DR ELLIE CANNON: My GP tells me I must live with my swollen, red legs at age 90. Is she right?

For a good six months I have had swollen legs. At times they’ve been red, hot and very painful. I’m 90 and I’ve been prescribed antibiotics twice, but they didn’t help. Most recently my GP said I had to learn to live with it. Is she right?

Leg swelling, wounds and ulcers that are slow to heal are all common and very distressing problems for the elderly which affect mobility and quality of life.

They deserve proper treatment. In the 1990s a brilliant district nurse, Ellie Lindsay, set up The Leg Club in order to help people with these problems. It’s a network of nurse-led drop-in clinics offering treatment and advice to help prevent problems from returning.

They also provide an opportunity for patients to meet others in the same situation, as issues with the legs that limit mobility may also be very isolating.

Legs can be swollen for a number of reasons in someone older – this is called oedema. Sometimes it is due to a lack of mobility, as normal walking encourages the circulation, moving fluid out of the legs. But problems with the veins can also be an issue as the valves controlling blood flow don’t work as well with age. Compression stockings and using moisturisers are important treatments.

Leg swelling, wounds and ulcers that are slow to heal are all common and very distressing problems for the elderly which affect mobility and quality of life

Your GP also needs to consider if your heart is pumping effectively, as if the rate is poor it can lead to swollen legs, and whether any medications you take are worsening the problem.

To find out more about The Leg Club, visit legclub.org or ask your GP receptionist.

About 15 years ago I started to become breathless with exercise and was diagnosed with atrial fibrillation. I was given tablets which sorted it out, but over the past year I’ve started to feel puffed out again, even when doing something simple such as bending down to tie my laces. I am a 65-year-old man, fairly fit and not overweight. Should I worry, or is this just old age?

The kind of breathlessness described here isn’t something to be expected as we age, and it certainly shouldn’t be ignored. Anyone experiencing this must visit their GP who can start trying to look for a cause.

Tests should be able to flag-up any problem with the heart – atrial fibrillation is a condition that leads to an irregular heart beat and this might trigger breathlessness. But there could be other issues, such as faulty heart valves or a problem with the pump action of the heart.

Investigations should also look at the lungs.

Many problems with the lungs will cause breathlessness, from asthma and chronic obstructive pulmonary disease (COPD) to less common issues such as lung fibrosis, which is a build up of scar tissue that can occur after infections.

If the GP can’t run tests, then patients should expect a referral to a hospital clinic.

We have seen a lot of people suffering with breathlessness in the past few years as a result of developing long Covid, and you should discuss this possibility with your doctor.

Beyond the heart and lungs, other issues may also be relevant.

Anaemia – when a lack of iron means you don’t produce enough red blood cells to ensure the body gets the oxygen supply it needs – can cause breathlessness, particularly during exercise, and blood tests can ascertain this or similar issues with Vitamin B12.

The ability to breathe well while exercising can be affected by problems within the sinuses or nasal passages, too.

I was put on statins – one called atorvastatin – because of high cholesterol (not hugely raised, but higher than it should be). Within days I began getting heavy nosebleeds. My GP told me to stop taking the tablets and the nosebleeds stopped. Does this mean that I can’t be prescribed statins?

Nose bleeds are a side effect of this statin – as many as one in ten people who take atorvastatin will suffer the problem. Regular nose bleeds would be a reason to stop taking a medication, but it might be possible to switch to another statin, such as rosuvastatin, which doesn’t cause this side effect.

We prescribe statins due to a patient’s overall cardiovascular disease risk and the likelihood they might suffer a heart attack, stroke or other heart-related problem in the next ten years.

GPs calculate the risk by taking many factors into account, such as family history, other medical problems, age and weight.

To reduce stroke and heart attack risks, we advise measures such as controlling high blood pressure, taking a statin, increasing exercise, losing weight and quitting smoking. Trying to live as healthily as possible is important, regardless of whether you’re taking statins.

For those who cannot take statins due to side effects – which is very rare but can happen – there are other cholesterol-lowering medications which a cardiologist can prescribe.

You can trust pharmacists with any everyday ailment

Pharmacists will soon be able to prescribe a range of medicines in order to relieve the pressure on GPs, Prime Minister Rishi Sunak, pictured above, has announced

Pharmacists will soon be able to prescribe a range of medicines in order to relieve the pressure on GPs, Prime Minister Rishi Sunak, pictured above, has announced.

It will mean patients with a host of common problems such as sore throats, shingles and urine infections can pop into their high street chemist for treatment, rather than scrambling for a GP appointment.

I know some patients are nervous about this. How can a pharmacist possibly offer the same standard of care as a family doctor?

Well, let me reassure you. I frequently call on the pharmacist for advice on what to prescribe certain patients – they often know better than us. They are fully qualified healthcare professionals who are perfectly capable of diagnosing and treating some of the most common complaints I see in clinic.

It also means fewer clogged-up phone lines and more time for GPs to spend with patients with far more complex problems. Trust me – it’s a win-win for doctors and patients.

No swift solution to chronic pain

A major trial has confirmed that one of the most commonly prescribed drugs for chronic pain doesn’t work.

Millions of Britons are given an antidepressant called amitriptyline to treat arthritis, for example, or where the root cause of the pain is unknown.

Older studies showed a lower dose could help by reducing pain signals in the brain.

The latest trial results have seen GPs facing criticism for seemingly dishing out unnecessary antidepressants.

The unfortunate truth is that not much works well in tackling chronic pain. Patients may get a referral to a pain clinic where they try physiotherapy and exercises, but in my experience there is no panacea, so you can’t blame doctors for wanting to try anything that might help.

The Government must fund research into better options – that’s the only way things will improve for patients.