Will losing weight help improve my balance? Ask the GP DR MARTIN SCURR

Q: I had a TIA “mini-stroke” last year and it took away my balance. I exercise daily, but would losing weight also help?

Mrs C Sault, Cannock, Staffs.

A: I'm sorry to hear that you are having this complication after your transient ischemic attack (TIA), but it is good to hear that you are exercising as balance problems are best treated this way.

To the question of whether losing weight would help, I would first like to explain how our balance system works.

Balance is controlled by a part of the brain called the cerebellum, which receives information from your eyes, the inner ear vestibular mechanism, and something called the proprioceptive system (where data about the position of your joints is fed back to your brain). .

Using this information, the cerebellum sends signals to control your balance through nerves and muscles. However, as we age, the proprioceptive system becomes less effective – which is one of the reasons why older people are more likely to trip and fall.

In addition, a TIA (or 'mini-stroke') can affect balance because it occurs as a result of a brief interruption of blood flow to the brain, which can disrupt many neurological control systems.

After a stroke or other event, balance training – in the form of physical exercises – is important to help strengthen the muscles and 'retrain' the control mechanisms in the brain.

Losing weight if you're overweight can help, because excess weight isn't distributed evenly, which can affect the messages sent to the brain – and your balance.

If you are not already under the care of a physiotherapist, you have the right to request a referral from the NHS. I would expect you to have three sessions each week for six to eight weeks, gradually building up the exercises over time.

The exercises — for example, standing on one leg and lifting the other leg — must be supervised to prevent you from falling.

Another option is a Tai Chi class, something I can personally recommend as it helped me regain my balance after an illness (my muscles were weakened by steroids). Studies confirm that Tai Chi improves stability more than other exercises. Whichever options you choose, the prospects for improving your quality of life are good.

Q: My wife has severe Crohn's disease and requires regular blood tests and vedolizumab infusions. Due to her age (83), the blood tests become quite traumatic and painful as nurses have difficulty locating veins – the last few visits they have had to 'give up'. She now dreads her hospital visits.

Brian Jones, by email.

A: Crohn's disease is a form of inflammatory bowel disease that, as the name suggests, results from inflammation in the digestive tract; it causes debilitating symptoms such as pain and diarrhea.

Your wife will receive regular infusions of one of the most effective medications for this condition, which reduces inflammation by preventing too many white blood cells from entering the intestine.

But these cells are part of the immune system, so the patient needs regular blood tests to check for signs of infection.

However, in older people, the peripheral veins can scar and atrophy, reducing their number over time, and they are also more fragile, making blood sampling difficult. Pain-relieving creams can prevent the discomfort of the needle, but your wife's problem is the lack of veins suitable for a blood sample.

Vedolizumab is usually given via an intravenous infusion and I'm wondering if your wife is getting her infusion through a 'port'.

This is an implanted device, usually in the chest, with an access point under the skin near the collarbone, from which a thin tube connects to a large vein.

This means that an infusion can be administered directly through a needle in the tube, without puncturing the skin. The same spot can also be used to draw blood for tests.

Such a device would save your wife a lot of pain and suffering in the future. Implanting a port requires minor surgery, usually under anesthesia; the access point can handle up to 2,000 needle sticks before needing to be replaced.

If this is not suitable, an alternative is a femoral puncture, which sounds worse than it is.

Here, a doctor removes the blood sample directly from the large femoral vein in the groin, which is easily recognizable and robust.

Taking the sample from here is less awkward than you might expect. I would urge you to suggest this or the installation of a port when you accompany your wife to her next appointment.

In my opinion… We need dietitians who work together with general practitioners

The season of weight loss and dieting is upon us. In many cases, this is more than a simple desire to fit more comfortably into clothes, and actually a necessity to maintain health.

The question is: how do you deal with it?

We've known for years that low-carb diets are an effective way to lose weight – and now research in the BMJ has confirmed that the type of carbohydrates you eat matters, with increased consumption of starchy foods (such as refined grains, potatoes) linked to this. is. with greater weight gain in middle age; while low-starch vegetables (such as broccoli, spinach), whole grains and fruit lead to less weight gain.

This shows how complex it can be to make the right choices. That is why we need dietitians who work in general practices. Such professionals could shoulder a major burden that would otherwise have to be borne by GPs – which, as we know, is in short supply.

Write to Dr Scurr

Write to Dr. Scurr from Good Health, Daily Mail, 9 Derry Street, London, W8 5HY or email: drmartin@dailymail.co.uk.

Dr. Scurr cannot enter into personal correspondence.

If you have health problems, consult your own doctor.