Do doctors practise what they preach?

We meet the experts who suffer from the ailments they treat and discover . . .

EVER feel like your doctor just doesn’t understand how you feel? You’d be surprised. Here, leading consultants explain how they share the same conditions they treat every day in their work and reveal how their insight affects the help they offer patients, as CHLOE LAMBERT discovers . . .

DERMATOLOGIST WHO HAS ACNE

Dr AnjAli MAhto is a london-based nhS and private consultant dermatologist and a spokesperson for the British Skin Foundation. I’ve suffered from severe acne since I was 11, and many of the doctors I saw, particularly in my teenage years, seemed to be older men who couldn’t understand why it upset me. That was partly why I decided to become a dermatologist — to be a more sympathetic ear.

Over the past 20 years I’ve probably tried every acne treatment on the market — numerous antibiotics, the oral contraceptive pill, chemical peels, laser treatment, hand-held light devices, isotretinoin (or Roaccutane), in addition to modifying my diet. I have polycystic ovarian syndrome, where cysts form on the ovaries, which can trigger a hormone imbalance and result in resistant, difficultto-treat acne.

The treatment that worked best for me was Roaccutane, which acts by reducing oil production in the skin. Most people have one course and they’re sorted, but I’ve had seven courses each lasting about six months over 20 years.

My skin tends to stay clear for a year or two after each course, but with each one, it then relapses more quickly. Unfortunately, I can’t take it any more, as two years ago I suffered a very rare side-effect where muscle tissue starts to break down.

I’m now taking a medicine called spironolactone, which works well and is something I prescribe frequently for my female adult acne patients [although it’s not licensed for acne so must be given off-label, meaning the doctor bears legal responsibility if anything goes wrong].

It acts on androgens, hormones that can promote the development of acne. Legally, I can’t prescribe to myself, so I see a dermatologist.

Having had so many of the treatments myself means I can advise patients on what the treatments are really like and some little tricks to help manage sideeffects. For example, spironolactone is a diuretic, which makes you pass water more frequently. Pharmacists will often recommend taking it in the morning so you don’t have to get up at night.

If you are busy during the day, this can be impractical, so I take mine in the evening when I know I’ll be at home.

People expect their dermatologist to have perfect skin and fortunately my skin is better than it was in my teens, but I still have days where I want to hide and make no social contact. Or at least it feels that bad.

Once you’ve had acne it is easy to get a distorted view about your skin and, when you look in the mirror, all you see are your spots.

STOMACH DOCTOR WITH ACID REFLUX

Dr Anton EMMAnuEl is a consultant gastroenterologist at university College hospital, london. IRRITabLe bowel syndrome ( IbS) and acid reflux (where stomach acid splashes back up the gullet) are two of the most common problems in my area of medicine — and I happen to be one of the 15 per cent who have both.

My acid reflux started in my early 20s. as a medical student I was a big lad and carried a lot of weight around my middle. Then in my 40s I decided it would be a good idea to slim down. I started eating smaller amounts, avoiding late night meals and alcohol in excess, and dropped from 16st to about 13st (I’m 6ft 1in). My reflux has been much better since.

Weight loss can help by reducing the pressure on the stomach and the gullet that can force acid back up the wrong way, and it’s often the first thing I advise my patients to try.

The IbS is a more recent thing which I have noticed in the past decade. It is a little unusual to first have symptoms at my age (I’m 50). It’s not something that bothers me hugely — from time to time I get a colicky tummy pain and the need to go to the loo. For me, it seems to be triggered by stress rather than something in my diet, as it tends to occur during busy periods and dietary changes make no difference.

If I’m in the middle of a bad patch I might take Imodium. Finding distractors such as playing the guitar to help me deal with stress has also helped calm the symptoms.

It’s important to find what your triggers are. Patients often come to me saying they think it’s linked to one thing — milk, for instance — when actually it’s something else. The best thing to do is keep a symptom diary [where you record symptoms], and an open mind.

HEADACHE EXPERT WITH MIGRAINES

Dr MArk WEAthErAll is a consultant neurologist at Charing Cross and Ealing hospitals and spokesperson for the Migraine trust. IF yOU’Re having migraines, it’s easy to feel like they are never going to settle down. but migraines often come in spells — sometimes years or e even decades apart — and a b bad run needn’t be a sign of something sinister. The key thing is, they do often get bett ter. and, what’s more, I can say t this from personal experience.

as a teenager I suffered from migraines, sometimes once a month, and my parents had th them, too. but they’d pretty much stopped by the time I was 19 9 and were forgotten by the ti time I trained as a neurologist.

Then, about four years ago, wh while chopping logs in the garde den I had a migraine attack, havin ing not had one for 24 years.

a as in my teens, it was a migraine wi with aura, causing me to see fla flashing lights and blind spots.

I then went two years without ama migraine, but in 2013 I had a ver very bad run, and had 11 attacks in six weeks — at one point I had three in three days, all with the visual symptoms as well as the headaches.

IeI even had one during a consultat tation with a patient with mig migraines. I looked down, and real realised I couldn’t see what I was writing. I explained to him what was happening and we both appreciated the irony.

I managed to plough on, and as soon as he went, I took some ibuprofen and had to lie on the couch with my eyes closed. I’m fortunate in that my migraines seem to respond well to painkillers.

I did become a little worried and wondered about having a scan to rule out anything more sinister, but then they stopped and since then I’ve had no more attacks with aura, just the occasional headache.

ALLERGY DOCTOR WITH HAY FEVER

Dr ADriAn MorriS is an allergy consultant at Surrey Allergy Clinic. THe best thing hay fever sufferers can do is anticipate when their symptoms are starting and begin taking medication straight away.

I have suffered from hay fever every summer since my teens but, like most doctors, I am a terrible patient. I never seek help and have a huge aversion to medication as I like to think the body can cure itself .

Instead, I try all sorts of useless and unproven things such as eating local honey every day (thought to help by acclimatising the body to local pollens), wearing sunglasses to stop pollen getting into my eyes, vaseline on the nose as a pollen barrier — you name it. It’s a weird thing, but I quite enjoy sneezing.

eventually, though, my family become so fed up with my sneezing t hat t hey i nsist I t ake an antihistamine. Then I wonder why I didn’t do that before and prevent all the suffering.

Generally, people aren’t very good at taking medication. They come in and say to me: ‘Nothing works’, and then I tease out of them that they haven’t been taking it as prescribed.

They forget, or stop taking it because they don’t think it’s working. I understand their position, but I do find it quite frustrating.

However, I would never tell them

that I am bad at taking it, too. Of course, t hey will know t he truth now.

HAIR SURGEON WHO’S GOING BALD

Dr BessAm FArjo is a hair transplant surgeon and founding director of the Farjo hair Institute. YOUNG men with hair loss often come to me wi t h high expectations, wanting something done immediately, typically a hair transplant. They say: ‘When I’m 40 it won’t matter as I’ll be married then.’

I try to help them see that it would be a shame to rush into having a transplant and then to stand out later for having hair in the wrong or unexpected place, so I tell them my own cautionary tale.

People frequently ask me why I haven’t had a hair transplant. In fact, I have — but 23 years ago, when the techniques we have today were not available and, in hindsight, I probably wasn’t the best candidate for what was possible at the time.

I came across hair transplants when I was training as a general surgeon in the early Nineties. I was in my late 20s and, as was the case with pretty much all the men in my family, had lost a great deal of my hair, with just a bit left on the sides and back.

I wanted to do something about going bald, and also I thought I should practise what I preached. At the time the treatment involved taking much larger grafts of hair from the back and sides of my hair than the grafts we use today.

It worked well at first, but as I got older my hair loss continued into the area where the grafts were taken from, and the area of transplanted hair became thin again. As I only had a little bit left on the sides, I couldn’t have further transplants.

Which all goes to show how important it is to have a hair transplant at the right time — generally when you’re towards the end of the hairloss process, but still have enough left to use efficiently.

There are now good medications that prevent hair falling out, such as Propecia and Minoxidil, as well as laser therapy. I tried them when they came out, but it was too late. They work best when you are in the process of losing hair at an early stage in your life.