I keep experiencing an alarming problem where I get a zigzag wavy line before my eye which obscures my sight. While I don’t get a headache when it occurs, I wonder if this could be some sort of migraine?
Dr Ellie replies: Strange lines within your field of vision alongside a change in sight absolutely warrants a review with an optician.
They will be able to examine the retina – the back of the eye – as well as the blood vessels and the optic nerve, which could all be connected to this problem. They will also check for glaucoma, where the optic nerve has been damaged by a build up of fluid.
It is true that strange visual effects could be part of a migraine condition. There is a very specific – and rare – type called a retinal migraine. This may only affect the eyes and not cause a headache. It is thought to be related to the blood vessels in the eye narrowing.
A retinal migraine comes on suddenly and can cause sight loss for up to an hour, or it may cause a missing patch of sight.
Other symptoms can include blurry vision and seeing flashing lights, wavy lines or even coloured spots.
However, it is important not to self-diagnose this – a thorough examination is needed.
As with all migraines, there may be certain triggers for each individual such as stress, caffeine and dehydration. It may be worse for people with high blood pressure, so it is worth getting your blood pressure checked at a pharmacy.
A GP can prescribe migraine medications, but paracetamol or ibuprofen are reasonable to use if they work.
I’ve recently started getting strange sinus problems, along with pins and needles in my face. My ears become blocked like I’m on a plane, which causes me to feel dizzy, and my eyesight is affected. Could this be related to my underactive thyroid medicine, thyroxine, which I take every day?
Dr Ellie replies: This is not the first time that I’ve been asked about thyroxine and sinus issues, and yet these problems are not listed as an official side effect of the drug.
We do know that people with thyroid conditions can experience sinus issues, hearing problems and nasal congestion. However, this would be more likely if the condition wasn’t well controlled.
There are also other reasons you might be experiencing sinus problems. Sleeping can put pressure on the sinuses, which is why many people experience nasal congestion in the morning.
Going from lying to standing, as we do in the morning, causes fluid to move within the ears and sinuses, and can trigger minor swelling. It also happens that most of those on thyroxine take the tablet in the morning, which might explain why people connect it with sinus problems.
It might be worth changing the time you take the drug, just as a trial, to see if the time the symptoms arise also moves.
Any symptom that you believe is directly related to a medicine you take should be reported to the medical safety regulator, the Medicines and Healthcare Products Regulatory Agency. The agency runs a Yellow Card scheme where side effects can be logged. You can do this online or by asking a GP or pharmacist.
My wife has had a shunt fitted to drain fluid from her brain. Since then she has suffered severe stomach bloating which continues to get worse. Do you think this could be triggered by the shunt?
Dr Ellie replies: While uncommon, it is possible that this kind of procedure can trigger a build-up of fluid in the abdomen.
A shunt – a thin tube surgically inserted into the body – is often used to treat a condition called hydrocephalus, which is caused by too much fluid building up in the brain. This liquid adds to pressure within the skull and can cause complications, such as speech and vision problems, which is why it is so important to treat.
Shunts take fluid from the brain and pass it into the abdomen. Usually the fluid is reabsorbed into the bloodstream and shouldn’t cause a problem.
However, in some cases the shunt can drain too much fluid, causing an uncomfortable build-up in the stomach.
Shunts can also become infected, which would lead to abdominal pain.
Considering how recently your wife had the shunt fitted, it would make sense for it to be a potential cause of the problem. I would contact the surgical team who performed the procedure, who will be able to review this.
It is important to always get persistent bloating checked out by a doctor because, in rare cases, it can be a sign of ovarian cancer. However, most of the time, bloating is related to irritable bowel syndrome and can be treated with a daily probiotic or peppermint oil.
We’ll pay the price on prescription fees
Prescription fees went up last week – by 25p. It’s now £9.90 per prescription, which isn’t huge if you think about the cost of many medications, but I don’t think people should be charged at all.
Certain groups – under-16s, over-60s, diabetics and pregnant women to name a few – don’t have to pay. Others, such as women who take HRT, get a massive discount. Yet I’ve long felt this list was unfair. Asthmatics, for example, have to pay for every single prescription.
The money generated by prescription charges amounts to roughly £600 million a year. But this is trivial next to the NHS’s annual £19.2 billion bill for medicines.
Meanwhile, some of the poorest in society end up going without medicines due to the charges, get sicker and end up in hospital, costing the service far more in the long run. If you made all medicines free, you’d eliminate at least some of this issue.
Let me know what you think about this idea.
Some of the poorest in society end up going without medicines due to the charges, get sicker and end up in hospital, costing the service far more in the long run
The dark side of hair-loss drug
Hair-loss drug finasteride may trigger libido problems, erectile dysfunction and even depression, UK health officials warned last week.
The drug – which comes in tablet and lotion form – restricts the amount of testosterone the body processes to slow thinning.
We also prescribe it to men with prostate problems, but in much larger doses.
Finasteride isn’t offered for hair loss on the NHS, but it is sold by a number of online companies which package the drug as something more akin to a beauty product rather than hormone-altering medication.
The drug – which comes in tablet and lotion form – restricts the amount of testosterone the body processes to slow thinning
All drugs have possible side effects, and this is no different. It’s important to know that the chances of these finasteride side effects happening to you are very low. But the risk is there, so it’s important patients consider this carefully before starting treatment.
If you do begin to experience unexpected mental or physical symptoms while taking it, let your GP know immediately.
