Ask the Doctor - November

Sunday 28th November - Slipped Disc

I've been diagnosed with a slipped disc.  I've not been able to work or play golf now for six weeks.  What Can I do? Colin, St Andrews

Mr J N A Gibson is a Consultant Spinal Surgeon at Spire Edinburgh Hospitals.

Lumbar disc prolapse is a common condition and actually some evidence of a slipped disc will be evident on sophisticated imaging in up to 30% of a normal middle-aged population.  In most instances patients will be entirely asymptomatic or suffer intermittent and short-lived episodes of discomfort only.  Physiotherapy or osteopathy may be all that is required, even when sciatica is fairly acute.  If pain is unremitting, further investigation by MR scanning can define the problem.  Surgery may be an option, with expected success rates of 95%.

During the last five years techniques have been pioneered to remove disc fragments by a minimally invasive approach. The disc is visualized by a HD video camera introduced through a small incision.  Recovery is rapid and patients are usually able to return home on the same day.  This method is now available at the Spire Shawfair Hospital Edinburgh; the first private hospital in the UK with this state of the art technology. 

Sunday 21st November - Ear Ache

Mr Ray Kelleher is a Consultant ENT surgeon at Spire Edinburgh Hospitals.

Infections of the ear canal are often associated with trauma from cotton buds, poking or skin conditions. Pain, itch, discharge or deafness may be evident. Management includes removal of any debris from the ear canal and steroid/antibiotic ear drops for any infection.  The cause should be addressed to prevent recurrence.

70% of children have at least one episode of middle ear infection (inside the ear drum).  Severe earache and fever often accompany viral infections such as the common cold in young children.  Treatment is pain and temperature control in the first 48 hours – paracetamol / calpol is the drug of choice.  Antibiotics should not be considered as first line treatment.  Discharge suggests that the ear drum has burst.  Combined oral antibiotics and drops are indicated in this situation.  The ear drum usually repairs itself.

Any persisting ear discharge, pain or deafness merits specialist referral.

Sunday 14th November - Stroke Recovery

Polly Dhar is a Neurological Physiotherapist.  For further information contact Spire Livingston Physiotherapy Clinic on 01506 448181. 

A stroke can affect the body in different ways and the limitations caused are different for each individual.  Although the majority of your recovery will have taken place within 2 years of your stroke there is usually further improvement which can be achieved in walking and function.  An assessment, carried out by a specialist neurological physiotherapist, would look at all areas of your walking, movement and muscle changes highlighting your specific problems and limitations.  Following this you will be given specific physiotherapy input and exercises which work on muscle tone, strength and movement patterns to help improve your confidence in walking and enable you to enjoy exercising. 

Sunday 7th November - Throat Concern

Mr Richard Adamson is a Consultant ENT specialist at Spire Edinburgh Hospitals.

The sensation of a lump in the throat is a common symptom. As long as it is not associated with problems swallowing, voice change or pain it is rarely serious. Common causes are stress and acid reflux.

Rarely there can be a more concerning underlying problem. Cancers of the throat were traditionally seen in older patients and associated with heavy smoking and drinking. Over the last fifteen years there has been a significant rise in cancers of the tongue base and tonsil area in younger non-smoking patients. We now know this is due to the human papilloma virus, which also has a role in cervical cancer.

The current recommendation is that if symptoms persist for more than four weeks referral to an appropriate ENT specialist should be made. In the majority of cases a clinic visit including a straightforward endoscopic examination of the throat is all that is necessary to rule out serious problems.