Q: I have been taking a statin and a blood pressure pill for several years. However, at a recent check-up I was told I had developed chronic kidney disease, which was a total shock. I am 80 and have always had good health. Could my medication have caused this kidney problem?
Dr. Ellie answers: Statins and blood pressure medications are crucial medications for reducing the risk of heart disease, but in some cases these pills can cause other problems.
Statins lower cholesterol levels, one of the fats in the bloodstream that can contribute to fatal heart disease or stroke.
Statins are not known to cause chronic kidney disease, but in rare cases the pills can cause a condition called rhabdomyolysis, which can damage the kidneys.
One of the most common types of blood pressure medications are angiotensin receptor blockers, or ARBs, and they often affect the kidneys.
Statins are not known to cause chronic kidney disease, but in rare cases the pills can cause a condition called rhabdomyolysis, which can damage the kidneys.
These ARB drugs relax blood vessels by blocking the production of certain hormones in the kidneys, which helps lower blood pressure. However, this can also limit kidney function, sometimes leading to chronic kidney disease, where the organs slowly stop working.
However, it is important to point out that the benefits of using these medications almost always outweigh the risks.
High blood pressure is one of the most common causes of chronic kidney disease. This means that not taking ARB medications is more likely to lead to kidney disease than taking them.
The drugs are even considered safe enough to be regularly prescribed to patients who already have kidney problems, albeit at a lower dose.
Furthermore, chronic kidney disease is a common condition, affecting approximately one in five people over the age of 80.
Whatever the cause, it is critical that you learn the severity of your chronic kidney disease.
In the meantime, do not stop taking your other regular prescriptions unless your doctor tells you otherwise.
Q: After recently suffering a stroke, I developed severe pain and was prescribed morphine daily. But I feel like a zombie for hours afterwards. My GP says that slow-release morphine tablets are not currently available in the UK. Is there anything else I can take instead?
Dr. Ellie answers: Unfortunately, GPs and pharmacists currently spend a lot of time tackling medicine shortages.
For someone with chronic pain, the situation is particularly dire. Pain management is an entire specialty of medicine in itself, and it can take months or even years of trying different regimens and non-pharmaceutical options to help someone get through it.
So it is incredibly frustrating and debilitating to find a regimen that is not available here.
Using regular opioid medications may also not be the best option for pain relief.
A pain management team or pain clinic can review all options to help treat someone with chronic pain holistically and safely.
This may involve medication, but also psychological therapy and exercise treatments.
Consider looking beyond the opioid medications and into anti-inflammatories and topical treatments, as well as nerve pain medications. A GP should be able to prescribe one of these alternatives and refer you to a pain specialist.
Question: I am a 67 year old woman and have always had a sluggish intestinal tract. Last year I was diagnosed with diverticulitis. I started exercising more and eating a lot of fiber, but I still suffer from the complaints. What should I do?
Dr. Ellie answers: Diverticular disease is an intestinal disorder that causes people to occasionally experience pain in the lower part of the abdomen. It happens when small pouches form in the lower parts of the intestines, called the colon.
It can cause bloating, constipation, diarrhea and, most commonly, abdominal pain, especially on the left side. It can also cause mucus or blood in the stool.
Increasing the amount of fiber you consume is one of the most important and effective ways to combat this.
It should always be done slowly, to avoid possible bloating and flatulence.
Adults need around 30 grams of fiber a day, and according to government figures, most of us in Britain aren’t eating enough.
Fiber in cereal or porridge is a good start, along with fruit and vegetables with their skins, rye crackers, oatcakes and nuts or seeds.
In addition, for the fibers to do their work, you must drink two to three liters of fluid per day to promote bowel movements. Exercise also helps. Specific laxatives are also used, called bulk-forming laxatives that are high in fiber, which can help relieve the constipation or diarrhea that many patients experience.
A doctor can also prescribe anti-spasmodic medications to relieve pain.
The charity Guts UK has excellent advice available on diverticular disease, including simple ways to increase the amount of fiber in meals. Find out more at gutscharity.org.uk.
What do you do to keep the gray at bay?
Going gray has always been considered a fact of life; a fate that awaits us all, some sooner than others.
And in all my years as a GP, I have never had a patient ask if anything could be done to banish his silver locks. It’s always been seen as an inevitability – even for stars like George Clooney, below with wife Amal.
But while the process is largely determined by your genes, it turns out there are things you can do to slow the advance of gray hair.
Research in recent years has shown that simple steps such as tackling stress and wearing a hat in the sun can keep the gray at bay – at least for a while. Have you managed to maintain your own hair color in later life and, if so, what is your secret? Please write to me at the email address below and let me know.
There is still cover if you are ill abroad
One of my big travel concerns after Britain left the European Union was the prospect of having to get medical help if any of the family members got sick during the holiday.
But I only recently discovered that although the European Health Insurance Card (EHIC) – which entitled all British citizens to free emergency care anywhere in Europe – was scrapped after Brexit, it has been replaced by something called the UK Global Health Insurance Card is mentioned. GHIC) which offers almost identical benefits in the EU and some other countries.
If your old EHIC card has not yet expired, you can continue to use it until it expires and then replace it with a GHIC, which is easily obtained from the NHS website.
However, you still need travel insurance, because the GHIC card does not cover the costs of medical repatriation – where you are flown home under the supervision of a doctor – nor does it cover non-urgent treatments, such as prescriptions.
Do you have a question for Dr. Ellie Cannon? Email DrEllie@mailonsunday.co.uk
Dr. Cannon cannot enter into personal correspondence and her responses must be placed in a general context.