Dr Le Fanu's online health clinic, Friday 29th May 2012 Kinds Regards Sara Fawcett Dear Ms Fawcett, Thanks for your query to which regrettably I cannot give a definitive answer as you will appreciate there are so many possible causes of lower abdominal pain. If you have not done so you really need to see your doctor during an episode for a physical examination that should clarify what is amiss. I would have thought, however, in the absence of any other symptoms, it is quite probable that this pain is "musculosketetal" perhaps due to pressure on the nerves in the lower back. Dear Dr Le Fanu A forlorn hope that you may have some help to suggest. I am in my early 60s. For some years I have suffered from pain during penetrative sex. I have seen my GP and then a specialist NHS clinic and for some time used HRT patches which did help. But I became scared of the possible consequences of long term HRT having been on it in pill form for some ten years already before, for the menopause. I was referred back to the clinic where I was basically told there really is nothing else to be done. I have recently wondered whether there would be any anaesthetic possibility? And suggestions would be welcome. Thank you, Anne Dear Anne, Thanks for being in touch with what you will be aware is a very common problem in your age group. It is highly relevant that those HRT patches were "of help" as this would indicate the pain in due at least in part to "drying up" of the vaginal tissues from loss of estrogen - that can be corrected by the regular use of the estrogen containing Premarin cream. It is possible however that there is also a loss of elasticity of these tissues which can be improved with "pelvic floor physical therapy" involving massage and gentle pressure to relax and stretch those tightened muscles in this area. Your conundrum this week is of particular interest to me as I to have felt the same sensation albeit on an intermittent basis and slightly to the left hand side of my chest. At first I found myself fumbling for my mobile which I always leave on vibrate and in my shirt breast pocket, as being deaf in the left ear, I can't often hear the ringing. When the buzzing sensation occurs I find myself desperately searching for the mobile as I think that is what is causing it. I then discovered that I was experiencing the buzzing without the mobile being in my pocket at all. I haven't had an attack for want of better word, for some time now, but it still happens from time to time and can be very irritating when it happens and my mobile is on my desk in front of me and not ringing. Henry Wodehouse Dear Mr Wodehouse, Thanks for your comments. Several other readers have described a similar experience which I will be returning to in the weekly column of Monday 9th July Hello! For the past few years,my 30 year old son develops a sore area on the pad of his palm, under the middle finger, on his right hand when playing tennis. He puts plasters on but with limited success. He has seen his GP who says he has no ideas. The only connection we have made was that he used to wear a ring on that finger..... Any ideas would be much appreciated. R. Robson. Mrs Dear Mrs Robson, Thanks for your query on behalf of your son. This hand pain associated with playing tennis is, I gather, not unusual especially when starting off or returning to the game after some time. It is obviously related to the strain on the muscles and tendons in the hand induced by the impact of the ball on the racket. It may be he needs advice on his grip and the type of racked used - the lightweight with a large head size being preferable. These pains do tend to improve with practice. Hello Dr Le Fanu My watery eyes create refraction of my sight. When drawing the attention of the registrar at the eye clinic to this condition she answered negatively 'that she had never heard of it'. On putting the same question to my optician she replied a hot wet flannel pressed against the eyes should relieve the condition. I perform this ritual every morning and it works. Regards Maurice Crowe. Dear Mr Crowe, Thanks very much for that useful advice which I am sure will be of interest to those with a similar problem. Dear James, I can't believe I've missed out on your comments on watery eyes and blocked tear ducts, as I'm an avid reader of your column, but can only suppose I was on holiday when this complaint was featured. Would you be able to send me the information fed back to you by other readers, please? I see the comment in Monday 25 June's paper - referring to previous mentions. I have waited since January for a hospital appointment about my problem, later this week, and should be delighted to have some other sufferers' ideas, rather than have to undergo something nasty! Several times I've had attempts done to clear the tear duct with various sizes of canula, but without any success. The allergy season is causing me extreme misery this year, in particular. Penny Turnbull Dear Ms Turnbull, Thanks for your query - my previous comments on this matter can be found by going to Telegraph online and searching for "Le fanu and watery eyes" Dear Dr.James, I am 84 years old and an insulin-dependent diabetic [over 30 years].Recently I have noticed the graual loss of my senses of taste and smell.I have tried steam inhalations without success.Can this simply be age related-sinuses seem ok- any advice would be gratefully received.Thank you. Stanley Rubin Dear Mr Rubin, My great sympathies for this gradual loss of taste and smell. I suspect you are right that the probable cause is disturbance of nerve function associated with the diabetes - thought I am not aware this type of problem is necessarily commoner in those with your condition. In general this loss of taste and smell is usually attributed to some "virus" interfering with the function of the olfactory nerves which does tend to improve with time - though it may take a year or so to do so. Some people find that a short course of high dose steroids produces temporary improvement and it is claimed the drug Theophylline taken as 250mg twice a day for six to eight weeks can restore smell function towards normal (R I Henkin. The Lancet 1988 vol 2 p515). The lady who reported a strange vibration in her chest isn't alone. I usually put my phone in my shirt pocket and it seems to act as a sounding board, amplifying the vibrations under my ribs. The buzzing can be felt not heard and can be so strong, I regulalry pull out my phone thinking I'd got a message. Subjectively, the buzzing/vibration feels like turbulance in a blood vessel against a rib bone which worries me. I'm 65 with no known heart problems. Brian Wall Dear Mr Wall, Several other readers have described a similar experience which I will be returning to in the weekly column of Monday 9th July. You wrote an article on the benifits of gin and currants for atrhritis , how do you make this product ? W White Dear Mr White, The details of the gin and raisin remedy are as follows: first cover a shallow container of golden raisins (or sultanas) with gin; leave for a couple of weeks for the gin to evaporate. Consume nine a day. Both the gin and the raisins, it is claimed, contain anti inflammatory chemicals but it is their synergy that makes this such an effective remedy. I am a 74years old lady who has very swollen ankles when the weather starts to warm up. By the end of the day they look horrible especially the left one. I am in good health drink plenty of water and go to the loo quite a lot. Is there anything I could take, not water tablets. Any advice would be appreciated. Ruth Mason. Dear Ms Mason, This is a tricky one. The swelling of the ankles in hot weather is quite common - but there is never a satisfactory explanation though various factors such as being overweight and varicose veins may exasperate the problem. The usual advice (having excluded other possible medical causes) is to lose weight (if appropriate), keep the legs elevated when sitting, (perhaps) cutting down on salt intake and to wear compression stockings to improve the return of blood from the legs to the heart. There is no doubt that "water tablets "or diuretics can be helpful. Dear Dr., I had the same problem of an invisible blister on my heel (under its edge) during a walking tour but some time later my skin cracked in that area and I treated it successfully with a urea-based cream [from Compeed]. Does the heel somehow dry from the inside? This was how I discovered the vast range of treatments for dry heels as you get older! It was not really connected with the walking tour. Cheers, Ian Elliot Dear Mr Elliott, Thanks for that most useful observation. Dear Dr. Le Fanu, I have long read your articles in The Telegraph and vaguely recall one some years ago referring to a throat problem which I now think may affect me. There is a spot on the back of my throat which is sensitive to all manner of things like saliva, a drink and many other things and any of these will cause an involuntary cough which becomes worse very quickly and it is most difficult to stop coughing. Some few years ago it became so bad that I consulted my GP who referred me to the hospital. Their conclusion was that it was caused by a slight return of asthma, from which I suffered in childhood, and a chest infection. I was coughing for such long periods and with such force that on many occasions I would pass out. As I was smoking quite heavily in those days it seemed likely that would have a bearing on the problem. Last week I consulted my GP again regarding other pills that I have been taking for approximately 12 years for raised blood pressure. In the course of my appointment I mentioned that I have stopped smoking about 3 months ago and again mentioned the throat problem to which he showed about as much interest as the previous GP and the Consultant: i.e. none other than to say it looked a bit inflamed. I am 3 weeks short of my 70th birthday and other than the blood pressure in fairly good health. I eat well but avoid exercise to the point of idleness. I hope you may be able to cast some light on my problem and look forward with anticipation to anything you may have to say. Kind regards, Clive Wilde Dear Mr Wilde, I can't recall having mentioned this before but hope to do so in the column in the near future in the hope it will elicit some useful comments from readers. In the meantime this "sensitive" spot does sound like it might be due to an overactive gag reflex causing the airways to go into spasm - and hence the protracted coughing. If this is a regular occurrence you might consider using the local anaesthetic Difflam spray to the back of the throat three times a day, or a Ventolin inhaler to keep the airways open. Dear Dr. Lefanu. I am 67 years old and have been diagnosed with osteonecrosis of my right hip. My GP has told me to come back to him when I am on maximum dose of paracetamol and ibuprofen and still in pain. I have told him that I cannot take these quantities of pain killers but to no avail. Is this a standard response to such a crippling symptom? Or should I seek a second opinion? Yours sincerely. Mrs. S. Dubuis. Dear Mrs Dubuis, Thanks for your query - though I presume you have osteoarthritis rather than osteonecrosis of the hip. There is certainly no urgency in having it replaced if your symptoms are adequately controlled by regular exercises, anti inflammatory and analgesic drugs. But if this is not the case or the hip is causing you to limp or waking you at night you should indeed insist on referral for an orthopaedic opinion. Dear Sir, Having recently been diagnosed with Grade 2 invasive ductal cancer following a routine breast screening I was a little concerned to read that according to the British Medical Journal a third of women with breast cancer detected by screening do not have the condition. Having been sent for a second mamogramme, biopsy and ultrascan is there anything else in your opinion that I should do to make sure I have been correctly dianosed? Yours faithfully E. Janet Waters Dear Ms Waters, Thanks for being in touch about this vexed issue. My understanding is that the problem of "over diagnosis" really applies to those with the very earliest form of this cancer, Ductal Carcinoma In Situ (or DCIS) that is still confined to the relevant tissues. The situation is rather different with your "grade 2, invasive" where the cancer has started to spread locally. Most specialists, I am sure, would recommend some form of treatment, though the prognosis as you may be aware is very favourable with an 85% long term survival free of cancer. I would so appreciate any advice you, or perhaps your readers could give me through your very useful and informative column. Is there any remedy for vertigo? I have had this for nine months now - pills (Buccastem, Prochlorperazine) have had minimal effect; the Epley Manoeuvre has helped in that rooms no longer circle, unless I really tilt my head back. But I'm left with being rather unsteady on my feet and somewhat disoriented in crowds. I also have occasional waves of (physical) weakness. I really would like my hitherto 100% healthy and active life back and would be so grateful for any help you can give me! Sincerely Gillian Williams Dear Ms Williams, Thanks for your query my great sympathies for this dizziness and unsteadiness which I presume must be due to disturbance of the balance mechanism of the middle ear. I note you have already had the two established forms of treatment - Buccastem and the Epley Manoeuvre. The third option as you may know is "Vestibular Rehabilitation Therapy" which sounds a bit long winded but essentially involves exercises to "retrain" the brain - by, for example, using a balance board. Some hospitals have a special device similar to that for training astronauts that whirls around thus "challenging" the balance mechanism and so improving it. You can find more details by Googling Vestibular Rehabilitation.