Why is my cholesterol on the rise even when I’m taking my statins?

I have been on statins for a year to treat high cholesterol, but recent blood tests showed that my cholesterol continues to rise, as does something called bilirubin. I am a 72 year old woman. Will the medicine not work for me?

Bilirubin occurs naturally in the bloodstream from the breakdown of old red blood cells. This can be determined with a liver blood test.

Doctors can use bilirubin levels, along with other proteins and enzymes, as an indicator of how well the liver is working. High levels may suggest a problem with your liver, especially if other markers are elevated. However, some people are born with high bilirubin levels, but this is usually not a sign of a problem or problem.

Statins are drugs used to lower cholesterol levels. However, it’s not just offered to people with high cholesterol or who are at high risk of having a stroke or heart attack within 10 years. They may also be offered to people with angina or diabetes.

We routinely perform liver function tests on people taking statins, and high levels of bilirubin are not a known side effect. It is usually the levels of other enzymes that increase.

This requires further investigation, as it is unusual for both cholesterol and bilirubin to be elevated in patients taking statins. If cholesterol does not decrease, statins should not be continued.

Further liver tests, such as ultrasound scans, may be needed, and alternative cholesterol-lowering drugs are also an option. Your general practitioner can give you advice on how much statin you need.

Some people with high cholesterol are not at risk for other heart diseases, such as high blood pressure. In these cases, statins are not always necessary.

Recently, I’ve developed a small bump behind my ear that is very red and painful. I wear glasses a lot, so I’m worried that they might rub off, but I’ve been wearing glasses for years, so this is the first time this has happened to me. can you help?

People who wear glasses often develop a skin problem called dermatitis. This is where the skin becomes inflamed, similar to eczema, but the cause is contact with the substance that caused the inflammation.

You may not notice a problem the first time you touch your skin, but repeated exposure can cause problems. In addition to being red and bumpy, the skin may also appear dry and cracked.

The best way to test for irritant dermatitis is to spend some time without using irritants and see if the problem goes away. However, this can be difficult with glasses.

Using a barrier cream, such as diaper cream, between your glasses and your skin will prevent contact and quickly resolve the problem. For this type of skin condition, over-the-counter steroid creams, which your pharmacist can advise, also work well.

The area behind the ears is a common location for certain rashes, such as seborrheic dermatitis. It is a red rash that looks flaky and forms a scab. This is thought to be a yeast infection, and antifungal treatments such as creams and antifungal shampoos are used to calm it down.

If the rash is painful rather than itchy or sore, it should be examined by a medical professional. For example, shingles is a serious cause of painful rashes. Pharmacists are very good at assessing and treating such rashes and can advise on treatment and whether it is worth seeing your GP.

You can also send photos to your doctor via an online form, who can assess the problem and recommend treatment over the phone.

My 92-year-old mother suffers from angina, but is otherwise generally healthy. However, a few weeks ago she became short of breath and had difficulty walking even short distances. Last week she said she had a strange feeling in her chest and we went to A&E but were sent home after tests. The doctor said it was just angina. Should I have taken more tests? Also, is there anything I can do to improve her condition?

It may seem prudent to seek more help from the emergency doctor for your loved one, but A&E is not the best place to support someone with a long-term condition.

An emergency doctor’s job is to diagnose and treat patients on the spot. However, once someone is discharged from the hospital and returned to the community, different types of doctors are responsible for monitoring and further testing.

Older people with worsening angina or heart symptoms should see their general practitioner. Your GP will consider what to do next based on the results of the tests carried out at the hospital. We can also arrange an emergency appointment at your local chest pain clinic.

It is very important to seek care from your GP as they can also detect other problems that may be related to your heart condition. This includes limited mobility, anxiety caused by symptoms, and potential side effects.

Angina pectoris can be treated with a variety of medications. Different types treat the pain itself, while some are specifically designed to prevent heart attacks.

Other health care professionals may also be involved in caring for older patients. For example, occupational therapists can help patients overcome challenges with daily tasks such as walking, dressing, and doing laundry by suggesting equipment to use.

Local exercise classes can also help seniors build strength and maintain their confidence.

Are physician collaborators putting patients at risk?

We have heard the alarming story of a 79-year-old man who went to his GP complaining of a month-long headache but was misdiagnosed by a physician assistant (PA) and is now fighting for his life.

These workers are medical professionals and increasingly work alongside general practitioners like me. Although they did not attend medical school, they have extensive clinical training. Importantly, he needed to be supervised by a doctor, but this PA told the man that he was not, and that he was simply stressed. He was then taken to the hospital with a brain hemorrhage.

This is not a one-time thing. Last year, 30-year-old actress Emily Chesterton died from a pulmonary embolism (a blood clot that blocks blood vessels in the lungs) after a PA misdiagnosed her with a prolonged coronavirus infection and anxiety.

Our practice PAs are an important part of our team, and patient feedback has been extremely positive. But in other regions, there are concerns that GP staff shortages mean PAs are taking on complex medical tasks without support. Have you ever had a bad experience at PA? In that case, please send an email to the address below.

The jab that missed a generation

A few weeks ago, I wrote that it’s never too late to get the MMR vaccine (the vaccine that protects against measles, mumps, and rubella).

The main concern is the ‘Wakefield population’ – children who were not vaccinated after horror stories about the autism-causing jab were widely circulated in the 1990s. False claims by disgraced academic Andrew Wakefield (he was later found guilty of gross professional misconduct and removed from the medical register) led to a temporary and significant reduction in MMR intake caused.

But are there other people at risk: older Brits?

Individual measles vaccines were introduced in the 1960s, but coverage was quite low until MMR became routine vaccination in the 1980s, so there may be a population of older people who are not vaccinated. means.

I would like to know, could I have avoided measles even though I missed the measles vaccination? Please write to me using my email address.