THE DOC REPLIES

I HAVE blackheads on my nose – could they develop into something else, and how do I remove them?

Blackheads are a common complaint and tend to develop over the greasy areas in the central part of the face. They are harmless, can sometimes be a little unsightly but should not cause any major problems. Many people squeeze them – however this can cause a bit of trauma to the underlying tissues and may result in a little bit of scarring. There are many preparations available over the counter which will help with cleansing the skin and keeping these to a minimum.

My daughter has something called achalasia, which gives her terrible heartburn. What is it?

Achalasia is the name given to a disorder of motility of the lower part of the gullet and affects the sphincter or opening into the stomach. Often there is a failure of the muscles to relax which causes a narrowing and can result in symptoms such as difficulty swallowing and, as in your daughter’s case, heartburn and reflux.

A scan revealed I have gallstones. The symptoms aren’t bad – can I turn down surgery if I feel I don’t need it?

Gallstones are ver y common and many people have them without knowing about them. If they are not causing you any problems then there is probably no need to have surgery at this point in time. The main difficulties are if the gallstone lodges in the narrow neck of the gall bladder, this can cause fairly severe pain and an operation may be required.

Can you get laser treatment for varicose veins? Is it expensive?

Laser treatment can be used for varicose veins but mainly for the small surface

veins. You’ll need to check with private health clinics for the price, as it can vary from place to place.

I find it difficult to swallow at times. I’ve suffered from bad acid reflux over the years, so could the conditions be related?

Yes, reflux of acid from the stomach can result in difficulty swallowing as it can result in inflammation at the lower end of the gullet. If this, however, is happening consistently and you are having difficulty swallowing foods or fluids then it is important you see your GP to have this investigated further.

I often see floating shapes in my vision. Is this normal or should it be checked out by the doctor or optician?

Floaters are fairly common and are due to small pieces of debris that float into vitreous humour, which is the clear jellylike substance filling the space in the middle of the eyeball. They usually occur as eyes change with age and, in most cases, don’t cause any significant problems or require treatment. However, if you notice a sudden increase or change in floaters and, in particular, if you notice any white flashes then it would be worth visiting your optician. They can make a thorough examination and decide whether you need an eye specialist.

I have a constant need to clear my throat – I can’t get rid of the sensation. It feels like there’s a build-up of sticky fluid and it causes me to cough. I’m in my 60s.

This sounds as though you are having a problem with catarrh. This is a thick mucous that can gather at the back of the nose and throat, often causing cough and irritation. If this is the case then using a nasal spray may help to relieve the problem. Sometimes a feeling of thickness at the back of the throat or irritating cough can be due to a bit of acid reflux. Your GP can help.

My right knee sometimes seizes up, leaving me unable to straighten it for a few hours. It goes back to normal after a while but I wondered if it’s arthritis. I’m 61.

It may be that you are developing a little bit of arthritis. You do not mention whether you have had any injury to this knee in the past or indeed more recently. Sometimes a knee which locks on – not able to fully straighten or fully bend – can be a sign of cartilage problems. If the situation is not resolving then it would be worth seeing your GP.

I HAVE atrial fibrillation. Is it safe to exercise?

Atrial fibrillation is a common condition which results in an irregular heart rate which often can be quite fast. You will no doubt have been started on medication to keep your heart rate under control. It is important to have a healthy lifestyle, including a healthy diet, and exercise should be part of this. It is certainly safe to continue with exercise, as long as it’s within your limitations.