I’m 84 and I can’t stop yawning. It’s upsetting my family and friends because they think I’m bored of them. I’m not tired either, so that can’t be the cause. What should I do?
Dr Ellie Cannon replies: Excessive yawning can be a sign of a breathing problem.
Breathing is controlled by the muscles in the chest wall and the diaphragm – a large muscle underneath the lungs.
Most of us don’t really think about how we breathe, unless perhaps we are singing or exercising, because it’s something we do automatically. However, some people can develop a problem called dysfunctional breathing, where the rhythm becomes disrupted or inefficient.
Yawning is one symptom, along with difficulty taking deep breaths or persistent coughing.
It is usually triggered by lung problems such as asthma.
Dr Ellie helps a patient worried about their excessive yawning
Dysfunctional breathing is also a reported effect of long Covid – persistent symptoms that can last for weeks, even months, after an infection with the virus.
A GP can refer patients with dysfunctional breathing to a respiratory physiotherapist, who should be able to help manage the condition and correct the breathing so that yawning occurs less frequently.
The GP should also assess what – if anything – is causing the problem. For example, asthma, which can be managed with inhalers.
Treating the underlying condition should also relieve some of the yawning too.
I’ve suffered with lower back and pelvic pain for years, and I also need to urinate about five times every night. I’m 78. What could be wrong?
Dr Ellie Cannon replies: Lower back pain is one of the most common health complaints, particularly among older people.
For some, this pain will resolve itself with no treatment after a few months. However, if an elderly patient is suffering with severe back and pelvic pain that is waking them in the night, they would likely need to be referred to hospital for scans, because these can be a sign of a serious problem in the spine.
This might be arthritis, which occurs when the spine bones are damaged and the nerves are squashed, causing severe pain.
However, it can also be a sign of the bone-thinning disease osteoporosis. This condition, which is more common in women, causes the bones to crumble and raises the risk of dangerous fractures.
This is why it is so urgent that older patients with these symptoms be seen in hospital. There are drugs which they can be given to reduce the risk of severe fractures.
Less commonly, lower back pain can be a sign of certain cancers, for example myeloma, which affects bone marrow.
If an older woman complains of pelvic pain then she would likely need to have a pelvic scan to rule out the possibility of ovarian cancer. This disease can also trigger changes in urinary habits. So it is crucial that anyone who has severe lower back later in life should make an appointment with their GP.
I recently had a mini-stroke that caused my left arm to flap uncontrollably. Apparently I suffered a brain bleed which caused an epileptic event in my arm. I am now on medication and am due for a check-up with my neurologist in a month. Am I allowed to drive before then?
Dr Ellie Cannon replies: After a mini-stroke, patients are not supposed to drive a car or motorbike for at least a month.
A mini-stroke, also known as a transient ischemic attack, occurs when blood flow in the brain is temporarily blocked. In some cases, patients experience few symptoms. By contrast, a stroke is a more lasting blockage which can lead to long-term disability.
A mini-stroke can lead to impaired mental function or disrupt normal function of other parts of the body – for example, limb movement.
For this reason, patients have a legal duty to inform the Driver and Vehicle Licensing Agency (DVLA) about a recent mini-stroke or stroke.
It is up to the DVLA, not the NHS, when it is safe for patients to drive again after one of these health events.
The DVLA also has separate regulations for epilepsy and seizures which can affect stroke patients.
For example, if a stroke triggers an epileptic event, and there is reason to believe the same could happen again, patients may be excluded
from driving for six months. However, if a doctor decides that the patient is unlikely to experience another epileptic event in the near future, a one-month ban may be enough.
This decision would be based on the decision of a neurologist, so patients should not drive until they have attended this appointment.
The DVLA’s guidance on health conditions can be found in detail on its website (gov.uk).
- Do you have a question for Dr Ellie Cannon? Email [email protected]
- Dr Cannon cannot enter into personal correspondence and her replies should be taken in a general context
Keep tabs on loved ones on antidepressants
Lady Gabriella Windsor’s husband Thomas Kingston took his own life last year after suffering ‘adverse effects’ triggered by new antidepressants he had been taking
I was moved to hear the parents of Thomas Kingston speak for the first time last week about his untimely death.
Lady Gabriella Windsor’s husband, 45, took his own life last year after suffering ‘adverse effects’ triggered by new antidepressants he had been taking, according to a coroner.
Thomas had been using the drug sertraline before his GP switched him to another tablet called citalopram. Both are called selective serotonin reuptake inhibitors (SSRIs) and, in some rare cases, they can trigger mood changes or suicidal thoughts.
It’s for this reason I always advise my patients to tell their family and friends when they begin taking SSRIs.
Loved ones should watch out for agitation or worsening mood. If these symptoms occur, the patient needs to be seen by their GP as quickly as possible or go to A&E immediately. This is so crucial that if a patient tells me they don’t intend to tell anyone about their new medicine, I often won’t prescribe it.
Did prediabetes warning work?
I was surprised to read that the American medical expert who coined the term prediabetes now believes he made ‘a big mistake’.
Dr Richard Kahn, formerly of the American Diabetes Association, came up with the term in 2001.
The intention was to warn patients that they were on their way to developing type 2 diabetes – the blood sugar condition which affects more than four million in the UK.
Patients are diagnosed with prediabetes if their blood sugar is consistently raised but not high enough to be diabetic .
Dr Kahn now believes that diagnosing patients with prediabetes has not lowered cases of diabetes while also lining the pockets of drug firms that manufacture blood-sugar lowering drugs.
However, I disagree. I find that when I tell people in my surgery that they are prediabetic they are more likely to improve their diet and lifestyle, which lowers their risk of full-blown diabetes.
Have you been told you are prediabetic? Was this helpful? Please write and let me know.
[Notigroup Newsroom in collaboration with other media outlets, with information from the following sources]
