DR. ELLIE CANNON: I was off my anticoagulant after having an aorta inserted - so why do I still bruise so easily? - Today's news (2023)

A few years ago I had a stent placed in my aorta after a scan revealed an aneurysm. I was also prescribed clopidogrel, an anticoagulant, and it wasn't long before I noticed that every time I got a knock, no matter how small, I immediately started to bruise badly. In January, my pills went off, but I still bruised easily. is this normal?

A stent is a surgical implant -- a mesh-like tube placed in a blood vessel that acts as a scaffold, holding the blood vessel open and ensuring blood flow.

If they are blocked, they are usually placed in a heart artery to prevent a heart attack. In the case of an aortic aneurysm, a weak point in the wall of the body's aorta, a large stent is used to relieve pressure on the blood vessel and prevent it from rupturing.

After a stent is placed, anticoagulants are usually given to stop blood clots from forming around the stent, which can cause further blockage and cause heart attacks and strokes.

When prescribing anticoagulants such as clopidogrel, we warn patients that they may bleed more easily, for example from the gums after brushing their teeth.

A bruise, a small hemorrhage under the skin from a blow that damages the small superficial blood vessels, is also more common.

These side effects should stop when the anticoagulant is stopped. But it's important to note that these problems occur with most of these drugs - so if you switch to a new drug, the problems may persist.

Bruising or increased bleeding is not life-threatening, so we usually say that the benefits of the drug - in terms of preventing fatal events like heart attacks - far outweigh these minor risks.

If medications are not the cause, blood tests may be done to check for normal levels of clotting proteins and platelets, as well as other tests such as liver function, which is also an important part of the blood clotting system.

With age, thinner skin, more fragile blood vessels, and easier bruising are also common.

Earlier this year I got shingles on my neck and shoulder blades. It hurt incredibly, I had no appetite, couldn't sleep and was extremely tired. It took months and even now, six months later, I still get a tingling pain in my neck. I'm afraid I'll never be the same again. Suggestions?

Shingles is the reactivation of an old chickenpox infection. After the initial infection, the virus that causes chickenpox - which most of us contracted as children - remains dormant in the body.

But as you get older, or if you weaken or become frail, immunity to the virus (varicella-zoster virus (VZV), part of the herpes virus group) can weaken, allowing it to become active again.

VZV is found in nerves - which is why the rash it causes, when it becomes active, can appear in bands or plaques along nerve lines.

That's why it's so painful, causing burning, pain, and something called neuropathic pain -- nerve pain that feels like an electric shock or tingling.

Shingles can also cause a long-term condition called neuralgia - when the pain persists, it causes stabbing pain. For some people, shingles neuralgia becomes chronic and requires treatment.

It is worth seeing your GP after a severe shingles attack. There may be an underlying problem, from stress to insomnia or even depression, that can exacerbate the discomfort.

We also vaccinate everyone over the age of 70, and if you're not vaccinated it's worth trying to avoid getting the disease again.

I went to my GP in January for vulvar pain and was told I may have a type of skin cancer called basal cell carcinoma. This obviously worried me, but the doctor didn't seem too concerned and said I could do a biopsy if I really wanted to. If it's going to be painful, should I bother?

This looks confusing. Basal cell carcinoma is a slow-growing cancer usually found on areas of the skin exposed to the sun, such as the face.

It is believed to be very rare in the vulva (the outer part of the female genitals), so it is unusual to diagnose it on examination alone.

Most vulvar skin cancers are squamous cell carcinomas that usually grow on the labia near the opening of the vagina.

Vulvar cancer is rare, affecting 1,400 women in the UK each year, but is more common in women over the age of 65.

Disturbing symptoms that may indicate cancer include persistent pain, bleeding or soreness, raised or thickened areas of skin, nodules, or persistent itching that does not go away.

Persistent vulvar changes are one of the criteria for a GP group's so-called cancer target referral, and patients should be able to make an appointment with a gynecologist within two weeks. During this appointment, the specialist can take a closer look and perform a biopsy.

This does involve taking a small sample of tissue after an injection of local anesthesia, but is very important if cancer is suspected.

Talk to the Ask Eve information service, which offers advice to any woman concerned about gynecologic cancer.

The helpline is 0808 802 0019 or visiteveappeal.org.uk.

Calorie counts on menus are harmful, not helpful

Last week confirmed one of my biggest suspicions: that calorie counts on menus aren't helping with the obesity crisis.

That is the conclusion of a major study presented at the European Congress on Obesity, one of the world's largest obesity conferences. The researchers concluded that calorie labeling would have "little or no impact."

I'm not surprised at all. There are doubts about the quality of the evidence supporting the initiative, which took effect last spring.

And the policy is not without risks. Eating disorder charities are deeply concerned about the harm done to the thousands of people living with these life-threatening mental illnesses.

Some of my eating disorder patients avoid eating out for fear that confronting the calories will ruin their recovery.

The sooner we scrap this stupid plan, the better.

Know the signs of dementia

This week I'm supporting a movement to help people understand the difference between normal, age-related memory loss and dementia.

I often hear people talking about older relatives and they keep asking the same questions. This is not a normal sign of aging. In fact, it is one of the telltale signs of dementia.

It's normal to walk into a room and forget what you're looking for - we all do. But with dementia, people forget words and forget times and dates. There are many other lesser known symptoms, such as insomnia and restlessness. The sooner people are diagnosed, the sooner they can get medicine to relieve symptoms.

If you're concerned about a loved one, visit the Alzheimer's Association (alzheimers.nl) or consult your doctor.