The Scottish Mail on Sunday

Can anything cure my sore and swollen legs?

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I SUFFER from dreadfully swollen, red and sore legs, which the doctor said is due to cellulitis, a skin infection. I’ve been given an ointment but it doesn’t seem to help. I’m at my wits’ end. Can you help?

CELLULITIS is a relatively common infection of the skin and the underlying tissues which causes swelling, redness, heat and pain.

To get it under control, it needs to be treated urgently with antibiotic­s, often in hospital.

But the problem can persist, which seems to be the case here. It can get so bad that walking is affected – in fact, cellulitis can be debilitati­ng, so medical interventi­on is absolutely vital to prevent worsening complicati­ons.

This may come directly from the GP, district nurse or the local healthy leg or tissue viability teams – exactly which of these is dependent on the services provided in your area, but the GP is always the first port of call.

Cellulitis is most often caused by problems with the blood supply in the legs. If the veins are not channellin­g the blood properly back to the heart, fluid accumulate­s, leading to swelling and infection.

Along with medication, caring for the skin is an important part of treatment, as recurrent swelling and infections can lead to splitting, ulceration and even permanent damage.

The profession­als involved in care should advise on applying moisturisi­ng creams to the legs – for instance, it should be applied in a downward direction, as this is proven to work best, particular­ly at night.

Compressio­n stockings, exercise and other lifestyle measures, such as giving up smoking and maintainin­g a healthy weight, will be needed, too. No one should be managing this alone. I WAS diagnosed with high blood pressure about 15 years ago, aged 50, and I have been on medication ever since. For years my reading has been about 125/80. I had a check yesterday and was told it was 150/80. When I asked if this was too high, the nurse was very dismissive and said it was all right. Do you agree?

HIGH blood pressure causes very few symptoms itself but is a significan­t problem, putting those who suffer from it at higher risk of stroke and heart attacks. Large trials over the past few decades have shown us that strict control of blood pressure numbers is really important in preventing these problems.

Our blood pressure does change throughout the day – if you were to take it yourself at home, you would see these fluctuatio­ns with tiredness, emotions and even simply at different times of the day. Blood pressure is recorded with two numbers. The first figure shows systolic pressure – the force of blood as the heart beats. The second is diastolic – the pressure inside blood vessels between beats. About 125/80 would be an excellent reading.

Ideally, the blood pressure for someone who is not diabetic (those with diabetes are at higher risk of heart attacks, so have a lower blood pressure target) would be under 140/90.

So 150/80 is not all right, as it is above this target. And there is another problem.

No one should be looking at just one reading and deeming it to be fine or not fine. This should have been repeated either at the time or over the course of a few appointmen­ts to determine if there has been an increase.

A one-off blood pressure reading is just one moment in time and not a true reflection of what is going on.

Ideally, at this stage, I would recommend a patient gets a home blood pressure machine and take readings twice a day for a week or two. Mornings and evenings are best, and keep a record of your results. With this informatio­n, you can then have an online or telephone consultati­on with your GP about what to do next, if it is indeed high.

This will be far more accurate than a one-off clinic reading.

SIGNIFICAN­T weight loss is very hard to achieve, so anyone who’s managed to lose 3st should feel proud of themselves.

But in some ways the weight loss is the easy part – a crash diet can feel exciting and results are seen quickly.

The challenge is finding a way to stay a healthier weight. This will need to be less strict than the crash diet, so that you can enjoy life, but not a return to the eating patterns that caused you to become overweight in the first place.

Exercise is a key part of that. Walking and cycling are great – again, nothing too extreme, but something you can do every day that’s enjoyable.

Blood sugar levels may take time to change. We use a test called HbA1c to look at diabetes risk, which reflects blood sugar levels over the preceding 12 weeks, so it may be that a test after three months of weight loss wouldn’t show a dramatic change.

Aim to have another test in three to six months.

It’s also important not to focus too much on a single factor. Weight loss itself and an increase in exercise levels have a beneficial effect, aside from blood sugar levels. TESTS at the start of the year showed I had raised blood sugar, and the doctor said I could be at risk of diabetes. I decided to go on a diet and managed to lose 3st in three months. I have just had another blood test and it showed I still have high blood sugar. I felt deflated. Just what do I have to do to get into the healthy zone?

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