Will a cooker stop my pacemaker working?

...and other reader conundrums I’ve enjoyed investigating on YOUR behalf

I

T’S 12 years since I was asked to join the Good Health team as the resident GP columnist. to be honest I jumped at the chance.

Here for me was an opportunity to take on an educational role and maybe correct some of the misgivings about what GPs should be doing or might be offering.

My ambition has been to be a guide on a rocky path, to provide advice and explanation to the readers of Good Health (the premier health pages in the national media!) that goes beyond what they may find in an information pamphlet — to give them real insight into the kind of information that helps guide a GP’s decision. My aim is to give readers a level of knowledge expected of senior medical students.

this is because I believe that the more information you give a patient, the better, as it allows them to have more involvement in their diagnosis and treatment, which in turn makes them feel more confident in the care they receive — as well as providing a sense of control that inevitably leads to better outcomes.

sadly, this is not always about providing a definitive solution. sometimes the best thing a GP can offer is to spend time listening quietly: but this alone can be therapeutic for some.

And the letters I receive never cease to remind me of the need for GPs and their generalist expertise: there is value in a medical friend who might not know the answers but who knows who to ask, and who will fight your corner, and be your advocate in the complex and ever changing world of medical care.

Knowledge does not stand still and there have been occasions when answering a reader’s question has meant me tapping into the extraordinary range of expertise in this country — not only for some of the more unusual subjects, but for other more common problems, which remain difficult to treat and where the greatest challenge is to find a way to offer hope...as you can see from the following selection of readers’ letters I’ve received over the years . . .

WHAT CAN I DO ABOUT ‘BURNING’ MOUTH?

I’d never come across this rare complaint until a couple of decades into my career — but over the course of my time at the Mail, I’ve had a number of letters about ‘burning’ mouth. As well as an almost intolerable constant burning and tingling sensation of the tongue, it causes a bitter metallic taste in the mouth.

to learn more I spoke to a leading oral surgeon and a senior neurologist, who in turn consulted their colleagues. the only agreement was that there was no agreement, either about cause or suitable treatment: in short, every specialist had a different suggestion — never good for a GP who wants a straightforward answer.

I later came across a patient in my practice who’d had burning mouth syndrome for ten years until her previous doctor prescribed clonazepam, a tranquiliser and an anti-convulsant. this gave her considerable relief (although it didn’t cure it) for as long as she kept taking a single daily dose. that became my suggestion to readers who wrote to me.

DO CREASED EARLOBES MEAN I’LL GET HEART DISEASE?

SOMETIMES I get letters from readers who fear their GP won’t take their concern seriously. A good example is the question of whether creases in the earlobes are a sign of impending heart disease. It would be easy to dismiss this as an old wives’ tale, but a little research on my behalf

confirmed there is truth to this. It was first reported in 1973, then a study in 1982 showed a link between creases on the earlobes and coronary heart disease. One theory is that the creases occur as a result of malformed blood vessels, which may also be true of those supplying the heart.

I’m not convinced, although I did once have a patient whose creases disappeared after surgery to clear blocked arteries. Both ear creases and heart disease are linked to ageing, so perhaps the former should be seen as a reason to ask your GP about screening tests for heart disease.

CAN ALUMINIUM PANS CAUSE DEMENTIA?

SIMILARLY, another reader asked

me about whether using aluminium cooking pans is a risk factor for dementia because she thought the question a waste of her GP’s time. It took a fair bit of research to be able to offer suitable reassurance

that the pans are not a danger.

WILL A COOKER STOP MY PACEMAKER?

AND still in the kitchen was the request from the reader about the potential dangers of an induction hob. She was due to have a pacemaker — a battery-powered device that monitors the heart and ensures it pumps with a regular rhythm — and had been warned not to stand closer than one metre from the hob, as the electromagnetic field might affect the pacemaker.

This made it impossible for her to cook and I suspected that her cardiologist hadn’t considered this. But when I consulted two leading cardiologists, both expert in pacemaker technology, they couldn’t advise and, after discussions with manufacturers were less than helpful, I found myself speaking to a university physics department.

Eventually it became apparent that for an induction hob to upset a pacemaker, contact would have to be very close — i.e. lying face down on the hob, which is far closer than

merely standing over a saucepan!

CAN A MOBILE GIVE YOU HEADACHES?

ONE of the most mysterious – and commonly asked — questions relates to electromagnetic hypersensitivity: where exposure to electromagnetic fields emitted by a whole manner of devices is said to affect health. The subject has been carefully investigated by the UK Health Protection Agency.

It seems that exposure to the radiation associated with highvoltage power lines, radar, TVs,

mobile phones, microwave ovens and fluorescent lights is a real

and occasionally disabling problem for some people, with symptoms including skin changes (redness and tingling), impaired concentration, nausea, palpitations, fatigue, headache and sleep problems.

However, tests have failed to show a clear relationship between exposure and symptoms, or effective treatment, so my advice has come down to trying to minimise exposure by whatever strategies are sensible and practical.

PATIENTS NEED TO BE SHOWN KINDNESS

THE most difficult letters involve conditions that are common but are not straightforward to treat. Post-viral fatigue is a common example — it can follow a host of conditions, from flu to shingles and more recently Covid-19. The best prospect for a patient is supportive care from a doctor with the understanding and experience to confirm the diagnosis — once depression has been excluded — and offer treatment based upon the knowledge of that patient. Irritable bowel syndrome (IBS) causes similar dilemmas.

With no definitive test, the only way to reach a diagnosis is by first

ruling out other diseases with similar symptoms, including coeliac disease.

Yet it’s all too easy, especially when patients are stressed by the pressures of life, to assume the symptoms are simply related to this, and not investigate further.

Similarly, fibromyalgia, which causes long-term, body-wide pain, is difficult to diagnose with no definitive test, let alone treat, but is a still real and very distressing condition nonetheless.

IBS and fibromyalgia are often described as heartsink conditions because they’re hard to treat, and they share the reputation of being

‘psychological’ complaints, implying that, to some extent, they’re imaginary. Yet the mind and body are connected, and to think otherwise is a hindrance in treating such conditions.

What these — and indeed all — patients need is not just knowledge, but kindness and a listening ear.

The problem is that they seem to find themselves having to turn to a newspaper doctor to find this.