TUBERCULOSIS is unexpectedly rising across the country.
TB, as it is known, is a disease that was rife 100 years ago but most people won’t know it is still a big issue.
Until the disease is eradicated, World TB Day – March 24 each year – will not be a celebration of its disapearance, but a push to raise awareness of symptoms.
TB is an infection of the lungs that can start with a phlegmy cough lasting a few weeks.
You should see a GP if you have this, or are constantly exhausted, not hungry or are losing weight or have a persistent high temperature.
Cases in England rose ten per cent last year compared to 2022, with 4,850 infections diagnosed.
Globally, 7.5million people were diagnosed with TB in 2022 – the most ever recorded.
A new study last week found TB can be transmitted via breathing, and four in five TB patients tested didn’t even have the tell-tale symptom of a cough.
Fortunately most cases can now be treated with antibiotics.
Here’s what readers have asked me about this week . . .
HELP, ON STROKE MEDS
Q) MY partner Gary had a stroke last November but wasn’t aware until he went to the GP weeks later for a pain in his side.
He was diagnosed with lacunar stroke and high cholesterol, and prescribed clopidogrel and atorvastatin.
His cholesterol levels have fallen but his triglyceride levels are still too high.
He was given icosapent ethyl tablets, taken twice daily.
He doesn’t seem to have any side effects yet. Will he be on medication for ever or will it be stopped if his cholesterol normalises?
Could it have any long-term consequences?
Gary is 61, has smoked most his life and likes a few beers, but has cut down on both the cigarettes and drinking. We eat a good diet.
A) Patients with a history of any stroke are at much higher risk of suffering a further stroke.
So it is important to take measures to reduce this risk.
We call this secondary prevention, and it is a combination of medication and improving general health to reduce risk factors – including smoking and excess body weight.
Icosapent ethyl, which is also known by brand name Vazkepa, is a newer medication.
While atorvastatin and clopidogrel focus on lowering cholesterol and preventing blood clots respectively, Vazkepa tackles the problem of high triglycerides which are a type of fat in the blood.
Icosapent ethyl is a highly purified omega-3 fatty acid which is made from fish oil.
You may have heard of omega-3 fatty acids, which are a type of “good fat” that protects the heart and blood vessels.
It is the main reason we should include oily fish in our diets.
So as long as Gary has no side effects, I would advise him to stay on this medication long-term.
It is important to also continue improving his overall health, through healthy eating, exercise and reducing smoking.
He has been doing great so far.
Regarding long-term side effects, extensive clinical trials show that Vazkepa is very safe and effective in reducing cardiovascular events without significant concerns about adverse effects.
But like any medication, rare or unexpected long-term side effects are possible, on top of the known, more common ones such as constipation, pain in joints, muscles or bones, or swelling in legs, hands or feet.
It is reassuring to hear Gary hasn’t experienced any so far.
Do get in touch with your GP should you notice any changes.
When yawning can be a warning
Q) LATELY, I have been yawning a lot. When I check this with Dr Google, it says I may have a medical issue.
Over the past year, I have been suffering with neck pain and headaches. I’ve been to my GP a few times.
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They keep telling me that it is osteoarthritis in my neck and that the medication I am on is the cause of my headaches.
What might cause yawning?
A) While yawning is usually a natural response, significant changes may signal an underlying issue.
Excessive yawning can be associated with many conditions such as multiple sclerosis (MS), liver failure and, very rarely, a stroke or brain tumour.
It is also linked to fatigue, stress, anxiety or even medication side effects.
Dr Google can be a minefield and the information you find can be very daunting and not relevant to your case.
Stick to reputable sources such as the NHS website or patient.info.
It is important to have a full assessment with your GP if you think there is an underlying problem.
Regarding your neck pain and headaches, the muscles of the neck and scalp are connected, so the headache you may be experiencing could be what’s called a tension one.
There is such a thing as a medication-overuse headaches and this may be the case for you if taking painkillers more than 15 days of each month, for at least three months.
There is also the possibility of osteoarthritis in the neck – cervical spondylosis – which is a common condition.
Read up on the three things I mention – tension headaches, medication-overuse headaches and spondylosis – to see if any fit with your symptoms and then go back to your GP with what you’ve learnt.
Keeping a symptoms diary can also be extremely helpful.
If you have no luck or don’t feel listened to then don’t be afraid to seek a second opinion.
Tip of the week
A NEW medication called PrEP is free on the NHS and can reduce risk of getting HIV, which 100,000 people in the UK live with today.
Those who may benefit include gay and bisexual men.
You can get PrEP from a health professional at an NHS sexual health clinic.
Q) SOMETIMES I get a pain in my stomach.
I take omeprazole for acid reflux and mebeverine for irritable bowel syndrome.
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A) Your medication regimen of omeprazole for acid reflux and mebeverine for irritable bowel syndrome (IBS) suggests you are managing gastrointestinal issues.
Omeprazole helps reduce stomach acid production, which ease acid reflux and its symptoms such as heartburn.
Mebeverine is commonly used to relieve symptoms associated with IBS, such as abdominal pain and cramping.
But while both of these medications can provide relief, for their respective conditions, occasional stomach pain can still happen.
If you are experiencing persistent or severe pain, or if there are any changes in your symptoms, it is important to consult with your GP.
In the meantime, consider keeping a journal to track your symptoms, including when the pain happens, its intensity and any factors that may trigger or alleviate it.
This information can be valuable for your doctor, to help them suggest more tailored care.
But other ways to reduce abdominal pain include drinking plenty of water, eating smaller, more frequent meals, avoiding trigger foods, using heat pads, and gentle exercise.
WHAT YOUR MOUTH PROBLEM MIGHT BE SAYING TO YOU
BAD breath and mouth ulcers are common, but they may signal an underlying health problem, too.
Ahead of World Oral Health Day on Wednesday, dentist Dr Rahul Nehra of The Smile Gallery, explains.
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BLEEDING GUMS: Persistent bleeding gums, especially during brushing or flossing, can indicate gum disease.
This is often caused by plaque build-up along the gumline, leading to inflammation.
It’s essential to address bleeding gums promptly to prevent further complications like gum recession and tooth loss.
Proper oral hygiene is crucial, along with professional dental cleanings to remove plaque and tartar build-up.
BAD BREATH: Chronic bad breath, or halitosis, can be a sign of various dental issues, including poor oral hygiene, gum disease or cavities.
But it could be an underlying health problem such as diabetes or gastrointestinal issues.
Dental check-ups can help identify and address the root cause.
Improving bad breath typically involves maintaining good oral hygiene habits, such as brushing twice daily and flossing.
LUMPS AND SORES: While occasional mouth sores are often harmless, persistent lumps or sores that don’t heal within two weeks could be signs of more serious conditions such as oral cancer.
Other concerning signs include white or red patches, numbness, or difficulty moving the jaw.
If you notice any of these symptoms, seeing a dentist or doctor for further evaluation is crucial.
Mouth sores may benefit from topical treatments or prescribed medications.
WOBBLY TEETH: Loose teeth can indicate advanced gum disease or tooth decay.
Without prompt intervention, this can lead to tooth loss and bone deterioration.
Seeking dental care as soon as possible can help preserve remaining teeth, possibly through procedures like scaling and root planing or dental restorations.
DIFFICULTY SWALLOWING: Also known as dysphagia, this can be caused by various factors, including oral infections, inflamed tonsils, or even throat cancer.
Seek medical or dental attention promptly for evaluation and treatment.
CROAKY VOICE: This can result from various conditions affecting the throat or vocal cords, including acid reflux, respiratory infections, or vocal cord nodules or polyps.
In some cases, poor oral hygiene or throat irritation can contribute to it.
If you experience persistent hoarseness or voice changes, it’s advisable to consult with a healthcare professional.
Addressing a croaky voice may involve lifestyle modifications, such as avoiding irritants like tobacco smoke.