Q: Over the past ten years, I have suffered frequent bruises on my arms, often from the slightest blow. I am 74 years old; Is this something that can be cured or will I just have to live with it?
Stephen Young, via email.
Dr Martin Scurr responds: A hematoma occurs when blood leaks from small blood vessels called capillaries and pools under the skin.
When there has been no obvious injury or when the extent of bruising is out of proportion to the trauma, we use the term “easy bruising.”
Age is an important factor because, as we age, the layer of fat under the skin that acts as a cushion against bumps and knocks begins to thin, leaving blood vessels less protected and more easily injured.
Age is a big factor in “easy bruising” because as we age, the layer of fat under the skin that acts as a cushion against bumps and bumps begins to thin.
These types of “easy bruises” appear more on the arms and legs simply because they are the most exposed parts and most likely to be hit, even below your level of consciousness.
The head, face and trunk are not as exposed to blows on a day-to-day basis, so any spontaneous bruising in these areas would be more worrying.
Some medications, such as aspirin, ibuprofen, and blood thinners such as warfarin, can interfere with blood clotting mechanisms and make bruising more likely after minor impact.
Other medications, such as corticosteroids (such as prednisolone), cause thinning and increased fragility of the skin, which can increase the risk of widespread bruising, again most commonly affecting the extremities.
Some natural remedies, such as ginkgo biloba and ginseng, are thought to be linked to easy bruising, and while there isn’t a lot of research on this, it may be a potential risk factor that you should consider. .
Your best strategy is probably protection; This means wearing long sleeves while doing your daily activities.
Q: I woke up one morning about six months ago with hip pain that never went away. An x-ray showed it was bursitis. I do the exercises they told me to do, but the pain gets worse.
On a visit to my GP I was told that a steroid injection might help, but no one at the surgery was able to give it to me. The pain wakes me up at night.
Heddy Bell, Fife.
Dr Martin Scurr responds: I’m sorry to hear of your pain and think you should seek a referral for the steroid injection your practice mentioned.
Hip bursitis is where the fluid-filled sac (‘bursa’) that cushions the hip joint becomes inflamed and swollen, causing pain; This affects the prominent point you can feel if you slide your hand down the outside of your upper leg from your pelvis. .
Lying on the affected side can be painful, as can weight-bearing activities and sitting for long periods with legs crossed.
Hip bursitis can be caused by overuse (for example, when overweight people exercise) and trauma (I have often seen this condition in patients after a fall). But sometimes there is no obvious trigger.
When it first occurs, using an ice pack for 20 minutes, two to three times a day, along with a pain reliever such as ibuprofen may provide relief (although this medication should not be taken long term, a maximum of one to two weeks). ).
It is also important to avoid activities that make pain worse, such as sleeping on that side.
The good news is that the problem can usually be “cured” with an injection of steroids, a powerful anti-inflammatory administered right to the spot, but only a radiologist can perform this, using ultrasound to precisely locate the pocket.
Since the pain is disrupting your sleep, I suggest it is time to refer you.
- Write to Dr Scurr at Good Health, Daily Mail, 9 Derry Street, London, W8 5HY or email drmartin@dailymail.co.uk
- Dr. Scurr cannot correspond personally. Answers should be taken in a general context. Consult your family doctor if you have any health problem.
In my opinion…we need to keep an eye on our medical watchdogs.
In the wake of the Cass Review into gender identity services for children, the question I am concerned about is why did the regulators not identify the issues that resulted in this review at an earlier stage?
After all, healthcare regulation took a virtual leap after the murderous activities of Harold Shipman.
With the Care Quality Commission finally emerging after a long birth, I fear the regulator was too busy with its major evolutionary changes and learning on the job, just as referrals to gender identity services increased.
Dr Hilary Cass on the publication of her Independent Review of Gender Identity Services for Children and Young People (the Cass Review) last month
His eye wasn’t on the ball. In my experience, they seemed overly concerned about the type of soap in the office sink and where staff vacation request files were kept. The inspections were irrelevant in terms of patient protection and well-being.
And let us not forget that the General Medical Council, another regulatory body, did not realize the implications of Dr Harold Shipman’s narcotic addiction (he was arrested in the late 1970s while using pethidine, a morphine-type drug). Despite police involvement, a court process, a sentence and minimal rehabilitation, the regulator never pursued him further.
If it had been, 200 murders could have been prevented.
Who controls the regulators?