General Health Thursday October 30, 2014

Dr Hilary Answers Your Questions

Have you ever wanted to ask a health question, but didn't want to bother your GP? Maybe it seemed too unimportant to actually make an appointment for? Well now you can direct all your burning health questions to our partner Medical Advisor, Dr Hilary Jones, in our new blog series - Dr Hilary Answers.

Take a look below to find out how Dr Hilary got on with our first batch of questions. If there's anything you'd like to ask him next time, please leave a comment below!

1. I sometimes get a pressure in the middle of my chest (sternum?), which is only relieved if I stretch and ‘crack’ it like when you crack your knuckles. What could be causing this?

Your ribs articulate with your spine at the back and your sternum or breastbone at the front. The joints here are partially mobile and can certainly become inflamed if you sit at a desk all day in a slouched position with your ribs compressed at the sternum in the front. You can feel these joints with your fingers either side of your breastbone and they can often be tender if your posture is bad. When you arch your back and stretch, the cracking that you hear is the joints opening up and being restored into their proper position. So stretch often and practice salmon flips, which you carry out by lying on your front with your hands behind your head and arching your spine backwards.

2. Why do I occasionally feel a sensation on my leg like water is trickling down it but my leg is dry – it is something inside?

This sensation is known as dysaesthesia and is caused by the mechanical irritation of the nerve that runs down your leg. It is a bit like sciatica, but an abnormal sensation rather than pain. It may be that you have some issues with your lower back causing pressure on the nerve, so think about your posture and do some exercises to strengthen the core muscles around your lower spine, which incorporate the abdominals the side muscles and the back muscles.

3. Why do I feel starving hungry for a week and not at all hungry the next week? Is it a hormone thing (I am female)?

Hunger is sometimes unpredictable. Our levels of stress and physical activity can affect our appetites in major ways and so can your hormones particularly at certain times of the month. The idea that we should all eat 3 meals a day dictated by the clock is actually rather unhealthy. Eating when your body tells you to and only when you are hungry, rather than bored or stressed out, is actually a much more natural approach.

4. Sometimes my fingers go white and look dead when I am cold, and the only way to get the colour back is to run them under warm water. What is the reason for this?

You may actually be suffering from Raynaud’s Disease. This is caused by an abnormal sensitivity of the small blood vessels in your extremities to even moderate cold temperature. People with this condition often get symptoms like yours in their fingers toes and ears. Stress and certain stimulants like nicotine and caffeine can make symptoms worse, and keeping warm and wearing gloves will help. There are also many pharmaceutical medicines that are very effective in keeping the circulation going in the extremities, which can be taken once a day, and without side effects.

5. I was playing football recently and pulled my thigh muscle quite badly so it’s still painful to walk a week later. I put some ice on it and it helped a bit, was this the right thing to do? How else should I treat it?

Muscle tears can be variable in how quickly they heal, depending on how big the tear is. Ice works in the first instance to reduce bruising and swelling but after that warmth and massage are better. A physiotherapist can use ultrasound and passive stretching to ease the muscle out but taking an anti-inflammatory medicine such as Nurofen would also be useful. Enjoy warm baths and avoid vigorous exercise, but try some gentle activity to ease the muscle out. Give it a good 3 to 4 weeks before seeking further help.

6. In my previous job I worked on a laptop all day and I would sometimes feel like I was going to faint if I held my neck in a certain position. My GP said I might be obstructing the artery but this seems unlikely to me! What do you think? I now work on a desktop computer and it seems to be fine.

I think your GP was probably right. The vertebro-basilar artery runs up the back of your neck through the tiny vertebrae to that part of the brain that is responsible for balance. If your posture is bad when sitting at a desk, or later in life when you develop osteoarthritis in these intervertebral joints, headaches, giddiness and faintness can occur. It may be that your office ergonomics (the position of your chair relating to your computer screen) is better now in a new job, but keeping your neck mobile by doing little exercises now and again is always helpful.

7. Why do we all crave sugary foods? Is sugar addictive? What harm does sugar cause to your body?

Sugar itself is not addictive, but a rise in blood sugar will trigger nerve impulses along the pleasure pathway and make us feel good on a temporary basis. We get used to the taste of sugary foods, which we often find comforting and nice, but we do not need extra sugar in our bodies and indeed it can have harmful long-term affects such as obesity and a greater risk of diabetes. It isn’t easy to wean ourselves off the taste for sugar but, with a concerted effort, the unhealthy habit of craving sugary foods can be beaten if you persevere with it for more than 30 days, just like giving up smoking.

8. Is it actually true that stress can cause your hair to turn grey and fall out?

There is very little evidence to support the theory that stress alone makes your hair turn grey. 50% of people aged 50 will have 50% grey hair. That’s just due to the aging process. It is caused by the gradual loss of dark pigment produced by the hair follicles finding its way into the shaft of the hair. The theory that stress affects the circulation to the hair follicle and speeds this process is not substantiated by research. Nor is there any evidence to support the claim that people who have had a massive shock such as seeing a ghost or being sentenced to death can go grey overnight. If the theory were true, how do you explain that some people who are very stressed have a full head of black hair?

9. Why do I sometimes feel like I am getting ill – aches, tiredness etc., but then the next day I feel fine? Did my body fight off a virus in one day?

We all assume that the way we feel on any particular day is determined by our state of health at that moment in time. But if we feel ill and tired on a Monday it could well be as a result of what we did on Friday Saturday or Sunday. Take for example the fact that our muscles are aching and stiff after a run we did a day or two before. Take for example how hungry we feel if we ate very little the day before. Feeling ill and tired may often be the result of lack of sleep, stress and anxiety or activity levels that were imposed on us in previous days. The same applies to exposure to viruses and bacteria, which occurs thousands of times on a daily basis.

10. When I go for blood tests or try to donate blood the nurse really struggles to get any blood out of me! Do I have small veins or is there another reason for this?

Some people have superficial veins very near the surface, which are large and visible. Other people have smaller veins deeper in the subcutaneous fat under the skin. In that way we are anatomically all very different, and if you have deeper veins the nurse will find it more difficult to find them. They are there however, and sometimes more compression on the upper arm and the application of massage or heat to bring them to the surface may be needed.

11. I’ve seen articles stating that if you are sunburnt three times in your life, your risk of skin cancer will be higher. Is this true? As most people I know get burnt about three times a year…

Yes it is true. The more times you are sunburnt the greater your accumulated risk of developing skin cancer in the future. Much depends on your skin type, but burning is a sign of DNA damage to the cells in your skin. Over the course of time, this increases your risk of malignant change in those cells. You do not need to become sunburnt to develop a tan, so bear this in mind and, if you have children, remember that because their skin is thinner they are even more vulnerable to burning and greater risks in the future.

Well there we go. Let us know what you made of Dr Hilary's answers by leaving a comment below, or if you have your own burning question to ask him, please get in touch!

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