ASK DR. KAYE: The Side Effect of Coughing Too Hard You Don’t Have to Deal With

I am a 74 year old woman and when I have a bad cough I feel like I need to go to the toilet.

It has gotten so bad that, just to be on the safe side, I go to the toilet every time I have to cough.

Could this be a pelvic floor problem?

Dr. Kaye responds: Leaking, whether feces or urine, is seen by many as a normal part of aging, but this is absolutely not the case. In women, the problem often stems from weakness in the pelvic floor—the hammock of muscles that sit in the pelvis and support organs such as the bowels, uterus, and bladder.

As you age, your pelvic floor can become weaker, especially after menopause.

Chronic cough or constipation can also result, which puts pressure on the muscles.

Fortunately, there are ways to address this problem.

A women’s health physiotherapist can provide exercises to strengthen the muscles, which will help to reduce the leaking. If this doesn’t work, there are medications that can help reduce the urge. In some cases, patients may be offered surgery, for example to treat an organ prolapse if that is contributing to the problem. These are all options that patients can discuss with their GP.

I was recently diagnosed with an underactive thyroid and prescribed a medication called thyroxine. But now I am constantly too hot in bed, causing me to sweat and lose sleep. Is this a side effect of the medication?

Dr. Kaye responds: FEELING TOO HOT or sweating is a common symptom of an underactive thyroid. Also known as hypothyroidism, it occurs when the body stops producing enough of the hormone thyroxine, which has functions such as regulating body temperature.

Thyroxine is produced by the thyroid gland – which is located in the neck – and the condition is much more common in women. As well as feeling too hot or too cold, people with an underactive thyroid may also experience fatigue and weight gain. The condition is normally treated with levothyroxine – also known as thyroxine – which replaces the lost hormone with a man-made version.

However, this medication can cause patients to feel too warm in general, even at night.

The dose of levothyroxine that patients receive will fluctuate depending on how much their doctor thinks they need. This can also change over time.

Someone who initially has only a mild form of hypothyroidism may find that his or her condition worsens over a number of years. This means that he or she will need a higher dose of levothyroxine.

For this reason, patients usually have a blood test done every year to check their levels. If someone taking levothyroxine continues to have symptoms, they may need a higher dose, or the dose may need to be reduced. This is something you can discuss with your GP.

I am 74 and have been suffering from severe pain on the right side of my head for over two months. I have been referred for an x-ray of my neck and spine and was told the results were ‘not bad considering my age’. I have not been offered any treatment and the pain keeps me up all night. What should I do?

Dr. Kaye responds: There are many causes of headaches, but in older adults, changes in the neck are a surprisingly common trigger. Most severe headaches are associated with migraines or cluster headaches.

The cause of these conditions is unknown, but they are thought to be triggered by stress and fatigue. Both can lead to one-sided headaches and neck pain. Patients often report other symptoms such as dizziness, vision problems, and difficulty speaking.

In recent years, a number of new medicines have been introduced on the NHS that may reduce the risk of migraine or ease its symptoms once the disease has started.

However, migraines are common and they go away, so if you have constant headaches, you probably have another problem.

This is due to arthritis in the neck, which causes pain and stiffness and can also radiate to the head.

In older people, this is usually due to wear and tear of the joints over time, also known as osteoarthritis.

The condition can be both painful and cause limited movement. In addition, many patients say that standard painkillers do little to help. However, there are other medications to treat the pain of osteoarthritis.

This includes the drug amitriptyline, which helps to combat chronic pain and also makes it easier to sleep. It is important that patients with headaches are diagnosed – for example, whether it is osteoarthritis – so that they know what the next step should be.

Patients with long-term pain can also see an NHS pain specialist, who can teach them techniques to manage the unpleasant sensation.

• Dr Ellie will be back next week. If you have a question for Dr Ellie Cannon, please write to DrEllie@mailonsunday.co.uk
• Dr. Kaye cannot enter into personal correspondence and her responses must be read in a general context.

Image showing need to address vaping epidemic

Britain’s largest doctors’ union has called for a total ban on all flavoured vapes in a bid to tackle the e-cigarette ‘epidemic’. I agree that urgent action is needed.

Figures show that vaping among children has increased almost sixfold in a decade, often with devastating consequences.

An 18-year-old in the US was recently put on a ventilator with lung damage and pneumonia. Juliet Roberts, above, became ‘addicted’ to vaping when she started at just 14 years old.

Vapes often come in flavors that appeal to children, but many adults who quit smoking and switch to vapes cite the tasty flavors as the reason for their switch.

Banning flavored e-cigarettes could ultimately lead some people back to smoking, which is much more dangerous.

• Have vapes helped you quit smoking? Would you miss the flavors if they were banned? Let me know what you think.