I mistook sight loss for a stroke but GP says it was migraine
Q
I’M 34 and have had a couple of episodes in the last three months when I have lost the vision in my right eye for around 10 minutes. The second time it happened it started with a small black blob in my eye which gradually got bigger. I was really worried I might be having a stroke but my doctor says it’s probably a migraine even though I didn’t have a headache. Is that possible?
A
SUDDEN loss of vision in an eye can be a sign of an interruption to the blood supply either to the light-sensitive membrane at the back of the eye or to the part of the brain controlling vision. It can also be a sign of inflammation of the optic nerve supplying the eye and no matter what your age, it is a reason for getting urgent medical advice.
It sounds as if you may have experienced an ocular migraine, which is thought to be caused by a spasm of the blood vessel supplying the eye (rather than a blockage).
In this, vision may slowly become blurred or dimmed, or there may be an area where you cannot see, which slowly enlarges. In some cases there are flashes of light too.
The loss of vision, which usually only affects one eye, tends to last 10 to 20 minutes and though some people do get a headache afterwards, many do not.
Ocular migraines are more common in a personal or family history of migraine.
Attacks may be triggered by stress, bending over, exercise, being dehydrated or excessively hot and also by high blood pressure and smoking.
Treatment usually involves taking painkillers for any headache and trying to prevent further attacks.
There’s no best way to treat or prevent ocular migraines but if you get repeated attacks, taking beta blockers or calcium channel blocking drugs may be helpful. Your GP can prescribe these.
Q
I’VE recently been diagnosed with Type 2 diabetes. I’m a bit overweight but a friend suggested that my smoking was to blame. I’ve managed to cut right down but I am finding it hard to totally give up.
A
TYPE 2 diabetes occurs when the pancreas cannot produce enough of the hormone insulin to keep blood sugar levels under control. Fat cells are resistant to the action of insulin and the fatter you are, the more insulin the pancreas has to produce which is why being
overweight increases the risk of becoming diabetic.
Smoking does not increase the risk of becoming diabetic and does not affect blood sugar levels. However, the tar in cigarette smoke can damage and narrow arteries and unfortunately raised blood glucose levels can also have the same effect.
So the combination of both smoking and diabetes is especially dangerous, vastly increasing your risk of a heart attack, stroke or having a leg amputated due to poor blood supply.
Impotence is a very common problem in diabetic smokers as the blood supply to the penis is reduced. Losing weight can be very beneficial in helping to keep blood sugar levels under control, and in some, can mean that medication is not required.
Your GP should have referred you for advice on healthy eating but it is also really important for your health that you stop smoking altogether.
Nicotine is not harmful to arteries, so you may find using nicotine replacement therapy helpful in quitting.
A receptionist in my surgery has been trying out the newVoke device, which looks like a cigarette but does not involve any vapour and she’s found it very useful in satisfying her cravings for nicotine.
QI’VE had swollen glands in my neck for months and eventually my GP referred me to a specialist. I’ve been diagnosed with chronic lymphocytic leukaemia but I’ve been told I don’t need any treatment.
How can this be? I thought it was always better to have treatment for cancer as soon as possible.
ACHRONIC lymphocytic leukaemia (CLL) is a type of blood cancer where the bone marrow produces too many of a type of white blood cells known as lymphocytes, which are not fully developed and do not work properly.
Lymphocytes are an important part of the immune system and over time this can lead to an increased risk of picking up infections, which may last longer and be more serious than when the immune system is working properly. Other symptoms can include swollen glands in the neck, armpits and groin and feeling tired.
Swollen glands inside the abdomen can lead to tummy discomfort. In later stages, CLL can cause a fever, night sweats and weight loss.
CLL progresses very slowly and research has shown that, unlike many cancers, there is no benefit in treating it in the early stages when it is not causing any symptoms as treatment can lead to significant side effects. Instead, you should be kept under regular review, often for years, and treatment should only be started if you develop enlarged glands in three or more places, have a high white cell count or if it is starting to cause symptoms such as night sweats.
Treatment then usually involves having three medicines in cycles lasting a month.This does not usually cure CLL but can keep it under control, usually for years.There are no UK statistics for CLL survival but generally those diagnosed in the early stages, like you, live for more than 10 years, often a lot longer.
● If you have a health question for Dr Leonard, write to her in confidence at the Daily Express, One Canada Square, Canary Wharf, London E14 5AP or email yourhealth@express.co.uk. Dr Leonard regrets she cannot enter into personal correspondence or reply to everyone.
‘It’s really important for your health that you stop smoking’