I developed a slight tremor in my right arm and hand 18 months ago. After several visits to my GP, as well as seeing a neurology consultant privately, I was diagnosed with benign essential tremor. I was told it’s not sinister but is untreatable – and it’s gradually getting worse. Can I do anything to improve it?
Benign essential tremor (BET), which can occur at any age, is a neurological condition that usually affects both hands equally, causing them to shake rhythmically. We don’t know what causes it but it seems to be hereditary.
People often notice that an essential tremor is made worse with stress, a lack of sleep and coffee but, interestingly, can often improve after a small amount of alcohol.
An essential tremor doesn’t just affect the hands – some patients report problems with their head and neck, too.
Today’s reader has asked DR ELLIE CANNON about a slight tremor in her arm which has developed over the past 18 months
At the beginning the shaking tends to be sporadic, but often worsens with time.
Patients are not usually offered treatment at the outset. This is perfectly fine if the tremor is mild and doesn’t affect your eating and drinking, for instance.
As the tremor can vary in different people, it is key you keep a symptom diary to see if any obvious triggers, such as caffeine, become apparent. It would then be worth considering whether avoiding these is a practical and worthwhile option.
Some treatments do help reduce the tremor and patients usually opt to take them intermittently. This would involve taking a beta blocker – a drug that reduces blood pressure – prior to certain activities or before socialising, for example.
This isn’t just reserved for more severe tremors and it is reasonable to use for relief at any stage.
I am 75 and generally healthy but have suffered from bacterial cellulitis for a long time. I have antibiotics at the ready for flare-ups – when my leg swells and I get a high temperature. The most recent episode has been severe –after five days on tablets, my leg is still red and warm but now subsiding. Should I see an expert?
Cellulitis is an infection and inflammation of the skin and the layers of tissue beneath it, often occurring in the legs. The infection enters the body via a break in the skin, such as an insect bite or a wound.
For some it can become a chronic issue. This often happens in people who generally suffer with swollen legs through a condition called lymphoedema, diabetes, or skin conditions such as eczema or leg ulcers.
Urgent antibiotic treatment is essential as it can rapidly worsen and trigger sepsis, which is a potentially fatal immune system reaction to an infection.
It is not uncommon for sufferers to require intravenous antibiotics in hospital.
The symptoms of cellulitis are usually easy to spot. The leg becomes red, hot and swollen and it is common to feel unwell with a fever or flu-like symptoms.
Having recurrent episodes of cellulitis is likely caused by an underlying condition, such as circulation problems in the lower leg. This would usually be managed by a GP but patients may require input from the vascular team at the hospital, too.
Leg clubs are also helpful – these are community groups for people with lower-limb problems, such as difficulties walking, swelling, ulcers and infections including cellulitis. Meeting others who are in the same situation can be a great support, and nurses are also on site to advise on treatment.
I had an emergency operation in August to remove part of my bowel, and suffered an infection soon after. I am still in discomfort, especially when I cough or laugh, and I have what looks like two belly buttons. Is the tenderness normal, and can I do anything for the way I look?
Recovery from abdominal surgery takes time.
The muscles of the abdominal wall are complex and are involved in many minor and major movements – when we cough and laugh, as well as changes of posture and opening the bowels. Healing can take even longer if patients suffer a post-operative infection.
The muscles of the abdominal wall are complex and are involved in many minor and major movements – when we cough and laugh, as well as changes of posture and opening the bowels. Healing can take even longer if patients suffer a post-operative infection
Scar tissue is not like muscle – it is fibrous and will not share the same movement or flexibility. Areas with scarring can often feel tight and may limit movements that were previously normal.
More from Dr Ellie Cannon for The Mail on Sunday…
Post-operative abdominal exercises would help to gently stretch the abdominal scarring and improve matters. This should be done under the supervision of a physiotherapist to ensure the wounds are protected while the muscles are being worked.
A consultation with the GP would be important for anyone after emergency surgery. They can help with pain relief, a referral for physiotherapist and provide emotional support.
Situations such as these can be traumatic, and I always think it’s beneficial to try to explain to patients what has happened and why. The GP can also examine the wounds to check everything is healing correctly and whether a further referral is required for scar revision – a surgical procedure to alter the appearance of the scar for cosmetic reasons or to restore movement.
Is this the end of morning sickness?
A cure for morning sickness could be close at hand.
The condition affects as many as two-thirds of pregnant women, who are hit with waves of nausea and vomiting. Mothers-to-be can also develop hyperemesis gravidarum – when vomiting is so relentless they have to be hospitalised as they can become dangerously dehydrated.
It had been unclear what causes morning sickness, but University of Cambridge researchers say they have found the source – a hormone produced by the foetus called GDF15. The scientists say that gently exposing women to increasing levels of the hormone ahead of pregnancy could help resilience and reduce symptoms.
It’s early days, though. There will have to be rigorous testing before women are given it, but it’s something I’ll be keeping a close eye on as, if successful, it could be game-changing.