I’m dizzy and slur my words but I still can’t get a diagnosis

I HAVE been suffering from dizziness — sometimes extreme — and blurry vision. I also find I’m slurring my words. The GP ordered blood tests last year but I have heard nothing more since. Having done my own research I think I have ataxia, which seems to be getting worse by the day. What do I need to do to get an official diagnosis?

ATAXIA is the name for a range of serious brain conditions affecting balance, speech and co-ordination. It can be a long process to get a diagnosis with a neurologist, who will need to undertake many tests, including MRI scans.

The most common type of genetic ataxia is called Friedreich’s ataxia, which is inherited from parents. Usually people notice their symptoms developing very slowly over time before the age of 25, although not always. People can also develop ataxia as a result of other conditions, such as multiple sclerosis, or after a stroke.

It is usually not possible to treat ataxia but it may be possible to relieve the symptoms. This could include speech and language therapy, physiotherapy and occupational therapy. Medications are also available to help with muscle spasms and pain.

The Ataxia Foundation of Ireland has more information and support. See afi.ie

I HAD my baby in March and then a smear test in June, which showed I had the HPV virus — but the doctor said I had no abnormal cells. I have to return in June for another smear to check the situation. My problem is we would like to try for baby number two. Is it safe to do so before my next test?

THERE are many different types of HPV — more than 100. It’s a very common virus that doesn’t cause problems in most people, but some types can cause genital warts or cervical cancer.

While HPV affects up to 80 per cent of adults at some point, this will undoubtedly drop over the years as teenagers are now vaccinated against it.

But because of its association with cervical cancer, smear tests looks for HPV. People who don’t have it are very unlikely to develop the disease.

If someone does have the virus, the cells on the cervix — the entrance to the womb — are examined for abnormal changes.

It is reassuring if none are found, and then women are kept under a closer surveillance. For most people the virus will go away and not cause cancer: nine in ten HPV infections clear within two years.

Weighing this up with the desire to try for another baby is a very personal decision, looking at the risks and benefits. I would advise patients to see through the HPV process as a priority, both for practical and emotional reasons.

MY RIGHT big toe joint is very painful and I’m often unable to move it. I was told years ago that I had hallux limitus that would eventually become hallux rigidus. I was also advised that the only treatment other than surgery, which I’m reluctant to have, was painkillers. Is there anything else out there I am not aware of you could suggest?

SURGERY can seem daunting, but when weighed up against not being able to walk or put shoes on, it could be worth undertaking.

Hallux limitus is osteoarthritis of the big toe, caused by wear and tear. The surfaces of the bones become damaged and rub against each other, restricting movement until the toe can’t move at all.

Anti-inflammatory tablets or gels such as ibuprofen, as well as other painkillers, are useful. It is recommended to wear stiff-soled shoes or those with a rocker bottom during activities.

It may be possible to be referred for podiatry or orthotics — specially made shoe insoles. Doctors may also offer a steroid injection into the joint — this can provide months of relief.

There is a range of operations, and an orthopaedic surgeon would advise which is the most suitable, as it depends on the condition of the joint. The operations either preserve the joints or leave them unable to move, which can sound rather frightening. But in all cases the aim is to reduce pain — studies show that weight-bearing on the foot improves with surgery, even if the joint is fused.