DR ELLIE CANNON: Desperate to avoid constant trips to the loo at night?
My wife and I have to get up four or five times a night to pee. I feel as if I’ve not had a good night’s sleep for years. Is this normal?
The need to pass water can have a massive impact on sleep as we get older.
For men this may be prostate-related – the prostate gland is located just below the bladder, and it’s common for it to grow with advancing years. This can affect how much the bladder can hold, and the ability to hold on.
For women, bladder changes can be related to the menopause and change in hormones. Also, the pelvic-floor muscles, which support the bladder, weaken with age.
‘My wife and I have to get up four or five times a night to pee. I feel as if I’ve not had a good night’s sleep for years. Is this normal?’ (stock image)
For both men and women, overactive bladder syndrome can occur – when the muscle contracts involuntarily, even when the bladder isn’t full.
With all these problems, cutting out caffeine can help, as it can cause aggravation.
Drinking a normal quantity of other fluids is important – about eight glasses a day – otherwise the urine can be concentrated and even more irritating for the bladder.
Drugs known as anticholinergics, such as oxybutynin or solifenacin, can be prescribed. These temporarily desensitise the bladder nerves, reducing the urge to go.
My husband suffers with terrible osteoarthritis in his back, knees and hands. He’s 75 and finds it hard even to use cutlery. He’s been given a tablet called naproxen which helps a bit. But is there anything else?
Osteoarthritis is the most common form of arthritis. It’s likely that, at 75, most people will have it to differing degrees.
The cartilage which covers and protects the bones in the joints gets damaged and worn with age, weakening muscles and obesity. This causes pain and stiffness but also swelling, particularly of the small joints like the hands.
GPs tend to focus on painkillers for osteoarthritis, such as naproxen or other anti-inflammatories. But that is far from the full picture. Most patients do not get a specialist referral, and there is not a cure for osteoarthritis, but it is possible to get relief and better movement if you explore a range of options.
Exercise is important, although patients can be apprehensive because of pain. Specifically muscle-strengthening and range- of-movement exercises ease and improve symptoms. A physiotherapist can advise, but it’s hard to get to see one on the NHS in many areas. The charity Versus Arthritis (versusarthritis.org) is a good resource, with exercises explained and illustrated on its website.
Exercising in water can be more comfortable and even soothing.
Weight loss is often recommended. It doesn’t just reduce the strain on the knees and hips – evidence suggests that even hand arthritis may improve, as being overweight increases levels of chemicals in the body that exacerbate joint pain and swelling.
There is very little scientific basis for the use of joint pain supplements but many people do find them helpful – glucosamine, chondroitin and fish oils are worth a go and results can be felt after two to three months.
And, as simple as it sounds, ice packs are still one of the best ways to reduce swelling and inflammation. They can be applied for 20 minutes a few times a day. Massage, medical acupuncture and osteopathy are also worth exploring.
To get the best pain relief from medication, ask your pharmacist about combining naproxen with gels such as heat rubs or adding in paracetamol. The trick with good analgesia is to safely combine through trial and error – but make sure that you always stick to recommended doses. Privately, injections of hyaluronic acid are offered for knee pain.
Dust off the Tupperware! The secret to weight loss is organisation – as proved by John Clark, 39, and his partner Charlotte Deniz, 34, who have lost 15 stone between them, not by spending loads of money on fancy superfoods but by batch-cooking each week’s meals for just 60p a dish.
Weighing 21st 6 lb at his heaviest, ‘Fat John’, as he was known, a lorry driver, lived on a diet of burgers, sausage sandwiches and pub lunches. Now he says: ‘We make absolutely everything from scratch and we eat whatever we want.’
I totally approve. Batch-cooking prep is boring, but having home-made food ready to eat in the freezer stops all of us reaching for the snacks and takeaway menu.
You do have to do a lot of cooking and boxing up. But on the occasions I manage to be this organised, it absolutely works for me, particularly with a hungry family during busy weeks. It is also a great way to save money.
‘Safe’ painkillers can be dangerous
There is no such thing as a ‘safe’ painkiller. I never use the term as all treatments come with risks. Public Health England warned earlier this month that even the ‘safer’ pain pills gabapentin and pregabalin, also known as gaba drugs, may lead to addiction and withdrawal.
I see patients on them suffering major side-effects and dependence. One-and-a-half million Britons are on them, and they’re often used when other treatments fail. They may help people. But they’re not a quick fix to the opioid crisis – rather, simply replacing one problem with another.
There is no such thing as a ‘safe’ painkiller. I never use the term as all treatments come with risks (stock image)
It was tragic, but also sadly not surprising, to hear last week that a coroner has linked the deaths of five patients with anorexia to the poor care they received from one NHS trust. I can admit, when I diagnose a patient with anorexia I am always anxious about what will happen next. NHS care for eating disorders is still poor, putting vulnerable lives at risk, as these deaths show. Waiting lists are too long, specialist centres have been decimated and in some areas a patient’s weight has to be dangerously low before any help is offered. Why are we still getting this so wrong?
DO YOU HAVE A QUESTION FOR DR ELLIE?
Email [email protected] or write to Health, The Mail on Sunday, 2 Derry Street, London W8 5TT. Dr Ellie can only answer in a general context and cannot respond to individual cases, or give personal replies.
If you have a health concern, always consult your own GP.
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