of the heart. The concern is that it is often associated with unexpected death in young adults who did not know they had it.
But knowing that someone has long QT syndrome means doctors can offer treatments to help control it, such as beta blockers or a pacemaker.
Having this condition should not cause any delay in surgery, but a cardiologist’s opinion may be sought in case there is a risk of someone’s heartbeat becoming dangerously irregular during the operation.
Anyone facing unexpected delays in medical care should speak to their GP, who will be able to check that everything is under control. Sometimes we find that patients think they are on a waiting list when in reality they are not.
Do you have a question for Dr. Ellie Cannon? Email DrEllie@mailonsunday.co.uk
Dr. Cannon cannot engage in personal correspondence and her responses should be taken in a general context.
Left without an NHS dentist?
Damning images of a giant queue snaking outside a new NHS dentist in Bristol show how desperate the UK’s dental crisis has become.
People suffering from dental pain or other problems regularly appear on my clinic list, but the GPs are not trained to treat these problems, so I have to dismiss them with little more than advice on painkillers.
The shortage of available appointments and the high costs of treatment have led some patients to resort to extreme measures, such as traveling abroad for medical care or extracting their own teeth, for example.
Have you or someone you know relied on similarly extraordinary lengths? Or have you had difficulty finding a dentist who will accept you as a patient? Please write to the address below and let me know.
Giant queue forms outside new NHS dentist in Bristol – shows how desperate the UK’s dental crisis has become
There is no place for homeopathy
Amid reports of the King’s cancer diagnosis, I read a story about Dr Michael Dixon, head of the Royal Medical Household.
The family doctor is also a supporter of homeopathy, a treatment based on diluted substances. But when Dr Dixon’s position became public last year, Buckingham Palace was quick to point out that it does not believe such alternatives can cure cancer.
On that, we agree. But I think homeopathy has no place in medicine, much less in such a serious illness.
Every time I say this there seems to be an outcry from “believers” on social media, outraged that I could dismiss what they see as a life-saving therapy.
The fact is that there is no good evidence that homeopathy does anything at all, and it certainly has no place in cancer care. We are safer if we continue with conventional medications.