DR ELLIE CANNON: My GP says there is no treatment for blood cancer. Is that right?

I was diagnosed with anaemia three years ago and, although no cause could be found initially, in April I was diagnosed with myelodysplasia. My GP says there is no treatment. Is he right?

There are many causes of anaemia – when the body doesn’t produce enough red blood cells, leading to fatigue, shortness of breath and pale skin, among other things. Causes range from a lack of iron in the diet to blood lost during heavy periods.

As people get older, we do become more concerned it’s a sign of hidden cancer. Blood can be ‘used up’ by a growing tumour or it can be because of ‘hidden’ bleeding due to bowel problems. That’s why, from around the age of 40, we would order investigations to rule out anything sinister if anaemia was picked up in blood tests.

This might involve a CT scan, a colonoscopy or other tests. If no cause is found, it may be that a haematologist referral is made to rule out issues with the bone marrow, which is where blood cells are made.

Myelodysplasia is a type of cancer in the blood that usually occurs in the elderly. Although it is a cancer, it can remain mild and not life-threatening for many years.

The haematologist would decide on a treatment plan rather than a GP. Myelodysplasia stops the bone marrow making the usual healthy blood cells, which would also account for the anaemia.

If there are questions about treatment and assessments, this would have to be addressed with the haematologist. A GP can’t carry out some of the specialist testing and monitoring that might be offered to those suffering from myelodysplasia.

It can be normal for people with mild myelodysplasia to have no treatment but instead to have monitoring with regular blood tests to watch for changes.

In April 2022 I had a double hip replacement and, following the surgery, was given a physiotherapy plan, which I followed until August 2023 when suddenly I became exhausted. Instead of feeling better, my legs felt weak and my toes became stiff. I am wondering if I did the physio too long?

It isn’t really possible to do physiotherapy for too long if you are following the set programme.

Usually there are 12 weeks of regular, more intensive exercises, scaled back to fewer times each week which will be continued long-term.

After a hip operation, exercises are designed to strengthen the muscles around the joint and regain strength in the legs. This is in order to get the patient back to normal or improved walking.

The exercises are mild and not impactful and should improve function around the hip and the use of the legs.

Recovery after a hip replacement is said to take around six months and at this stage people can be back to sport and improved quality of life.

It is concerning if a physiotherapy programme is making someone exhausted and this could possibly imply the proper regime is not followed and instead the exercises are being overdone or too frequently.

If anything, the exercises should get easier and strength is gained. Symptoms including weakness and toe immobility would need to be assessed as a new issue. I wouldn’t expect to see this sort of thing at this stage after a joint replacement.

In many GP surgeries now you can see a physiotherapist without seeing a GP, so it is worth asking the reception team if this is possible. Otherwise the GP can assess.

I suffer from a pain in my ribs, which a nurse told me was costochondritis. Before this started ten weeks ago, I was suffering repeated chest infections and prescribed multiple courses of antibiotics. How long will costochondritis last and what is the treatment?

Costochondritis is an inflammation of the joints of the ribs in the chest wall.

The ribs have joints within the rib cage and, just like any other joint, this can be inflamed or even sprained.

This would not be unusual after a long bout of coughing linked to a chest infection. It tends to cause chest pain within the centre of the chest – around the breast bone – and you can usually feel the pain if you press in this area.

Because of the movements of the rib cage when breathing, the pain will also normally be worse when you take deep breaths.

Like any pain condition involving the joints, the pain can last anything from a few days to a few weeks. It will certainly be better once the trigger causing the problem has been removed.

So if coughing is the main cause, any underlying infections or conditions that are treated should help in the first place. Otherwise time and normal breathing will be beneficial.

Anti-inflammatories can be helpful in this scenario, working both as a painkiller and also to reduce the inflammation that is causing the problem.

An anti-inflammatory could be taken regularly with food under the guidance of the pharmacist.

The condition normally clears up on its own. If it does not, local steroid injections may be offered via a referral from the GP.

You can go gluten-free, or just be careful this Christmas

This Morning’s Vanessa Feltz, pictured above, got into a trouble last week for suggesting coeliac disease wasn’t on a par with a peanut allergy regarding its severity.

After her comments live on air, many took to social media to complain she’d been irresponsible for ‘playing down’ the condition – when the immune system attacks the body once gluten, a protein in wheat and other grains, is consumed.

In Vanessa’s defence, her tone might have seemed undiplomatic, but she isn’t entirely wrong. Nut allergies can be rapidly fatal – that’s why you have to be extra careful to provide nut-free environments, especially for at-risk children.

Gluten, if eaten by a coeliac patient, can trigger digestive discomfort. And even microscopic traces that don’t cause symptoms can damage the gut so this must be considered when cooking, for instance. However, there is no strict medical need to ban all gluten-containing food from a meal if someone with coeliac disease is a guest as long as everyone is careful their dishes don’t get contaminated. Still, it can be a nice gesture to all go gluten-free in solidarity.

Patient’s ‘shock’ bill on way to op

Do you have private health insurance? Millions of people in the UK do, paying a monthly premium so that they may be able to fast track that vital op.

With NHS waits spiralling, the number taking out contracts is ever rising, too. But last week, I heard an interesting – and worrying – story about a chap who was on his way into surgery when he was given a ‘surprise’ bill that he wasn’t expecting.

He was told he’d have to pay £800 in anaesthetist fees out of his own pocket – and, if not, his operation would be called off.

A bit of asking around revealed that the doctors’ pay disputes aren’t simply limited to the NHS, and these ‘shock’ bills are a symptom of medics in the private sector demanding they’re paid properly.

I’d like to hear if something similar has happened to you. Write to me and let me know.