We shielded during the pandemic, is it safe to go out in neighbour’s car?
QBOTH my wife and I have underlying health conditions and have been shielding ourselves at home. We have read that it is OK for us now to venture out and a neighbour has offered to drive us out to the country for a walk, which we’d love to do. But is it safe to get into someone else’s car?
ATHE idea of shielding was to prevent those most vulnerable to a severe infection from Covid-19 from coming into contact with it.
The amount of virus circulating in most parts of the country is now very low, which is why those shielding have been advised they can go outside as long as they follow social distancing guidelines.And as from the end of this month, shielding is going to be “paused”.
It will be good for you and your wife to get outside for some fresh air, a little sunshine (for vitamin D) and exercise. But if you do get into your neighbour’s car, use the back seat (so if they cough or sneeze you are less likely to be in the fallout zone of any droplets) and ask them to wear a face mask, which will help to protect you.
It would also, of course, be kind of you to wear masks to help protect your kindly neighbour and it will also help you to avoid touching your face.
Take a good supply of hand sanitiser with you and use this frequently, especially after touching the door handles.
QMY wife had a fall in December last year and an X-ray showed a fracture in her left shoulder. Initially her arm was put in a sling for a couple of weeks and then regular visits to the hospital were arranged for physio.
In March, due to the coronavirus, physio sessions were cancelled until further notice, after six months the shoulder is still causing pain, more so in bed giving her sleepless nights. She is keen not to take painkillers as they seem to make her tired and woozy during the day. Is there any advice you can give to relieve the pain and how long does an injury of this type take to heal?
ATHE shoulder is a complex joint involving three bones – the clavicle (or collar bone), the bone in the arm (the humerus) and the scapula (shoulder blade).These are held in place by ligaments – which attach one bone to another – and also tendons, which attach muscles to bones.Any of these bones can be fractured or broken, causing slightly different symptoms. Occasionally surgery may be required, especially if the bones become displaced. But most shoulder fractures can be treated by keeping the affected bones immobilised in a sling, usually for around six weeks, which allows healing to take place. Unfortunately, when one of the shoulder bones is broken it is common for some ligaments and tendons to be injured as well and this can lead to pain and stiffness afterwards with severe restriction of shoulder movements.
The aim of physiotherapy is to gently get the shoulder moving again and most people do eventually get full movement back, though this can take many months. Unfortunately, your wife has not had any physio and this means that even though the bone will almost certainly have healed, the ligaments and tendons will be very stiff.Your GP should be able to refer her back now
for physio, though she will probably be stuck on a waiting list for several more weeks.
In the meantime, doing some gentle exercises will be helpful. Your GP may be able to print off some instructions for these from your local hospital or you (or one of your family) can find them online. I use the patient information sheet from Guy’s and St Thomas’ hospital.
Painkillers containing codeine can cause tiredness and a fuzzy head (and also constipation) so if possible these are best avoided.
A better option may be a pain modulating agent such as amitriptyline or gabapentin. These work by reducing the pain messages to the brain but they can take a couple of weeks to take effect, so you do need to be patient.
Many people regard paracetamol as a weak painkiller but if taken in the right dose it can be very effective and that means two standard 500mg tablets every six hours.
Unless you have liver disease, it is a very safe drug and side effects are rare. In particular, it does not cause drowsiness, so I suggest your wife gives it a try.
All the medicines I have mentioned are available on prescription from your GP.
QI AM 88 and generally in good health but for the past five years I have had severe pains in both legs and tests have shown this to be likely to be due to nerve damage.
Some months before this problem developed a routine blood test indicated I was borderline diabetic. As a result I was placed on an NHS lifestyle change course and eventually reduced this reading.
My GP says that I was never seen to be diabetic (my reading was 48 mmol). However the time lapse between the initial reading and the start of the “lifestyle change” course was two-and-a-half years.
Could my problem be due to diabetes?
ANERVES can be damaged as they leave the spinal cord, often from pressure from arthritic joints between the bones of the spine.T his can cause pain in the area supplied by the nerve, down the outside of the leg if the sciatic nerve is affected.
More generalised pain that is not confined to one area is more likely to be due to damage to nerve fibres within the leg, a condition known as peripheral neuropathy. This can be caused by numerous different health conditions, including autoimmune diseases such as lupus or rheumatoid arthritis, some infections, such as shingles or Lyme disease, lack of vitamin B and also some medicines, especially some chemotherapy agents.
Diabetes is also a common cause of peripheral neuropathy but it tends to be a long-term complication that develops in those that have had diabetes for many years, especially if it is not well controlled.
The measurements you have given are for glycated haemoglobin – HbA1c for short – which is made when sugar sticks to red blood cells and the higher your blood sugar level, the higher the HbA1c level.
Red blood cells live for two to three months and the HbA1c level gives an indication of your blood sugar level during this time and is now used for diagnosing if you are at increased risk of diabetes, which happens when the level is above 42mmol/mol (6 per cent), or if you have developed diabetes, when the level is above 48mmol/mol (6.5 per cent).
It is possible in those years after your slightly high reading and your lifestyle change that your blood sugar levels did go into the diabetic range. But even if they did, it is unlikely the levels were high enough for long enough for nerve damage to occur.
● If you have a health question for Dr Leonard, email her in confidence at yourhealth@express.co.uk. Dr Leonard regrets she cannot enter into personal correspondence or reply to everyone.