ASK THE DOC
Surgeon and lecturer Dr Sarah Rayne gives advice on recurring urinary tract infections, sudden hair loss and a persistent case of frozen shoulder.
Q: I’ve always suffered from urinary tract infections (UTIs) and have had all the relevant tests, but it seems I’m prone to them. Someone suggested I drink 100% cranberry juice if I feel an infection coming on; is it a proven remedy? A: I love the idea of cranberries as the first line of defence against UTIs, but this is a myth. The theory is that cranberries have a substance that stops the UTI-causing bacteria from sticking to the bladder wall, which prevents the infection. But recent research has shown it doesn’t work in practice. Drinking water (six to eight glasses a day) is what will reduce the risk of a UTI. Our urethra (urine pipe) is short and right beside our anus and vagina, which is why half of all women will get one in their lives, and one in five will have more.
I’m assuming that the tests you’ve had done included those for diabetes and kidney stones, which all women should do if they’ve had more than one UTI. Also, it’s worth looking at ways to prevent them, like wiping from front to back, urinating after sex, wearing cotton underwear and emptying your bladder frequently. It’s also worth discussing this with your gynae, as a lowdose antibiotic regularly or after sex may help. Q: I’m 52 and my hair is falling out by the handful! I haven’t changed anything in my diet. My hairdresser says it’s seasonal, but it’s never happened before. A: Hair loss affects up to 20% of women at some point in their lives. Hair has three phases of life: active growth (two to eight years), regression (two weeks) and resting, when the hair falls out. There is sometimes a change in the dynamics of the phases (hair might ‘rest’ for longer, then suddenly fall out), similar to when animals moult – so your hairdresser is right in a sense that this can happen too. Your hair may look thinner all over, but it should grow back within the year. Hair follicles can also ‘rest’ due to stress, like when you’re pregnant or ill (thyroid problems or iron deficiency are common culprits).
If your hair is replaced by thinner, more brittle hair, this can lead to female-pattern hair loss, which is common in older women and affects the top of the head but not the hairline. The aim of treatment is to maintain hair rather than regrow it, so see a dermatologist early to discuss what can be done. Q: My mom has been suffering from frozen shoulder for more than a year. She is unable to raise or use her arm and is in excruciating pain every day. Over-the-counter painkillers don’t seem to help. Are steroid injections an option? A: I’m sorry to hear about your mother’s pain. My first responses are: ‘Are you sure this is frozen shoulder?’ and ‘Get help!’ Here’s why: frozen shoulder tends to happen later in life and is the name given to a condition where the shoulder capsule (the connective tissue that surrounds the shoulder joint) sticks together, like a ball of clingfilm, and stops it working properly.
There are three phases that can last up to three years but will usually resolve without intervention: the painful phase (two to nine months), the stiff, non-painful phase (four to 12 months) and thawing phase (one to three years). Physiotherapy, painkillers and sometimes a steroid injection will help – and will not cause longterm harm.
If your mother has had pain with stiffness for more than a year, it may not be a frozen shoulder but a different problem with the joints (like arthritis) or tendons around the joint (rotator cuff). These will not resolve by themselves, and she needs to see a specialist to discuss her options. I also suggest you look carefully at the painkillers she is taking: non-steroidal antiinflammatory drugs (NSAIDs) such as Brufen or aspirin can cause stomach ulcers, and stronger painkillers can cause constipation and unexpected addiction.