A virus has paralysed my face… how long will I look like this? DR ELLIE CANNON replies

I was recently diagnosed with Ramsay Hunt syndrome. The left side of my face has dropped and is agonisingly sore. I can’t close my eyes and my mouth is stiff. How long will this last?

Dr Ellie Cannon replies: Ramsay Hunt syndrome is a distressing form of shingles.

It is triggered by the virus varicella zoster, which most people carry from childhood as

it also causes chickenpox, but in later life, as the immune system weakens, it can flare-up, causing a painful blister rash down one side of the face and neck.

Ramsay Hunt syndrome occurs when a shingles outbreak affects a nerve in the skull called the facial nerve. Along with blisters, this can lead to paralysis of the face and problems with hearing, balance and dizziness. It can also cause problems with taste and the ringing ear issue tinnitus.

It is also very painful, which is why the NHS offers a shingles vaccine to everyone aged 70 to 79, as well as those turning 65.

Usually it is treated with the anti-viral medicine acyclovir, which targets the virus and makes long-term complications less likely.

Given the intense pain it causes, it’s important that doctors also provide pain-relief options such as amitriptyline and gabapentin.

Occasionally, steroid tablets are offered to fight the inflammation.

If patients can’t close their eyes due to the weakness, its important they see an eye specialist to make sure they are protected from long-term damage.

But even with treatment the condition can last a long time, and sadly, symptoms such as hearing loss and muscle-weakness in the face can become permanent.

Would you put your trust in a chiropractor?

I was surprised to read a report arguing that the NHS should use chiropractors more often to help reduce patient waiting times to see physiotherapists. It’s certainly true that, with more than 320,000 people with musculoskeletal issues on health service waiting lists, we need to do something to speed up treatment. However, I’m not convinced that chiropractors – who use their hands to try to relieve problems with the bones, muscles and joints – are the answer, as the University of York claims. There is little evidence that chiropractors can improve symptoms – the NHS considers it to be a type of alternative medicine – and I worry that the forceful manipulation of the body involved can sometimes be dangerous, causing serious injuries. This is why I never recommend it to my patients. Have you had a bad – or good – experience with a chiropractor? Please write in and let me know.

would you put your trust in a chiropractor?

I was diagnosed with severe osteoporosis 14 years ago and took alendronic acid for five years. I was then told my bones were healthy and the treatment was stopped. That was nearly a decade ago – should I get retested just in case?

Dr Ellie replies: OSTEOPOROSIS is a disease which causes thinning bones, and as we get older the risks associated with the condition increase.

It is most common in women – particularly those who have gone through the menopause.

Thinning bones makes dangerous breaks more likely which can not only be intensely painful but also deadly. Hip fractures are one of the leading causes of death in older women, as the break severely decreases mobility and increases the risk of serious complications.

When someone is diagnosed with osteoporosis, doctors will usually start them on medicines which increase bone strength, including bisphosphonates such as alendronic acid. The NHS also recommends calcium and vitamin D supplements, as well as weight-bearing exercise such as walking or dancing.

Usually, after five years, if scans show significant improvements in bone-strength, treatment is stopped. NHS guidelines state that patients should undergo scans and an assessment with a bone specialist every two to five years – or earlier if the patient breaks a bone. If patients have not been offered a check-up, they should inform their GP, who can organise a referral.

I was given antibiotics in December for a chesty, phlegmy cough. It hasn’t gone away and is keeping me up at night. I have asthma but I’m not experiencing any wheezing so I don’t think it’s connected. What can I do?

Dr Ellie replies: An ongoing cough with phlegm could be a sign of a long-lasting lung disease.

Excessive phlegm which does not go away is sometimes related to chronic bronchitis. This is a type of COPD – chronic obstructive pulmonary disease – which leads to inflammation of the airways. Symptoms include a phlegmy cough, chest pain when coughing, shortness of breath and a sore throat.

People who smoke are more at risk of chronic bronchitis.

Write to Dr Ellie

Do you have a question for Dr Ellie Cannon? Email DrEllie@mailonsunday.co.uk

GPs often suspect chronic bronchitis when patients are producing excessive phlegm for three months of the year for two or more consecutive years. But they can provide treatment sooner if they believe it is necessary. This typically involves a combination of steroid inhalers to combat inflammation.

An ongoing cough can also be related to whooping cough – also known as the 100-day cough – that is triggered by a bacterial infection.

It is usually treated using antibiotics but many patients experience a cough for several months after the bug has gone.

In this situation all they can do is wait it out – but the symptoms will ease eventually.

When asthma patients experience any sort of post-infection cough, it may be helpful for them to try steroid inhalers. This is because an infection can worsen the asthma inflammation, meaning more drugs may be needed to bring it back under control.

Sometimes irritable coughs are caused by the stomach when acid rises into the throat – known as acid reflux or heart burn.

A trial of an over-the-counter antacid drug from a pharmacist could help to reduce these symptoms and also pinpoint the cause of the problem.