Paralysed by choice?
Why too many options make us unhappy
While most women sail through menopause wondering what all the fuss is about, some do not. They included the late and much-lamented Tory MP for Billericay, Teresa Gorman. “I became listless, dreary, forgetful and irritable,” she told the House of Commons in June 1988 – that is, until hormone replacement therapy restored her sanity: “I became a resurrected woman.”
She remained an advocate of HRT for the rest of her life, not only for its rejuvenating properties, but also as a remedy for those distressing hot flushes and night sweats. If that wasn’t recommendation enough, she also said it was good for dispelling the blues, strengthening the bones, and protecting against heart attacks and strokes.
Gorman’s zest for life remained unabated, even after the loss of her husband in 2007, when she placed a small ad in Private Eye: “Old trout seeks old goat. No golfers. Must have own balls.” When interviewed three years ago, having just turned 80, she said: “I get up at dawn and feed the ducks. I never feel tired.”
St Teresa of the Menopause (as she became known) remained unfazed by the bad publicity generated by two major studies 15 years ago, that more than halved the number of women taking HRT in Britain. Far from being a wonder drug, hormone replacement, it was claimed, failed to improve women’s quality of life, while increasing the risk of breast cancer.
This was not just obstinacy on her part: gynaecologists with a special interest in menopausal problems have long been highly critical of these badly flawed investigations. And rightly so, it would seem, for, as reported last week, the pendulum has now swung back in HRT’s favour.
Wrist assessment
The man woken with severe wrist pains, as recently featured in this column, illustrates the adage that clinical judgment trumps the objective findings of diagnostic tests. His nocturnal wrist pain is characteristic of carpal tunnel syndrome caused by pressure on the median nerve – except in his case, the nerve conduction tests did not confirm this.
The tests are, indeed, the diagnostic “gold standard”, notes Dr Graham Davenport, of Keele University, but can be misleading. “Over the years, I have encountered several patients with CTS whose tests were normal,” he writes.
A couple of readers claim relief from their wrist pain from wearing either the wrist supports Actesso or compression gloves at night. That would suggest their symptoms, too, are due to CTS.
Dry eyes a turn-off
This week’s medical query comes courtesy of Mrs ON from Newcastle, troubled for the past couple of years with a curious variant of the common dry eyes that she describes as “an irritation”, coming on within a few minutes of driving or watching television – but not when sitting in front of her computer. She has discovered by trial and error that the irritation does not occur if she closes (or covers) one or other eye, and also that it is readily relieved by partially closing her eyes, tilting her head back and looking downwards. “Bright and moving images are obviously troublesome,” she writes – but why should they cause this dry irritation avoidable by ocular manoeuvres?
Listening cure
Further to the recent comments on the merit of seeking new perspectives on a familiar problem, a reader reports consulting his doctor eight years ago after his wife complained about his poor hearing. This was attributed to a combination of impacted wax and otitis externa (eczema of the ear canal), warranting their being syringed with warm water. When this did not improve matters, he was referred to the audiology department at the local hospital, which prescribed costly hearing aids (£1,500 apiece). These helped a bit, but were hopeless if there was any background noise: “Needless to say, they are still in the drawer.”
Time passed and he moved to Hampshire, where his new family doctor referred him to the ENT specialist nurse, who declared that she had never seen ear canals so obstructed with wax and inflammatory debris. She set to work clearing them with a glorified vacuum pump and, for the first time, he can hear the birdsong in the garden of his new home.