Q. After a routine check-up by my GP, I was told blood tests indicated I was suffering from chronic kidney disease. I was totally shocked – but the doctor said I shouldn’t worry, just to get on with life, and that about ten per cent of his patients had this. I was in and out in ten minutes. I’m now Googling the condition and feel worried and confused.
A. Chronic kidney disease (CKD) is a tricky problem for doctors and patients, not least because of its name. Calling something a disease when in fact it affects ten per cent of the UK population is of course going to cause anxiety and worry unnecessarily in well people.
In fact, half of people aged 75 or more have some degree of CKD so it could actually be seen as a normal part of the ageing process rather than a disease.
Half of people aged 75 or more have some degree of CKD so it could actually be seen as a normal part of the ageing process rather than a disease
Essentially it means the kidneys are ageing and their function to remove waste and control blood pressure is less efficient than before.
Some conditions make it more likely for CKD to develop earlier, such as type 2 diabetes and high blood pressure.
There are five stages of the condition, with the fifth being the most serious: kidney failure.
Most people are diagnosed with stage one, two or three, which is considered mild or moderate and requires annual monitoring, blood and urine tests, and blood-pressure checks.
Scientific evidence shows CKD is a risk factor for other diseases, namely heart disease and stroke, and being aware of the higher risk of future disease because of CKD allows us to work together with patients to lower other risk factors such as cholesterol and smoking.
It is worth discussing these things further with your doctor and looking at what you can do. But yes, getting on with life and not worrying is also important.
Q. I am a 63-year-old woman. Last year I was diagnosed with glue ear, something I thought affected children, and I will shortly be having a grommet fitted which I hope will restore the hearing in my left ear. No one seems to know why this has happened and I am concerned it might happen again.
A. Glue ear is a very common condition usually found in children but also seen in adults. It is a problem with the middle part of the ear where the bones involved in hearing are located, behind the ear drum. This area should be free of fluid so the ear bones can move freely. It’s kept free of fluid by the Eustachian tube, which runs from within the ear to the back of the throat, acting as a drain.
For various reasons in adults and children, this may not drain properly, meaning it remains full – a condition we call glue ear. This results in symptoms of hearing loss, dizziness and even pain.
In an adult, it may be the result of Eustachian tube dysfunction, where the tube is blocked or narrow, or it may be due to allergies or smoking.
When the tube is not working, the air pressure drops in the middle ear, creating a vacuum that forces fluid to seep in and build up. A small plastic tube, or grommet, is inserted into the ear drum, creating a hole. The pressure goes back to normal and this stops the fluid seeping in.
Grommets improve hearing loss because once the fluid has gone, the ear bones can move normally and hearing function is restored.
The implants normally fall out of their own accord after about nine to 12 months. The condition can recur, but if a cause for Eustachian tube dysfunction can be found, then glue ear can be prevented from coming back.
Too many men like Bill avoid the doctor
Bill Turnbull’s story is, sadly, a familiar one to me: the former BBC breakfast presenter last week revealed he has prostate cancer which has already spread to his bones. Bill, 62, who told his story after an episode of Celebrity Great British Bake Off, put the pain he was suffering down to ageing and avoided the GP until it became unmanageable.
I can see how this happened. Men are less inclined to visit the GP, especially if they can explain away their symptoms and otherwise feel fit and healthy as Bill did. This is particularly true in hardworking, active people who are almost too busy to be distracted by what may have originally been relatively minor symptoms.
Even now Bill continues to work while he has chemo, so he obviously has a stoic disposition.
My advice to middle-aged men is this: from about the age of 40 (but really at any age), be vigilant of any urinary changes.
If you are going to the loo more often or finding it harder to go despite feeling you need to, or anything else, then see your GP.