IF you’ve got kids or grandchildren, you should know about meningitis.
Cases of the potentially fatal condition, which causes inflammation of the protective layers around the brain and spinal cord, have risen. There were 378 serious cases of bacterial meningitis last year, up from 320 the year before.
Youngsters are most at risk and outbreaks often occur in shared living spaces, such as university halls.
Warn them that early symptoms, such as vomiting, fever, aches, muscle pain, cold hands and feet and headaches, can be mistaken for colds or flu.
Meningitis can lead to sepsis or septicaemia, which can quickly cause serious illness.
Keep an eye on unwell people for signs of a stiff neck, dislike of bright lights, confusion, delirium, fits, severe sleepiness, very cold hands and feet, pale or blotchy skin, or rapid breathing.
Babies may refuse feeds, be floppy or have a high-pitched cry. Do not wait for the “meningitis rash” (a rash that doesn’t disappear when a glass is rolled over it) before seeking help, as it doesn’t always occur.
Here’s a selection of what readers have asked this week . . .
My mouth ulcers are so bad I can’t eat or speak
Q: MY son, 42, suffers from mouth ulcers that have become worse in the past six months.
His mouth swells, making it impossible to eat, sleep or sometimes speak. Episodes last about two weeks.
None of the usual over-the-counter medicines work.
He has stopped eating all fruit, tomatoes and cucumber.
The other day, he removed a slice of lemon from a Coke he ordered, but after one sip, the ulcer came – and that left him in a lot of pain for two weeks.
A: The symptoms sound severe, compared to typical aphthous ulcers, which most of us experience occasionally.
This could reflect an underlying health issue or nutritional deficiencies.
Because his episodes are worsening, he should see a doctor or dentist AND, crucially, if anyone has an ulcer that does not heal after three weeks, it must be checked and they may need an urgent biopsy to rule out cancer.
Blood tests can look for deficiencies in vitamin B12, folate and iron, and also for conditions such as lupus, Behcet’s, coeliac or Crohn’s disease.
If other things are ruled out, he may get the diagnosis of recurrent aphthous stomatitis. There is no cure for RAS, the aim of treatment is to avoid flare-ups, alleviate the pain and support healing.
This can include topical corticosteroids, anaesthetics (gels, mouthwashes, sprays or lozenges), which your son might have tried anyway, and pastes that can give a protective barrier layer over the ulcer.
In very severe cases, a short course of oral steroid tablets can be used, or other medicines that alter the immune system’s function. But there can be long-term side effects from these.
Avoid spicy, acidic, abrasive or salty foods, and fizzy, caffeinated or very hot drinks.
Some studies suggest tomatoes, oranges, lemons, and pineapple can be inflammatory for people with RAS.
Finally, advise him to use a toothpaste that does not contain the additive sodium lauryl sulfate.
This is the ingredient that makes the paste foam up, but it can be an irritant to some, causing dry mouth and ulcers.
Good dental hygiene is vital, as sharp or broken teeth can damage the soft tissues of the mouth and this can also cause ulcers.
OAP CAN’T AFFORD CURE
Q: I HAD an eye infection and was prescribed chloramphenicol with antibiotic eye drops.
But I am now troubled with meibomian gland dysfunction (blocked tear ducts) for which my optician suggested gentle massage and an eye mask.
The recommended mask was much too expensive for me to buy, as I’m an OAP.
I tried a warm flannel on my eye, and this does help for a short time before the gunge starts again.
I am also continuing with chloramphenicol drops during the day. Can you recommend anything?
A: I’m sorry you’re dealing with this.
MGD can be quite persistent and uncomfortable. Although you’re already doing some of the right things, I can suggest a few low-cost steps that can make a big difference.
MGD occurs when the tiny oil glands along your eyelids become blocked or inflamed, leading to poor-quality tears and sometimes sticky discharge.
It’s often chronic, meaning continued management rather than a one-time cure.
Rather than using flannels for warm compresses, use a home-made heat mask.
Fill a clean cotton sock with uncooked rice or flaxseed.
Tie it and warm it in the microwave for 20 to 30 seconds (test on your wrist – it should be comfortably warm, not hot).
Use for five to ten minutes, twice daily. The goal is to gently melt the oils in your glands.
Immediately afterwards, massage your eyelids. Use a clean finger or cotton bud, and gently roll or press along the eyelid margins (from top to bottom for the upper lid, bottom to top for the lower) to help express the blocked oils.
It is also important to clean the lids. Use diluted baby shampoo (a drop in a cup of boiled, cooled water) once or twice daily to remove dirt and bacteria.
If your GP or optician told you to keep using chloramphenicol, finish the prescribed course.
But do not continue long-term without review because overuse can upset your normal eye flora.
Finally, stay well-hydrated and make sure you have omega-3 (oily fish and flaxseed) in the diet, as this can help improve the quality of the gland secretions.
Strange sense of something in eye
Q: COULD you please tell me why, at times, it feels as if I have something in my left eye?
l suffer from glaucoma, so could this have something to do with it?
Then, all of a sudden, it feels as if it has gone. This usually happens at night.
A: Feeling that something is in your left eye – something we may describe as a “foreign body sensation” – can happen for several reasons.
Some types of glaucoma can cause eye discomfort at night.
Glaucoma is a group of conditions where pressure is increased due to impaired drainage of fluid from the eye.
At night, our pupils dilate to allow more light in, and this further increases pressure in the eye, which can exacerbate symptoms including blurred vision, halos around lights, and an ache in the eye.
These symptoms may be intermittent and resolve after sleep, but can return.
However, this does tend to be described more as an ache, or pressure, rather than a “foreign body”.
That said, if you notice pain, redness, sudden blurred vision or halos around lights, seek urgent medical advice, as these could be signs of angle-closure glaucoma or other serious eye conditions. Let us consider what else could be causing the sensation of a foreign body in your eye.
Dry eyes are a frequent cause, and glaucoma medications can sometimes contribute to dryness.
Your optician or pharmacist will be able to advise on some suitable hydrating drops and gels.
Surface irritation, such as a scratch or mild inflammation of the eye, can create this sensation, and does not necessarily mean there is something in there.
So again, if it is not settling, it is best to see your optician, who can examine the eye.
