My health issues make me feel like giving up on living
My wife sadly died a couple of years ago. I didn’t have time to really process everything before I became very ill - rheumatism, a heart attack, diverticulitis, as well as neuropathy, which has led to mental health issues. I don’t feel like going on, despite having two loving children in their forties - do you think I am selfish?
A Any physical health condition such as heart disease, can cause emotional stress and if, in addition, there is ongoing pain, then there is a high risk of developing depression as well. There is good evidence that the more symptoms that are caused by an underlying health condition, the more likely it is that a person will also experience mental health problems.
Unfortunately, it’s the physical conditions that often get all the attention when you see a doctor, and the mental health issues can easily be ignored.
However, they are every bit as important in terms of wellbeing, especially as being anxious or depressed can make the pain from a condition such as neuropathy seem worse.
You clearly are feeling very depressed, to the extent that you do not think your life is worth living – but have you told your family, or your doctor just how miserable you are?
Just opening up about how you are feeling can be helpful, though I am aware it is something that many men of your generation find difficult. I’m sure if you admitted to your family how desperate you are they would try to help and support you.
I sense you feel you are already taking too many tablets, but you may benefit from antidepressant medication, and talking to a counsellor would almost certainly be helpful too.
Your GP will be able to arrange this for you. You can also get support from Mind (0300 123 3393), SANE-line (0300 304 7000) or the Campaign Against Living Miserably (CALM) on 0800 585858.
If you are really at crisis point, then please call the Samaritans (116123).
Q I’m 91 and about four weeks ago a rash appeared on my chest with flat brown mole-like spots. Some of these have also appeared under my breast but without the rash. I’ve been applying E45 and calamine lotion. Online photos of seborrheic keratosis appear to be identical to my problem, but does it come on suddenly like this?
A In seborrheic keratosis (also known as seborrheic warts) crusty, slightly greasy looking spots appear that look as if they have been stuck on the skin. They have an irregular outline and can vary in colour from pale brown to nearly black.
They can occur anywhere on the body, though are most common on the back, chest and abdomen, and tend to start appearing in the late forties. With increasing age, more can slowly appear and existing ones can enlarge and darken. Their cause isn’t known, but they can run in families.
These warts are harmless and unless they are causing problems by catching on your clothes, they can be left alone. However, I suspect the rash is a separate issue. With increasing age the skin can become very dry. Using a moisturiser, such as E45, can be helpful, but calamine lotion can be astringent and drying, and may be making any tendency to irritation and itching worse. I suggest you contact your GP surgery for help in getting a diagnosis and treatment.
In many surgeries the quickest way of doing this is by sending in photographs. Hopefully either one of your family or a friendly neighbour can help you to do this if need be.
Q I was diagnosed with type 2 diabetes a couple of years ago and, up until recently, was managing my blood sugar level by being careful with my diet. The routine blood tests I had done last autumn showed that my cholesterol level was a bit high, so my doctor prescribed me atorvastatin. I had a follow up blood test recently and although my cholesterol level had come down, my HbA1c had gone up. I’ve now been advised to take metformin tablets. Is this because of the statin and, if so, should I stop taking it?
A There is some evidence that statins can increase blood sugar levels in around one in 10 people who take them. This is thought to be because they can increase insulin resistance, decreasing the ability of insulin to help move glucose from the bloodstream into cells where it can be used for energy.
This means that some people taking statins are more at risk of developing type 2 diabetes, and those already diagnosed with diabetes may find they need to start or increase the medication they use to adequately control their blood sugar levels.
Both diabetes and a raised cholesterol level can increase the risk of fatty deposits developing inside the walls of arteries, increasing the risk of having a heart attack and a stroke.
Because of this, it is especially important for diabetics to avoid having a raised cholesterol level. The ideal total cholesterol level for diabetics is under 4.00 mmol/l, with an LDL (often called ‘bad’ cholesterol) below 2.0mmol/l. This is lower than the target level for others without diabetes (which is 5.0 and 3.0 respectively).
It is very difficult to get your cholesterol level this low by diet alone. Although it might sound tempting to stop the statin and metformin in order to try to control your diabetes, in terms of your long term health you are better to keep taking the statin to keep your cholesterol low, and the metformin to help control your blood sugar levels.