My doctor recommended that I start statins, but he was quite adamant and said it was my decision. I’m 69, not overweight, eat a varied diet and drink about a bottle of wine a week. My father had a heart attack in his mid-70s and my mother had a small stroke in her 80s. My cholesterol levels fluctuate between about 5.5 and 6.5. What do you think I should do?
When we suggest statins that reduce the risk of heart attack and stroke, we consider many factors – not just cholesterol levels – such as blood pressure, smoking, age, zip code (our environment affects our health) and family history.
In fact, there are more than twenty criteria that make up a heart attack risk score. Guidelines recommend statins if your risk score is more than ten percent in the next decade. However, patients can also request them if their risk score is lower.
Most people have to weigh the benefits of preventing a serious health event such as a heart attack or stroke against the disadvantages of taking a pill, such as side effects and the need for regular check-ups or blood tests – although statins generally cause few problems.
Today’s reader Dr. Ellie Cannon asked if they should follow their doctor’s advice to take statins to reduce the risk of a heart attack or stroke
There is always an option to try the medication to see if it is effective and does not cause any problems.
Age has a large influence on the risk score and therefore usually only increases. Alcohol is also a risk factor for high cholesterol – we consider it high if it’s above five – because it can raise levels of triglycerides, a type of fat in the blood, and can also lower levels of the beneficial cholesterol HDL. We used to think alcohol was good for the heart, but for women over 55 this is only the case if consumption is less than five units a week – around two glasses of wine or two pints – and even then the benefits are small.
I injured my ankle when I fell down a flight of stairs. After bouncing around for days, I went to the emergency room and was told that I had a hematoma but that I would be better in two months. Six months later and without any improvement, a scan showed that the hematoma was still present. My ankle hurts and wearing shoes is painful. Can you recommend anything to speed up recovery?
Ankle injuries can take an annoyingly long time to heal because it’s hard to avoid strain. I often see patients with persistent swelling after a year or more. However, if the illness persists for that long, patients should seek further medical advice.
A hematoma is a type of bruise in which bleeding collects under the skin and forms a lump. These problems usually go away without additional help, but it may take some time.
If a hematoma persists for more than a year, it should be surgically removed, if possible. This may be due to the pain and impaired mobility, therefore a GP can refer you.
Ankles are complex. Injuries can lead to broken bones, sprained ligaments and instability of the entire joint. Add to this the swelling of the soft tissue and it is easy to see why the problems can persist for a long time.
Physiotherapy can be very effective and you can ask your GP about the best way to arrange an appointment. The exercises offered by physiotherapists can strengthen the joints and ligaments.
Anti-inflammatory medications such as ibuprofen are good for pain relief and promoting mobility, but make sure you can take them with other medications you are taking. Some medications and health conditions can also contribute to ankle swelling, so it’s worth checking that out as well.
About two hours after taking my heart pills, I start sweating profusely. These include nebivolol, which lowers blood pressure, and apixaban, a blood thinner. It’s not like I’m doing something high energy and it lasts like an hour or so. However, my doctor suspects that I have a “sweat problem” called hyperhidrosis. is he right
Any side effects that can be attributed to a medicine must be reported to the Medicines and Healthcare Products Regulatory Agency. You can do this online by searching for “Yellow Card Scheme”. Alternatively, a pharmacist or GP can do this for you.
Sweating is an unknown side effect of nebivolol or apixaban, but this does not mean that it is absolutely not the cause; This can come from another medication or the combination of medications a patient is taking.
It can also be a symptom of the condition being treated: blood thinners such as apixaban and beta blockers such as nebivolol can be used for heart conditions such as heart failure, which in themselves can cause sweating.
Hyperhidrosis is what we call excessive sweating. It can be related to medications, medical conditions, anxiety and even alcohol. For some people, sweating occurs all over the body, while for others it may occur in specific areas, such as the hands or armpits.
Treatment depends largely on how this symptom affects someone. If it is really a medication that is causing it, there may be an opportunity to change the medication on the advice of a doctor, as long as it does not affect the stability of the heart disease.
This may not be possible if the benefits of the drug are significant and no alternative is available or would cause the same problem.
Another option would be to treat the sweat.
In the case of hyperhidrosis, a special deodorant cream with aluminum is first used, which can be used specifically on specific areas such as the armpits.
Click into this week’s Medical Minefield podcast to hear why doctors are fighting over a £45 cholesterol-lowering drug
Good test kits – but now what?
You can now get an HIV self-test kit from Tesco.
Launched late last month, it costs £18 and delivers results within 15 minutes with a drop of blood.
Overall, I’m all for it. In the 1990s, when I studied medicine, HIV testing had to be done in hospitals, requiring looming consultations with nurses and doctors. The process was unpleasant and the recording was not great.
Today we have highly effective treatment options and Prince Harry is doing these instant fingerprint HIV tests for media around the world.
It goes a long way to eliminating the stigma that prevents people from getting tested, diagnosed and receiving medical care. I have one concern: As with all DIY tests, there should be quick support for those with positive results.
It is far from ideal to perform a home test that produces alarming results when patients then have to wait days for a GP appointment to get a correct diagnosis. I hope Tesco has thought about this.
Pills can’t solve all your problems – I wish they could
A group of leading doctors have written an open letter to the British Medical Journal suggesting that GPs should prescribe fewer antidepressants. They say we should instead try to address the “root causes” of suffering, such as loneliness, poverty and poor housing.
A group of leading doctors have written an open letter to the British Medical Journal suggesting that GPs should prescribe fewer antidepressants
I fundamentally agree. Many of the problems we encounter every day, not just depression, are the result of loneliness, poor nutrition or lack of exercise. But in reality, the best thing we can do for a patient is often to offer medication that can alleviate at least some of the symptoms.
In an ideal world, I could demand better housing, more money and better social support. But unfortunately I can’t.
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Crystal Leahy is an author and health journalist who writes for The Fashion Vibes. With a background in health and wellness, Crystal has a passion for helping people live their best lives through healthy habits and lifestyles.
