MyGPsays there’s no treatment for blood cancer. Is that right?

I WAS diagnosed with anaemia three years ago and, although no cause could be found initially, in April I was diagnosed with myelodysplasia. My GP says there is no treatment. Is he right?

THERE are many causes of anaemia – when the body doesn’t produce enough red blood cells, leading to fatigue, shortness of breath and pale skin, among other things. Causes range from a lack of iron in the diet to blood lost during heavy periods.

As people get older, we do become more concerned it’s a sign of hidden cancer. Blood can be ‘used up’ by a growing tumour or it can be because of ‘hidden’ bleeding due to bowel problems. That’s why, from around the age of 40, we would order investigations to rule out anything sinister if anaemia was picked up in blood tests.

This might involve a CT scan, a colonoscopy or other tests. If no cause is found, it may be that a haematologist referral is made to rule out issues with the bone marrow, which is where blood cells are made.

Myelodysplasia is a type of cancer in the blood that usually occurs in the elderly. Although it is a cancer, it can remain mild and not life-threatening for many years.

The haematologist would decide on a treatment plan rather than a GP. Myelodysplasia stops the bone marrow making the usual healthy blood cells, which would also account for the anaemia.

If there are questions about treatment and assessments, this would have to be addressed with the haematologist. A GP can’t carry out some of the specialist testing and monitoring that might be offered to those suffering from myelodysplasia.

It can be normal for people with mild myelodysplasia to have no treatment but instead to have monitoring with regular blood tests to watch for changes.

IN April 2022 I had a double hip replacement and, following the surgery, was given a physiotherapy plan, which I followed until August 2023 when suddenly I became exhausted. Instead of feeling better, my legs felt weak and my toes became stiff. I am wondering if I did the physio too long?

IT isn’t really possible to do physiotherapy for too long if you are following the set programme.

Usually there are 12 weeks of regular, more intensive exercises, scaled back to fewer times each week which will be continued long-term.

After a hip operation, exercises are designed to strengthen the muscles around the joint and regain strength in the legs. This is in order to get the patient back to normal or improved walking.

The exercises are mild and not impactful and should improve function around the hip and the use of the legs.

Recovery after a hip replacement is said to take around six months and at this stage people can be back to sport and improved quality of life.

It is concerning if a physiotherapy programme is making someone exhausted and this could possibly imply the proper regime is not followed and instead the exercises are being overdone or too frequently.

If anything, the exercises should get easier and strength is gained. Symptoms including weakness and toe immobility would need to be assessed as a new issue. I wouldn’t expect to see this sort of thing at this stage after a joint replacement.

In many GP surgeries now you can see a physiotherapist without seeing a GP, so it is worth asking the reception team if this is possible. Otherwise the GP can assess.

I SUFFER from a pain in my ribs, which a nurse told me was costochondritis. Before this started ten weeks ago, I was suffering repeated chest infections and prescribed multiple courses of antibiotics. How long will costochondritis last and what is the treatment?

COSTOCHONDRITIS is an inflammation of the joints of the ribs in the chest wall.

The ribs have joints within the rib cage and, just like any other joint, this can be inflamed or even sprained.

This would not be unusual after a long bout of coughing linked to a chest infection. It tends to cause chest pain within the centre of the chest – around the breast bone – and you can usually feel the pain if you press in this area.

Because of the movements of the rib cage when breathing, the pain will also normally be worse when you take deep breaths.

Like any pain condition involving the joints, the pain can last anything from a few days to a few weeks. It will certainly be better once the trigger causing the problem has been removed.

So if coughing is the main cause, any underlying infections or conditions that are treated should help in the first place. Otherwise time and normal breathing will be beneficial.

Anti-inflammatories can be helpful in this scenario, working both as a painkiller and also to reduce the inflammation that is causing the problem.

An anti-inflammatory could be taken regularly with food under the guidance of the pharmacist.

The condition normally clears up on its own. If it does not, local steroid injections may be offered via a referral from the GP.