Your HEALTH

Got a medical problem or need health advice? Ask GP Dr Philippa Kaye

Q

I’m in my late 50s and need to have an operation on my foot, – it will be my first operation ever. I want the surgery, but I am terrified about the anaesthetic. Could you please explain to me what happens? I’m worried about waking up during the operation!

A

Please do speak to your medical team about your concerns so that they are aware and can offer you more support. It’s common to feel anxious about the surgery itself, the recovery from the operation and the general anaesthetic.

For a general anaesthetic, your anaesthetist will see you before the surgery and explain everything that will happen. Either when you are on the ward, or in the anaesthetic room, once you are in your gown, a cannula (drip) will be inserted, generally into your hand, so that the doctors can give you fluids and medications. A mask will be placed over your face to give you oxygen during surgery.

You can be anaesthetised using either gas or an injection, and you are often asked to count backwards from 10 as it is given. Generally, a combination of medications is used – one to keep you asleep and another to relax your muscles.

Having had general anaesthetics myself, I can honestly say it feels like falling asleep and then waking up some time later! Depending on the surgery you are having, it may be possible to carry it out under local anaesthetic, perhaps with an epidural for pain relief, so please do speak to your doctors.

Q

For a few months I have had an intense pain on the right side of my stomach, where I think my liver is, a few hours after eating. It is worse after having a heavy meal or something fried. What is going on?

A

It is possible that you have gallstones, small stones that develop in the gall bladder. This is indeed near your liver. About one in 10 people will have gallstones and may not have any symptoms, but they can lead to pain, often after eating. If the gall bladder becomes infected, you may develop a fever, the pain can worsen, and you can have jaundice and become more ill.

The gall bladder stores bile, used in the digestion of fat, which may be why symptoms are worse after fried food. Gallstones are more common in females, especially if you’ve had children, are over 40 and are obese.

If you are found to have gallstones, for example on an ultrasound done for another reason, but have no symptoms, no treatment is required. However, if they cause symptoms or complications, keyhole surgery is offered to remove the gall bladder. Contact your GP, who will know your history, is likely to examine you, and may order blood tests and an ultrasound to confirm the diagnosis.

Q

I have been diagnosed with breast cancer and am currently recovering after a mastectomy and removal of the nodes in my armpit, before starting a course of chemotherapy. I am 54 – is that too old for it to be genetic, or should my children get tested?

A

Whether or not your children get tested to see if they carry a gene increasing their risk of breast cancer is a decision only they can make. Breast cancer can occur at any age, and as the most common cancer in the UK, it can appear in more than one member of the same family by chance, as opposed to genetics. However, some gene mutations do increase your risk, irrespective of your age, such as mutations in the BRCA1 and BRCA2 genes, or others involving the TP53 and CHEK2 genes. The BRCA mutations also increase your risk of ovarian cancer. In men, mutations in BRCA increase the risk of prostate cancer, and BRCA1 can increase your risk of colorectal cancer.

You may choose to be tested yourself, after discussion with your oncologist, and your children can discuss with their GP if they would like a referral to a genetic counsellor to consider testing. Depending on the results, options do include removing, for example, the breasts and ovaries.