DEMENTIA is something that scares many of us, especially if we have witnessed loved ones go through it.
Middle-age is a prime time to help prevent the disease. A recent study linked having normal blood pressure, no diabetes and not smoking from age 45 to 65 to warding off dementia for 13 years.
Dr Zoe Williams helps Jattvibe readers with their health concerns
This week Dr Zoe helps a reader whose mum has had recurrent UTIs Credit: Getty Images
We already know that brain health is linked to lifestyle choices, which also includes exercise, alcohol intake and your social life.
While you may not be able to avoid dementia entirely as genetics also play a role, you may be able to increase the number of years you may live dementia-free, which is far more positive to focus on.
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Here I answer some of the questions readers have asked this week . . .
Q) MY mum, 69, has had recurrent UTIs since June and has already had five courses of antibiotics.
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She has to urinate every 30 minutes, but it’s not just a dribble.
She also has a sore vaginal area, made worse by sitting, walking, going out, every bump in the road.
What frustrates her most is that she hasn’t seen a doctor or nurse, only handed in urine samples.
I implore her to phone the surgery again, but her words were, “They don’t care about me”.
It makes me feel awful as a doctor to hear that she thinks this, as I can almost guarantee she is cared about.
A) GP services are under huge pressure, and unfortunately, people who are less likely to push can struggle to get the attention they need.
With her permission, you are within your rights to contact the surgery on her behalf and could also attend with her if she would find that helpful.
One reason that recurrent urine infections can happen after menopause is because lower oestrogen levels change the tissues around the vagina, vulva, urethra and bladder.
Called genitourinary syndrome of menopause, it can cause soreness, burning, urgency, frequency and recurrent UTIs.
Vaginal oestrogen treatment can be very effective for some women. But your mum needs an examination and proper investigation, as there are other potential causes too.
Antibiotic-resistant types of bacteria, infection, but also vaginal atrophy, vulval skin conditions, prolapse, bladder pain syndrome, stones, incomplete bladder emptying, diabetes or, less commonly, something more serious, could be to blame.
Symptoms this severe and for months should not be managed only by repeated antibiotics.
After five courses, doctors need to know whether this is persistent infection, repeated new infections, resistant bacteria or symptoms mimicking UTI.
It is important that urine samples are sent for culture, so antibiotics can be targeted.
She should ask clearly for a face-to-face appointment with a GP or nurse practitioner. If this fails, try 111.
Seek urgent help if she develops fever, loin pain, vomiting, confusion, blood in the urine, weakness or becomes unable to pass urine.
MENOPAUSAL ISSUES
Q) I am 52 and had my last period 15 months ago. For the last couple of weeks, I’ve been experiencing an achy stomach and tenderness in my breasts, which I used to get before my period was due.
I’ve also noticed a clear slimy discharge when wiping myself after the toilet.
Are these normal menopause symptoms, or should I be concerned?
A) I can see why this has been worrying.
Once you have gone 12 months without a period, you are considered post-menopausal, so it is sensible to pay attention to new symptoms.
Breast tenderness and an achy lower abdomen can sometimes feel like the premenstrual symptoms you used to get.
Even after periods stop, hormone levels do not switch off overnight, and some women still notice occasional hormonal-type symptoms for a while.
A clear, slippery discharge can also happen and is not automatically serious.
Vaginal discharge can change with hormones, sexual arousal, irritation, infection, or vaginal and vulval tissue changes after menopause.
However, because these symptoms are new after 15 months without a period, I would suggest you see your GP.
They may suggest a urine test, swabs, and an abdominal, pelvic or speculum examination.
Pelvic inflammatory disease is infection involving the womb, fallopian tubes or ovaries, and can cause lower abdominal pain, pelvic discomfort, discharge, pain during sex or bleeding.
It is less common after menopause, but still possible and needs treatment.
Vaginal bleeding or spotting (red, pink or brown) after menopause is a red flag – even a small amount.
I’d also suggest you see someone for discharge that smells unpleasant, changes colour, causes itching or soreness, or if you develop fever, worsening pelvic pain, persistent bloating, feeling full quickly, unexplained weight loss, or needing to pass urine more often.
Getting assessed does not mean something is seriously wrong, it means making sure nothing important is missed.
SHAKING CHILLS LEAVE ME PARALYSED
One reader is struggling with severe shakes like hypothermia Credit: Getty Images
Q) I AM a 70-year-old man and, for 30 years, I have had an unusual problem.
I can get extremely cold with severe shakes like hypothermia and can barely walk and would not be able to drive.
It does not even have to be cold, but it feels like -20C and my heart rate is elevated. All I can do is curl up and wait for it to pass, usually I sleep.
I have heart failure. It can be very scary for my wife. Doctors have got nowhere.
A) I’m sorry you have been living with this for so long.
I don’t know what is causing this, but it is definitely not something to ignore.
Severe shaking chills can happen with infection, but also potentially with sudden changes in blood pressure, blood sugar problems, thyroid or adrenal issues, medication effects, abnormal heart rhythms, or problems with the nervous system’s temperature regulation.
A next step is to gather more information during an episode.
Your wife could note your temperature, pulse, blood pressure (if you have a machine), how long it lasts and whether you are confused, breathless, clammy, blue-lipped or having chest pain.
She could take a video to show your doctor what the shaking looks like. It would be reasonable to ask your GP whether heart rhythm monitoring – a 24-hour, 48-hour or seven-day Holter monitor – is needed to pick up abnormal heart rhythms.
Ask for a review of your heart failure, medications and blood tests, including full blood count, kidney and liver function, thyroid, glucose, inflammation markers, B12, folate, ferritin and possibly cortisol depending on your history.
You should not drive until you have discussed this with your doctor, as DVLA guidance says sudden, disabling or recurrent dizziness must be reported.
If you become confused, very drowsy, breathless, have chest pain, collapse, or your wife is seriously worried, call 999.
TIP OF THE WEEK
DO you struggle to get, or maintain, an erection? It could be an early warning sign of heart disease.
Vascular changes often affect the smallest blood vessels first, sometimes years before a diagnosis. So don’t be embarrassed to seek help, book in to see your GP.
SOLAR SIGHT WARNING
Only purpose-built eclipse glasses bearing the ISO 12312-2 safety standard can allow you to watch an eclipse Credit: Jordan Pettitt/PA Wire
EYE doctors are warning people not to use their sunglasses to view the solar eclipse tomorrow evening.
More than 90 per cent of the sun will be obscured by the moon between 6.17pm and 8.06pm – the most it has been obscured in UK skies since 1999.
But the Royal College of Ophthalmologists warns using standard sunglasses, no matter how dark, could leave you with permanently damaged eyes.
Equally, you should never look at the sun through binoculars, a telescope or any other direct method. After the 1999 total eclipse, around 70 people in the UK reported vision problems.
About 40 per cent of those had looked at the sun for less than a minute.
Mohamed Elalfy, president of the college, said: “The safest way to enjoy the eclipse is to observe it indirectly, such as by watching a live broadcast.
“Looking directly at the sun can cause damage to the retina, potentially damaging the cells responsible for sharp central vision.
“The retina has no pain receptors, so people will not feel damage as it happens.
“While some recover over weeks or months, others can be left with permanent visual impairment.
“Symptoms may only become apparent several hours later and can include blurred vision, a central blind or dark spot, distorted vision, reduced colour perception and increased sensitivity to light.”
Only purpose-built eclipse glasses bearing the ISO 12312-2 safety standard can allow you to watch an eclipse.
DRUGS’ SUNBURN RISK
YOUR medicine could put you at risk of blistering sunburn.
The Medicines and Healthcare products Regulatory Agency has urged people using painkillers and other common medicines to take extra precautions as the nation faces another heatwave this week.
The watchdog’s chief safety officer, Dr Alison Cave, warned: “Some commonly used medicines can affect the body’s ability to stay hydrated, regulate temperature, or protect itself from sun exposure”.
Pain relief drugs such as ibuprofen and naproxen could increase sensitivity to the sun, “meaning skin can burn faster or more severely than expected,” she said.
Antibiotics doxycycline and tetracycline; acne treatments like isotretinoin and topical retinoids; and antifungal medicines such as voriconazole carry the same risk. If you take disease-modifying antirheumatic drugs to treat rheumatoid arthritis, psoriatic arthritis and lupus, you may also be at higher risk. This includes medicines like methotrexate and azathioprine.
“Proton pump inhibitors, commonly used to treat acid reflux and heartburn, have also been linked to a very low risk of a lupus-like skin reaction triggered by sun exposure,” Dr Cave added.
And diuretics, prescribed for blood pressure or heart conditions, can increase fluid loss and make dehydration more likely.
“Some antidepressants and antipsychotics can affect the body’s ability to regulate temperature, and medicines such as beta blockers may reduce the body’s response to heat stress,” Dr Cave added.
