DR ELLIE CANNON: My GP says there is no treatment for blood cancer. Is that right?

I was diagnosed with anemia three years ago and although no cause could initially be found, I was diagnosed with myelodysplasia in April. My doctor says there is no treatment. Is he right?

There are many causes of anemia – when the body does not produce enough red blood cells, leading to fatigue, shortness of breath and pale skin, among other things. The causes range from a lack of iron in the diet to blood loss during heavy menstrual periods.

As people get older, we become more concerned that this is a sign of hidden cancer. Blood may be 'used up' by a growing tumor or by 'hidden' bleeding due to intestinal problems. Therefore, from about the age of 40, we ordered examinations to rule out something sinister if anemia was picked up by blood tests.

This may involve a CT scan, a colonoscopy or other examination. If no cause is found, a referral to a hematologist may be made to rule out problems with the bone marrow, where blood cells are made.

Myelodysplasia is a form of blood cancer that usually occurs in the elderly. Although it is a form of cancer, it can remain mild and not life-threatening for years.

The hematologist would draw up a treatment plan and not the GP. Myelodysplasia prevents the bone marrow from producing the usual healthy blood cells, which could also explain the anemia.

If there are any questions about treatment and assessments, they should be discussed with the hematologist. A GP cannot carry out some of the specialist testing and monitoring that may be offered to people suffering from myelodysplasia.

It may be normal for people with mild myelodysplasia to not receive treatment, but instead have regular blood tests to watch for changes.

In April 2022 I had a double hip replacement and after the operation I was put on a physiotherapy plan, which I followed until August 2023, when I suddenly became exhausted. Instead of feeling better, my legs felt weak and my toes became stiff. I wonder if I've been doing physio for too long?

Doing physiotherapy for too long is actually not possible if you follow the established program.

Typically there are 12 weeks of regular, more intense exercise, scaled back to fewer times per week, which will continue over the long term.

After hip surgery, there are exercises designed to strengthen the muscles around the joint and regain strength in the legs. This is to help the patient walk normally or better again.

The exercises are mild and not impactful and should improve the function around the hip and the use of the legs.

Recovery after hip replacement is said to take around six months and at this stage people can return to exercise and improve their quality of life.

It is concerning if a physiotherapy program leaves a person exhausted and this could potentially mean that the correct regimen is not being followed and the exercises are instead being done excessively or too often.

In any case, the exercises should become easier and strength will be gained. Symptoms such as weakness and immobility of the toes should be assessed as a new problem. I wouldn't expect this kind of thing at this stage after a joint replacement.

In many GP practices you can now see a physiotherapist without seeing a GP. So it is worth asking the reception team if this is possible. Otherwise, the GP can assess.

I have been experiencing pain in my ribs, which a nurse told me was costochondritis. Before this started ten weeks ago, I was suffering from repeated respiratory infections and was prescribed multiple courses of antibiotics. How long does costochondritis last and what is the treatment?

Costochondritis is an inflammation of the joints of the ribs in the chest wall.

The ribs have joints within the rib cage and like any other joint this can be inflamed or even sprained.

This would not be unusual after a long coughing fit associated with a respiratory infection. It tends to cause chest pain in the center of the chest – around the breastbone – and you can usually feel the pain when you press on this area.

Because of the movements of the rib cage during breathing, the pain will also normally be worse when you take deep breaths.

As with any pain condition involving the joints, the pain can last from a few days to a few weeks. Things will definitely be better once the trigger causing the problem is removed.

So if coughing is the main cause, any underlying infections or conditions that are treated should help in the first place. Otherwise, time and normal breathing will be helpful.

Anti-inflammatories can be helpful in this scenario because they act both as a painkiller and to reduce the inflammation that is causing the problem.

An anti-inflammatory can be taken regularly with food under the supervision of the pharmacist.

The condition normally goes away on its own. If this is not the case, local corticosteroid injections can be offered through a referral from the GP.

You can go gluten-free, or just be careful this Christmas

This Morning's Vanessa Feltz, pictured above, got in trouble last week for suggesting that celiac disease wasn't on par with a peanut allergy in terms of severity.

After her comments went live on air, many took to social media to complain that she had been irresponsible for “downplaying” the condition – when the immune system attacks the body once gluten, a protein in wheat and other grains, is consumed.

In Vanessa's defense, her tone may have seemed undiplomatic, but she's not entirely wrong. Nut allergies can quickly become fatal. Therefore, you should be extra careful about providing nut-free environments, especially for children who are at risk.

Gluten, if eaten by a celiac patient, can cause digestive problems. And even microscopic spores that do not cause symptoms can damage the intestines, so this must be taken into account when cooking, for example. However, there is no strict medical need to eliminate all gluten-containing foods from a meal when hosting someone with celiac disease, as long as everyone is careful not to contaminate their dishes. Yet it can be a nice gesture to all eat gluten-free out of solidarity.

The patient's 'shock' bill on the way to surgery

Do you have private health insurance? Millions of people in Britain do just that, paying a monthly premium so they can get that crucial operation done quickly.

As waiting times in the NHS continue to increase, the number of contracts being concluded is also increasing. But last week I heard an interesting – and disturbing – story about a guy who was on his way to surgery when he got a “surprise bill” that he wasn't expecting.

He was told he would have to pay £800 in anesthetist costs out of his own pocket – and if he didn't, his operation would be called off.

A little asking around revealed that doctors' pay disputes are not just limited to the NHS, and these 'shock bills' are a symptom of doctors in the private sector demanding they be paid properly.

I'd love to hear if something similar has happened to you. Write to me and let me know.