Is 93 is just too previous to get a brand new hip? DR MARTIN SCURR solutions your well being questions 

My 93-year-old mom is in fixed ache from osteoarthritis in her hip, however her age guidelines out joint substitute surgical procedure. Her GP really helpful co-codamol however it impacts her digestion, so she takes paracetamol. Are there different medicine that may assist?

Wendy Thurley, by e-mail.

One in 4 of us develops osteoarthritis by our 80s. Your mom has now reached the purpose the place her mobility is restricted, and that is dangerous for her general well being in addition to compromising her independence.

Paracetamol can work for some however not all sufferers. Including codeine could assist (co-codamol is a combination of codeine and paracetamol), however the side-effects typically make it unacceptable, as your mom has discovered: drowsiness, constipation, nausea and headache are widespread. Dependency can be a fear when codeine is taken often for lengthy durations.

One in 4 of us develops osteoarthritis by our 80s. Your mom has now reached the purpose the place her mobility is restricted, and that is dangerous for her general well being in addition to compromising her independence

Paracetamol can work for some however not all sufferers. Including codeine could assist (co-codamol is a combination of codeine and paracetamol), however the side-effects typically make it unacceptable, as your mom has discovered: drowsiness, constipation, nausea and headache are widespread

Different painkillers embody non-steroidal anti-inflammatory medicine (NSAIDs), reminiscent of ibuprofen and diclofenac.

However quite than take them every day, it’s extra acceptable to take them when wanted, reminiscent of earlier than your mom’s about to go away dwelling for buying or different comparable actions. Routine utilization is discouraged as a result of these medicine could trigger ulceration of the abdomen lining and improve the danger of heart problems and kidney injury.

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In case your mom does take an NSAID, strive to ensure it’s on the lowest efficient dose and for the minimal attainable length.

Non-drug remedies embody, surprisingly, train, and strolling aids. Ideally she would see a physiotherapist for an train programme, an method that’s been proven to enhance perform and cut back ache.

The purpose is to enhance the vary of movement and strengthen the muscle tissues across the hip.

As for surgical procedure, hip substitute shouldn’t be dominated out on the grounds of her age alone.

This can be a protected and efficient operation in older sufferers — the extra necessary consideration is whether or not the affected person is properly sufficient to have the operation.

Hip substitute is without doubt one of the most profitable procedures in orthopaedics — may or not it’s value investigating as soon as extra if it will be appropriate in your mom?

I’ve had a fungal nail an infection for years, although up to now month it has given me a whole lot of ache. At my final appointment the chiropodist mentioned my nail is unfastened and wished to tug it off! However is that the reply?

Mary Blackwood, by e-mail.

Specialists — notably microbiologists — discover fungal nails fascinating as a result of they’ve such a variety of causes, together with yeasts and moulds.

However for GPs and sufferers there’s one principal focus: learn how to beat this typically very difficult-to- deal with drawback.

In my expertise, it’s typically greatest left alone until it’s inflicting ache, or so disfiguring to the nail that it turns into very unpleasant.

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Ache just isn’t widespread, however when it happens, it’s often as a result of micro organism have invaded and triggered an inflammatory response.

Specialists — notably microbiologists — discover fungal nails fascinating as a result of they’ve such a variety of causes, together with yeasts and moulds. However for GPs and sufferers there’s one principal focus: learn how to beat this typically very difficult-to- deal with drawback

In some sufferers who produce other situations, notably kind 2 diabetes, this may result in an infection spreading into the gentle tissues of the toe and foot, even the leg. Topical anti-fungal medicine aren’t terribly helpful — and whereas oral anti-fungal remedy is doubtlessly more practical, it might probably trigger disagreeable side-effects reminiscent of nausea.

I wouldn’t oppose elimination of the nail by your chiropodist. This can be a easy process carried out underneath an area anaesthetic.

The ache you’ve skilled will probably be resolved, and there will probably be an instantaneous remedy.

There’s a excessive likelihood the issue will recur as the brand new nail grows out — often as a result of microscopic traces of fungal spores stay within the space.

You’ll be able to attempt to forestall this by making use of an anti-fungal to the nail mattress — the usual remedy is with amorolfine (model title, Loceryl). It’s prescription-only, so your GP might want to prescribe it or you can strive an internet pharmacy service.

 Write to Dr Scurr

Write to Dr Scurr at Good Well being, Day by day Mail, 9 Derry Avenue, London W8 5HY or e-mail: [email protected] — embody contact particulars. Dr Scurr can not enter into private correspondence. Replies must be taken in a common context. Seek the advice of your personal GP with any well being worries.

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 For my part… Hidden dangers of our epidemic of tattoos

There’s one thing of an epidemic of tattoos sweeping the nation, amongst folks of all ages: I believe I’m the one one at my fitness center who doesn’t have one.

My fear is the danger of infections, provided that the approach includes penetrating the pores and skin with needles, with explicit concern about hepatitis B and hepatitis C.

This isn’t, I agree, a major drawback. However this type of transmission does occur.

Whereas within the UK each tattoo artist have to be licensed by their native council, common inspection of apparatus and premises just isn’t necessary. Sterilisation of apparatus between purchasers is inspired, and the usage of disposable needles is crucial. This all helps consumer safety. So in the event you’re planning on getting a tattoo, examine that these requirements are noticed

Lately it was reported that 21 folks had been contaminated with monkeypox in a tattoo parlour in Spain — 9 of these contaminated had been underneath the age of 18. When investigators examined the premises, traces of the virus had been discovered on chairs, work surfaces and gear.

Whereas within the UK each tattoo artist have to be licensed by their native council, common inspection of apparatus and premises just isn’t necessary.

Sterilisation of apparatus between purchasers is inspired, and the usage of disposable needles is crucial. This all helps consumer safety.

So in the event you’re planning on getting a tattoo, examine that these requirements are noticed.

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