Ask DR PHILIPPA
Woman’s GP Dr Philippa Kaye answers your questions
What’s the cure for a snapped Achilles?
Q As I was running recently I had a terrible pain in my ankle, and heard a snapping noise. I couldn’t walk and went to A+E where they said I had ruptured my Achilles tendon. I am in a cast – now what?
Philippa says
A The Achilles tendon is at the back of your heel, connecting your heel to your calf muscle. The tendon can rupture or tear, generally during sports or exercise. There is sudden pain and often a snapping noise, there can also be swelling in the calf and you won’t be able to stand on tip toe. You may be offered surgical or non-surgical treatment. The nonsurgical option involves a cast or boot, before progressing to a brace. If surgery is performed you will need to wear a cast or brace. You will also be referred for physiotherapy.
Has the pandemic caused her tic?
QMy 12 year old daughter has developed a tic, it started during the first lockdown and initially was a shrugging of one shoulder. More recently she has started doing other things, what should we do?
Philippa says
AThe incidence of children and teens, particularly girls, developing tics has risen sharply over the past year since the start of the pandemic. There could be multiple reasons, but it may be associated with the rise of anxiety, stress and mood disorders also being seen. Not drawing attention to the tic or reinforcing the behaviour may help, but if you are concerned, then please see your GP.
Can I take meds without relying on them?
QI have been struggling with my mood for a long time, but things have really spiralled out of control recently. I am worried about getting addicted to medication if I start it; are antidepressants addictive?
Philippa says
AI’m sorry to hear you’re struggling. The starting medication for depression is generally a selective serotonin reuptake inhibitor (SSRI). These are not addictive, but need to be withdrawn slowly to avoid discontinuation syndrome, where you can get withdrawal-like symptoms. Generally if you start an SSRI you’ll be on them for at least six months. If this isn’t the first time that you have had depression it will be recommended that you take them for longer, generally at least two years. Depending on the dose it can take a few weeks or months to then slowly wean down. Please speak to your GP.
The menopause is making sex unbearable
Q I have had breast cancer in the past and have been told I can’t have HRT. But I have terrible soreness in my vagina which makes sex impossible and the GP wants to give me oestrogen – isn’t that HRT?
Philippa says
A Vaginal dryness is a common problem after the menopause and can cause itching, burning and soreness and just as you describe, pain during sex. It can be treated with vaginal moisturisers and by using lubricant during sex. However if that isn’t enough then vaginal topical oestrogen can be used. Although technically it is a hormone replacement it is applied topically through the skin and acts locally – just in the vagina and vulva and isn’t absorbed into the rest of the body so doesn’t have the same risks as general HRT. In fact using vaginal oestrogen for one year is thought to be the same as taking just two tablets of oral oestrogen HRT so it is often used safely for women who have had breast cancer in the past.