Dear doctor

My shoulder is frozen

Q I have a painful stiff shoulder and can't lift my arm up beyond a few degrees. I can dress, drive and go to work, but it's all an effort and I can't lie on that side so my sleep is disturbed. A friend had a steroid injection for her frozen shoulder but I'm wary. What do you advise?

A When it's working properly, the shoulder has a huge range of movement. But flexibility comes at a price. The joint is easily dislocated and damaged. A thin capsule of tissue surrounds it and small tears make it thicken and become more rigid, which restricts movement. With a frozen shoulder, there is gradual development of pain over a few months, then, as the pain settles, the shoulder stiffens and you lose power and movement of the arm for up to a year. The good news is that after that the shoulder improves. The bad news is that it takes an average of 30 months from start to finish and that treatments do little to alter the outcome. Anti-inflammatory tablets such as Brufen are good in the early stages. Physiotherapyis at least as good as a steroid injection and less likely to cause harm. An operation is probably to be avoided.

Heart disease risks

Q Several members of my family have died of heart disease in their 50s and 60s. I asked my GP what I could do to avoid following in their footsteps but was told that apart from not smoking, eating healthily, exercising regularly and having my blood pressure checked from time to time, there was nothing much. He offered to do a cholesterol blood test. Is there much point?

A There's a lot of point. If your cholesterol level is high with an unhealthily high proportion of the "bad" part of cholesterol, LDL, you will be advised to try to reduce it by adopting a low fat diet. This rarely helps much and you may be offered drug treatment with one of a group of drugs known as statins. There is some concern about using statins for more than 10 years. Your risk of developing heart disease over the next 10 years can be calculated taking into account your age, smoking, blood pressure, whether you're diabetic and your cholesterol level. If your risk is above 15%, I'd ask for a statin. Some health authorities are a bit tight with them, only giving them to those with 30% risk or more. But stand your ground if necessary or ask to be referred to the local lipid clinic for an expert opinion.

HIV and oral sex

Q I have a new partner and am being conscientious in insisting he use condoms when we have sex. Can I catch HIV from oral sex?

A Suprisingly, the answer is "yes". The risk after one-off oral sex is low but it has been shown that if you have oral sex with a man who is HIV-positive, you could be at risk.

Testing for cancer

Q I've heard there is a blood test for cancer. How can I get one? There's a lot of cancer in my family.

A The blood test is known as DR-70tm (tumour marker) and is now on sale in Canada and China and soon to find its way to the UK. Its manufacturer, AMDL, an American company, claims it can detect 13 different cancers, including common ones. It's based on the notion that cancer cells release chemicals known as proteases, which can be measured in the blood and from which the type of cancer can be identified. Critics of the test say the scientific evidence is unreliable as it is based on small studies. SureScreen, the company due to market it in the UK, plans to sell it to health professionals rather than directly to the public. Insurance companies may request the test as part of routine health screens - and presumably won't be keen to insure those who test positive. If the test can be proved to be reliable, it is likely to be a useful to early diagnosis of cancers. Until then, the jury's out.

These answers are intended to be as accurate and full as possible, but should never be used as a substitute for visiting a doctor and seeking medical help. If you have a question for Dr Robinson, email or write to her c/o The Health Editor, The Guardian, 119 Farringdon Road, London EC1R 3ER. She regrets that she cannot enter into personal correspondence.

Thanks to who have provided this article. View the original here.


comments powered by Disqus