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DR ELLIE CANNON: What can be done to ease pain of 'electric shocks' in my mouth?

Q. Three years ago, while on vacation, I suffered from what felt like electric shocks in my mouth. When I got back, I went to the dentist, who diagnosed me with trigeminal neuralgia. My GP agreed, but was unable to give me any advice or treatment. Fortunately, the pain subsided over time, but a few weeks ago it started again. My doctor prescribed pregabalin, but it didn’t help. Can anything else be done?

A. Trigeminal neuralgia causes attacks of sudden, severe facial pain, usually on one side of the face. Patients often describe it as electric shocks or sharp, stabbing pains in the jaw, teeth, or gums. The attacks are usually short, lasting from a few seconds to a few minutes, but in severe cases, this can happen up to 100 times a day. They can be activated by touch, talk and even brushing your teeth.

Understandably, it is a distressing condition and can be disabling.

The pain is caused by a problem with the trigeminal nerve, which runs from the temple and branches around the eyes and forehead, also sending signals to the jaw muscles.

In some people, there is an underlying cause, such as damage caused by dental problems, a blood vessel or tumor pressing on the nerve, or a condition such as multiple sclerosis that causes nerve degeneration. If there are other worrisome symptoms, such as vision or balance problems, a primary care doctor may order a scan to rule out anything more sinister.

But trigeminal neuralgia in itself is an important condition. Patients may find that they cannot eat, thus lose weight, and suffer from depression and even job loss because they are unable to carry on with normal daily activities.

It is certainly not something doctors should ignore.

The epilepsy drug called carbamazepine is approved for use in this condition, and primary care physicians may prescribe it to relieve the pain. NHS guidelines suggest that if this drug does not work or cannot be used, a specialist should be involved to manage the pain and offer treatments, including other epilepsy medications and specific neurological pain relievers. Ask for a referral to a team of neurology or pain specialists.

Trigeminal neuralgia causes attacks of sudden, severe facial pain, usually on one side of the face (file image)

Trigeminal neuralgia causes attacks of sudden, severe facial pain, usually on one side of the face (file image)

Q. My husband has been advised to take his blood pressure twice a day because he has had very high readings. The NHS website states that readings should be taken three times at one minute intervals, and that we should ignore the first reading as it will always be higher. The thing is, the GP only took it once and then gave him medication. Could they be wrong?

A. Blood pressure naturally varies throughout the day, depending on many factors, including the time of day, what we ate and drank, and how stressed we are.

Being nervous also raises blood pressure, which is why it’s often higher when the GP takes it – this is a phenomenon called white coat syndrome. So repeated measurements, not one-time measurements, are the only real way to determine if a person has high blood pressure.

Taking three times is about improving accuracy – taking five or ten times would be even better, but of course we have to do what’s convenient. That said, very high values ​​in the clinic can clearly indicate a problem and lead to the prescription of blood pressure medication. We would still ask to read at home, to confirm the diagnosis and give us a clear picture of a patient’s blood pressure.

We normally ask for a week’s worth of measurements.

One of the best ways to test blood pressure, especially if there is uncertainty or large differences in readings, is to use a blood pressure monitor called an ABPM. This is a digital monitor that is attached to the patient’s waist and attached to an arm cuff. It is worn for 24 hours and records at least 14 readings during waking hours. It is considered an accurate way to confirm a diagnosis of high blood pressure.

Q. I was recently diagnosed with osteopenia. I’ve heard that exercise can help improve bone density, and I’d like to try it, but I’m worried about breaking a hip or something. Shall I stay away altogether just in case?

A. Osteopenia is a diagnosis we make when bone density is below average, but not low enough to be considered complete osteoporosis – when the bones become brittle and prone to fracture. Normally, people with osteopenia do not receive osteoporosis medication, but it is recommended that lifestyle changes are made in an effort to improve things.

And yes, sports is the message. Even people with osteoporosis are advised to exercise as it is unlikely to cause bone fractures. In fact, it’s the exact opposite: exercise increases bone density, improves muscle strength and reduces the risk of fractures. Walking and climbing stairs, skipping, tennis and star jumps are all good options, as a little impact stimulates bone growth. Muscle building exercises are also recommended. This may include lifting weights, using resistance bands, or doing bodyweight exercises such as wall pushups two to three days a week.

Patients with osteopenia are usually advised to have adequate vitamin D from a daily supplement and to take in adequate dietary calcium – the Royal Osteoporosis Society has good advice on its website on choosing calcium rich foods (theros.org. UK)

Why Your Leaky Water Pipe Might Not Mean Prostate Cancer?

Would you recognize the signs of prostate cancer? Okay, that’s a bit of a trick question.

Leaking water pipes may not be a sign of cancer

Leaking water pipes may not be a sign of cancer

Leaking water pipes may not be a sign of cancer

The truth is that for a large number of patients there are no obvious symptoms. So I was pleased to see experts from Cambridge University raising concerns about the NHS’s public health campaigns telling men to be aware of urinary problems, such as going more often than usual, as a possible sign. However, there is little evidence to link these problems to the disease, and they are more likely to be caused by an enlarged prostate.

Confusion about the real signs may be one reason why about half of all prostate cancers are not picked up until later stages.

So what should you pay attention to? It’s all about risk factors – being over 50, of African or Caribbean descent, or having a father or brother with a history of the disease. If all three are true, regular GP checkups are crucial. If you tick two boxes, attend all health checks and look out for something different than usual.

I feel Covid problems again

Covid-related anosmia – the loss of sense of smell – is back with a vengeance, if my patients have something to go on.

This curious symptom became synonymous with the virus in the first few waves.

DO YOU HAVE A QUESTION FOR DR ELLIE?

Email DrEllie@mailonsunday.co.uk or write to Health, The Mail on Sunday, 2 Derry Street, London, W8 5TT.

dr. Ellie can only answer in a general context and cannot respond to individual cases or provide personal answers.

Always consult your own doctor in case of health problems.

But then Covid changed, people got vaccinated and developed immunity, and it seemed to kind of go away.

Well, not anymore. The latest wave of Covid has raised a whole bunch of cases.

Another observation: who gets the terrible Covid symptoms and who brushes it off seems rather random these days. I know older people who said their infection was nothing more than a bad cold, while young, sporty types have been hit with ‘the worst flu ever’.

I’m curious about your stories – how has Covid affected you? Did you get a stinker, or do you barely notice it? Write and let me know.

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