Why an operation might make you unsteady months later

I got a right hip replacement fifteen months ago. The procedure went smoothly, and the pain subsided after a few days. Since then, though, I’ve lost my balance and need walking sticks. Could my 85-year-old brain have been impacted by the anaesthetic used during the procedure? nnI’m sorry to hear that this problem has cast a shade on what otherwise seems to have been a very successful operation.nWhat you are feeling is a typical side effect, particularly following hip (or knee) replacement or spine surgery.nIt’s not connected to the anesthetic, as you indicate (my brother and son are anesthesiologists, so I’ve been able to get a number of professional opinions on this), but rather it’s a side effect of being bedridden, even if it was only for a short time.

Being less mobile than usual after surgery can often lead to balance and gait problems. The theory is that disruption of normal activities has a detrimental effect on proprioception, which is our sense of where our joints and limbs are and their movement.

Proprioception relies on messages running between the brain and your muscles and limbs to make sure they move in the right order and in the right way. This is necessary to maintain a good balance.

However, this feeling – which is largely controlled by the cerebellum, a small part of the brain – gradually weakens once we pass the age of about 60.

It can also be adversely affected by excessive alcohol consumption, a brain injury, or a period of relative immobility, for example due to a flu-like illness or surgery.

It may be that these affect the messages reaching the cerebellum, but the exact mechanism is not clear. There is some evidence that training can restore much lost proprioception. You say in your longer letter that you have been referred for strength and balance classes, but this has had little effect.

While you can lose your proprioceptive ability in just a few days, it takes months of training to get back to where you were, so I recommend sticking with it.

I am also a big believer in tai chi, which has been shown to improve lower extremity proprioception. One or two sessions with a teacher per week would be ideal.

My daughter, 33, can’t go three or four weeks without getting a cold, cough, and chest infection ? she hacks and hacks until her chest and neck feel like they’re on fire. We went to A&E and the doctor said her lungs are wet and put her on an inhaler. I’m panicking this is serious.

Pauline Cowley, by email.

Please try not to worry – it sounds like your daughter’s condition isn’t more serious than you’ve been told. But her history makes me wonder if she has asthma. This is essentially an inflammation of the airways.

Airway inflammation has four classic symptoms: wheezing, coughing, shortness of breath, and chest tightness (File Image)

It usually involves four classic symptoms: wheezing, coughing, shortness of breath, and chest tightness. These will not necessarily always occur.

Viruses can trigger asthma symptoms. But viruses can also cause asthma-like symptoms, such as wheezing and coughing.

For that reason, I agree with the ER doctor that your daughter should regularly use a steroid inhaler to suppress any inflammation, as well as a salbutamol or salmeterol inhaler to open up the airways.

She must also undergo a spirometry test, which involves breathing into a tube to assess lung function.

She must use the inhalers for at least six to eight weeks. If they work, this will help confirm the underlying asthma diagnosis.

Given the frequency of her infections, it would be a good idea for her to get a blood test as well.

One possibility, though rare, is that she doesn’t have enough immunoglobulin A (IgA), an antibody that’s part of the defense mechanism in the mucous membranes lining the nose, sinuses, and lungs. Treatment is with regular injections of the antibody. I suggest she talks to her GP about the inhalers and further investigation.

In my opinion… All the more reason to take care of your gut

A few years ago, a patient I had known since he was a child was diagnosed with colon cancer at just 29 years old. The news shocked me.

That month, another patient, a 48-year-old woman, was diagnosed with the same cancer.

Several years ago, a patient I had known since he was a child was diagnosed with colon cancer at just 29 years old, writes Dr. Martin Scurr.

I am happy to report that, six years later, both are still healthy, but at the time I was surprised to have two such young patients with this diagnosis – traditionally a disease of the over 50s. But now research shows that the incidence has risen dramatically in younger patients (those under 50), by 25 percent over the past ten years.

Some clues as to what might be going on have emerged from a study that compared the microbiome — the microbes that live in the gut — of younger patients with colorectal cancer to that of patients older than 65. The researchers found that the younger patients had higher levels of a type of fungus called Cladosporium, which is common in homes and food; the older group had a different set of organisms not seen in the younger ones.

Could this finding help in terms of prevention? That’s the pace of microbiome research, I suspect we’ll know more sooner rather than later.

Write to Dr. Scurr

Write to dr. Scurr at Good Health, Daily Mail, 9 Derry Street, London W8 5HY or email: [email protected] ? add contact details. Dr. Scurr cannot respond to personal correspondence. Answers should be taken in a general context. In case of health problems, consult your own doctor.