DR ELLIE CANNON: My GP tells me I must live with my swollen, red legs at age 90. Is she right?

I have had swollen legs for over half a year. Sometimes they were red, hot and very painful. I’m 90 and I’ve been given antibiotics twice, but they didn’t help. Recently my GP told me to learn to live with it. Is she right?

Swollen legs, wounds and sores that heal slowly are all common and very distressing problems for the elderly that affect mobility and quality of life.

They deserve good treatment. In the 1990s, a brilliant community nurse named Ellie Lindsay founded The Leg Club to help people with these issues. It is a network of nurse-led walk-in clinics that provide treatment and advice to prevent problems from recurring.

They also provide patients with the opportunity to meet others in the same situation, as leg problems that limit mobility can also be very isolating.

Legs can be swollen for a variety of reasons in someone who is older – this is called edema. Sometimes it is due to a lack of mobility, as normal walking promotes circulation, which drains fluid from the legs. But problems with the veins can also be a problem, because the valves that control blood flow don’t work as well with age. Compression stockings and the use of moisturizing creams are important treatments.

Your GP should also consider if your heart is pumping effectively, if the rate is poor it could lead to swollen legs, and if any medications you are taking are making the problem worse.

For more information about The Leg Club, visit legclub.org or ask your doctor.

About 15 years ago I started to get breathless with exercise and was diagnosed with atrial fibrillation. I was given tablets that cleared it up, but over the last year or so I started feeling bloated again, even doing something simple like bending down to tie my shoelaces. I am a 65 year old male, reasonably fit and not overweight. Should I be concerned, or is this just old age?

The kind of shortness of breath described here is not something we can expect as we age, and it certainly shouldn’t be ignored. Anyone experiencing this should see a doctor, who can look for a cause.

Tests should be able to spot any problem with the heart – atrial fibrillation is a condition that leads to an irregular heartbeat and can cause shortness of breath. But there can also be other problems, such as faulty heart valves or a problem with the heart’s pumping function.

Investigations should also look at the lungs.

Many problems with the lungs cause shortness of breath, from asthma and chronic obstructive pulmonary disease (COPD) to less common problems like pulmonary fibrosis, a buildup of scar tissue that can occur after infections.

If the GP is unable to perform tests, patients should expect a referral to a hospital clinic.

We have seen many people suffer from shortness of breath in recent years due to developing long-term Covid, and you should discuss this possibility with your doctor.

In addition to the heart and lungs, other matters may also be relevant.

Anemia — when a lack of iron means you don’t make enough red blood cells to ensure the body gets the oxygen supply it needs — can cause shortness of breath, especially during exercise, and blood tests can identify these or similar problems with vitamin B12.

The ability to breathe properly during exercise can also be affected by problems in the sinuses or nasal passages.

I was put on statins – one called atorvastatin – because of high cholesterol (not hugely elevated, but higher than it should be). Within days I had heavy nosebleeds. My GP told me to stop taking the tablets and the nosebleeds stopped. Does this mean I can’t get statins?

Nosebleeds are a side effect of this statin – as many as one in ten people taking atorvastatin will experience them. Frequent nosebleeds could be a reason to stop taking a medication, but it is possible to switch to another statin, such as rosuvastatin, that does not cause this side effect.

We prescribe statins because of a patient’s overall risk of cardiovascular disease and the likelihood that they will have a heart attack, stroke, or other heart-related problem in the next 10 years.

GPs calculate the risk by taking into account many factors, such as family history, other medical problems, age and weight.

To reduce the risk of stroke and heart attack, we recommend measures such as controlling high blood pressure, taking a statin, exercising more, losing weight and stopping smoking. Trying to live as healthily as possible is important whether or not you take statins.

For those who can’t take statins because of side effects – which is very rare but can happen – there are other cholesterol-lowering medications that a cardiologist can prescribe.

You can trust pharmacists with any everyday ailment

Pharmacists will soon be able to prescribe all kinds of medicines to ease the pressure on GPs, Prime Minister Rishi Sunak, pictured above, has announced.

It means that patients with many common problems, such as sore throats, shingles and urinary tract infections, can go to the pharmacy for treatment instead of having to see a GP.

I know some patients are nervous about this. How on earth can a pharmacist provide the same care as a general practitioner?

Well, let me reassure you. I regularly call the pharmacist for advice on what to prescribe for certain patients – they often know better than we do. They are fully qualified healthcare professionals who are perfectly capable of diagnosing and treating some of the most common complaints I see in the clinic.

It also means fewer congested telephone lines and more time for GPs to spend on patients with much more complex problems. Trust me – it’s a win-win situation for doctors and patients.

No quick fix for chronic pain

A major study has confirmed that one of the most commonly prescribed medications for chronic pain is ineffective.

Millions of Britons are given an antidepressant called amitriptyline to treat arthritis, for example, or when the cause of the pain is unknown.

Older studies showed that a lower dose could help by reducing pain signals in the brain.

In the latest research results, GPs have been criticized for prescribing apparently unnecessary antidepressants.

The unfortunate truth is that not much works well for dealing with chronic pain. Patients can be referred to a pain clinic where they try physical therapy and exercises, but in my experience there is no miracle cure, so you can’t blame doctors for wanting to try something that might help.

The government should fund research into better options, only then will it be better for patients.