DR ELLIE CANNON: How bad will these tremors get if there really is no cure? –

I have been suffering from something called essential tremor since childhood. I’m 77 now and it started getting serious five years ago. The tremor affects my whole body and I hate going out because I feel like people are looking at me or laughing. I asked my doctor if I could see a neurologist, but the hospital refused, saying there was no treatment. Instead they suggested a website I could read. I want to know what to expect in order to be prepared in the future. I feel so alone.

Tremor can be a debilitating, distressing, and embarrassing condition to live with. It is also one of the most common neurological problems, often beginning in childhood.

In any lifetime condition, I would say it deserves further scrutiny if there is deterioration.

Other causes of tremors include Parkinson’s disease, multiple sclerosis, and medication side effects.

Essential tremor usually means shaking of the arms, hands, neck muscles, head, face, and even jaw muscles during times of emotion and stress. Sometimes the tremor may decrease during sleep or while focusing on an activity.

Treatment is available both for social situations alone and daily to improve normal function, such as drinking a cup of tea.

Medications, including beta-blockers and antiepileptic drugs, can help. There are options like Botox as well as more invasive treatments including deep brain stimulation.

In this case, the hospital’s response seems inadequate. There may be other neurological centers to refer to. If that means traveling, it might be worth it for an expert’s opinion.

Appointments at the NHS hospital are currently very limited. However, all patients deserve a good consultation and, if necessary, a second opinion.

I am a 72 year old male and sometimes I wake up at night to find out I had an accident in bed. Tests for bowel problems were negative and I have no other symptoms. My diet is bland so I don’t know what could be causing the problems.

This is what we call losing control like incontinence and requires extensive testing by a doctor.

Such a symptom is not a normal part of aging. We would classify this as a change in bowel habits, one of the possible red flag symptoms for colon cancer.

Basic screening tests for colon cancer are not sufficient. To rule out cancer, you may need to have a small procedure called a colonoscopy, which involves placing a camera in the back passage.

Various muscles and nerves control the intestines, and if something goes wrong, incontinence may follow. This can happen in intestinal conditions such as colitis or irritable bowel syndrome, or any injury, such as postpartum, as well as nerve injuries and neurological conditions such as multiple sclerosis.

It is not an uncommon side effect in patients who have had cancer treatment in this area, such as radiation therapy for prostate or colon cancer.

Muscles in the hospital should be properly tested with both pressure monitoring and ultrasound to assess what is happening. The NHS offers specialized bowel and bladder continence services and testing in many locations.

Urinary incontinence can occur if the stool is too loose, so stool tests are important for intestinal conditions such as infections, cancer, and colitis.

After completing a full evaluation, there are many options that can help, including physical therapy, medications, and even surgery if needed.

After my shoulder surgery in 2018, I had a severe anaphylactic reaction to teicoplanin, one of the antibiotics given to me. I ended up in intensive care. I haven’t had surgery yet and I’m afraid it will happen again.

Teicoplanin is an antibiotic used especially in hospitals. It is particularly useful as it has a wide reach and can treat the notorious MRSA.

It is used for severe skin infections, pneumonia and heart infections. It can be used as a pre-operative prophylactic, especially in orthopedic procedures with a high risk of infection.

As with any drug, people can be allergic to it. Sometimes people who are allergic to teicoplanin are also allergic to another antibiotic, vancomycin.

Anyone who has had a severe anaphylactic reaction to an antibiotic should clearly document and mark it in their hospital and GP records.

Patients often receive an evaluation prior to surgery, and now is the time to raise this issue. It’s also a good idea to mention this when you arrive at the hospital and make sure the allergy is noticed by the team.

It is not necessary to take Teicoplanin beforehand, especially in a person who is almost dying from it. There will be safe alternatives. It may be helpful to get a summary of the antibiotics you have been prescribed in the past that did not cause allergic reactions from your doctor so that the hospital has options.

Anyone experiencing anaphylaxis should see a specialist for further testing and advice on how to manage future seizures, including wearing an EpiPen.

In a situation like the one described here, if doctors were sure it was the antibiotic’s fault, then it might not be considered necessary.

Covid is still a threat… so don’t ignore the next edition

Last week, the health minister announced plans to recall the Covid-19 vaccine in the fall to increase protection as we enter winter. This will happen about six months after the spring supplements, as immunity is likely to drop.

Government vaccination counselors recommend an additional dose for people over 65, clinically vulnerable, nursing home residents, and primary care and social workers. In that case, expect an SMS or phone call from the NHS or your OR telling you to sign up for the shot. Invitations are usually sent out in time for the launch, so expect them to be in late August or early September. You should be able to easily book through the NHS website.

While we’re almost back to normal, Covid is still very present and without frequent updates it could prove fatal to a small but significant number. Remember that you need an injection even if you have had Covid. An extra boost of protection wouldn’t hurt. And it’s always better to be safe than sorry.

While we’re almost back to normal, Covid is still with us and without frequent updates it could prove fatal to a small but significant number.

Are you having trouble sleeping? Download an app

I was pleased to learn that the NHS is offering the Sleepio app for sleep rather than tablets to help people with insomnia, but this will not be new to my patients.

Doctors in my office, like many of my colleagues elsewhere, have been recommending this and other practices for some time now. We know that sleeping pills often do not help people with insomnia. In fact, they can do more harm than good because they are addictive. The best approach is to combine sleep therapy with sleep hygiene – the room is not dark, too hot, and quiet, and not watching TV or surfing social media in bed – and that’s what an app is for. lists you can deliver without a long wait.

If you have trouble sleeping, ask your doctor for a practice recommendation or give you details of a local sleep therapy group.