DR ELLIE CANNON: Mum had a stroke in her 80s... will statins help me avoid one? trends now
My doctor has suggested that I go on statins, but he was fairly noncommittal and said it's up to me. I'm 69, not overweight, eat a varied diet and drink about a bottle of wine a week. My father had a heart attack in his mid-70s and Mum had a mini-stroke in her 80s. My cholesterol level fluctuates between about 5.5 and 6.5. What do you think I should do?
When we suggest statins, which lower the risk of heart attack and stroke, we look at a lot of factors – not just cholesterol levels – such as blood pressure, smoking, age, postcode (our environment has an influence on our health) and family history.
In fact, there are more than 20 criteria which make up a heart attack risk score. Guidelines recommend statins if your risk score is higher than ten per cent over the next ten years, though patients can request them even if they have a lower score.
Most people have to weigh up the benefits of preventing a big health event like a heart attack or stroke with a pill's disadvantages, such as side effects and the need for regular monitoring or blood tests – although statins generally cause few problems.
Today's reader has asked Dr Ellie Cannon whether they should accept their GP's suggestion to start taking statins to reduce the risk of suffering a heart attack or stroke
There is always the option of trying the medication to see if it is effective and doesn't cause issues.
Age has a big impact on the risk score, so it will usually only go up. Alcohol is also a risk factor for high cholesterol – we consider it high when it's above five – as it can raise levels of triglyceride, which is a type of fat in the blood, and also reduce the levels of beneficial cholesterol HDL. We used to think alcohol was good for the heart, but for women over 55 this is only if the intake is under five units a week – roughly two glasses of wine or two pints – and even then the benefits are small.
I injured my ankle falling off a stepladder. After days of hobbling I went to A&E and was told I had a haematoma but it would be better in two months. Six months on, and with no improvement, a scan showed the haematoma was still there. My ankle is sore and wearing shoes is painful. Can you suggest anything to speed up recovery?
ANKLE injuries can take an annoyingly long time to heal as it's hard to avoid weight bearing. I often see patients with continued swelling after a year or more. But if things do persist for this long, patients should seek further medical advice.
A haematoma is a kind of bruise where bleeding under the skin builds up to form a lump. These normally resolve with no extra help but it can take time.
If a haematoma persists for a year it might be necessary to have it surgically removed, if possible. This could certainly be justified on the basis of pain and disrupting mobility, and a GP could refer you for this.
Ankles are complex. Injuries to them can cause bone fractures, sprains to the ligaments as well as instability of the joint as a whole. Add to this swelling of the soft tissue and it's easy to see why problems can become protracted.
Physiotherapy can be very effective, and you can ask your GP receptionist for the best way to get an appointment. The exercises that physiotherapists offer can strengthen the joint and ligaments once again.
Anti-inflammatory drugs such as ibuprofen are good for pain relief and to help mobility, but make sure they are safe to take with any other medication you might be on. Some medications and health conditions can also contribute to ankle