I get pain around my ribs and can’t breathe – help! Dr Zoe Williams answers your health concerns

THE King’s cancer diagnosis serves to highlight the benefit of early detection.

Symptoms can alert you to changes in the body, but it’s important to take note of what is normal for you.

What are your typical toilet habits? How much do you weigh? Do you know what your moles look like?

Knowing your “normal” is also helpful for spotting any clues when doing at-home health checks, which I urge all readers to do.

Once a month, women should check their breasts (and armpits and collarbone area) for changes, while men should check their testicles.

Always take up NHS invitations for mammograms, smear tests and abdominal aortic aneurysm screening.

And do your bowel cancer test when the kit comes through the letterbox – it could save your life.

If you’re aged between 40 and 74 and have no pre-existing conditions, you will be invited for an NHS Health Check every five years to assess your risk of serious health conditions.

Here’s what readers have been asking me this week . . . 

Q) I RECENTLY had an angioplasty as I had angina pain and a history of heart disease.

My arteries are now clear. However, I am still getting quite bad shortness of breath on lifting.

An endoscopy was clear and so was a chest X-ray. It’s not asthma either.

But I regularly get pain in the ­sternum. It feels like something pressing around my ribs.

 It has stopped me working, walking and doing anything physical. I’m 61 and diabetic. The symptoms started eight weeks ago.

A) Your symptoms sound severe if you can’t work or walk, so definitely need to be looked into further.

Angioplasty is a procedure to open the inner tube of the arteries so oxygenated blood can flow properly to supply the heart muscle.

The heart pumps blood around the body without ever having a break, which is quite amazing really.

Unfortunately, it only takes one of those arteries to be significantly blocked to cause angina symptoms, which can cause pain and/or shortness of breath.

There are lots of heart conditions that can cause breathlessness and/or pain, including myocarditis, pericarditis, auto­immune conditions such as sarcoidosis and heart failure.

Anaemia, or other types of chronic disease, can also cause breathlessness.

I expect you are due to be followed up by the cardiology team, but I wouldn’t wait for your appointment.

You could contact your cardiologist’s secretary to see if the team think they should see you sooner.

Failing that, ask your GP to check you over and get some blood tests and an ECG in addition to the chest X-ray you already had.

• Got a question for Dr Zoe? Email her at health@mcb777.site

Frozen shoulder’s got me screaming

Q) I’VE just been diagnosed with a frozen shoulder, but the pain is mainly in my bicep area, not so much in my shoulder. What causes it? Would a cortisone injection help? The pain is so bad I scream.

A) Adhesive capsulitis – or ­frozen shoulder – is a ­condition where the shoulder becomes painful and stiff, often for no particular reason.

It affects about three in 100 adults at some stage, but usually between ages 40 and 60 and is more common in women. People with diabetes are slightly more likely to get it.

The range of movement can significantly reduce, often so much that the shoulder can become completely “frozen”.

 It most often affects only one shoulder, but it can affect both. Without treatment, symptoms usually go away naturally but that can take up to three years.

The pain is often over the front of the shoulder, around the bicep, or down the outside of the arm, so this fits your symptoms.

Another cause of pain is biceps tendonitis, or an inflamed biceps tendon. It can happen in isolation or with a frozen shoulder so I would suggest an ultrasound to see exactly where the problem is.

The good news is that a ­steroid injection can treat both conditions, but it must go into the site where the problem is, so have an ultrasound first.

Meanwhile, try ice packs and anti-inflammatory medication. You can do rehabilitation exercises, but your GP or physio can advise on how often and when to start.

Q) IN the past six months I’ve lost a lot of weight, and I have painful joints, breathlessness and digestive problems.

I have bronchiectasis and one cystic fibrosis gene. I have been told I am a CF carrier. I went to my GP, who thought I might have diabetes, but my blood tests didn’t show anything.

However, I’ve never had a glucose diabetes test for people with the CF gene. Do you think I should ask the doctor for one?

 A) Your case is fairly complex and it is important to get to the bottom of it, especially as your symptoms are progressively getting worse.

You’ve been diagnosed with bronchiectasis, which is a condition where the airways of the lungs become widened. This can lead to excess mucus in the lungs, leaving them more vulnerable to infection. It’s a condition that often affects people who have CF, but it can occur for other ­reasons too.

If you have bronchiectasis that is not well managed, you should be referred to a respiratory specialist doctor. It’s also important for your GP to examine you and do a full set of investigations looking for other causes of this rapid unintentional weight loss and your other symptoms.

These should include a full set of bloods and a chest X-ray as a minimum, and potentially other tests depending on your symptoms and examination findings.

For a diagnosis of cystic fibrosis, you need two mutated copies of a particular gene. If you have one normal copy and one mutated copy – as in your case – then you’re a carrier. You do not have CF, but could pass it to your children if their other biological parent is also a carrier. Most CF carriers don’t have symptoms, but some can have symptoms associated with CF.

New research suggests carriers have a higher risk for CF-related issues such as bronchiectasis. The 2020 study from the US compared 19,802 CF carriers to 99,010 people who had no mutations at all.

They assessed the risk of getting 59 health conditions. CF carriers were found to have a higher risk for 57 of the 59.

You and your GP need to be aware that you could be vulnerable to other conditions. It’s new research that will not be well known, so it may help to share the study with your GP and then discuss next steps.

One of the more likely conditions in a CF carrier is diabetes, so an oral glucose ­tolerance test may be a good idea.

Do let me know how you get on.