Health Expert Addresses Concerns Over Cellulitis and Migraines

As summer approaches, many are focusing on their health and well-being. In response to various health concerns, Dr. Zoe, a health columnist, provides insights and advice on issues ranging from cellulitis to migraines. This week, she addressed several reader inquiries, shedding light on persistent health challenges and offering guidance on managing them.

Understanding Cellulitis Aftermath

One reader reached out with concerns following a severe bout of cellulitis in the left leg that occurred four years ago. Despite managing a few recurrences with immediate antibiotic treatment, the individual now experiences a persistent red mark on the lower calf and excess fluid accumulation in the left ankle and foot. The swelling increases throughout the day, prompting a need for advice.

Dr. Zoe explained that severe cellulitis can lead to lasting changes in skin and tissue, which may include the accumulation of fluid due to damage to the lymphatic vessels. These vessels are responsible for draining fluid from tissues, and if they are scarred or weakened, chronic swelling may result. Compression therapy, such as wearing compression stockings, along with leg elevation and physiotherapy, can help manage these symptoms.

The red mark observed could be a form of post-inflammatory hyperpigmentation, a condition where skin appears darker due to the healing process. Dr. Zoe noted that while this may gradually lighten, it might not completely disappear. She emphasized the importance of monitoring the area for signs of new infections, including increased redness, pain, or warmth, and advised proper skin care through moisturization and avoiding injuries.

Concerns Over AL Amyloidosis Diagnosis

Another inquiry came from an individual worried about a potential diagnosis of AL amyloidosis, a condition marked by the buildup of abnormal proteins in the body. The reader, who has peripheral neuropathy and has been diagnosed with orthostatic hypotension, expressed concern about delays in receiving a definitive diagnosis, particularly given their complex medical history.

Dr. Zoe highlighted that timely diagnosis of AL amyloidosis is essential, especially when organ damage is suspected. She explained that the NHS has mechanisms to expedite diagnoses, although it does not fall under a formal two-week cancer pathway. Diagnostic tests may include blood and urine analyses, imaging studies such as echocardiograms, and biopsies to detect amyloid deposits.

Patients suspected of having amyloidosis are encouraged to be referred to the National Amyloidosis Centre at the Royal Free Hospital in London, where appointments can often be arranged within two weeks if cardiac involvement is suspected. Dr. Zoe provided the centre’s website, ucl.ac.uk/amyloidosis, for further information.

Evaluating New Migraines in Older Adults

An 83-year-old man reported experiencing occasional migraines after a long absence of symptoms, lasting between 15 to 30 minutes. Given the significant gap since his last episode, Dr. Zoe advised that any new or unusual headaches in individuals over the age of 50 warrant careful attention.

She stressed that the recurrence of migraines, particularly with changes in frequency or aura, should be evaluated as a new headache. Symptoms such as visual disturbances could indicate more serious conditions, including transient ischaemic attacks (TIAs) or mini-strokes. Dr. Zoe recommended that the individual book an urgent appointment with their GP and maintain a symptom diary to track the nature and duration of the migraines.

In conclusion, these inquiries illustrate the importance of seeking medical advice for persistent health issues. Dr. Zoe encourages readers to remain proactive about their health and to consult healthcare professionals when faced with concerning symptoms. By staying informed and vigilant, individuals can better navigate their health challenges and make informed decisions about their well-being.