THE DOC REPLIES

What is a burst capillary? I have purple blotches on my legs and have been told that is what they are.

A capillary is the name for a very small blood vessel as can sometimes be seen under the skin. These are fragile and can be burst by trauma. They can also occasionally spontaneously burst, especially as one gets older, or if the skin is exposed to the elements. This is seen most commonly on the face and also sometimes on the legs – especially in people who have varicose veins. This causes increased pressure on the capillaries under the surface which are then more likely to burst and cause blue discolouration. I have Sudeck’s Atrophy. What is it?

Sudeck’s Atrophy is more commonly known nowadays as complex regional pain syndrome. It is thought to be due to nerve damage often caused by trauma or surgery. While the original injury improves, nerve symptoms persist. The skin in the offending area is often very sensitive, there can be skin and hair changes along with swelling. Movement can be affected. Treatment is difficult although there are a number of drugs in use nowadays which are very effective for nerve pain. How much tinned tuna is safe to eat? Am I at risk of mercury poisoning?

It depends on a lot of factors – so the short answer is I am not sure. I know that for pregnant women who are more at risk of mercury toxicity it is recommended that no more than four tins are eaten at a time. I think a normal healthy diet with a good balance of foods – along with a sensible amount of fish – is likely to be safe. I have pericarditis – what is it and what could have caused it?

This is an inflammation of the lining sac of the heart. It can be caused by many things – most commonly with infections, especially viral ones. It can also be down to chemical changes in the blood or even some forms of cancer. It’s painful but, if the pericardium becomes restricted or swollen or filled with fluid, it can cause problems. It can affect the efficiency of the heart which causes breathlessness. Occasionally, when examined, you can hear a rubbing noise coming from the layers of the pericardium. It can be quite debilitating but most people make a full recovery. My grandson was born with a tooth already in his mouth and the decision was taken to remove it. Will a tooth come in normally in the space?

Although unusual this is not unheard of. I am not a dentist but my understanding is that this would be a baby tooth and therefore that baby tooth would not be replaced, However, he would certainly get a normal second tooth. I’ve developed a problem where I can’t stop biting at the side of my mouth, especially when I’m nervous. It’s causing some bleeding.

I think there are two issues here – one is the physical and the other is the psychological. You should have someone look at your mouth, either a dentist or a doctor, to ensure that there is no underlying reason why the biting is happening and that you are not causing any significant problem to the mucus membrane lining of the mouth. The psychological is more difficult. It may just be a habit and habits can be difficult to break. If it is down to anxiety then it may be worth having a chat with your doctor.

My foot arch has dropped – is there any way to restore it as it’s become quite painful?

If you are having a lot of pain I think you should see either a podiatrist or your GP to diagnose you correctly. Everyone’s arch is a different size and some people are more flat-footed than others. It may be that your arch is needing support or it may be that you have another problem such as a condition called plantar fasciitis. You may need some sort of support for your footwear.