I’m worried about crackling noise in my chest, help! Dr Zoe Williams answers your health queries
WHEN life gets really busy, it can be easy to forget about our health.
Readers often tell me they have tried seeing a GP but are having no luck, which further puts them off seeking help. It is important to persist.
Speak to your GP surgery about the best way to arrange appointments, because some may only make bookings available online through their website or an app, such as the NHS app.
This is to free up phone service for those with urgent needs, which is why you may be turned away if you call.
Sometimes, surgeries offer appointments a few weeks later, and it is better to take their offer than not.
But if you are really concerned about your symptoms, tell reception and they should listen to your problems and fit you in as they see best.
Many GPs now offer telephone consultations.
This could lead to a face-to-face appointment if your GP thinks it is necessary, such as for blood tests or an examination.
Always keep a diary of symptoms and think about what you will say beforehand to ensure you make the most of your appointment.
Here is a selection of what readers asked me this week . . .
Q) I HAVE had an ongoing issue over the past couple of years.
On my left side below my chest, I have almost constant pain.
At times there is a crackling noise as well.
I recently had a chest X-ray and everything seems fine.
The GP thinks it may be musculoskeletal.
However, I am not convinced.
A) It is really tricky to ascertain what is going on here without examining you.
If it has been going on for the last couple of years, I’d like to know how it started — was there any trauma, for example — and whether it feels like it is getting worse.
I’d also like to know how sedentary or active you are. You don’t mention your age.
I’m reassured by the fact you’ve had a normal chest X-ray, which would rule out a number of the more concerning issues.
The crackling noise is interesting.
Is it located in the lungs when you breathe?
This could suggest that there may be some fluid in the lung, but I would have expected this to show on an X-ray.
Or is it in the skin?
Do you hear or feel crackling when you press the area?
In this case, you could be looking at something called subcutaneous emphysema, which is when air gets trapped under the skin, and could be leaking from the lung.
Or is it more when you move and it sounds like the cracking of a joint?
There are a number of musculoskeletal issues that could be causing your symptoms.
For example, straining the joints or muscles associated with the breastbone, which can cause swelling and popping.
I’d advise you to revisit your GP for further assessment.
If the chest X-ray was completely normal then, depending on your answers to the above queries, they may consider an ultrasound scan, which can assess the soft tissues.
Keep a diary of the pain as your doctor will want to know if there are things that seem to make it worse or better, and if it tends to flare at certain times.
Please email back and let me know the outcome.
Q) CAN I do anything to alleviate the menopausal symptoms I still have at 81?
I had a partial hysterectomy in my early 70s but I have night sweats, hot flushes, mood swings, fatigue and migraines and I cry for no reason.
The contraceptive pill caused thrombosis in my legs. I was told not to take HRT.
My daughters keep telling me I should try oestrogen patches, but surely that is HRT?
A) So many women put up with symptoms well after menopause but don’t think they can access anything to help.
Ask your GP practice if there is a practitioner with a special interest in menopause you can book an appointment with.
HRT prescribing advice has changed dramatically in the years since you were advised not to go on it, but it is important that you seek advice from your doctor.
The Menopause Charity states that most women who are otherwise fit and well still gain benefits from taking HRT, even if it has been more than ten years since their menopause.
Your previous history of thrombosis will need to be carefully considered.
It may be that you need to be referred to a menopause specialist.
If your entire womb was removed then there is no need to take progesterone.
Oestrogen patches are a type of HRT and replacing the hormone via the skin (by patch, gel or spray) is the safest way.
Also, some types of HRT have been made specifically for older women, with smaller doses of oestrogen.
Natural fabrics such as cotton or bamboo will keep you cooler during hot flushes.
Look into The Menomat, which covers your pillow and bottom sheet and is designed to wick away sweat and keep you cool.
Keep a diary of your symptoms.
You may see a connection with particularly disturbed sleep and your low moods.
I'M WORRIED BY EYE FLASHES
Q) I SEE flashes when looking at white paper, and my optician isn’t concerned.
But I’m worried. Clear threads, like curly veins with little marks around them, are getting worse. I also suffer from the odd migraine.
A few years ago my GP sent me to the optician, but I feel a bit of a fool going back to the doctor now.
A) Firstly, please don’t ever feel like a fool for going back to your GP.
We mean it when we say, ‘Please do come back if it is getting worse’.
Opticians usually write to your GP if they have any concerns.
However, there are potential causes of your symptoms that may not present as an abnormality when your eyes are carefully examined, such as migraines.
The “threads” that you describe sound like “floaters” – caused by small flecks of protein in the gel-like substance in the back of the eye, which is called the vitreous.
They cast a shadow on the retina, and that is what you see.
When you try to look at them directly, they tend to move away.
Have a try and see if this happens.
Floaters are very common as we get older and almost everyone will experience them.
If you see flashes, this usually indicates that some of the vitreous is pulling on the retina, which is also common as we age.
Retinal detachment can be a very serious condition which can give floaters or flashes in the eye, but your optician would have picked this up easily.
Your GP can explore migraines in more depth with you.