Why your fingers are always cold. No, it’s not just the weather – it could be a sign of worrying health problems, reveals Dr ELLIE

I’m 94 and have developed sensitive fingertips over the past year. They are constantly cold and I have to wear gloves all the time. What could be wrong with me?

Dr. Ellie Cannon replies: Tender fingertips may be due to peripheral neuropathy, a condition in which the nerves do not function properly.

The senses of pain, touch and temperature can go wrong. This can lead to hypersensitivity, pain or numbness.

Some causes of peripheral neuropathy include vitamin B12 deficiency, chronic alcohol use, or as a long-term consequence of chemotherapy or diabetes.

A GP can assess this with blood tests and possibly refer patients to the hospital for a nerve conduction test.

If it is a nerve problem, there are specific painkillers aimed at treating it.

Although we are quite cautious about using this in the elderly, a very low dose may help, due to the increased risk of certain side effects.

Cold fingertips can also be a circulatory problem.

Raynaud’s disease is a problem in which the blood vessels at the ends of the fingers cramp. This usually causes color changes, with the fingers turning white and even purple.

Raynaud’s disease may be related to other conditions, such as arthritis or blood disorders, but it also occurs alone.

If you have Raynaud’s disease, it is essential to keep the whole body warm, not just the gloved hands. So it’s important to use layered clothing, warm shoes and even a hat. There are also hand warmers available that are specifically intended for patients.

My partner, who is 69, is terrified of hospitals as she had a terrible experience there, but she recently fell – twisting her leg – and now finds it difficult to walk due to pain in the top of her thigh. Should I talk her into going to the emergency room for an x-ray?

After these types of falls and these symptoms, my biggest concern would be a broken hip.

There are also problems moving the hip joint and you may even notice that the leg is twisted or may look shorter than normal.

It is important not to leave a fracture untreated for too long, as it can heal incorrectly or cause other complications such as infection.

The best way to identify a broken hip is with an X-ray.

An assessment by your GP can help determine the risk of a hip fracture and whether an X-ray is necessary. We offer this to patients who can no longer bear their weight after a fall.

The GP may also be able to help manage hospital appointments. Going to another hospital can feel less traumatic.

Or perhaps instead of going to the emergency room or a walk-in clinic, it is possible to make a specific appointment. This way, as little time as possible is spent in the hospital.

For some patients, it may be appropriate for a doctor to prescribe an anti-anxiety medication to take before an appointment.

For someone with a possible hip fracture, I would say the benefits of this outweigh the risks.

In October I started to suffer from serious illnesses and other digestive complaints. Since then the vomiting has not stopped and I have been hospitalized four times – the last time for ten nights. No one can figure out what it is, but I just can’t keep going like this. Do you have any advice?

Dr. Ellie answers: Persistent nausea and vomiting is really disturbing.

New vomiting or nausea can be a sign of cancer, especially if accompanied by weight loss.

Pancreatic cancer, stomach cancer or a brain tumor, although rare, must be ruled out.

Signs of this should have been spotted on multiple blood tests and scans, but only if the correct ones have been performed.

For example, a pancreatic tumor can actually only be seen on a CT scan of the abdomen and may not cause abnormal blood tests.

To get a good look at the brain, you also need an MRI. A colonoscopy, where a camera goes up into the intestine, may be helpful, but an endoscopy, where the camera goes down into the stomach, would also be important.

Sometimes many tests are done and patients are relieved, thinking they have been ‘tested’ when in reality they have not had the right ones.

There is also a condition called cyclic vomiting syndrome, which responds to the migraine medication sumatriptan – mainly used as a nasal spray.

Ondansetron and cyclizine are both anti-emetics that may work. If not, there are two alternatives: metoclopramide or prochlorperazine. The antidepressant amitriptyline can also relieve chronic vomiting – the bonus is that it can help patients cope with the terrible psychological burden of the constant nausea.

Do you have an answer to a burning mouth?

Have you heard of burning mouth syndrome? It’s something that GPs like me not infrequently see, but I don’t think many people have heard of it.

The distressing condition usually causes a warm feeling on the lips, tongue and the entire mouth. It is common for the symptoms to worsen after eating hot or spicy foods, talking a lot and during periods of stress.

This is not only very uncomfortable, but can also affect eating, mood, sleep and talking.

Unfortunately, it is very poorly understood – although we know it affects more women than men. It is especially a problem around menopause. And unfortunately, without knowing what causes it, it is difficult to treat.

I would like to know from those of my readers who suffer from it: Have you had any success in dealing with burning mouth syndrome? What worked and what did you try that didn’t help? Write to me at the address below and let me know. We plan to report on this topic in the coming weeks.

Focus on what makes us dizzy

I have been affected myself this week, but not with the usual Christmas cough and cold. I suffer from dizziness.

It’s a really horrible and disarming feeling when you feel dizzy. I think mine is the result of an inner ear infection called labyrinthitis. And luckily it passes as quickly as it came. From seeing so many patients with vertigo, I know how debilitating it can be when it happens over the long term: people stop driving, walking safely, and even just leaving the house.

In many people, dizziness is also accompanied by nausea.

It is not always easy to treat because there are so many different causes.

Do you suffer from dizziness? Write and let me know what caused it – if any was found – and how, if at all, you found relief.