DR ELLIE CANNON: Could my pins and needles be linked to my heart surgery?

Three years ago I had a heart attack followed by a quintuple bypass. Ever since the surgery, I have suffered numbness and pins and needles in my left leg. Recently, this has become much more frequent. Could the two things be linked?

Heart bypass operations involve replacing blocked blood vessels in the heart with healthy blood vessels from elsewhere. Usually, the healthy ones are taken from the leg during an operation. This can sometimes lead to damage in the affected area of the leg.

Blood vessels are often positioned close to nerves. So it is possible that, in the process of removing vessels, nerves become squashed or damaged.

Nerves are responsible for controlling all movements and sensations including pain, temperature and touch. If they become damaged or under pressure from nearby swelling or a scar, they don’t function properly. Sometimes, this manifests as pins and needles.

Nerve damage can also cause numbness, burning pains or weakness. It can even cause paralysis if the damaged nerves are the ones that control. Nerve damage from the bypass seems most likely in your case and a GP should be able to tell if this is true during an examination.

The problem can be assessed further with special investigations. Patients may be referred for neurophysiology at a local hospital, which involves the electrical impulses in the nerves being measured.

There are other possible reasons for numbness and pins and needles, such as a different type of nerve damage called peripheral neuropathy. This can be triggered by a vitamin deficiency such as B12 or other conditions like diabetes.

It’s for this reason that doctors usually perform blood tests on a patient with nerve-related symptoms. Peripheral neuropathy could also be a side effect of some types of heart medication.

A short time ago I was diagnosed with a hernia in my groin. But I was surprised to learn that I do not fit the criteria for treatment to have it repaired. I am 76 but very fit and healthy – I play tennis at least once a week. I would have thought that would mean I am more eligible for surgery than most?

Hernias are very common. They happen when an internal part of the body pushes through a weakness in the muscle wall and appears as a lump. They most commonly develop in the groin or abdomen.

Not everyone needs treatment for a hernia as for many people they cause no symptoms and no problems. In such situations it is a case of weighing up the potential benefits of the operation versus the risks.

It might be worth getting an ultrasound, which will tell you exactly where it is and the size.

Hernias become a concern when a part of the body gets stuck in it. For example, blood vessels can get trapped in the hernia causing the blood supply to be cut off.

Surgery being offered depends on a few factors including the chance of dangerous consequences. Other issues would be the extent to which symptoms are affecting a patient’s quality of life, their general health and the location of the hernia.

A hernia would not normally get better without surgery – but it may also not get worse.

It may seem as if doctors don’t offer hernia operations to save the NHS money, but usually this isn’t the case. Instead, the reason is to spare patients from an operation that is not needed.

I have suffered for years with infected ingrown hairs around my jawline. They are thick, white and cause unsightly swelling. My GP has prescribed antibiotics, and Fucidin or azelaic acid creams, which can thin the skin after long term use. Obviously I cannot be on antibiotics forever. Will anything else help?

Skin problems can be very distressing – especially if they affect a part of the body that is so visible, like the face.

Ingrown hairs develop when hair gets trapped in the skin. They tend to cause raised, itchy bumps which become inflamed and sore. Sometimes, the bumps get infected, causing an even larger swelling and pus.

Once this happens, a condition called folliculitis can develop, when the hair follicles become inflamed. This is often seen in people with beards.

One reason ingrown hairs develop is due to an accumulation of dead skin cells which trap the hair. Exfoliating the skin can help prevent this, but make sure you use mild enough product for the face. You can buy creams over the counter that contain salicylic acid, which may also help.

These soften the skin, allowing hair to grow more easily. They are also anti-inflammatory.

Try them first on a small section of the skin to ensure they don’t irritate.

Some moisturisers available for eczema are also antibacterial and might help to prevent things worsening. One widely available moisturiser is Dermol, which can be used for washing as well as moisturising.

It is true to say you can’t be on antibiotics for ever. However, GPs do use longer term courses of antibiotics for certain conditions such as acne and rosacea. You could ask your GP about whether you can continue taking the pills for six to 12 months in order to push the condition into remission.

Teens don’t need parents’ ok to get the measles jab

I have some advice for teenagers which a few parents may not like. If you didn’t have your measles jab – the MMR vaccine – as a baby, ask your GP if you can have it now, regardless of your parents’ opinions on vaccines.

We are on the brink of a major measles outbreak, with 2023 cases already twice that of last year – and we’re only in July.

Do not underestimate this illness. Around a fifth of patients will end up in hospital and in some cases, it can kill.

Sadly, what we’re seeing now is a result of the unfounded scare stories about the MMR jab in the early 2000s. Many young adults aged 19-25 weren’t vaccinated because their parents were influenced by these unfounded claims.

But now that this age group can make decisions for themselves, it is time to get protected. And in doing so, you’re protecting those around you, too. It’s never too late – just ask your GP surgery for more information.

Heavy periods? Go to your GP

This week I was taken aback by a post I saw on Twitter, shared by a gynaecologist I follow.

She posted an image of a chair lined with paper towels, explaining that this was how her teenage patient coped with heavy periods.

I have to say it rung true. Over the years I’ve been astonished by the lengths women go to to cope with their bleeds – including never wearing white clothes or calling in sick to work.

Please don’t hide the problem and go to your doctor. Bleeding heavily can be a sign something is seriously wrong. For women of menopausal age, it can indicate endometrial cancer. For younger women, it could be fibroids or endometriosis.

Even if there isn’t an underlying issue, heavy periods can hugely affect quality of life. GPs and gynaecologists can and should help, so please ask us!