I am thinking about a breast reduction at the age of 76. I am a GG cup and 5ft 1in tall, and I’m fed up with the debilitating aches in my back. But I have high blood pressure and an underactive thyroid. Is it too complicated?
There are many reasons why it might not be advisable to go through with a particular type of surgery. High blood pressure is not necessarily one of them, and nor is an underactive thyroid.
As with any operation, there are risks involved, and these should be weighed against the benefits of the procedure. A 76-year-old with high blood pressure would have to undergo a detailed anaesthetic assessment before any operation.
Breast-reduction operations are common in the UK. There are a range of personal reasons why women opt to do it, and patients shouldn’t feel they have to justify it.
Today’s reader wants advice on whether she should have her large breasts reduced in size because of the adverse impact they are having on her back
Unfortunately, because of a lack of NHS resources, the operation is available only to those who fit a strict criteria. This includes those who suffer severe backache or significant emotional distress related to a large bust.
More from Dr Ellie Cannon for The Mail on Sunday…
Patients find that they feel far lighter after the operation and quickly see their symptoms diminish. Such a result can be essential to having a good quality of life, regardless of age.
For those considering going private, it is important to check that the clinic is registered with the Care Quality Commission, which regulates all medical facilities offering operations in England. I’d also recommend that patients ask surgeons how successful they expect the operation to be, and whether it will achieve their aim of feeling more comfortable. A potential risk is that you may not see the desired result.
Breast-reduction surgery involves a general anaesthetic and usually takes about three hours, with two or more nights in hospital. People in their 70s normally take a couple of months to recover. You should consider all of these factors when deciding whether to go ahead.
Six weeks ago I had a lung flow test at a pop-up testing site. My results showed no lung cancer but did reveal signs of coronary calcification. Should I be worried? I can’t get hold of my GP to discuss the issue properly. I am 69 and take 10mg of atorvastatin.
If coronary calcification is spotted on a scan, it is important to act. It means there is a build-up of calcium in the blood vessels of the heart, putting the person at risk of a heart attack or stroke.
Heart attacks and strokes can be caused by blood vessels that become furred up with fatty plaque. This plaque can also contain calcium crystals, which is why doctors sometimes refer to ‘hardening’ of the blood vessels. If it is detected during a lung test, a doctor may arrange a specific type of scan that looks at calcium in the heart.
Results usually come in the form of a calcium score, which indicates the severity of the problem. A GP may then refer a patient for more sophisticated tests with a cardiologist to assess the impact of the calcification on the heart’s function.
The most important thing for coronary calcification is to lower your heart-attack risk in other ways. This can include giving up smoking, and reducing cholesterol and blood pressure by eating healthily and doing more exercise.
Factors including family history and ethnicity, and other diseases such as kidney disease may also affect your heart health.
A doctor can help you to minimise all these risks. If lifestyle changes are too hard, the GP may prescribe a statin for cholesterol and other drugs for controlling blood pressure.
My husband recently developed a rash on his leg which doctors diagnosed as mild impetigo. He was given trimovate, which didn’t work, and then penicillin and mometasone. The rash vanished for two weeks before returning. The doctor then suggested my husband may have the MRSA bug, which would explain why the impetigo won’t clear up. What’s going on?
It can be hard to tell which skin condition a patient has, because many have the same symptoms.
Trying a particular treatment can give you clues about the correct diagnosis. For instance, if the problem is a fungal infection, an antifungal cream should offer some relief.
Another issue with diagnosing skin conditions is that they mostly come and go. It means you can mistakenly think a treatment has worked when it is merely a coincidence that the rash has disappeared. This often happens with eczema and dermatitis.
Impetigo is a bacterial infection of the surface of the skin that can crop up spontaneously or be passed from another person, sometimes through sharing clothing or towels.
It is a very common condition affecting all age groups, but particularly young children. It is more prevalent in those with weakened immune systems.
The condition first appears as red sores or blisters but these quickly burst, leaving patches of crusty, golden-brown skin. Typically it happens when someone already has broken or damaged skin – perhaps due to eczema or an insect bite.
In mild cases, antibiotic creams such as fucidin or mupirocin usually deal with the infection within a week. If it’s more severe, doctors may try penicillin or flucloxacillin.
If impetigo is not clearing up, it may be worth considering the possibility of an underlying problem. If another skin condition, for example eczema, is making open wounds more likely, it is important to get this under control, otherwise the impetigo will keep reappearing.
Rishi should have spoken up on lockdowns at the time
Rishi Sunak didn’t agree with Covid lockdowns after all, he said in an interview last week.
Apparently he thought the scientists had too much decision-making power, and his colleagues failed to consider the public health impact of locking down.
Well, it would have been nice for him to speak up at the time. I seem to remember that Mr Sunak, along with the rest of the Cabinet Ministers, ignored a letter sent by myself and other GPs warning of the devastation caused by restrictions.
I seem to remember that Rishi Sunak, along with the rest of the Cabinet Ministers, ignored a letter sent by myself and other GPs warning of the devastation caused by restrictions
The growing tide of mental illness, missed heart attacks and record delays for cancer treatment were all flagged.
Mr Sunak and his colleagues didn’t even bother to write a response. If he genuinely cared about the health of the nation he would not have stood back and let the lockdowns happen in the way they did. And to blame others beggars belief.
Call me cynical, but it is hard to see his sudden change of heart as anything more than a tasteless ploy to win votes.
Fed up with those digital menus
I’m starting a one-woman campaign to ban digital menus in restaurants and cafes.
Wherever I go, it seems, I’m asked to scan one of those squiggly codes with my mobile which causes the menu to pop up on the screen. And what happens? Everyone at the table is suddenly glued to their phone, stifling conversation.
Countless studies have highlighted the importance of social interaction at mealtimes. Not only does it stop you eating mindlessly, but it’s a key time for offloading stress by talking.
Only last week another study showed that parents who spend too much time on smartphones are more likely to yell at and nag their children.
Digital menus are one of many Covid measures that have no business sticking around post-pandemic. I doubt they stopped many infections anyway.