the doc replies THE DOC REPLIES

Is there an illness associated with too much yawning? My husband yawns almost constantly and I’m worried it could be indicative of something else.

Yawning is a normal physiological phenomenon. The body yawns to increase the oxygen supply to our lungs and therefore to our brain. It happens to everybody when we need a sleep. There are other causes of yawning. There are some drugs that can cause yawning as a sideeffect in particular antidepressant medication. Brain damage can also cause yawning. I’ve got a pounding sensation in my left ear, which feels like my heartbeat. It’s especially noticeable at night.

There are many different causes of what you describe which could be a type of tinnitus. The problem could be coming from your outer ear, such as wax or infection, the ear drum itself, due to a lack of movement of the ear drum or a middle ear problem relating to the bones and balance centres within. The first thing is to see your Doctor and get them to have a look at your ear. I have a problem with my legs which makes them feel hot and swollen all the time. My doctor has suggested a spinal scan. Do you have any ideas as to what it could be?

This is a difficult one to answer by letter. You mention that your legs feel swollen but whether or not they are I am uncertain. Feeling hot can be related to infection of the skin or tissues, also to arthritic problems, circulatory problems or nerve problems. Swelling can happen because of fluid drainage issues but also more rarely with liver and heart problems. The fact that your Doctor is considering a scan suggests that they are looking more at the nerve side of things. I think you need to discuss further what they think is wrong. I was recently started on a course of Citalopram by my doctor. My tongue and throat have become very dry, though. Is this a symptom of these drugs?

Yes it is a recognised side-effect of Citalopram and is contained in the information leaflet. It is not harmful. I’ve recently quit drinking alcohol after years of abuse. Will my liver repair itself?

Largely the liver has a great capacity to repair. It can take quite a lot of pounding resulting in inflammation and often return to normal. A simple blood test followed by a period of abstinence for at least three months will show whether or not the liver is improving. I’ve noticed my eyelash hair is thinning as I get older. Is this normal?

Hair thinning can happen anywhere on the body we have hair including eye lashes. We do have hair thinning as we get older,

usually men more than ladies. If you have generalised thinning that you think is unnatural for you at your age then discuss it with your Doctor. Is it possible to have a chronically-infected nail? My thumbnail is heavily discoloured after my finger became infected a few months ago and shows no sign of clearing up.

It is quite common to get nail infections, in particular fungal nail infections. They are treatable or sometimes they grow out themselves but can linger for many months or years. Finger nails take at least six months to grow. Your Doctor can take a clipping of the nail to find out if it is infected. My friend says I could have “claudification” in my legs. What is it?

Claudication is a term for peripheral vascular disease. This is where the blood is not flowing adequately to the periphery, in particular the legs and feet because of blood vessels being furred up. This is usually related to smoking or to some rare hereditary conditions and can be aggravated by high cholesterol. The symptoms are usually leg cramps and cold feet. Your circulation can be assessed by examination and if necessary ultrasound. Your Doctor can then discuss with you if whether or not anything can be done.