My family has very high cholesterol and I have been prescribed statins and another medication called ezetimibe to control it. I now suffer from stomach pains and flatulence, which are known side effects of ezetimibe. Should I stop taking it?
We offer medications to lower cholesterol (a fatty substance in the blood) to try to reduce the risk of heart attack and stroke.
Statins work by affecting the way the liver works: they stop it from making as much cholesterol and help remove it from the blood. Ezetimibe, on the other hand, works by preventing the intestine from absorbing cholesterol from food, which is where digestive side effects come from.
If a medication does what it should but also causes problems, the doctor and patient should have a serious conversation to weigh the pros and cons.
If someone describes its side effects as mild, the benefits of the medication may outweigh the disadvantages. Or the opposite may be true. Only the patient knows how much the side effects affect her daily life.
If a drug does what it should but also causes problems, doctor and patient need to have a serious conversation to weigh the benefits and drawbacks, writes Dr ELLIE CANNON (file photo)
Digestive discomfort can be distressing, embarrassing, and seriously affect quality of life.
One option might be to continue the medications if they are valuable, but add another medication to deal with the side effects.
This is something your GP could handle.
It is also important to note that there are other medications that can be taken instead of ezetimibe.
For a long time I have had difficulty emptying my bladder completely. When I go, I often have a weak flow and need to return shortly after. I was recently told I would need a hysterectomy because, at age 77, I was suffering from intermittent bleeding. Will the operation solve my bladder problem?
NOT being able to completely empty the bladder is known as urinary retention. Combined with a weak stream, in a woman this could be a symptom of prolapse.
This occurs when the pelvic floor muscles are weak and the structures within the pelvis, including the bladder and uterus, are not adequately supported, so they could crush against each other and cause urinary retention. In this scenario, if a patient has a hysterectomy for another reason, she may improve urine flow.
Women can also suffer from forms of urinary retention if they suffer from chronic constipation, if the uterus is “bulging” – for example, due to benign growths known as fibroids – or due to certain neurological conditions that can prevent the bladder from functioning properly, such as multiple sclerosis.
Some medications can also prevent the bladder from emptying completely, including antidepressants and the medications we use to treat overactive bladder and urinary incontinence.
One concern about urinary retention is that it makes women susceptible to urinary tract infections. Any treatment for urinary retention will always depend on the cause. In someone with prolapse, hysterectomy is not the first treatment of choice. This usually involves pelvic floor exercises or a small operation to elevate the uterus and separate it from the bladder.
At the end of last year I fractured a vertebra in my back. I went to the emergency room but did not receive any treatment. I still have difficulty walking or standing for more than a few minutes due to the pain. I requested another scan but was told it won’t be done until December. I am 79 years old. Do doctors not take my pain seriously because of my age?
ANYONE who suffers a fracture should be under the care of a specialist until the injury heals.
Vertebrae are the bones of the spine and can break like any other bone, but patients are not usually offered an operation because they can heal on their own. Sometimes a brace is placed on the spine to keep it stable and allow the bone to heal in the correct position. Many patients are also offered physical therapy to strengthen their back.
However, most people who suffer fractures receive a scan within three months to ensure the bone is healing properly.
A fracture can also be a sign of osteoporosis, a condition that thins bones. The risk of this increases with age.
Anyone with osteoporosis should be offered medications to help prevent new fractures, as if left untreated it can lead to life-threatening injuries.
Most hospitals have fracture clinics where patients can receive a DEXA scan (an x-ray that can reveal signs of osteoporosis) and then, if necessary, be referred to a specialist for treatment.
Waiting another six months for a scan in severe pain does not seem appropriate or safe. It is possible that a referral to a fracture clinic was supposed to be made, but was not. A GP can check medical notes taken when you visited A&E, known as a discharge summary, to see if a referral was missed.
Men: Was bone disease overlooked?
Are men missing out on vital care for osteoporosis, a bone-thinning disease, just because they are men?
Last week, The Mail on Sunday published the shocking story of Steve, who was diagnosed at the age of 71 after a series of horrendous spinal fractures.
He had been going back and forth with his family doctor, who kept telling him that his discomfort was simply wear and tear due to aging. Only after another fracture, caused by a sneeze, did she decide to pay privately for a bone scan and his illness was recovered.
We were later contacted by another man, aged 75, with an equally miserable story: he suffered seven fractures, which deprived him of his mobility and independence, before receiving a diagnosis.
Women are four times more likely to get osteoporosis, but that doesn’t mean men should be fooled. I would like to know if he is a man and had a delay in diagnosis. Please write to me and let me know.
AstraZeneca is phasing out its Covid vaccine, ending its short history as one of the main ways out of the pandemic.
The blood clots caused by the AstraZeneca injection were extremely rare and those who suffered from them should not worry about the problems that will now develop.
Given the amount of negative attention the vaccine received on social media, there is a temptation to think that this move could have been due to concerns about side effects, including the much-discussed risk of blood clots.
But the fact is that there are now much more effective vaccines that protect better against the new variants.
And in fact, this was the case when the first Covid booster program was launched, which is why everyone received Pfizer and Moderna shots.
The important thing to know about the AZ vaccine is that blood clots were extremely rare and people who received it should not worry about problems that will develop now. If something was going to happen, it would have happened practically immediately.
