ASK THE EXPERTS
GP with 20 years of experience in general practice. Woking in Perth since 2010 with special interest in women’s health and mental health.
I’m having pain and numbness in my wrists and sometimes I need to shake them after waking up. Even when I’m driving my fingers sometimes get tingly? Is it serious? I’m afraid to see my GP. (Brenda, 43)
Your symptoms sound like Carpal Tunnel syndrome where one of the nerves supplying the hands are compressed and this then causes the tingling, numbness and pain. The median nerve runs through a little tunnel in the wrist and if there is any pressure or swelling around this area it can cause these kinds of symptoms. It often happens at night when you sleep with your wrists bent or when you hold onto your steering wheel in a certain way while driving. You will then find when you shake your hands a bit the symptoms will clear. If the pain gets more intense or lasts longer or if you start developing weakness in your wrists and hands, it is a sign of a more serious compression of the nerve and you would not want it to get to that point. It is important to discuss this with your doctor who will ask a few questions and examine your hands, arms and neck to rule out some other possible causes. The doctor might also send you for some nerve conduction tests to confirm which nerve is trapped. Usually a wrist splint to wear at night or while driving to stop you from bending your wrist will help alleviate the symptoms. If it is quite severe, your doctor might refer you to an Orthopaedic surgeon who can do a small operation to release the nerve by cutting the little tunnel open.
After a blood test, I am low in vitamin D and iron. I’ve been taking supplements for the last 3 months but I still feel tired and find it hard to concentrate at uni. What’s the quickest way to help me regain my energy? My periods are really heavy sometimes, but not always. (Chris, 19)
Low iron is a very common cause of tiredness and especially in females that have heavy periods. To supplement with oral iron tablets works well, but it often takes at least 3 months to reach an optimum level. It can sometimes also cause some side effects like constipation or nausea that can be troubling. An iron infusion, on the other hand, can be done in your doctor’s surgery and will make you feel better quicker and has less side-effects. It is also very important to address the cause of your iron deficiency and talk to your doctor about options to reduce the heavy flow of your period to prevent your iron stores becoming depleted again and again. A low vitamin D level is usually due to a lack of sunshine or dietary intake. You might need quite high doses (30005000IU/D) initially to get it back to normal levels and then about 1000IU/d to maintain. 20 minutes of sunshine per day should also be enough to maintain normal levels. I would suggest you go back to your doctor to discuss this.
My partner and I are trying to get pregnant and have been trying for 12 months. Should we see someone, like a fertility specialist, or wait a little more before investigating? I don’t want my wife to start feeling that there is something wrong if we haven’t given it enough time. (Steve, 34)
Theoretically, if you have been trying to conceive for more than 12 months you should seek some medical advice. I would suggest that you and your wife see your GP to have a conversation about the matter as there might be some basic issues that need to be addressed first. The GP will make sure that you and your partner’s general health is good and might do some tests to establish that there are no obvious problems. Things like a pap-smear and some blood tests for her and perhaps a spermiogram for yourself might be requested and the GP will also make sure that your partner takes the necessary supplementation like folic acid.
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