A. Ganglion cysts are the most common type of swelling that doctors see in the hand or wrist. They are usually found on the back of the hand, wrist or bottom of the thumb and are harmless. We don’t know what causes them, but they sometimes develop after injury and are more common in arthritis sufferers. Some people don’t notice them, but others do because they can cause pain or discomfort with certain movements. If a ganglion does not cause any discomfort, it is best to leave it alone as the majority disappear spontaneously. Because they’re fluid-filled cysts and not solid lumps, there’s no danger of them turning into anything bad if you ignore them. Years ago, doctors thought the best treatment was to hit them with a heavy book (which in most homes was a Bible, hence their nickname of Bible cysts), which was believed to redistribute fluid and relieve the swelling. Fortunately, we have now made some progress. Depending on where the ganglion is located, it may be surgically removed or the fluid aspirated with a needle. The success of such approaches depends on the location of the cyst and whether there are nearby blood vessels. Some health chiefs do not fund these procedures as they are considered cosmetic, but if the cyst is interfering with your daily life, treatment should be available on the NHS. If patients have questions about a ganglion removal procedure, doctors can refer them to an NHS hand surgeon who can provide more details. A reader is left in pain after developing a ganglion cyst on his wrist and asks what can be done to treat it (stock image) Q. Can you help with my erectile dysfunction problem? I used to take Cialis or Viagra pills and they worked very well, but now neither seems to have any effect. I am 82 and feel that my doctors are not taking the problem seriously as they think I am too old. Do you have any advice? A. Any health problem that affects your quality of life deserves a thorough investigation by a doctor, regardless of your age. Cialis and Viagra both treat erectile dysfunction, but if neither works, the doctor may initially wonder if the dose needs to be increased or if they are being taken correctly. These medications often need to be taken at specific times and not too close to meals. There are other drugs available – vardenafil and avanafil are worth trying. Erectile dysfunction is treated as a symptom of another condition, as there is often an underlying cause. GPs should do blood tests to check for diabetes and low testosterone, while also considering medication as a possible cause. A huge number of medications can lead to problems with sexual function, including antidepressants and high blood pressure pills. In older people, erectile dysfunction can be a sign of Parkinson’s disease or heart problems. If the problem develops suddenly – along with other weaknesses or changes in the body – it may indicate a stroke. Sexual function is also very closely linked to emotional well-being and problems can often be related to depression, anxiety and stress. Pills are not the only treatment. If drugs are ineffective, men should be offered treatments that can be prescribed by a specialist, such as vacuum pump devices, injections and creams. Q. Five years ago I was diagnosed with a problem with my bicuspid heart valve. But further tests of my heart function came back normal, so the doctor said no action was required. Is it likely to stay that way or can the problem cause problems? A. Valves in the heart are vital for ensuring blood flows in the right direction. For example, oxygen-rich blood must travel away from the heart to the rest of the body to guarantee that it receives the nutrients it needs. The main valve in the artery leading out of the heart – the aortic valve – usually has three folding parts that open when the heart beats and pumps blood, ensuring that blood travels in only one direction and cannot flow back into the heart. About one person in 50 is born with an aortic valve with only two leaflets. We call it a bicuspid valve. In most people, it doesn’t cause any problems and they only find out they have it during a cardiotomy done for another reason. Sometimes doctors will look for it through a scan if they hear a heart murmur.

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Email [email protected] or write to Health, The Mail on Sunday, 2 Derry Street, London, W8 5TT. Dr Ellie can only answer in a general context and cannot answer individual cases or give personal answers. If you have health problems, always consult your doctor.
If it doesn’t cause problems when detected by a doctor, they won’t do much more than monitor the patient regularly. Most people will not need further treatment. However, a two-way valve can also cause serious problems because it is more vulnerable to wear and tear than a regular valve. It can become stiff and narrow or very floppy, allowing blood to leak back into the heart. These problems stop the heart from working properly and lead to shortness of breath, chest pains, dizziness and even blacking out. If there are signs that the valve is degenerating, a specialist will increase the frequency of scans and may eventually recommend a procedure to replace it. But that means complicated heart surgery, so it would only be done if absolutely necessary. Why you shouldn’t overdo HRT I was alarmed by a letter from a reader last week who said she had been given “too much” HRT by her GP. When the prescribed dose failed to treat her hot flashes and insomnia, her doctor told her to use double the amount of medicine. That still didn’t work, so the doctor added another drug and then increased his dose. At this point the patient suffered chest pain, cramping, bloating, nausea and headaches. “I felt poisoned,” she wrote. I’m not surprised. High doses of female hormones can cause a number of serious side effects and taking larger than normal amounts is not recommended. She reduced her dose, found everything improved, and never went back to that doctor. Has anyone else had a similar experience? Write me and let me know. Dr Ellie Cannon contacted a reader who claimed she had been given an ‘overdose of HRT’ by a doctor (stock image) Let me know if you can’t contact your doctor online Is the seemingly endless effort to move all your GP services online causing you stress? Do you feel that without a smartphone, you will end up missing out on vital healthcare services? I know there are a lot of you out there – because I keep getting letters from readers saying so. An estimated one in ten Brits struggle with internet-based services, so GP surgeries these days can be a whole new world for some patients, with apps, texts and websites used for everything from prescriptions to reminders appointment. I’m afraid it will become more and more difficult for those who can’t get online. Your doctor should be able to give you advice, help and support to learn how to get online if you say you are struggling with access. But I worry that some are missing out. If that’s you, drop me a line and let me know – I want to try to help find a solution.