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DR. ELLIE CANNON: How serious will these tremors be if there really is no cure?

I have suffered from something called essential tremor since childhood. I am now 77 years old, and five years ago it started to get worse. The tremor affects my whole body and I hate going out because I feel like people are looking at me or laughing at me. I asked my GP if I could see a neurologist, but the hospital refused, saying there was no cure. They suggested a website that I could read instead. I want to know what to expect in the future, so I can be prepared. I feel so lonely.

Tremor can be a disabling, distressing, and embarrassing condition to live with. It is also one of the most common neurological problems, often beginning in childhood.

With any lifelong condition, if there has been a worsening, I would say this warrants further evaluation.

Other causes of tremor could be Parkinson’s, multiple sclerosis, and medication side effects.

Tremor can be a disabling, distressing, and embarrassing condition to live with.  It is also one of the most common neurological problems, often beginning in childhood.

Tremor can be a disabling, distressing, and embarrassing condition to live with. It is also one of the most common neurological problems, often beginning in childhood.

Essential tremor usually means that the arms, hands, neck muscles, head, face, and even jaw muscles shake during times of excitement and stress. Sometimes the tremor can be relieved with sleep or while concentrating on a task.

Treatment is available, either for social occasions only or daily to improve normal function, such as holding a cup of tea.

Medications including beta blockers and epilepsy medications can help. There are also options like Botox, as well as more invasive treatments like deep brain stimulation.

In this case, the hospital’s response seems inadequate. There may be other neurology centers to which you can be referred. If this means traveling, it may be worth seeking specialist opinion.

NHS hospital appointments are very restricted at the moment. However, all patients deserve a proper consultation and a second opinion if necessary.

I am a 72 year old man and occasionally wake up at night to find that I have had an accident in bed. Tests for bowel problems came back negative and I am not experiencing any other symptoms. My diet is bland so I don’t know what could be causing the problem.

We call this loss of control fecal incontinence, and it deserves a thorough examination by a doctor.

Such a symptom is not a normal part of aging. We would classify it as a change in bowel habit, one of the potential red flag symptoms for bowel cancer.

More from Dr. Ellie Cannon for The Mail on Sunday…

Basic screening tests for bowel cancer will not be enough. To rule out cancer, a minor procedure called a colonoscopy may need to be done, in which a camera is inserted into the back canal.

A variety of muscles and nerves control the intestines and if something goes wrong with them, incontinence can follow. This can occur with intestinal diseases such as colitis or irritable bowel syndrome, or any injury such as after childbirth, as well as nerve damage and neurological diseases such as multiple sclerosis.

It is not an uncommon side effect for patients who have undergone cancer treatment such as radiotherapy in this area, for example for prostate or colon cancer.

Assessing what’s going on should involve proper hospital testing of the muscles, either with pressure monitoring or ultrasound. The NHS offers services in many places that specialize in bowel and bladder tests and continence.

If the stool is very loose, incontinence can occur, so it is important to test your stool for infections, cancer, and intestinal diseases such as colitis.

Once a full evaluation has been done, there are many options that can help, including physical therapy, medication, and even surgery if necessary.

After shoulder surgery in 2018, I had a severe anaphylactic reaction to teicoplanin, one of the antibiotics I was given. I ended up in intensive care. I have to have another surgery and I’m worried it might happen again.

Teicoplanin is an antibiotic used mainly in hospitals. It is particularly useful as it has a wide range of action and can treat the notorious MRSA.

It is used for serious skin infections, pneumonia, and heart infections. It can be used before surgery as a preventative, particularly for orthopedic procedures that may have a high risk of infection.

As with any medication, people can be allergic to it. Sometimes people who are allergic to teicoplanin will also be allergic to another antibiotic, vancomycin.

DO YOU HAVE A QUESTION FOR DR. ELLIE?

Email DrEllie@mailonsunday.co.uk or write to Health, The Mail on Sunday, 2 Derry Street, London, W8 5TT.

Dr. Ellie can only respond in a general context and cannot respond to individual cases or give personal responses.

If you have a health problem, always consult your own GP.

Anyone with a severe anaphylactic reaction to an antibiotic should have this clearly documented and noted in their hospital and GP records.

Patients usually have an evaluation prior to surgery, and this is the time to address this. It would also be a good idea to mention it when you arrive at the hospital and make sure the team has recognized the allergy.

It is not essential to use teicoplanin as a preventive, much less in someone who has almost died from having it. There will be safe alternatives. It may be worth getting a summary from your GP of antibiotics you have been prescribed in the past that have not caused allergic reactions, so that the hospital has options.

Anyone who has had anaphylaxis should follow up with a specialist for further testing and advice on managing future attacks, including the use of an EpiPen.

In a situation like the one described here, it may not have been considered necessary at the time, if the doctors were certain that the antibiotic was to blame.

Covid is still a threat…so don’t ignore the next jab

The Secretary of Health announced plans last week for a fall booster of the Covid-19 vaccine to increase protection as we move into winter. This will happen about six months after the spring boosters, as immunity is likely wearing off.

Government vaccine advisers recommend an extra dose for everyone over 65, clinically vulnerable people, nursing home residents, and frontline health and social care workers. If this applies to you, wait for a text or call from the NHS or your surgery telling you to sign up for your injection. Invitations are usually sent out in time for launch, so expect late August or early September. You should be able to easily book through the NHS website.

Although we are pretty much back to normal, Covid is still with us and could be deadly for a small but significant number without frequent top-ups. Remember, you need an injection even if you have had Covid. An additional protection boost does no damage. And prevention is always better than cure.

Although we are pretty much back to normal, Covid is still with us and could be deadly for a small but significant number without frequent top-ups

Although we are pretty much back to normal, Covid is still with us and could be deadly for a small but significant number without frequent top-ups

Struggling to sleep? get an app

I was delighted to learn that the NHS is offering the Sleepio sleep app instead of tablets to help people with insomnia, but this won’t be news to my patients.

The doctors in my practice have been recommending it along with other apps for a while, as have many of my colleagues elsewhere. We know that sleeping pills often don’t help people with insomnia. In fact, they can do more harm than good, as they are addictive. The best approach is a combination of sleep therapy with sleep hygiene: making sure the room is dark, not too warm, quiet, and that you don’t watch TV or surf social media in bed, and this is what an application can offer without long waiting lists.

If you’re having trouble sleeping, ask your GP for an app recommendation or details of a local sleep therapy group.

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