The doc replies

I wake up at 4.30am every morning, without fail, no matter if I go to bed earlier or later. I lie there unable to get back to sleep. Do you have any ideas how I can sleep right through?

People can vary in their sleep patterns and this may be a normal pattern for you, especially if it is long-standing. As we get older very often we need less and less sleep andthiscanbe frustrating. Sometimes recognising this as a normal pattern for you can be quite liberating. If you have recently started waking up early in the morning then this is worth discussing with your doctor as this can be caused by underlying conditions, such as depression.

I have developed a spongy lump on my elbow. It’s not very painful although it is a little uncomfortable.

This sounds like a bursitis of the elbow. Everyone has a thin film of fluid that protects the elbow but this can get inflamed and become quite large. Very often it settles down by itself although it can be drained in the surgery. Occasionally, it may become infected but you would know that because it would become painful, swollen and red.

What’s the best way to rid myself of a fungal nail infection on my toe?

Fungal nail infections that happen just on the surface of the nail – especially when it is a single nail – can often be treated with a simple cream that you can get from your pharmacist. However, deeper fungal nail infections or nail infections involving multiple nails often require a prolonged course of tablets and you should discuss this with your GP.