DR ELLIE CANNON: What can be done to relieve the pain of an ‘electric shock’ in my mouth? –

Q. Three years ago I suffered from what looked like an electric shock to my mouth while on vacation. When I got back, I went to the dentist who diagnosed me with trigeminal neuralgia. My doctor agreed, but was unable to give me any advice or treatment. Fortunately the pain subsided over time, but it started again a few weeks ago. My doctor prescribed me pregabalin but it didn’t help. Can anything else be done?

a. Trigeminal neuralgia causes sudden and severe episodes of facial pain, usually on one side of the face. Patients often describe it as electric shocks or sharp, stabbing pains in the jaw, teeth, or gums. Attacks are usually brief and last from a few seconds to minutes, but can occur up to 100 times a day in severe cases. They can be activated by touching, talking, or even brushing their teeth.

Understandably, it’s distressing and can disable it.

The pain is caused by a problem with the trigeminal nerve, which starts at the temples and runs through the branches around the eyes and forehead, and also sends signals to the jaw muscles.

In some people, there is an underlying cause, such as damage from dental problems, a blood vessel pressing on the nerve, or a condition such as multiple sclerosis, which causes the tumor or nerve to degenerate. If there are other bothersome symptoms, such as poor vision or balance, the primary care physician may order a scan to rule out anything worse.

However, trigeminal neuralgia is an important condition in itself. Patients may find that they are unable to eat, thus losing weight and depression, and even losing their jobs because they cannot carry out their normal daily activities.

This is certainly not something doctors should ignore.

An epilepsy drug called carbamazepine is approved for use in this condition, and primary care physicians may prescribe it for pain relief. NHS guidelines suggest that if this medicine does not work or cannot be used, a specialist should be involved to manage pain and offer treatments, including other epilepsy medicines and specific neurological pain relievers. Seek a referral to a neurology team or pain specialist.

Q. My husband was advised to measure his blood pressure twice a day as he had very high readings. The NHS website states that readings should be taken three times at one-minute intervals and that we should ignore the first reading as it will always be higher. The fact is that the doctor took it only once, and then gave him the drugs. Could they be wrong?

a. Blood pressure naturally changes throughout the day, depending on many factors, including the time of day, what we eat and drink, and how stressed we are.

Being nervous also raises your blood pressure, so it’s usually higher when your family doctor uses it – this is a phenomenon called white coat syndrome. Therefore, the only real way to determine if a person has high blood pressure is repeated measurements, not one-time measurements.

Taking it three times means increasing accuracy: it would be even better to take five or ten times, but of course we must do what is appropriate. However, clinically very high values ​​may clearly indicate a problem and lead to the prescription of blood pressure medication. However, we want us to read it at home to confirm the diagnosis and give us a clear picture of the patient’s blood pressure.

Normally we ask for one week measurements.

One of the best ways to measure your blood pressure is to use a blood pressure meter called an ABPM, especially if there is uncertainty or large differences in readings. This is a digital monitor that is worn around the patient’s waist and attached to a cuff. It is worn 24 hours and records at least 14 readings while awake. It is considered an accurate way to confirm the diagnosis of hypertension.

Q. I was recently diagnosed with osteopenia. I’ve heard that exercise can help increase bone density, and I’d love to try it, but I’m worried about breaking my hip or something. Do I have to stay away completely just in case?

a. Osteopenia is a diagnosis we make when bone density is below average but not low enough to be considered complete osteoporosis, when bones become brittle and prone to breakage. Normally, people with osteopenia are not given osteoporosis medications, but lifestyle changes are recommended to make things better.

And yes, exercise is key. People with osteoporosis are also advised to exercise as they are less likely to cause bone fractures. In fact, it’s the opposite: exercise increases bone density, increases muscle strength, and reduces the risk of fractures. Walking and climbing stairs, jumping, playing tennis and stargazing are all good options because a small effect stimulates bone growth. Muscle building exercises are also recommended. This may include lifting weights, using resistance bands, or doing bodyweight exercises like wall push-ups two or three days a week.

Patients with osteopenia are often advised to get enough vitamin D from a daily supplement and adequate calcium in their diet – there is good advice on choosing calcium-rich foods on the Royal Osteoporosis Society’s website (theros.org. UK)

Why Your Leaky Hookah May Not Mean Prostate Cancer

Do you recognize the symptoms of prostate cancer? Ok, that’s a bit of a trick question.

Leaky water pipes may not be a sign of cancer

The fact is that for a large number of patients there are no obvious symptoms. That’s why I’m glad that Cambridge University experts have voiced their concerns about NHS public health campaigns telling men to be aware of urinary problems, such as urinating more often than usual as a possible sign. However, there is little evidence to link these problems with the disease, and they are more likely to be caused by a large prostate.

Confusion about true symptoms may be one reason why about half of all prostate cancers go undetected until later stages.

So what should you pay attention to? These are risk factors: being over 50 years old, of African or Caribbean descent, or having a father or brother with a history of the disease. If all three are correct, regular GP checkups are essential. If you tick the two boxes, attend all health checks and watch out for something different than usual.

Again I feel problems with Covid

If my patients have anything to do, Covid-related anosmia – loss of smell – comes back with a vengeance.

This interesting symptom became synonymous with viruses in the first few waves.

But then Covid changed, people got vaccinated and developed immunity and it seemed to be gone.

Not anymore. The latest Covid wave has increased many cases.

Another observation: having the terrible symptoms of Covid and refusing them seems pretty random these days. I know older people who say their infection is nothing more than a bad cold, while the younger and sporty types get “the worst flu ever”.

I’m curious about your stories: How has Covid affected you? Did you catch a scent or do you barely notice it? Write and let me know.