DR ELLIE CANNON: Can statins scale back my danger of stroke?

My physician has advised that I’m going on statins, however he was pretty noncommittal and mentioned it is as much as me. I’m 69, not obese, eat a diverse weight loss program and drink a couple of bottle of wine every week. My father had a coronary heart assault in his mid-70s and Mum had a mini-stroke in her 80s. My ldl cholesterol degree fluctuates between about 5.5 and 6.5. What do you assume I ought to do?

When we recommend statins, which decrease the danger of coronary heart assault and stroke, we have a look at quite a lot of components – not simply levels of cholesterol – corresponding to blood stress, smoking, age, postcode (the environment has an affect on our well being) and household historical past.

In reality, there are greater than 20 standards which make up a coronary heart assault danger rating. Guidelines suggest statins in case your danger rating is greater than ten per cent over the subsequent ten years, although sufferers can request them even when they’ve a decrease rating.

Most individuals must weigh up the advantages of stopping a giant well being occasion like a coronary heart assault or stroke with a tablet’s disadvantages, corresponding to unintended effects and the necessity for normal monitoring or blood assessments – though statins typically trigger few issues.

Today’s reader has requested Dr Ellie Cannon whether or not they need to settle for their GP’s suggestion to begin taking statins to cut back the danger of struggling a coronary heart assault or stroke

There is all the time the choice of making an attempt the remedy to see whether it is efficient and does not trigger points.

Age has a big effect on the danger rating, so it’s going to often solely go up. Alcohol can be a danger issue for prime ldl cholesterol – we contemplate it excessive when it is above 5 – as it will probably increase ranges of triglyceride, which is a kind of fats within the blood, and likewise scale back the degrees of helpful ldl cholesterol HDL. We used to assume alcohol was good for the center, however for girls over 55 that is provided that the consumption is below 5 items every week – roughly two glasses of wine or two pints – and even then the advantages are small.

I injured my ankle falling off a stepladder. After days of hobbling I went to A&E and was advised I had a haematoma however it will be higher in two months. Six months on, and with no enchancment, a scan confirmed the haematoma was nonetheless there. My ankle is sore and carrying sneakers is painful. Can you recommend something to hurry up restoration?

ANKLE accidents can take an annoyingly very long time to heal because it’s laborious to keep away from weight bearing. I typically see sufferers with continued swelling after a yr or extra. But if issues do persist for this lengthy, sufferers ought to search additional medical recommendation.

A haematoma is a type of bruise the place bleeding below the pores and skin builds as much as type a lump. These usually resolve with no additional assist however it will probably take time.

If a haematoma persists for a yr it is perhaps essential to have it surgically eliminated, if potential. This may actually be justified on the premise of ache and disrupting mobility, and a GP may refer you for this.

Ankles are complicated. Injuries to them could cause bone fractures, sprains to the ligaments in addition to instability of the joint as a complete. Add to this swelling of the delicate tissue and it is simple to see why issues can turn out to be protracted.

Physiotherapy may be very efficient, and you may ask your GP receptionist for one of the best ways to get an appointment. The workouts that physiotherapists provide can strengthen the joint and ligaments as soon as once more.

Anti-inflammatory medication corresponding to ibuprofen are good for ache reduction and to assist mobility, however ensure they’re secure to take with every other remedy you is perhaps on. Some drugs and well being circumstances can even contribute to ankle swelling, so that is additionally value evaluating.

I appear to get very sweaty about two hours after taking my coronary heart drugs. These embrace nebivolol, for blood stress, and apixaban, which is a blood thinner. It’s not once I do something energetic and it lasts for about an hour or so. However my physician suggests I’ve ‘a sweating downside’ referred to as hyperhidrosis. Is he proper?

Any unintended effects which may be from a medicine needs to be reported to the Medicines and Healthcare Products Regulatory Agency. You can do that on-line by looking out ‘Yellow Card Scheme’. Alternatively, a pharmacist or GP can do it in your behalf.

Sweating is a not a recognised facet impact of both nebivolol or apixaban, however that is to not say it completely is not the trigger – it could possibly be coming from one other drug or the mix of remedy a affected person is on.

It is also a symptom of the situation being handled: blood thinners corresponding to apixaban and beta-blockers corresponding to nebivolol could also be used for coronary heart circumstances, corresponding to coronary heart failure, which themselves could trigger sweating.

Hyperhidrosis is the title we give to extra sweating. It may be associated to remedy, medical circumstances, nervousness and even alcohol. For some individuals the sweating is everywhere in the physique, for others it could be in particular areas such because the palms or armpits.

The remedy would very a lot rely upon how this symptom impacts somebody. If it’s actually a medicine inflicting it, there could also be room to alter a drug, with the recommendation of a physician, so long as it does not have an effect on the steadiness of the center situation.

This is probably not potential if the advantages of the drug are vital and another is both not obtainable or would trigger the identical downside.

Another choice could be to deal with the sweating.

In the primary occasion, a particular deodorant lotion containing aluminium is used for hyperhidrosis that may be prescribed to make use of on particular areas such because the armpits.

Click on this week’s Medical Minefield podcast to listen to why medical doctors are at conflict over a £45 cholesterol-busting drug 

Great check kits – however then what?

You can now get an HIV self-test equipment at Tesco.

Launched on the finish of final month, it prices £18 and, utilizing a drop of blood, will give a lead to below quarter-hour.

Broadly talking, I’m all for this. Back within the ’90s, once I was a medical pupil, HIV testing needed to be performed in hospitals and concerned ominous consultations with nurses and medical doctors. The course of was disagreeable and uptake not nice.

Fast ahead to now, now we have extremely efficient therapies and Prince Harry doing these prompt finger-prick HIV assessments in entrance of the world’s media.

It does an ideal deal to take away the stigma that stops individuals searching for testing, being recognized and getting medical assist. I’ve one concern: as with all DIY assessments, there must be some form of fast help in place for individuals with optimistic outcomes.

It’s removed from splendid having a house check that offers a worrying outcomes if sufferers then want to attend days for a GP appointment for a correct analysis. I hope Tesco has considered this.

Pills cannot clear up all of your woes – I want they might

A gaggle of eminent medical doctors have written an open letter to the British Medical Journal suggesting that GPs must prescribe fewer antidepressants. They say that, as an alternative, we should always attempt to sort out the ‘root causes’ of struggling, corresponding to loneliness, poverty and poor housing.

A gaggle of eminent medical doctors have written an open letter to the British Medical Journal suggesting that GPs must prescribe fewer antidepressants

I agree, in principal. Many circumstances we see every day, not simply melancholy, are a results of loneliness, poor diets or a scarcity of train. But, in actuality, typically the very best we will do for a affected person is to supply remedy that may no less than alleviate a number of the signs.

In a super world I’d be capable to prescribe higher housing, more cash and enhance social help. But sadly I can not.