Q: During the primary wave of the Covid pandemic I suffered an itchy, burning rash from my toes as much as my knees, and an analogous one on each arms. I don’t know if it was Covid as a result of testing wasn’t accessible then. The rash cleared however ever since I’ve had highly regarded toes at night time. By morning I really feel as if I’ve been standing as much as my knees in boiling sizzling water. Is there something I can do?
Burning sensations can usually be brought on by a neuropathy – when the nerves don’t perform as they need to. As nerves are accountable for controlling sensations, together with how we really feel warmth and chilly, if they’re broken a sense of burning can come up.
Burning toes syndrome is a recognised situation, and the sensations are sometimes worse at night time. It’s not completely clear why but it surely could possibly be the change in circulation after we lie down.
It is usually restricted simply to the soles of the toes, however the ‘burning’ can go proper as much as the knees. It also can trigger the pores and skin to go pink, set off pins and needles, and a sense of aching or heaviness.
Burning toes syndrome is a recognised situation, and the sensations are sometimes worse at night time
Nerve injury or neuropathy could also be from an preliminary an infection akin to Covid, which we all know does have an effect on nerves. But there could possibly be many different causes, together with Vitamin B12 deficiency, diabetes, spinal arthritis and even alcohol or drugs. It is at all times price ruling these out with blood exams as there could also be remedy choices.
To assess the nerves, a medical examination is required after which additional hospital testing known as nerve research. These exams take a look at electrical exercise within the nerves.
Raising the toes and legs at night time is assumed to assist, in addition to anti-inflammatory medicine akin to ibuprofen or prescribed naproxen. These could be taken earlier than mattress.
Certain drugs used for nerve ache and neuropathy may assist. For instance, medicine akin to gabapentin or pregabalin taken at night time. Using ache drugs to get a correct night time’s sleep is a vital a part of with the ability to cope long run.
Q: I undergo from vitiligo, with pale white patches on my arms, decrease legs and again. They appeared six months in the past and regardless of making an attempt varied potions advisable by buddies, and in addition visiting my GP, nobody appears to have the ability to rid me of the issue. Is there a remedy?
Vitiligo is a pores and skin situation brought on by an absence of the pigment, known as melanin, within the pores and skin. It mostly impacts the mouth and eyes, arms, armpits, groin, genitals and contained in the mouth.
These adjustments are often symmetrical, with patches on the left aspect of the physique matching the fitting. If the lack of pigment doesn’t match, then it will not be vitiligo.
There are different widespread causes of patches with no pigment on the pores and skin – they might embrace non-serious short-term pores and skin rashes akin to pityriasis alba or a yeast an infection of the pores and skin known as pityriasis versicolor.
It is significant to get this prognosis proper by way of a GP or dermatologist, because it determines remedy and the psychological impression of a lifelong, versus momentary, situation.
Vitiligo is almost definitely an autoimmune situation – the place the immune system assaults the physique and stops it producing pigment or melanin correctly. It could generally be introduced on by being pregnant or hormones, stress, an sickness, and even from publicity to sure chemical compounds.
Vitiligo is a pores and skin situation brought on by an absence of the pigment, known as melanin, within the pores and skin. It mostly impacts the mouth and eyes, arms, armpits, groin, genitals and contained in the mouth
It is more likely in somebody with a household historical past of it or different autoimmune points, akin to rheumatoid arthritis or lupus. The Vitiligo Society (vitiligosociety.org) is a vital supply of help for anybody newly identified. A GP can begin remedy however a referral to a dermatologist is essential.
Early remedy is strict sunblock use and steroid lotions utilized to the patches every day for 2 months. Specialist remedy includes immuno-suppressant lotions and lightweight remedy. Skin camouflage merchandise are additionally accessible on the NHS.
Q: Two years in the past I began on statins however suffered joint aches and palpitations. My GP took me off them and I’ve since tried pure alternate options akin to plant sterols. My ldl cholesterol continues to be 7.9, which is excessive. I’m 70, not obese and do not need diabetes. I’d admire your ideas.
Total ldl cholesterol ought to ideally be 5 or much less. However it’s additionally essential to have a look at the degrees of LDL, a element of ldl cholesterol most carefully linked to coronary heart illness. These numbers must be given with each ldl cholesterol check.
A complete ldl cholesterol of seven.9 could be thought-about very excessive and will point out a genetic trigger, akin to familial hypercholesterolaemia. We’d suspect this in anybody with a complete ldl cholesterol over 7.5 and a household historical past of coronary heart illness at a younger age.
When GPs determine if we should always deal with ldl cholesterol, we take a look at a broad vary of things that make up the danger of coronary heart illness or stroke. It could also be that somebody with a excessive ldl cholesterol doesn’t want remedy, if different elements are usually not excessive, so the general threat isn’t raised. However somebody over 70 with a complete ldl cholesterol of seven.9 is prone to have a excessive threat and wish remedy.
It is unlikely a ldl cholesterol of seven.9 would reply to measures akin to plant sterol dietary supplements, which have solely a modest impact at finest.
But statins are usually not the one choice. There are different medicine, known as ezetimibe and bempedoic acid, taken as tablets. There can be a brand new injection, known as inclisiran, however in lots of NHS areas it’s reserved for individuals who have already had a coronary heart assault.
Public loos are a necessity – so why are there so few?
Along with dying and taxes, the necessity to go to the toilet is a certainty of life, and one which occurs fairly much more continuously as we age. So it baffles me that public bathrooms have gotten more and more scarce.
Conditions that imply we have to go extra usually, or discover it tougher to carry on, have an effect on tens of millions of individuals. I usually hear from sufferers who say their lives are curtailed by the concern they gained’t be capable to discover a bathroom whereas out and about.
Dr Ellie usually hears from sufferers who say their lives are curtailed by the concern they gained’t be capable to discover a bathroom whereas out and about
I assume that authorities financial institution on the truth that there’s at all times a espresso store or grocery store folks can nip into, however as everyone knows, that’s not the case.
I discover the scenario infuriating. I virtually really feel like telling folks to show up, en masse, to make use of the toilet at their native council workplaces. I’d like to listen to about your experiences – have you ever been affected by an absence of public conveniences? Please write to me on the e-mail tackle beneath and let me know.
Write to Dr Ellie: DrEllie@mailonsunday.co.uk