Transient Ischaemic Attack (TIA): What's the best medication?

Following a transient ischaemic attack (TIA) last year I had a number of scans. One showed that there had been a bleeding from the brain. The scan showed a small infarction, with "minimal haemorrhagic conversion". I have since been on bendroflumethiazide and ramipril to lower blood pressure. These have controlled my blood pressure, but have also interfered with my ability to get an erection. My GP was about to prescribe Cialis, but on checking found that it was not recommended where a haemorrhage has occurred. Is there any other medication that may be suitable?

Ankylosing Spondylitis: Could my starch intolerance be linked to AS?

"I recently discovered the existence of ankylosing spondylitis (AS) while doing a web search on starch intolerance. Every time I eat starchy food the pain in my lower back, which I have had for more than 20 years, flares up. At the same time I suffer chronic cramping in my intestines. The more I read about AS, the more I am convinced it is the cause of my problems. I've been told the next stage is to see my GP to have a blood test for HLA-B27. Over the years I have often gone to my GP for bowel and back problems and I have been made to feel like a hypochondriac. Twenty years ago I was diagnosed with inflammation of the sacroiliac joint. I don't know what my GP will say if I ask for a blood test, but I imagine it will be dismissive. I've looked into a private test, but it will cost £200 and I can't afford it. What should I do?"

Vasectomy: Is there anything I can do about the pain?

"I'm 61 and had a vasectomy in 1984. I was in great pain for a fortnight after the operation. Four years after the op I had another six-month bout of pain. I had ultrasound scans which did not show anything abnormal. Since April 2007 I have been in pain again. My PSA prostate test is normal. When the pain occurs there is a swelling of the testicle and epididymis. Is there anything I can do?"

Simvastatin tablets: Is it safe to eat grapefruit?

Since I had a stroke I have taken simvastatin tablets and I have been told not to eat grapefruit. Is the warning really for people who eat grapefruit two or three times a day? I enjoy the taste of grapefruit and wonder whether it would be all right to take, say, half each morning.

Pregnancy: Is this exercise safe during pregnancy?

A young friend is eight months pregnant and is concerned her husband is becoming restless. Consequently, she is determined to get her slim figure back as soon as possible and has started doing an exercise which involves pulling her abdominal muscles in to form a hollow under the ribs, then pushing the muscles in and out rapidly.It might be a yoga exercise, but I am sure it is not to be practised during pregnancy and am worried about what it might be doing to the baby.How should I advise her?

Coccyx: Bruised and uncomfortable

I have a bruised coccyx, which gives me considerable discomfort when sitting. I had a cortisone injection and manipulation under anaesthetic six months ago. This gave me a pain-free three-four months, but my consultant cautioned me about repeating it soon. How can I manage or cure the condition? I use a seat pad with a "V" cut-out, but getting up from the seated position is painful.

Middle Age: Why are fit people like me keeling over?

I'm 46, a lifelong non-smoker, moderate meat and alcohol intake (less than 20 units a week), cyclist/walker/runner/swimmer, BMI 21-23, and no family history of heart trouble. I should have no worries, but I'm mindful of the ostensibly healthy men who have keeled over in middle age (Alan Ball, Geoff Hamilton, Ken Barrington, Leonard Rossiter, Robin Cook, Billy Bremner, Douglas Adams...). I've always pushed myself hard when I run and swim. Should I ease up now I'm over 45? What medical tests should I request? I do get brief spells of apparently fluttering heart-beats, but I've always had this. Should I take these as a warning?

Osgood-Schlatter disease: A sporty teenager

My 14-year-old daughter has developed a tender lump at the top of her shin bone. It seems to swell and then go down. Her PE teacher said it will go away by itself if she rests, but she is a keen hockey player and it is difficult to persuade her not to play.

Osteophytes: A knuckle on my knuckle

The knuckle on my thumb is growing pointed on one side. It feels like the bone is growing and the thumb clicks quite loudly and frequently. Any ideas?

Antibiotics: Conflicting advice

I have received a lot of conflicting advice about antibiotics. Some doctors say they should be taken exactly at the right time (every eight hours, for example). Others say this is not important as long as you take the correct number of doses in a day (morning, afternoon and evening, for example). Some say they have to be taken before meals; others say after. Most say to avoid alcohol, but at least one doctor has told me that that doesn't matter either.

Osteoporosis: Rule of the bone

I am 47 and approaching the menopause. I have not had any dairy products for 10 years as they give me diarrhoea. Should I have a bone density scan to check for osteoporosis? I am 5ft 7in, 10st, size 12 (so the correct weight for my height) and I am healthy. I do a desk job but try to get to the gym once a week for a hour; I do a Pilates class every week and I cycle to work, but I'm aware that cycling is not a weight-bearing exercise. I feel that exercise is more important for bone density than calcium, but I know not everyone agrees.

Hair loss: Bald spot fears

In recent months I have noticed a slightly bald spot on my head. Like most men, I am not keen to lose my hair. I know there isn't much that can be done once your hair is gone, but in the last few years I've heard that there are very effective products one can take to prevent the loss of hair in the first place. Also, can anyone assess whether I will lose more hair or not? Can a GP or a professional hairdresser tell you? It would be good to know if my concerns are justified, and therefore whether there are measures for prevention, or if I am just paranoid.

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