My 70-year-old husband had an episode of total confusion last week and had to lie down for ten minutes until he felt better. He’s fine now, but I’m worried he may have experienced a mini-stroke?
Dr Ellie Cannon replies: A sudden, brief change in speech, vision, mental function, muscle function or balance are all signs of a mini-stroke.
It is also called a transient ischemic attack, and the symptoms can last from a few minutes to 24 hours. Total confusion would certainly be considered a possible symptom.
In a mini-stroke, the part of the brain affected suddenly has no blood supply and therefore stops working
A mini-stroke occurs because of a sudden interruption to the blood supply of the brain. Often this happens because a blood clot is blocking the artery, but it can also occur when there is a small bleed in the brain.
The part of the brain affected suddenly has no blood supply and therefore stops working, which explains the sudden symptoms.
Unlike a full-blown stroke, this loss of blood is temporary, usually because the clot comes loose and stops blocking the artery. However, no matter how brief the symptoms, it is crucial that anyone who suspects they’ve suffered a mini-stroke should be taken to hospital straight away.
This is partly due to the fact that doctors need to assess whether any brain damage has occurred. They may also offer treatment if it appears there is a clot still blocking the blood flow.
Even if it has been longer than a week since the episode – and the problem appears to have resolved itself – it is still worth going to hospital. This is because doctors can reduce the risk of another mini-stroke – or even a full stroke – from occurring again.
This might be done by recommending exercise, suggesting quitting smoking, or prescribing medication. A drug called clopidogrel is often used to prevent blood clots forming.
High-dose statins can be given to reduce cholesterol, lowering the chances of further fatty build-ups.
There are also other causes of sudden confusion in elderly people such as low blood sugar in somebody with diabetes. An infection can also trigger this symptom, but it would normally not be so short lived. A sudden change in level of awareness and confusion can also be a sign of a certain type of seizure.
Whatever the cause, it is crucial that someone who has these symptoms sees a doctor as soon as possible.
I was recently told that I have piriformis syndrome. I’m in so much pain. What should I do?
Dr Ellie replies: Piriformis syndrome is a type of sciatica but it specifically causes pain within the buttocks, normally on one side. It is caused by the same defect as sciatica, where the large nerve coming from the spine down to the lower limbs, the sciatic nerve, gets squashed or damaged.
This causes pain, numbness or tingling in the buttocks and the leg. However, people with piriformis syndrome feel it mainly in the buttock, particularly when going upstairs or rising from a chair.
The piriformis is a narrow muscle running from the lower spine through the buttock and to the top of the thighs and is involved in every movement of the leg. Pain can be caused by an issue within the muscle such as a swelling or an injury which then impacts on sciatic nerve.
For most, the symptoms should resolve within two weeks with simple exercises, rest and anti-inflammatory pain relief such as ibuprofen or naproxen.
Unfortunately, for some people the pain carries on and specialist physiotherapy and stretching are needed.
When pain is causing an impact on quality of life, it is vital to talk to a GP about controlling it properly.
A steroid injection to the area may be an option.
My husband has COPD and has used a number of different inhalers over the years. However, his condition is getting worse. Is there any other medication he could try?
Dr Ellie replies: COPD – short for chronic obstructive pulmonary disease – is a lung condition often related to a previous history of smoking. It is progressive, which means it does get worse over time.
Moderate to severe COPD sufferers will likely get a dark grey inhaler called Trimbow. This has three medications to reduce inflammation and keep the airways open.
If Trimbow is not working any more, it is important that you see your GP. They will need to assess how exactly the condition is getting worse. After this, a GP will likely refer you to a respiratory specialist.
One option is physiotherapy, which can help improve lung function. Another is oxygen therapy, which involves wearing a nasal tube or face mask at home which delivers extra oxygen into your bloodstream.
It is also important that anyone with COPD should be up-to-date on their flu, Covid and pneumonia vaccines, as these infections can worsen the condition.
Do you have a stoma story like Mollie’s?
Traitors star Mollie Pearce, pictured, who has a stoma bag, has been raising awareness of ulcerative colitis, one of the bowel diseases known as inflammatory bowel disease.
This condition attacks and damages the colon. Aside from the distressing digestive issues it causes, patients can be left with bouts of extreme pain and discomfort.
In Mollie’s case the disease was so severe she had a stoma operation aged 18, and found it hugely positive as it ended her agony. A stoma bypasses the bowel, either because it is damaged or removed, taking the stool out of the body via a tiny surgically constructed port and into a little, discreet bag.
I love that Mollie, pictured above, is a shining light for others with her condition. But I’d also like to know from my readers who have similar conditions, what are your experiences of life with a stoma?
What are the downsides, and do you get the healthcare and support you need? What more can we doctors do?
Please use the email address below and let me know.
Trendy language helps no one
I talk a lot about obesity to my patients, and in the media, and I can honestly say I have never heard the expression ‘people living with overweight’.
This clunky phrase is now being used within some NHS literature. I understand that it’s part of a trend to stop referring to people as ‘being’ their illness – for example, you’re not a ‘diabetic’, you’re someone ‘living with diabetes’.
Well, that may be, but in the case of ‘living with overweight’ it makes no sense to me, and I imagine to most people – which is a problem.
Decent health communication and education relies on us using sensible language that we all understand and which represents the facts – not making up phrases to satisfy a tick-box that your average patient will not appreciate.
Creating this new expression has nothing to do with accurate science – or grammar – and will not help patients.
Do you have a question for Dr Ellie Cannon? Email DrEllie@mailonsunday.co.uk
Dr Cannon cannot enter into personal correspondence and her replies should be taken in a general context.
