DR KAYE: Why do I get a dizzy sensation when I’m looking up at things?  

I’ve noticed that I start to feel dizzy when I look up. It happens, for example, when changing a light bulb or looking at the roof of the house. It only takes a minute, so it seems to be a relatively minor issue. Or is it something I should be concerned about?

This kind of dizziness — the sensation of spinning or moving while you’re not moving — is known as vertigo.

It is not a condition in itself, but is usually a symptom of problems with the way the body balances itself using the inner ear.

If the vertigo is caused by looking up or moving the angle of the head and lasts for about a minute, it is likely a condition called benign paroxysmal positional vertigo (BPPV). Some people notice that it occurs when they do something specific, such as washing their hair at the hairdresser or even just turning over in bed.

This is the most common type of vertigo and is most often seen in people over the age of 50. It is caused when crystals in the inner ear that help the brain sense the rotation of the head become detached and float freely. BPPV is rarely seen alongside hearing problems or tinnitus, unlike other forms of vertigo.

A GP can try to diagnose BPPD by seeing if dizziness can be caused by moving your head in certain positions. This can also be part of the treatment – ​​specific head movements that cause dizziness in BPPV patients may eventually help stop the dizziness.

You can try this at home – they are known as Brandt-Daroff exercises and instructions on how to do them safely are available on the NHS website.

For the past three years I have struggled to straighten the fingers of both hands. The problem is getting worse and the doctors still have to do something – they just put me on a waiting list. It causes me a lot of stress. Is there anything left to do now?

We hear a lot of reports of patients waiting ridiculously long for NHS treatment.

But when this happens, something has usually gone wrong with the referral process. There are exceptions, such as ADHD diagnoses, where the delays can be years due to unprecedented demands. But if the wait is that long, you should generally go back to your GP.

If it is a problem with the joints or muscles in the hands, the GP can refer patients to physiotherapists or rheumatologists. It wouldn’t take three years to get an appointment with these services.

If a GP suspects certain forms of osteoarthritis, he can refer patients for an emergency appointment.

When the joints in both hands are stiff and bent, most doctors suspect rheumatoid arthritis. The condition usually affects the small joints on both hands, causing pain and difficulty for patients to use their hands normally.

If a GP suspects certain forms of osteoarthritis, he can refer patients for an emergency appointment

Rheumatoid arthritis can mimic several types of arthritis, as well as other conditions such as lupus and gout, so it’s critical that x-rays and even MRI scans are performed to confirm the diagnosis.

Patients should go back to their GP if they don’t get answers, as not being able to use your hands properly can have a major impact on a person’s life. An occupational therapist may be able to provide treatment to help with everyday activities that are difficult because of the condition.

A few years ago I began to experience discomfort during intercourse. A doctor told me it was probably menopausal dryness and I should use lube. But the pain has gotten worse over time and I can even see areas of inflamed, split skin. Recently, a gynecologist diagnosed lichen sclerosus and prescribed four different creams to use most days, as well as a special lubrication. Is there nothing else?

It’s common for sex to become uncomfortable after menopause. The lack of female hormone estrogen means there is less lubrication in the intimate area, making it dry and sore.

Treatments include lubricants and topical hormone replacement therapy in the form of vaginal pessaries or creams, and standard HRT. Lichen sclerosus is another problem, but it is more common in menopause. It causes very painful, delicate, itchy skin, usually affecting the vulva and anus.

This causes problems with intercourse, which can be very distressing.

Those with lichen sclerosus are also at increased risk of vulvar cancer. The mainstay of treatment is steroid ointments. Gynecologists usually recommend that patients use every day for a month, then every other day for the next month, before cutting back to twice a week.

You can switch back to daily use if you have a severe flare-up.

Wearing cotton underwear and loose-fitting clothing and avoiding perfumed toiletries can reduce discomfort. It is best to wash with an emollient cream or plain water.

You can apply common emollients several times a day.

Other options are creams that suppress the immune system – prescribed by a gynaecologist.

Remember Deborah – stay alert

Like many of you, I no doubt watched the BBC documentary last week of Dame Deborah James, who died last summer from bowel cancer aged just 40.

I found it particularly emotional because I had colon cancer, and like Dame Deborah, I’m a mother of teens, so I know the impact it has on the whole family. I was diagnosed in my thirties – just like Dame Deborah. Fortunately, mine was caught early and treatment, while not easy, has been successful so far. I’m in remission.

Colon cancer is most common after age 50, but we all need to know the signs and symptoms, as so well emphasized by Dame Deborah, including a change in bowel habits, blood in your stool, abdominal pain, a lump in the abdomen, unintentional weight loss and fatigue.

Having one or more of these symptoms does not mean you have colon cancer, but you should always get them checked.

Like many of you, I no doubt watched the BBC documentary last week of Dame Deborah James, who passed away last summer from bowel cancer aged just 40.

Don’t forget to reserve your spring Covid-19 booster

In case you were in doubt, Covid is still with us. I’ve seen more and more cases in recent weeks and national figures show that infections among people over 70 have risen in the past month and a half.

Despite this, many shake their heads when I ask my elderly patients if they have booked their spring booster.

If you are 75 years or older, live in a care home or have a condition that affects your immune system, you are eligible for a new shot. If so, you should have received texts and emails reminding you. You can book online or by calling 119.

Protection from a vaccine diminishes over time, and this is especially true for the elderly, but the jab helps prevent the vulnerable from becoming seriously unwell and dying from Covid. So I strongly urge those who could benefit from it to have the booster.

In case you were in doubt, Covid is still with us. I have seen more and more cases in recent weeks and national figures show that infections among people over 70 have risen in the past month and a half