Q: My wife, who is 70 years old, has occasionally begun to lean to the right while walking. A head scan ruled out a stroke, but she takes anxiety pills and will soon be put on a 24-hour monitor to see if she has high blood pressure. Could that be the culprit?
A: Tilting to one side is usually not a sign of high blood pressure. But many older people suffer from balance or instability problems that cause walking problems, such as leaning to one side.
It is key to investigate a symptom like this. Not only can it be a sign of an underlying condition, it also increases the risk of falls, a major concern for people over 65, causing distress, pain and loss of confidence and independence.
A head scan is a good idea, but a stroke is more likely to cause a constant problem than an intermittent one.
However, instability can be caused by medications, including blood pressure medications called beta-blockers and commonly used antidepressants known as SSRIs.
Balance within the body is controlled by the inner ear. There are many conditions that cause the area, called the labyrinth, to be affected, particularly viral infections. But chronic diseases, such as diabetes and heart disease, are also known to cause balance problems and dizziness.
Leaning to one side may not be due to a balance or instability issue, but rather a nerve or muscle problem. Parkinson’s disease, or pain and arthritis, which causes weakness and affects muscles, can also cause someone to stoop when walking.
Q: After more than a decade of pain and three MRIs, I was diagnosed with spinal stenosis and osteoarthritis. My wrists, hands, elbows, neck and lower back hurt most of the time and I wonder if I actually have fibromyalgia. Is there a test for this? How is it diagnosed?
A: It is quite common to have pain that affects more than one joint at the same time; We call this polyarthritis. This tends to occur more frequently in women, people over 50 years of age, and in association with obesity. It also affects patients with arthritis and can also be a sign of the autoimmune disease lupus, which affects 50,000 Britons.
These conditions may be a factor in the development of spinal stenosis. In rheumatoid arthritis and lupus, for example, blood tests will not only reveal inflammation in the body but also specific autoimmune blood markers that diagnose the condition. Multiple joint pains tend to warrant these tests.
Fibromyalgia is a chronic pain condition and not just a joint condition. It causes pain throughout the body and muscle stiffness, as well as fatigue, brain fog, and headaches. It also produces increased sensitivity to touch and is often continuous.
There are no blood tests or specific markers on X-rays or other images to accurately diagnose fibromyalgia. Other conditions, such as arthritis, tend to be ruled out first as part of the diagnostic process. A set of symptoms that may suggest fibromyalgia is how we construct a picture of the condition. However, several GP appointments may be necessary to fully assess the situation.
Q: After a blood transfusion in 1995, I contracted Guillain-Barré syndrome and autoimmune hemolytic anemia. I know that people infected with HIV and hepatitis C through transfusions are being compensated by the Government after harmful NHS transfusions in the 1970s and 1980s, but where do I stand with the transformative effects this has had on my life?
A: Anyone who believes they have been infected with these viruses can apply online to the Infected Blood Support Scheme in England, or the appropriate alternative in Scotland, Wales and Northern Ireland.
Guillain-Barré syndrome is a rare nerve condition. It is not an infection, but it often occurs after one. Our immune system fights infections, but with Guillain-Barré it mistakenly attacks the body’s own nerves, damaging them and causing muscle weakness, numbness, pain and balance problems.
It is very serious and can take up to a year to recover. Some patients are left with problems walking, weakness and extreme fatigue, and sadly, one in 20 people die as a result.
They are left with problems walking, weakness and extreme fatigue and, sadly, one in 20 people die as a result.
Autoimmune hemolytic anemia is also a rare disease of the immune system that affects approximately one in 100,000 people. The body mistakenly attacks red blood cells, breaking them down and causing anemia. It can be fatal due to the destruction of cells, which are essential for transporting oxygen from the lungs to the body’s organs and tissues. It may also be related to autoimmune problems such as lupus or thyroid disease. The condition can be caused by viruses, including hepatitis and HIV, as well as antibiotics and anti-inflammatories.
It is possible to ask to see your hospital records, in writing or by email, which may show whether there is a link between the transfusion and any condition developed. You have the right to receive news from the hospital within one month.
All the vitamin drops will do is bleed you dry
Last week, whilst in a shopping centre, I came across a stall offering vitamin IV drops at a discounted price for NHS staff. His poster even had NHS branding on it, as if these treatments were medically backed in some way.
Doctors do not recommend vitamin drops.
The ones I saw offered to treat anything from hangovers to fatigue, but the science behind them was lacking, to say the least.
Coupled with a high price, it means people are parting with a lot of money for potentially zero profit.
And to be honest, it wasn’t the most medical environment. A drip involves inserting a needle under the skin and, even if it is small, there is a risk of infection.
Please don’t be fooled by the hype around vitamin drips, especially if someone claims they are backed by the NHS.
Good news about antidepressants
Most weeks I hear from patients and readers who are worried about starting antidepressants because they’ve read that they have some unpleasant withdrawal symptoms.
It is true that some patients who stop antidepressants experience dizziness, headache, nausea and insomnia.
However, I have always maintained that these cases are rare and that online scare stories have ended up discouraging many people who could really be helped with medication.
So it’s great news that a German study found that only one in 35 people who take antidepressants suffer symptoms severe enough to affect their daily life.
Anyone thinking about stopping antidepressants should talk to their GP; There are strict instructions on how to slowly reduce the dose. But first, hopefully this study will help more people feel safe taking them.
Have you suffered these withdrawal symptoms? Please write using the email on the right and let me know.