Recently I’ve been experiencing pins and needles in my left hand. Typically my fingers are so numb I can press them collectively and really feel nothing. I even have ache in my elbow. What may this be? I’m 66 years previous.
Michael O'Donnell, by electronic mail
The truth that the tingling and numbness in your fingers coincides with the elbow ache means that the trigger is an issue within the ulnar nerve.
This nerve, which travels in a groove close to the elbow, helps you progress your arm, hand, and a few fingers (primarily the little and ring fingers, but in addition the center finger). It additionally sends data to your mind about contact, temperature, and ache.
When folks ‘hit their humorous bone’, which could be extraordinarily painful and unusually numbing, they’re really hitting the ulnar nerve at that location.
A typical explanation for tingling and numbness in your little and ring finger is extended elbow flexion. I generally see this in sufferers who sleep on their facet with their elbow flexed. Nonetheless, straightening the arm often resolves this drawback inside a couple of minutes.
Tingling and numbness in your fingers might outcome from the delicate ulnar nerve's exit from its groove alongside the hand
One other – though a lot much less doubtless – trigger is arthritis of the elbow, which is uncommon and, in any case, doesn’t often have an effect on the ulnar nerve.
I ponder when you’ve got had any accidents to your elbow earlier than, and whether or not steadily scar tissue may very well be inflicting irritation on this space of ​​the ulnar groove. I counsel you get a full verify of this space out of your GP.
I not too long ago had a blood check at my GP surgical procedure, and was advised my kidney perform was 27 – which sounds fairly severe after wanting it up on Dr Google. How can I resolve this drawback? And is it a precursor to dialysis or a kidney transplant? I'm 67, eat a balanced weight loss program, stroll two to 4 miles a day and don't indulge an excessive amount of in food and drinks.
Barry Cooper, Strolling
Our kidney perform is often assessed by measuring our estimated glomerular filtration price, or eGFR.
It's actually a measure of how nicely your kidneys are filtering waste merchandise and extra fluid out of your physique, which is mirrored in blood exams. The traditional eGFR in a wholesome younger grownup is 80 to 120. And whereas our GFR tends to say no with age, a studying of 27 means that the issue right here is continual kidney illness (CKD).
It’s an more and more widespread situation, affecting over seven million folks within the UK, however typically goes undiagnosed for a really very long time as sufferers don’t initially expertise signs.
Because the illness progresses, it will probably trigger shortness of breath and fluid retention (which may trigger swollen ankles, ft, or palms and hypertension), in addition to fatigue. Widespread causes embrace a long-standing historical past of diabetes or hypertension (each of which may injury the small blood vessels within the kidneys) — in addition to threat components for coronary heart illness, corresponding to excessive ldl cholesterol and smoking (once more, as these can injury blood vessels).
Different doable causes embrace coronary heart assault, weight problems, and recurrent urinary infections.
Persistent kidney illness is a standard situation that impacts greater than seven million Britons, however typically goes undiagnosed as a result of sufferers don't initially expertise signs.
In my view, you have to be referred to a nephrologist, have a kidney ultrasound scan, and additionally it is doable that you must have additional investigation, and probably a kidney biopsy.
Though discovering out you have got a low eGFR is worrying, whether or not or not you'll want kidney dialysis is dependent upon a variety of components, and there could also be different therapy choices that may stop any decline in perform.
Please write once more after investigation, and press for an early referral out of your GP.
In my view… on-line prescriptions pose a severe menace
As a physician, I'm not allowed to prescribe remedy for my household. I say 'not allowed' nevertheless it's not really unlawful – it's simply frowned upon, and will find yourself with some type of reprimand from the regulatory physique, the Basic Medical Council.
The explanation for all that is that, irrespective of how motivated I’m, my resolution might not be unbiased within the case of my nearest and dearest, and it might inadvertently put their well being in danger. Additionally, I’ll not learn about issues of their private well being historical past which are related to their situation. So why are medical doctors allowed to prescribe remedy primarily based on on-line or telephone consultations to sufferers they’ve by no means seen? Particulars of previous medical historical past are too simply overlooked, both as a result of the affected person doesn’t acknowledge their relevance or to cover one thing.
For instance, we all know that younger ladies with deadly consuming problems are acquiring provides of the revolutionary weight reduction drug semaglutide on this means.
I as soon as met a younger scholar who was hooked on the sleeping capsule Zopiclone, which he had been acquiring for a number of years by way of on-line consultations. My concern is that regulatory our bodies are letting this slip via the web – till one thing horrible wakes them as much as it.
