My wife has had bruises on her for a number of years. She must wear long dresses or pants to cover them, and we have been told that nothing can be done about it. Can you help?
Alan Shipton, by e-mail
Easy bruises are common and can be caused by medication, an underlying medical condition or aging. In one study involving 500 healthy adults, 18 percent reported bruising that occurred without injury or after minor bumps or bangs. Bruises develop in a three-step process that starts with small blood vessels, the capillaries that get damaged and burst, leaking blood that collects under the skin. This triggers platelets – small cells circulating in the blood – to rush to the site of the damage and a & # 39; plug & # 39; to shape.
Easy bruises are common and can be caused by medication, an underlying medical condition or aging (file image)
Ultimately, this plug or clot is enhanced by proteins called clotting factors.
If one of these steps is changed, the risk of easy bruising increases. For example, platelet abnormalities can be caused by certain medications, and in some people even by eating garlic, while a liver disease or vitamin K deficiency can affect clotting.
We tend to get bruises faster as we age, and some people, especially women with fair skin or overweight, do this for no apparent reason.
It is important to determine whether significant bleeding – such as nosebleeds – and what medication a patient is taking.
Drugs that can cause bleeding are ibuprofen and other non-steroidal anti-inflammatory drugs (NSAIDs), anticoagulants (such as warfarin), anti-platelet drugs (e.g. aspirin and clopidogrel) and steroids (such as prednisolone).
Certain antidepressants are also accused (such as fluoxetine), as well as some antibiotics.
It is important to determine whether there is significant bleeding – such as nosebleeds – and which medication a patient is taking (file image)
I do not believe that your wife's condition is sinister, because the bruises are limited to her shins, and this has been going on for several years. No other aspects of background disease have become clear.
But it is sad to say that there are no treatments for this kind of inexplicable bruising, except to protect her shins with clothing.
That said, if she has five or more bruises that are larger than 1 cm, and has not bent or hurt her shins, then your wife should see a hematologist for examination.
A family member has had testicular pain for one year. I have read that this can be caused by an infection or even heavy lifting, but antibiotics and procedures have not helped.
Name and address specified
The testicles are sensitive and even a minor injury can cause pain or discomfort. Causes include swelling of the prostate (prostatitis), nerve damage caused by diabetes, testicular cancer and infections.
Heavy lifting is normally not implied unless the discomfort is due to an unnoticed early hernia that causes pain (which is felt in a part of the body other than the source).
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Always consult your own doctor with any health problems.
In your longer letter you explain that your family member has seen several urologists and that cancer is excluded. I suspect that he has prostadynia, a common but mysterious condition that is sometimes referred to as a & # 39; pelvic headache & # 39 ;, which, relieved to hear, is not sinister.
However, it can be quite a cause for concern, not least because of the series of tests that a patient can undergo to rule out other conditions.
Between 2 and 10 percent of men will suffer from prostadynia at some point, but the cause is unknown and the only symptom is a dull, nagging pain. This comes from the prostate, but can also be felt elsewhere, such as the lower back, the lower abdomen, the upper side of the upper legs or the testicles.
There is no definitive test and therefore the diagnosis is based on exclusion of other options. Similarly, there is no fixed treatment.
Urologists often prescribe alpha-blockers such as tamsulosin or alpha-reductase inhibitors such as finasteride. Both are used to help with symptoms of an enlarged prostate gland (benign prostatic hyperplasia). Finasteride is also used to treat male pattern baldness. How effective the drugs are in prostadynia, however, is unclear, because there are no valid studies.
Anti-inflammatory drugs can also be prescribed, often as suppositories, and treatment may need to be continued for up to a month.
I suggest that your family member increase the possibility of prostadynia at his next medical appointment.
In my opinion … we have to get NHS chefs back
The food poisoning of hospital patients, which has been associated with various deaths caused by the Listeria monocytogenes disease, is unfortunately not a surprise.
Hospital catering has fallen lower in recent years as a result of cutbacks, with kitchens that are now hardly more than assembly and distribution units.
The presence of a chef in the hospital preparing fresh meals is a distant memory. Pre-packaged foods, such as boring sandwiches served in departments, are made miles away in industrial units and then driven around the country in refrigerated vans on the pretext of providing healthy food to sick patients.
The presence of a chef in the hospital preparing fresh meals is a distant memory (file image)
Listeria is a common cause of new-born fatal meningitis – the reason pregnant women should not eat soft cheeses – and can also cause many other types of potentially life-threatening illnesses. The bacterium thrives well in cooled conditions and is an aggressive pathogen.
Apart from the health risks, ready-to-eat meals that are prepared and frozen are ready to be regenerated & # 39; (code for reheating) in the hospital, hardly a recipe for delicious menus.
Health Secretary Matt Hancock has ordered a review of the hospital catering. In my opinion, the only safe solution is to re-prepare the patient's own food preparation.
Tasty, nutritious meals not only help with recovery, they nourish the soul. As the Greek physician Hippocrates said: & # 39; Let food be your medicine. & # 39;
What we don't need is to waste more time and money on another food czar. Such pieces of PR can make headlines, but they make no difference.
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