THE DOC REPLIES

What is iron deficiency? My husband has it. He doesn’t eat red meat and I wondered if it would help.

Iron deficiency anaemia happens because of either a poor intake of iron or blood loss. Iron is found in meat, in particular red meat, and in green vegetables. A normal diet in this country would give all the iron necessary. Blood loss is usually obvious but occasionally it can go unnoticed. Iron deficiency anaemia can make the patient very tired and breathless and can aggravate other conditions. When we find iron deficiency anaemia we usually check diet with the patient and look for possible blood loss. Supplements can be taken but it is important to find the cause.

At night I’m often woken up by a nosebleed. What could the reason be?

Sometimes nose bleeds can be triggered by trauma such as sneezing, blowing or picking – yet sometimes they are spontaneous. They are more common in young people and often get better as we grow older. A nose bleed can be common in other conditions such as pregnancy or when taking anti-coagulant medicine. It is important to sit upright when you have a nose bleed, with a cold compress over the bridge of the nose and the nose pinched for 10 minutes. This should stop the bleeding. If the bleeding is very heavy or doesn’t stop then you need to seek medical attention. Mainly it’s just a case of managing until it settles down.

Can I have a troublesome keloid scar removed via the NHS?

It is difficult for me to answer this question as it will perhaps vary from place to place, and it will also vary depending on where it is on your body and how problematic it is. The problem with removing a keloid scar is it may recur. Keloid is an overgrowth of healing tissues and some people have a propensity to this condition – so further surgery can make it worse rather than better. See your GP.

My elderly mother is increasingly withdrawn and says she’s anxious about leaving the house, whether on her own or with me. Should I speak to the doctor on her behalf?

Encourage your mother to see her doctor. You could be describing an anxiety or depressive disorder, or she may be getting forgetful as part of the aging process. Of course, it could be social as her world changes. It is likely that a chat with a medical person will be able to decipher which of these causes it may be.

What’s the best way to deal with a baby who is suffering from colic?

Nobody really knows what colic is, or even if it exists. We do know that young babies often get upset more commonly in the evening with crying and apparently pulling up their legs. This may be pain, and it may be in the tummy, but we cannot prove this. We know it is common in babies in the first few weeks and months of life, especially if they are breast-fed. We know it’s more common in the evenings. There are medicines from the pharmacist that try to break up any wind within the baby’s tummy and this might be worth a try. Generally speaking, if the baby is healthy, and is developing in other ways, it does not require any management apart from consoling the baby and keeping them happy.

I worked on the roads for years and experienced numbness in my right hand. Two of my fingers have recently become pale and discoloured. Any ideas?

You may be describing vibration white finger syndrome. This is a recognised problem of blood vessel damage in people who work with heavy vibrating machinery like the type you perhaps worked with. Although it is not curable, there are medicines that sometimes may help a little bit. I think you should see a doctor to confirm this diagnosis and talk about possible treatment.