DR ELLIE CANNON: I fear mole has changed shape and could be cancer – but I can’t get GP appointment

I am worried about a birthmark on the right side of my body. It’s in an area that doesn’t get much sun, but I believe it has an irregular shape – which I know is one of the warning signs of cancer. It is also slightly elevated. I want to go to the doctor but am having trouble getting an appointment. Can I post a picture of it on a website that tells me if I should be concerned?

Even in Britain, where the sun is usually not that strong, around 46 people are diagnosed with melanoma skin cancer – the most serious form – every day. So it is crucial to know the signs of worrying looking moles.

A raised mole with an irregular shape is a cause for concern. Other warning signs include variation in color, size, and how it feels, such as if it starts to hurt, bleed, or itch.

It’s a good idea to compare the mole to other moles on your body. A potentially cancerous one would look and stand out differently. If this is the case, you should consult a doctor. It’s not always easy to get a face-to-face appointment with a GP, but I urge you to try.

Sometimes it’s easier to get an appointment by walking in rather than calling, especially later in the day. Check your GP practice’s website to see what’s on offer – you should be able to fill out a form to request an appointment.

You can also upload pictures of the birthmark so that your GP understands how urgent it is.

These web services are especially good for skin lesions. Photos taken with a phone can give doctors a good idea of ​​the seriousness of the problem, and they can use an NHS skin service called teledermatology to seek advice from a specialist.

Patients can even be referred directly without first having an appointment with their GP.

My husband has been treated for atrial fibrillation (AF) by his GP for over a decade and his pulse is still all over the place. He takes 10 mg bisoprolol daily. I think he might need to see a cardiologist – what do you think?

AF is when the heart beats in an irregular pattern. But it doesn’t always cause symptoms, so many people don’t know they have the condition. That is why GPs regularly check a patient’s pulse – to see if there is anything noticeable.

Symptoms include a pounding heart, palpitations, shortness of breath, and dizziness.

But the biggest concern with AF is what might be causing it — it’s a major stroke risk factor and tends to be more serious in people with the condition. It can also lead to heart disease, including heart failure.

When the heart rhythm is irregular, it disrupts the normal flow of blood through the heart. This means that blood clots are much more likely, which can lead to stroke and heart disease.

Rather than trying to normalize the rhythm, treatment for AF involves slowing the heart rate and preventing clots. Research shows that this is the most effective way to prevent strokes and further illness.

Heart-slowing drugs are more effective at reducing potential risks when combined with a blood thinner, such as rivaroxaban or warfarin.

To control the rate of the heart, a beta blocker is the most commonly used drug, and there are many on the market.

It is not often that GPs prescribe bisoprolol for this problem so it may be worth inquiring about the reasons why it was given.

My 19 year old granddaughter is extremely anxious and has developed strange behaviors like checking to make sure the door is locked at night. She no longer goes out with her friends on weekends and refuses to see a doctor or therapist. I’m afraid she will waste her life. What can we do?

This behavior is certainly concerning and indicates anxiety, phobias and/or obsessive compulsive disorder (OCD).

It is difficult when someone clearly needs help, but refuses to take it.

You might think a 19 year old is young, but at that age they are adults and, given common sense, they can turn down help if they want to.

This puts those around the person suffering in a difficult position – but there are still things you can do.

First, parents and loved ones should try to understand everything they can about the likely condition. Read information about anxiety and OCD on trusted websites, such as the Mental Health Foundation (mentalhealth.org.uk) and the GGD (nhs.uk).

Educating yourself is essential. It reduces the anxiety and stress around the affected person and teaches valuable skills. When to worry, what to say and how to behave are not only valuable insights for carers, but can reduce the person’s symptoms – people with mental health problems are often aware of their family’s concerns about them, which may exacerbate their grief.

Seeing a doctor or therapist may not be worth the stress it will cause to a young person who is determined not to.

Instead, seek help and advice online or through an app recommended by mental health charities. This technology can guide you through cognitive behavioral therapy on your own, helping to change thinking patterns and reduce anxiety.

It’s also worth looking at other ways to reduce anxiety, such as daily exercise and making sure they get enough sleep.

Don’t panic about the “risks” of losing weight

Reports have surfaced linking the trendy new slimming pill semaglutide to suicidal thoughts – and some of my patients are concerned.

The treatment, originally an essential drug for type 2 diabetes and other illnesses, became a secret quick fix among Hollywood celebrities who needed to slim down for movie roles.

About 35,000 people now have access to the drug on the NHS.

Try not to panic about the mental health risks. NHS chiefs have to be particularly vigilant with this type of medication, as weight loss drugs have historically caused unpleasant side effects.

It is right that authorities investigate every report of serious side effects, but so far these are only patient reports – there is no medical evidence that the drug caused these suicidal thoughts.

Still, this is an important reminder that all medication carries risks and there is no magic bullet for weight loss.

It’s time to end formulaic stigma

I support an important campaign that aims to make bottle feeding cheaper.

Currently shops are not allowed to promote the sale of baby food via loyalty points or special offers – but I, along with the Feed UK charity, want to change this, even if it seems counterintuitive as we are bombarded with messages about breastfeeding is best for babies . But this is a complex issue.

In an ideal world, every mother would breastfeed. But for a host of reasons, many are unable to — and in a cost-of-living crisis, feeding babies is the priority. I’ve heard of families diluting and even rationing milk.

Demonizing formula has long been used by public health chiefs as a tool to promote breastfeeding. It hasn’t worked, so it’s time we do away with that strategy for good.