Dr. Ellie: My Zumba class was weeks ago… so why is my heart still beating?

Q: A few weeks ago, during my regular Zumba class, my heart started pounding and I felt lightheaded. Since then I have often felt a tingling sensation in my chest and suffered from indigestion. Should I be concerned? I am a slim, active 70 year old woman.

A: This catalog of symptoms warrants a doctor’s consultation, especially in someone 70 years of age. My first thought is atrial fibrillation (AF).

This is a problem with the electrical impulses that make the heart beat. It causes episodes of a rapid, irregular pulse.

Other symptoms include palpitations – being very aware of or being able to feel the beating of the heart – chest pain, shortness of breath and feeling faint or light-headed.

Chest pain related to heart problems can sometimes be mistaken for indigestion.

AF can be diagnosed in hospital using a test called an electrocardiogram, more commonly known as an ECG. Electrodes are attached to the chest to record the activity of the heart.

However, because episodes of AF are not constant – they come and go – patients are often given a wearable version that they can wear for a few days.

This increases the chance that an ‘attack’ will be registered.

It is important to treat AF because the abnormal heartbeat can cause blood clots to form in the heart. These can travel to the brain and cause a stroke.

These symptoms may also be the sign of a condition called POTS – postural orthostatic tachycardia syndrome.

This causes the heart to beat faster when you get up. Patients also say it makes them feel dizzy and tired. This can be especially noticeable after exercise.

POTS is common and we have seen more cases of it since Covid as it is one of the hallmarks of people with long Covid-19, although it is not clear why.

Q: About three months ago I came down with a bad cold and was left with a dry, scratchy cough that shows no signs of healing. I tried antibiotics, linctus and hot drinks but nothing helped. Can you help?

A: I see a lot of this stuff in my operation, especially right now. More often than not, it’s what we call a post-viral cough – where someone continues to cough for a few weeks even after the initial cold or flu infection has cleared up.

In some cases it can last a few months and unfortunately there is little that can help stop it.

Usually, pharmacy remedies such as cough syrup and even honey are the best remedies to soothe symptoms, but they will only provide very temporary relief.

And if it is whooping cough, it can last even longer.

Also called whooping cough, it starts out like a typical cold but then develops into a terrible cough that can last three months or more.

It causes horrible coughing fits that feel non-stop. There is no specific treatment for whooping cough, but a blood test can be done to confirm the diagnosis. If you have ever smoked, especially if you are elderly, you should always speak to your doctor if you have a cough for more than three weeks.

Even if you have pain, weight loss or are coughing up blood, a doctor’s consultation is essential. This often results in a chest x-ray to ensure there is no underlying serious illness such as lung cancer. Persistent cough can also be caused by allergies, acid reflux, or long-term smoking-related lung diseases such as emphysema.

Question: I have been suffering from sore, dry eyes for some time and have been receiving conflicting advice from doctors about what to do about it. One suggested eye drops, which just stung. Another said to wash my face with soap three times a day and always use separate face and towels. This didn’t help either. What do you think I should do?

A: Dry eyes are a common problem that affects up to a third of older people. Normally, the eyes are protected by a layer of fluid produced by the tear ducts. But in people with dry eyes, this doesn’t happen as well as it should.

The main symptom is a gritty, painful feeling in the eyes.

They can also take a lot of water, but they usually don’t look red and vision is not affected.

There are a few options to ease the discomfort.

At this time of year, central heating can make living environments very dry, so a humidifier can improve the situation. Artificial tears, which come in the form of a gel or drops, are a treatment and there are many types.

In the beginning you can use it several times a day and as the situation improves you can reduce it to three times a week.

You can also get a soothing ointment that you can use before bed that lubricates the eyes. Omega-3 fats, the type found in oily fish, are believed to improve dry eyes. It’s worth adding this to your diet once or twice a week or trying a fish oil supplement.

Paracetamol warning for the elderly

Paracetamol may not be as safe for the elderly as we once thought. Regular use of the painkiller can increase the risk of heart, intestinal and kidney problems in people over 65, research shows.

This is especially concerning for patients with osteoarthritis – the painful joint problem that occurs in old age – because paracetamol can often be one of their only options.

We already advise this group against using anti-inflammatory drugs such as ibuprofen, because these can cause stomach and kidney problems.

For now, there is not nearly enough evidence to suggest that people should stop taking the tablets. But it reminds us that no medication is without risks. And no tablet, no matter how well known, should be taken lightly.

The wait for GP appointments is getting worse

I was incredibly disappointed to read that, according to a Lib Dems analysis, a million people were unable to contact their GP in the last month.

This means that – despite repeated attempts by telephone or internet – they could not get help.

Long wait times for appointments were already a problem before the pandemic. But it seems like things are getting worse.

It is not universal and every practice is different. At my practice, we can respond to most appointment requests within a few days – or within 24 hours if deemed urgent.

But elsewhere things appear to be going very badly – ​​and delays in diagnosis and treatment are putting lives at risk.

Have you waited longer than a month before making an appointment with the doctor? Please write it and let me know.