DR KAYE: I’ve misplaced the padding in my toes – how can I ever put on excessive heels?  

This sounds daft, however my toes appear to have misplaced their padding. It means sporting something aside from trainers is uncomfortable. I’ve a marriage developing and I’m dreading it, as I’ll should put on heels. Is there something I can do?

It isn’t daft in any respect – and it is perhaps one thing known as heel fats pad syndrome, in any other case referred to as fats pad atrophy.

There is a pad of fats which helps and cushions the heel, like a shock absorber. If this will get thinner, it will probably change into painful.

The ache is mostly in the course of your heel and is worse throughout high-impact actions, or when standing or strolling for lengthy durations. Treatments embody relaxation, making use of ice, anti-inflammatory treatment and utilizing cushioning shoe inserts to help the heel.

There’s additionally a situation referred to as plantar fasciitis, the place there’s irritation of the connective tissue (fascia) that helps the foot. This ache is usually worse within the morning and could be across the arch of the foot and the heel. The preliminary remedy equally contains cushioned, supportive footwear, relaxation and ice.

There are additionally workout routines and stretches that may assist – discover them on-line by looking for ‘workout routines for plantar fasciitis’.

If it appears like you might be strolling on cobblestones or pebbles, you might have a situation known as Morton’s neuroma, the place there’s a thickening round an irritated nerve within the foot.

Alternatively, there could also be a problem with the nerves to the toes that’s inflicting the change in sensation. This ache can change into debilitating and intrude with every day actions, so please search medical recommendation – you would possibly want a referral to a foot specialist who can provide a wider vary of therapies.

I endure sore pink patches of pores and skin on my interior thighs which I’ve handled with over-the-counter anti-fungal lotions. But these appear to have stopped working – what can I do as an alternative to manage it?

This seems like tinea cruris, a fungal an infection of the groin generally known as jock itch. It’s extra widespread when the climate is scorching and humid and in individuals who endure from the extreme sweating situation known as hyperhidrosis. Obesity and tight-fitting garments may also enhance the chance.

The rash could be scaly, itchy and pink or pink (or look darker in darker pores and skin tones). It may also depart darker patches on the pores and skin as soon as the rash has cleared.

We name this post-inflammatory hyperpigmentation. If it’s delicate then it normally disappears inside just a few months however it will probably take longer, and if it’s extreme the patches could also be everlasting. The color of the darker patches can vary from tan to blue/gray.

Tinea cruris is mostly handled with antifungal lotions, a number of of which can be found over-the-counter. Some should be used for ten days after the lesions have healed, so relying on the cream it’s essential to maintain making use of them for the desired time period, even when the rash is healthier. If this doesn’t work, see a physician as there are different pores and skin circumstances which may very well be inflicting the problem.

If you even have athlete’s foot or a fungal pores and skin or nail an infection elsewhere, it’s value attempting to deal with these to cut back the chance of re-infection. Sometimes oral antifungals are required, so see your physician.

My husband has suffered a mini stroke and a coronary heart assault up to now, and has had two stents fitted. His blood stress hovers at 160/80 however generally it rises additional, regardless of him being on the highest-strength tablets. Should we be apprehensive?

High blood stress, known as hypertension, is a typical but major problem. Although it doesn’t actually trigger signs day-to-day, within the long-term it will increase the chance of coronary heart assaults and strokes, which is why it’s essential to get it below management.

Blood stress is recorded with two numbers: the systolic stress (the upper quantity) is the pressure at which your coronary heart pumps blood round your physique; the diastolic stress (the decrease quantity) is the resistance to the blood circulate within the blood vessels.

The essential factor to know is {that a} systolic stress of greater than 140 and a diastolic stress of greater than 90 are thought-about excessive. These figures are barely decrease when you’re taking your individual blood stress at house.

Although treatment is mostly efficient in getting readings beneath this degree, some individuals have drug-resistant hypertension, which implies their blood stress stays excessive regardless of being on the utmost dose of tablets. It could also be, in these circumstances, {that a} totally different form of blood stress treatment may need a greater impact. A GP will be capable to do that, but when the issue persists then a referral to a heart specialist is perhaps wanted. These coronary heart specialists can discover additional remedy choices.

Sometimes, the rationale a drugs isn’t working is that sufferers will not be taking it commonly attributable to insupportable unwanted effects. If that is the case, it’s essential to speak with the physician to discover a resolution.

And, keep in mind, way of life measures will also be useful when tackling hypertension, akin to reducing the quantity of salt within the weight-reduction plan, weight reduction and growing bodily exercise.

We want the full-facts behind soup & shake weight-reduction plan

The ultra-low-calorie NHS soup and shake weight-reduction plan, which has been proven to place sort 2 diabetes into remission, can be provided to all eligible Britons by March subsequent yr, the Government introduced final week.

It’s been in trialled in 21 areas of England since November 2020 and has to date helped about 2,000 sufferers enhance their well being by reducing weight.

Studies have proven that dramatic weight reduction can press pause on the illness, however l have some issues. It’s not clear what quantity of sufferers on this weight-reduction plan handle to maintain the burden off long run and what occurs in the event that they don’t.

I’d like to listen to about your experiences with the soup and shake weight-reduction plan. Has it rid you of diabetes? Or did you place the burden again on and find yourself feeling defeated?

Write to the Health staff at Dr Ellie’s e mail on [email protected]. 

Dr Ellie can be again subsequent week 

Don’t make labour even tougher 

I’ve had plenty of questions in regards to the newly authorized ache reduction to be taken throughout labour which was introduced final week.

Plenty of expectant moms are involved as a result of the drug, known as remifentanil, is a kind of opioid – a robust and probably addictive painkiller –that sufferers can self-administer. But don’t fret when you’re provided it, because the system is being arrange so you possibly can’t take an excessive amount of.

It additionally works rapidly – inside 30 seconds – and wears off in a few minutes. This means girls can stroll round throughout labour, which may additionally assist to ease the ache, in contrast to when given epidurals, which may make you numb from the waist down.

There’s quite a lot of stress on girls to have a pure beginning, which I believe is probably dangerous – the extra that’s on provide to make childbirth much less excruciating, the higher.