Dr James Le Fanu: 4 April
We must all face reality when it seems there is nothing more that can be done. And that certainly appeared to be the situation for an 86-year-old Canadian woman a fflicted by the misery of the ‘electric shocks’ of trigeminal neuralgia shooting down the side of her face several times a day – despite being on generous doses of morphine and the powerful painkiller gabapentin.
However, when her dutiful son surfed the internet, he came across an unusual form of manipulation of the head and lower spine – craniosacral therapy – that was claimed might be of value. An appointment was duly booked.
‘I have no medical training,’ the patient writes, ‘but the practitioner and his methods were quite extraordinarily unimpressive.’
Nonetheless, this ‘odd gentleman with his odd ways achieved a minor miracle’. After just five sessions, her attacks ceased and she was able to discontinue all her medication except, on her neurologist’s advice, a very small dose of the gabapentin.
It is di fficult to know what to make of this, other than to presume that perhaps mainstream medicine does not have all the answers.
As if to emphasise this point, another reader describes a similar experience of being unexpectedly cured of the facial paralysis Bell’s palsy in a Soviet-era hospital in the Arctic Circle. The paralysis developed when he was working in a chemical plant in Tomsk, Siberia (average daily winter temperature -20C). He was admitted to hospital where every six hours his nurse would apply a fresh piece of lint soaked in methylated spirits to the side of his face, held firmly in place with a tight bandage.
‘The heat generated by the slowly evaporating meths into the nerve area behind the ear was quite signi ficant,’ he recalls.
The standard medical view would be that there is no speci fic treatment for Bell’s palsy, which, with luck, spontaneously resolves within six weeks. But the reader walked out, cured, from the Tomsk hospital (‘rather crude in those days, but I was well looked after’), just five days after he was admitted.
This week’s medical query comes courtesy of a lady from Suffolk who over the past year has been troubled by a permanent sour taste at the back of her mouth. She describes it as: ‘similar to the feeling when you are about to vomit’, with moderate discomfort in the stomach area, and a constant feeling of hunger. She produces an abnormal amount of wind (burping), but her appetite and bowel function are normal. Her symptoms are worse just prior to a meal and during the night.
She has seen both an ENT and gastrointestinal specialist who attributed her symptoms to acid reflux. But the standard treatment with the acid-suppressant drug omeprazole has not, as promised, brought any relief – and they don’t seem to have any further suggestions.
These symptoms are certainly typical of – and almost certainly due to – acid reflux. The acid-suppressant omeprazole is for most a highly effective treatment, though for a substantial minority – as here – it does not relieve the symptoms at standard dosage. Some will respond to a doubling of the dose but if this does not work, further investigation is required with a view perhaps to having anti-reflux surgery.
Email drjames@lady.co.uk
However, when her dutiful son surfed the internet, he came across an unusual form of manipulation of the head and lower spine – craniosacral therapy – that was claimed might be of value. An appointment was duly booked.
‘I have no medical training,’ the patient writes, ‘but the practitioner and his methods were quite extraordinarily unimpressive.’
Nonetheless, this ‘odd gentleman with his odd ways achieved a minor miracle’. After just five sessions, her attacks ceased and she was able to discontinue all her medication except, on her neurologist’s advice, a very small dose of the gabapentin.
It is di fficult to know what to make of this, other than to presume that perhaps mainstream medicine does not have all the answers.
As if to emphasise this point, another reader describes a similar experience of being unexpectedly cured of the facial paralysis Bell’s palsy in a Soviet-era hospital in the Arctic Circle. The paralysis developed when he was working in a chemical plant in Tomsk, Siberia (average daily winter temperature -20C). He was admitted to hospital where every six hours his nurse would apply a fresh piece of lint soaked in methylated spirits to the side of his face, held firmly in place with a tight bandage.
‘The heat generated by the slowly evaporating meths into the nerve area behind the ear was quite signi ficant,’ he recalls.
The standard medical view would be that there is no speci fic treatment for Bell’s palsy, which, with luck, spontaneously resolves within six weeks. But the reader walked out, cured, from the Tomsk hospital (‘rather crude in those days, but I was well looked after’), just five days after he was admitted.
This week’s medical query comes courtesy of a lady from Suffolk who over the past year has been troubled by a permanent sour taste at the back of her mouth. She describes it as: ‘similar to the feeling when you are about to vomit’, with moderate discomfort in the stomach area, and a constant feeling of hunger. She produces an abnormal amount of wind (burping), but her appetite and bowel function are normal. Her symptoms are worse just prior to a meal and during the night.
She has seen both an ENT and gastrointestinal specialist who attributed her symptoms to acid reflux. But the standard treatment with the acid-suppressant drug omeprazole has not, as promised, brought any relief – and they don’t seem to have any further suggestions.
These symptoms are certainly typical of – and almost certainly due to – acid reflux. The acid-suppressant omeprazole is for most a highly effective treatment, though for a substantial minority – as here – it does not relieve the symptoms at standard dosage. Some will respond to a doubling of the dose but if this does not work, further investigation is required with a view perhaps to having anti-reflux surgery.
BREATHE DEEPLY
Everything is soluble in water, including crusty nasal secretions that can be dissolved by steam inhalation – achieved by filling a pan with boiling water, placing a towel over the head and inhaling. The e fficacy of this has been con firmed in a study by the Common Cold Unit, reported in the British Medical Journal – it concluded that the severity of symptoms was halved in those who regularly used inhalation.Email drjames@lady.co.uk