The Mail on Sunday

Pills have stopped my heart flutter so do I still need them?

- Ask Dr Ellie THE GP WHO’S ALWAYS HERE FOR YOU

I AM active, fit and healthy but, in February, I started having a heart flutter – and was diagnosed with atrial fibrillati­on. Since then I have been on bloodthinn­ing tablets. Weirdly, my pulse seems to have returned to normal. Shall I stop treatment?

ATRIAL fibrillati­on, also known as AF, is a common heart-rhythm problem in which the beating pattern becomes very fast and irregular. There are several different types of the condition.

One, called paroxysmal atrial fibrillati­on, features sporadic periods of irregular heartbeats which last just a few days – but keep recurring. There’s also what’s known as continuous atrial fibrillati­on, which never goes away without treatment.

Most people with atrial fibrillati­on also have another problem, including high blood pressure, a history of heart attack or a lifelong heart condition. Some have other health problems – like diabetes or a bad infection.

Drinking a lot of caffeine or alcohol also increases the risk of atrial fibrillati­on.

The condition is serious because the erratic pulsating of the heart increases the risk of life-threatenin­g blood clots and strokes. And those who suffer short bouts of this are just as likely to suffer these complicati­ons as those with continuous atrial fibrillati­on.

Doctors treat the condition by controllin­g blood pressure and preventing clots using bloodthinn­ing medication – so patients should definitely keep taking the tablets.

MY 79-YEAR-old wife has suffered urinary tract infections for the past two years. Antibiotic­s have helped ease the discomfort but do not get rid of the problem. She has HRT patches too, which I’ve read are supposed to help with problems like this. Can anything else be done?

URINARY tract infections are incredibly common – especially in elderly people. But it is really important that patients see a GP if they think they have an infection, because there might be other factors that are causing the symptoms. When patients develop a urinary tract infection, they feel the need to go to the toilet often, and suffer burning or soreness when urinating.

Sometimes they notice a strong smell in the toilet, or that the water they pass is cloudy.

A GP will perform something called a dipstick test to spot the infection. But there are other, more detailed tests which involve sending a sample off to a lab to find out exactly which bacteria is the issue.

Doctors have to know the type of bacteria that are lurking around so they know which antibiotic­s to prescribe. But recurrent symptoms that seem to be a urinary tract infection may be due to something else. Crucially, it could be a sign of ovarian and other gynaecolog­ical cancers.

The bladder sits very close to the womb and other organs. A problem with these organs can irritate the bladder, causing UTIlike symptoms. An ultrasound scan of the pelvis area would give a good indication of potential problems with these organs, as well as the bladder and kidneys.

Changes after the menopause can cause symptoms similar to a UTI, mostly because a lack of oestrogen makes the tissues in the intimate area dry and irritated. If the issue is recurrent infections, doctors may suggest preventati­ve antibiotic­s.

This involves taking a daily low dose on a long-term basis, and has been proven to be highly effective.

CAN statins cause prickly heat rash? Ever since my husband started taking atorvastat­in in September 2019, he’s suffered extreme severe prickly heat. It happens every time we go abroad – nothing soothes it.

PRICKLY heat rash is a very uncomforta­ble reaction to very hot climates. It is caused by excessive sweating: sweat gets trapped in the glands under the skin, triggering small, raised, itchy spots. But it is not to be confused with another, similar condition called polymorphi­c light eruption.

This problem is caused by the skin’s reaction to sunlight – causing an itchy, burning rash. There are key difference­s. Polymorphi­c light eruption results from sunlight itself rather than just heat. It also causes blisters, burning or patches of raised pink or red spots. The reaction happens when sufferers haven’t been exposed to sunlight in a long while, and symptoms can get worse in further sunlight.

After a while, the skin of people with polymorphi­c light eruption becomes resistant to the

sun – patients find they can stay out for longer. But the affected areas of skin can become hard, and these patches can be difficult to get rid of. Patients can avoid it by covering the areas prone to rashes with loose-covering clothing and a good sun cream. Using an SPF50 sun block with a high UV-protection rating is important. Dermatolog­ists recommend cream, steroid pills or antihistam­ines to stop the itchy, burning feeling.

Specialist­s may also suggest increasing your resistance to the sun at home before travelling. This involves being in the sunshine for short periods every summer to build up tolerance.

Drugs including statins can cause photosensi­tivity and reactions of the skin in the sun.

This may be the case if the reaction appeared shortly after the course of drugs began – but it can be difficult to pinpoint a direct trigger.

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