THE DOC REPLIES

IS it normal to be dizzy for three or four minutes after waking up and walking around? I find it difficult to shake the feeling and have fallen a couple of times. Should I be examined by a GP?

When we sleep, our blood pressure becomes low and it subsequently rises when we wake, in order to allow us to walk around. A slight feeling of dizziness can be normal first thing in the morning. Just try to take your time. You could also give your legs a wee shoogle before getting out of bed.

I’M 86 and suffer from dystonia, which leaves me unable to speak. I use a salt pipe – is there anything else I can do?

I would recommend conventional therapy from a speech and language specialist to help with communication difficulties. A “salt pipe” is a traditional remedy of breathing in moist air with a high salt content similar to that found in underground caves. It is, however, unlikely to be of benefit.

MY partner recently experienced something called Bell’s palsy. What is it and how long will it last?

This is the condition caused when the facial – the seventh cranial to be precise – nerve is nipped and squeezed on its journey between the brain and the face. This causes a one-sided paralysis of the muscles in the face, which is cosmetically quite devastating. Urgent medical attention is required to confirm it’s actually Bell’s palsy rather than a stroke. However, in most cases recovery is quite rapid. Steroid treatment is often used to shrink any swelling of the nerve and to help the recovery. Follow-up treatment is required to check that the eye and mouth function properly in the long term.

I have been diagnosed with prostate cancer and have been given bicalutamide tablets. What happens now?

Cancer of the prostate gland can be treated by surgery, radiotherapy, chemotherapy injections and tablets or by “watchful waiting” if the disease is not spreading in an older man. Biclutamide slows the growth of cancer by blocking the effects of the male hormone, testosterone, on the gland. Your oncologist will follow up treatment with regular examination, blood tests and scans if necessary to assess whether there is any further response.

I have been told I have gastroenteritis – what is this and what can help it?

Gastroenteritis literally means inflammation of the gastrointestinal tract which begins at the mouth and ends at the anus. Most commonly it is the term used to describe a tummy upset such as food poisoning – yours will most likely have passed by now.

MY son was prescribed 20mg of Citalopram when he was 18. He’s 31 now and still takes the tablets, but I’m worried about long-term effects. Is it safe to be on anti-depressants this long?

Yes. A dosage of 20mg appears to be very safe in the long term.

I’M going for an MRI scan but am worried about being placed in the machine as I’m quite claustrophobic. Is there another option? To undergo an MRI scan you have to be able to lie still for 20 minutes in a confined space. In the older machines you literally entered a tunnel or tube, whereas in the modern machines you lie still while a large “doughnut” sweeps over you. You will be equipped with a panic button and a choice of music to listen to distract you.

I have a lump on my wrist that my mum seems to think will go away if I hit it with a book. Will this work? Sounds like asking for a broken wrist.

A traditional remedy for a ganglion or swelling over a joint used to be to hit it with a large book, typically the Family Bible. Modern thinking, however, is to leave a ganglion well alone as often it goes away naturally.