I feel out of breath, could it be to do with my second jab?
Q
Over the last six months or so I have become very breathless finding it difficult to walk 100 to 150 yards without stopping. I had a chest X-ray and my lungs were clear.
I had my two vaccine doses at the start of the year and am wondering if it might have been a result/side effect of that. I am 81 and have no other health issues.
Your advice is much appreciated.
A
Firstly, I do not think your vaccines will have anything to do with this. They will have protected you from a serious Covid infection and it is important you have your booster when you get your reminder.
If it is now more than six months since your second jab, please contact your surgery.
When you exercise, the muscles used require more oxygen than when they are resting and this is normally provided by the heart beating faster and harder, increasing blood supply where it is needed. Your breathing rate goes up as well, to get oxygen into the bloodstream from the lungs.
Breathlessness on exercise can be due to a problem getting air into the lungs, which can happen in someone with asthma or long-term lung inflammation, but it does not sound as if this is the case with you as your chest X-ray was normal.
It can also be due to anaemia, where there are low levels of the red blood cells which carry oxygen. However, this type of breathlessness in someone of your age is often due to weakening of the heart muscle, which means it cannot pump the extra blood required during exertion.
Other symptoms of this can include puffy ankles and feeling breathless at night if you lie flat. It’s a condition known medically – and over-dramatically – as heart failure, but this does not mean your heart has stopped, but it could do with some help to work better.
It can usually be diagnosed with a blood test checking for the level of a chemical known as BNP. If this is raised, the next test is an ultrasound of the heart, an echocardiogram.
Treatment is with a range of medicines that help the heart muscle work more effectively. Lifestyle changes can help, including eating a healthy diet and losing excess weight and stopping smoking.
Regular exercise is important too, though you need to do this in a way that does not make you too out of breath, which may mean gentle daily walks and taking breaks when you need to. Your GP will be able to arrange tests and treatment, so please get in touch with them.
Q
My brother was in rehab for alcohol and cocaine addiction last year. He swears he has been sober for some time now but his speech still sounds slurred to me. I know this can happen while you are drunk but can it really continue once the alcohol is fully out of your system? Could he have brain damage?
A
Slurred speech can certainly occur when you are drunk, but once you have sobered up, speech should return to normal. Long-term heavy use of both cocaine and especially alcohol can cause long-term brain damage, but it is likely there would be other symptoms, such as behaviour changes, mood swings, memory lapses and an unsteady walking style.
I sense you are only speaking to your brother on the phone and without talking to him face to face, it will be impossible for you to know the cause of his slurred speech. Meeting him would also be by far the best way of tackling such a sensitive subject. It is possible, as I suspect you are aware, that though he says he is sober he has started drinking again, but if this is the case then, as with any addict, the only person who can sort this out is him.
Distressing as you may find it, the best thing you can do is offer your love and support.
Q
I have this burning pain inside my rectum, which is affecting my sleep. My doctor says there is no inflammation or tear and prescribed suppositories, which do not help much. I had my prostate removed 28 years ago (I am 83). Can you suggest any treatment which would help to alleviate the burning please?
A
Pain in the rectum, the lowest part of the large bowel which leads to the outside via the anus, can be due to swollen veins (piles) or a fissure or tear, which is a split in the skin at the entrance to the anus.
However, both of these tend to cause pain when passing a motion rather than a more continuous pain that disturbs your sleep.
The most common cause of burning pain is inflammation of the lining and though your GP says there isn’t any, it can be difficult to diagnose accurately in the surgery.
The best way of being sure whether there is inflammation or not is to examine the lining carefully using a special instrument, a proctoscope, alongside tests of both your stools and your blood.
Stool tests should include one for calprotectin, a chemical that is produced in increased amounts when there is inflammation, plus also a check for traces of blood, a FIT test.
Blood tests that can be helpful include a check of your ESR and CRP levels, which can both indicate inflammation.
I doubt that the pain has anything to do with the removal of your prostate all those years ago – if it had been a side effect of the operation then symptoms would have occurred long before now. So as your sleep continues to be disturbed, please contact your GP again.
You may need a referral to a specialist to sort out the underlying cause. Once this is known, you should be able to have some effective treatment.
● If you have a health question for Dr Leonard, email her in confidence at yourhealth@express.co.uk. Dr Leonard regrets she cannot enter into personal correspondence or reply to everyone.