I was recently weighed and measured at a hospital appointment and was shocked to discover that, at 82, I have shrunk from 5ft 6in at school to 5ft 3in now. I have arthritis everywhere. Is this to blame?
Sally Launchbury, Oxon.
This phenomenon baffles many people, but there is a simple explanation, which boils down to how spinal anatomy changes as we age.
Two things happen here: First, the fibrous discs that act as shock absorbers between the vertebrae of the spine dry out and become thinner, a natural deterioration that cumulatively leads to a loss of centimeters over time.
A similar degenerative process affects the bone of the vertebrae. In this case, microscopic changes in bone structure, accelerated in people suffering from osteoporosis, cause the shrinkage of each of the vertebrae, which also contributes to the overall height loss.
A study, published in the American Journal of Epidemiology, suggested that women lose more height than men (File image)
It happens to all of us.
One study, published in the American Journal of Epidemiology, suggested that women lose more height than men (possibly due to menopause-related bone loss).
For both sexes, loss begins around age 30 and accelerates with age: men lose an average of 3 cm (just over an inch) between ages 30 and 70, and women, 5 cm (almost 2 inches). This increases to 5 cm for men and 8 cm (more than 3 inches) for women by the age of 80.
You may also notice, along with the loss of height, that your abdomen seems to protrude more.
This is not necessarily because you are fatter, but because the contents of your abdomen are now flattened, as the distance between the end of your ribcage and your pelvis has been reduced.
You don’t mention what type of arthritis you have, but it seems unlikely to me that it played a major role in your height loss, because although it may affect the facet joints in your spine, it will have little to no influence. in the vertebrae and the discs between them.
It is the age-related changes in these that are the key to height loss.
Last June, a small nodule was discovered in my right lung during a CT scan for an unrelated problem. I have monitored it and have more scans planned for December. Having had many CT scans and x-rays over the years, I would prefer to be followed up with MRI in the future. But would this be as effective as CT scans?
Malcolm Buchan, Peterhead, Scotland.
What you describe is known as an incidentaloma, essentially a lesion discovered while being investigated for something else: in your case, a CT scan highlighted a small nodule (which could be a growth) in your lung.
While this had not caused symptoms, it deserved follow-up to be sure.
Incidentalomas usually involve follow-up scans, perhaps every year or so. The idea is that because imaging is non-invasive and justified on precautionary grounds, the risks of the scan are outweighed by the benefits of early detection of a change. You are clearly concerned about the ongoing CT scans, which involve radiation exposure and the effect is cumulative.
However, the amount of exposure from each scan is small, equivalent to between a few months and a few years of exposure to natural radiation in the environment, according to the NHS.
The difference with MRI is that it does not involve radiation, so this potential danger is avoided.
Although I am not a radiologist, I have no doubt that most experts would agree that future MRI monitoring is appropriate and will be no less effective in detecting any changes in the lesion.
In my opinion… You have to plan for these part-time GPs.
An increasing number of GPs are choosing to work part-time – a three-day week is typical. This reflects an understandable emphasis on the importance of work-life balance, a phrase unheard of in 1973, when I became a hospital doctor.
At that time we lived in the hospital, in “one in two” shifts: we worked every day and alternated nights and weekends, which was equivalent to 102 hours a week.
An increasing number of GPs are choosing to work part-time – a three-day week is common (File image)
A year or two later, the 88-hour week was introduced. This presented an opportunity because these new rotations meant there were more hours than there were people to fill them and almost all colleagues were working as locums on “off” nights and weekends. The drive and energy to do it was partly to increase our income (two years after starting work I was able to buy an apartment). But our extra work also reflected a commitment to our calling and a desire to gain experience.
Admittedly, those early days often seemed like relentless work with only a modest income; but we accepted it as the price to pay for what would come next: better income, job security and a secure future.
I’m not sure young GPs feel the same way. Some of them, at least, don’t have the same sense of vocation as us either.
However, the genie is out of the bottle and we cannot go back to the way things were.
But this is a growing reason for the powers that be to better plan for a future workforce that will work only part-time.
Write to Dr. Scurr
Write to Dr Scurr at Good Health, Daily Mail, 9 Derry Street, London, W8 5HY or email firstname.lastname@example.org. Dr. Scurr cannot correspond personally. Answers should be taken in a general context. Consult your family doctor if you have any health problem.