I often suffer from pain in my left armpit, especially when I walk uphill or ride a bike a lot. My GP thought it might be angina and I was tested and my heart and arteries were given a clean bill of health. Any ideas?
The pain that occurs with effort makes us think of a heart problem. But once this is ruled out, I would look at musculoskeletal causes, particularly if there is discomfort as a result of extra movement or stress on the shoulder, chest wall or arm, from cycling or strenuous walking.
This may be muscle pain or a problem within the shoulder joint itself. The left armpit contains lymph nodes or glands that can become swollen, as well as sebaceous cysts (small infected lumps) or lipomas, which are small lumps of fat.
It is important to have an exam performed by a doctor to make sure that swelling in this area is not causing the problem.
A man on a bicycle. Exercise can cause more widespread swelling, and this could be why the pain worsens with these movements. One treatment option would be to try an anti-inflammatory gel or cream (file image)
The left armpit contains lymph nodes or glands that can become swollen, as can sebaceous cysts (small infected lumps or lipomas, which are small lumps of fat) (file image)
Exercise can cause more widespread swelling, and this could be why the pain worsens with these movements. One treatment option would be to try an anti-inflammatory gel or cream, which would be effective only if it was a local musculoskeletal problem and not something deeper.
Furthermore, I am often assured that it is nothing sinister if the discomfort has been the same for a long time and has not gotten worse.
For more years than I can remember I have suffered from diverticulosis. I don’t have any pain but some days I need to defecate more than ten times. Always having to be near a bathroom dictates my life. Do you have any advice?
Gut symptoms, particularly loss of control, are distressing and difficult to live with. The sick are often forced to isolate and stay home rather than risk falling short.
Diverticulosis causes small pouches in the lower part of the intestine that can become inflamed. Pain and diarrhea, bloating, and constipation may be common.
When it comes to diet, the key is to consume the right amount of fiber and drink plenty of water. Both help keep things moving. But increased fiber can also cause bloating, gas, and urgency in some patients, in which case doctors suggest trying a low-fiber (though not fiber-free) diet.
Dr. Ellie: Rushing to the bathroom after eating may not be related to diverticulosis, but rather be a symptom of another problem, such as lactose intolerance. It might be worth keeping a food diary for a week to see if any foods make the urge worse.
Gut symptoms, particularly loss of control, are distressing and difficult to live with. The sick are often forced to isolate and stay home rather than risk falling short.
That means limiting things that are harder to digest, such as onions, nuts and seeds, fruit and vegetable peels, whole-grain bread and cereals for a few weeks, and then gradually adding them back.
People who simply cannot tolerate fibrous foods could benefit from a fiber supplement. Pharmacists can advise on this.
Loperamide can be used for diarrhea, but only as an occasional treatment.
Antispasmodic tablets may also be prescribed for diverticulosis. It can help the intestine relax and not become as tight, and may result in fewer bowel movements.
Rushing to the bathroom after eating may not be related to diverticulosis, but rather a symptom of another problem, such as lactose intolerance.
It might be worth keeping a food diary for a week to see if any foods make the urge worse. And order a Just Can’t Wait card from Bladder and Bowel UK to help you quickly access toilets in cafes, restaurants and shops when you’re out and about (bbuk.org.uk).
I was recently prescribed melatonin to help with sleepless nights. It helped, but the GP told me I could only have a three-month supply. Because?
Melatonin is a sleep aid prescribed for short-term insomnia in people over 55 years of age. We cannot prescribe it for more than 12 weeks because, while studies have shown that its short-term use is safe for most adults, more research is needed to confirm its long-term safety.
Insomnia is a huge problem in the UK with millions affected. Although doctors handed out sleeping pills for decades, we now know that this was not effective. Pills do not work for many people and cause addiction in a large number. Younger people are not given melatonin for insomnia.
Insomnia is a huge problem in the UK with millions affected. Although doctors handed out sleeping pills for decades, we now know that this was not effective (file image)
The best way to address sleep problems is to undergo sleep therapy, including cognitive behavioral therapy. It is available on the NHS through the GP in group and individual settings, or online or via an app.
It is also worth exploring sleep restriction therapy with your GP. At first, this means going to bed at the latest possible time to get the average number of hours you currently sleep.
So, if you normally sleep only four hours and have to wake up at 7 a.m., you would go to bed at 3 a.m. After a few days you set your bedtime to sleep five hours, and so on. It requires commitment but it works.
Sleep therapy should not be confused with sleep hygiene (something everyone with sleep problems should do), but it is not a treatment by itself.
This involves creating the best sleeping environment using measures such as earplugs, avoiding the phone, and a quiet, cool bedroom for sleeping.
Are you honest about how much you drink?
Over the past week, an avalanche of worrying research has been published about the harm caused by alcohol: even just one glass of wine a day puts us at higher risk of cancer and liver damage.
I sometimes wonder if my patients are completely honest with me when I ask them how much they drink.
Friends enjoying a beer. Over the past week, an avalanche of worrying research has been published on the harm caused by alcohol: even just one glass of wine a day puts us at higher risk of cancer and liver damage (file image)
Then I would like you to write to me and tell me. Do you or someone you know rarely go a day without alcohol? Do you often find yourself drinking more than you intended?
Please email me, confidentially, at the address below.
We are better placed in sick notes
My GP colleagues have been talking a lot about sick leave since the Prime Minister announced a plan to stop giving it out.
Many welcome the move and say they don’t have time anyway. But I do not agree.
I believe that GPs are the right people to offer this service. Time off work is a valid part of treatment and I would rather my patients recover properly than try to continue struggling.
In my experience, few ask for notes they don’t need. In fact, I often encounter resistance when I suggest taking time off.
I’m not saying the system shouldn’t be abused – I’m not naïve – but a one-size-fits-all approach is not the answer. When practices work well, GPs can ensure that people do not end up on long-term leave. Well-resourced physiotherapy, psychology and pain clinics would also prevent patients from needing notes.
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.