Q: My wife suffers from ice pick headaches. She has had scans and seen doctors but no one seems to know why they happen. I am writing to you out of desperation. What can we do to help her?
Ice pick headaches, also known as primary stabbing headaches, cause an intense pain around the eye or at the side of the head that comes on suddenly.
The feeling lasts for only a few seconds, but can happen up to 50 times a day. It’s not known what causes them, but they can be triggered by bright lights or stress. They are more common in people who suffer from similar conditions, including migraines.
See a doctor for scans and an examination when they first happen so that they can make sure there is nothing else more serious going on.
It is also wise to have an assessment with a neurologist who specialises in this area, as ice pick headaches can be mistaken for things such as cluster headaches, which have similar features – a neurologist would be able to spot the difference between the two.
Ice pick headaches can be disabling as they cause so much pain, and for this reason pain clinics will often recommend psychological support, says Dr Ellie Cannon
Drugs including painkiller indomethacin can be used to prevent the attacks
Because the pain of ice pick headaches is so fleeting, despite being so severe, they are hard to treat at the time. However, drugs including indomethacin can be used to prevent the attacks. Indomethacin is a painkiller also used as an anti-inflammatory for conditions such as arthritis.
Ice pick headaches can be disabling as they cause so much pain, and for this reason pain clinics will often recommend psychological support.
Q: I had a scan a few years ago to see whether I had multiple sclerosis (MS) but it didn’t find anything. I’ve had extreme fatigue for a decade and my legs often feel sluggish and heavy. Recently I’ve felt mild numbness and tingling down one side of my body. Is it still possible I have MS?
MS is a neurological disease that can affect the brain, nerves and spinal cord, and impacts about 130,000 people in the UK. It occurs when the immune system turns on the body and attacks the protective layer around nerves called the myelin sheath.
The damage this causes can lead to numbness or tingling in the face and body, extreme tiredness, blurred vision, walking problems and even difficulty controlling the bladder.
There are different types of the disease, although most people find that their symptoms come and go. Sadly, some people’s MS gets worse over years, without any periods where they get better.
It would be worth getting a neurologist to take a look at anybody who has had unexplained symptoms of nerve damage for a long time, despite a long wait to see a specialist on the NHS.
When diagnosing a patient with MS, a doctor would firstly rule out other causes of nerve damage, such as deficiency of Vitamin B12. Another test would be a nervous system examination to see how well your reflexes work, which may involve tapping the knee or bicep with a reflex hammer.
In some cases an MRI scan can spot MS by picking up damage to the myelin sheath of the nerves in the brain and spinal cord.
But somebody can still have MS even if a scan doesn’t spot this, as it may not appear in all areas of the brain or may be less visible if they are small or if at an early stage. A neurologist may order other tests to help them diagnose MS, including a lumbar puncture – also known as a spinal tap. This involves using a needle and syringe to take some fluid from around the spinal cord, which is then analysed. Someone’s eyes may also be tested to see if there is damage to the optic nerve, which can be an early sign of MS.
Q: A huge 3in cyst was found on one of my ovaries in August and I was put on an urgent list for surgery. But doctors also found I have long QT syndrome, which causes irregular heartbeats, and now there seems to be a suggestion I won’t be fit for surgery. What should I do?
THE important thing is not to panic. Having to wait for surgery may be a good sign – ovarian tumours can be aggressive, so you would usually be called in for surgery quickly if doctors believed the cyst was cancerous.
Even so, non-cancerous ovarian cysts can be excruciating. The pressure from the cyst can also cause bloating and pain in the pelvis, and constipation or problems emptying the bladder.
Long QT syndrome is a rare condition where the heart’s electrical system takes too long to recharge between beats, which can lead to blackouts, palpitations and seizures. It’s usually something people have no idea they have until they have an ECG – a simple test that records the electrical activity of the heart. The worry is that it is often associated with unexpected death in young adults who were unaware they had it.
But knowing that someone has long QT syndrome means doctors can offer treatments to help control it, such as beta blockers or a pacemaker.
Having the condition should not cause any delays in getting surgery but a cardiologist may be asked for their opinion in case there is a risk of someone’s heartbeat becoming dangerously irregular during the operation.
Anyone facing unexpected delays in getting care should speak to their GP, who can check that everything is in hand. Sometimes we find that patients think they are on a waiting list when in fact they aren’t.
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.
Have you been left with no NHS dentist?
Damning pictures of a mammoth queue snaking outside a new NHS dentist in Bristol show just how desperate the dental crisis in the UK has become.
People regularly turn up on my clinic list suffering dental pain or other problems, but GPs aren’t trained to treat such issues, so I have to send them away with little more than advice on painkillers.
The shortfall of available appointments and high treatment costs have led some patients to resort to extreme measures – travelling abroad to get care or pulling out their own teeth, for instance.
Have you or someone you know relied on similarly extraordinary lengths? Or have you struggled to find a dentist to take you on as a patient? Please write to the address below and let me know.
A mammoth queue forms outside a new NHS dentist in Bristol – show just how desperate the dental crisis in the UK has become
There’s no place for homeopathy
Amid reports on the King’s cancer diagnosis, I read a story on Dr Michael Dixon, the head of the Royal Medical Household.
The GP is also said to be a fan of homeopathy – treatment based on diluted substances. But when Dr Dixon’s position was made public last year, Buckingham Palace was quick to point out he doesn’t believe such alternatives can cure cancer.
On that, we see eye-to-eye. But I think homeopathy has no place in medicine at all, let alone for such a serious disease.
Whenever I say this there seems to be an outcry from ‘believers’ on social media, outraged that I can dismiss what they see as vital therapy.
The fact is that there is no good evidence that homeopathy does anything whatsoever, and it certainly has no place in cancer care. We’re safer sticking to conventional drugs.