This treatment does sound alarming, but pleased be assured — your son has been correctly advised and is being properly treated.
His condition, haemochromatosis, is a genetic disorder that causes the intestine to absorb excessive amounts of iron from food during digestion.
Iron is an essential component of the blood, and is responsible for transporting oxygen around the body as part of the compound haemoglobin.
However, in excessive amounts it can be harmful. Normally, we absorb around one or two milligrams of iron each day from the food we eat — this is enough to keep our stores topped up.
By contrast, someone such as your son will absorb up to four times that quantity, and this will accumulate as the years pass.
So by middle age the body may contain as much as 20 grams of iron (most people have around four grams).
Although the body does lose some iron from the body from shed skin cells, sweat, and, in women, menstruation, this is not enough to clear the excess.
This build-up can have widespread effects throughout the body.
Three-quarters of people with haemochromatosis will have weakness and lethargy, and there may also be liver damage and pigmentation of the skin.
Loss of libido and impotence are common, and affect 45 per cent of sufferers, and diabetes affects half of sufferers due to damage to the pancreas.
Damage to heart muscle can also occur, and there may also be joint pains.
These are serious potential complications, but fortunately, treatment is simple — as you have been made aware.
CONTACT DR SCURRTo contact Dr Scurr with a health query, write to him at Good Health Daily Mail, 2 Derry Street, London W8 5TT or email drmartin@dailymail.co.uk — including contact details.Dr Scurr cannot enter into personal correspondence.His replies cannot apply to individual cases and should be taken in a general context.Always consult your own GP with any health worries.
Removing 500ml of blood (‘one unit’) removes 200 to 250mg of iron. This removal stimulates the bone marrow to make new blood cells.
In making new cells, the body removes the excess iron and over a year of blood removal much of the damage is prevented or even reversed.
The body will easily be able to replace the blood that is being removed, so please do not worry that he will be left deficient.
No supplements are needed if your son is eating normally, but when he has blood taken he should drink enough fluid and avoid vigorous exercise for 24 hours.
Once his iron stores are lowered to a suitable level he will need a long-term maintenance programme in which one unit of blood is removed every couple of months, and he will remain well.
Do be reassured — this is a safe and effective treatment for him.
For some time I have suffered a prolapse but this has not stopped me doing anything — I enjoy gardening, cooking and dancing. However, when lifting shopping recently it seemed to get worse. A gynaecologist has told me I need a hysterectomy (the appointment was rather distressing and consisted of him prodding me around and talking to the student nurses about my case as if I wasn’t there). I am considering cancelling — why should I put my body through this when I feel fine at the moment? But my family want me to go ahead — can you give me your opinion? R. M., Southampton.This has been an upsetting experience for you — and I can see there are two problems on which to advise.
The more simple is the nature of prolapse and what is to be done about it.
More difficult is how to put you at ease after the distress and trauma you were put through.
The impression I get is that you were treated very objectively, it seems rather roughly, as a teaching subject.
This was not the careful supportive and educational experience you expected and deserved, and I am not surprised your confidence is faltering.
A prolapse occurs when the muscles supporting the uterus — the muscles of the pelvic floor — weaken and stretch with age.
These muscles could also have been weakened by childbirth many years earlier.
When this happens, anything that increases pressure in the abdomen will force the uterus downwards, into, and through the vagina.
This force can come from innocuous activities such as coughing, lifting a weight or straining to empty the bowel.
More from Martin Scurr... How can I get this heavy feeling off my chest? 03/06/13 Ask the doctor: Bad breath is ruining my self-confidence 27/05/13 Ask the doctor: Will my shingles pain ever go away? 20/05/13 Ask the doctor: Is blood in my urine a reason to worry? 13/05/13 Ask the doctor: Why am I seeing stars in my eyes? 07/05/13 Ask the doctor: What has caused my unbearable leg pain? 29/04/13 Ask the doctor: Why are my teeth starting to crumble? 22/04/13 Ask the doctor: Simple steps for easing a hormone headache 08/04/13 Ask the doctor: Why do my wife's hands bruise so easily? 01/04/13 VIEW FULL ARCHIVEWhile this can be repaired surgically, evidence suggests a more effective outcome is to remove the uterus, and this is why the gynaecologist stated that you should undergo a hysterectomy.
It is possible to hold the uterus up with a firm rubber or plastic device inserted into the vagina called a pessary.
This can be seen as a temporary solution or used in those who are not fit enough for surgery due to other health problems.
However, the pessary needs to be replaced every few months for reasons of hygiene, so is not an ideal long-term solution.
Doing nothing is probably not a good option as the condition will gradually worsen.
This can interfere with normal bladder function and may also make evacuation of the bowels difficult.
In terms of the operation itself, it is very often possible for the uterus to be removed vaginally, without the need for an incision in the abdomen.
A general anaesthetic is the usual routine for this, although it can also be done with epidural anaesthesia along with intravenous sedation so you are almost asleep and unaware throughout.
I hope the shock and upset caused by the way you were handled has now faded and you are in a position to move forwards.
By the way...Why this delay in testing doctors’ English? How often have I banged on in this column about the pivotal role of good communication in medical care?On finishing their training at medical school, all doctors must present their credentials to the General Medical Council (GMC), the registration body that exists to protect and maintain the health and safety of the public.
The upholding of standards is a difficult task because of the balance to be achieved between protecting the public and being fair to the doctors — and there has always been a feeling, possibly misplaced, that the Council has tended to take the side of the doctors.
Closing ranks, as the saying goes.
For most of my 40-year career the regulator seemed to be fairly sleepy, mainly obsessed about whether or not doctors were sleeping with their patients, but not really very interested in the maintenance of standards.
Until 2004 that is, when the critical focus of Dame Janet Smith was applied as part of her investigation into issues arising from the case of mass murderer Harold Shipman.
Dame Janet identified multiple deficiencies in the procedures of the Council, and much of this has now been remedied.
The GMC has woken up and is starting to perform — but part of the problem has been the general uselessness and slack performance of Parliament.
Never was this writ larger than with the issue of doctors’ ability to speak English.
The GMC is independent of both the Government and the profession, but is accountable to Parliament.
It’s complicated, but one consequence of this is that while for years the GMC has been able to check the language skills of doctors from outside Europe, it’s only just been given the authority — through a change in the legislation via Parliament — to check in on those who qualify within the European Union.
How often have I banged on in this column about the pivotal role of good communication in medical care?
How many patients have suffered directly as a result of the poor English skills of their EU doctor?
Oddly, one of my friends, a consultant dermatologist, is English yet he graduated in medicine from a university in Germany — and on completing his degree there he had to pass a test of competence in speaking German before he was allowed to see a single patient.
Why have our parliamentarians been dilatory on this issue?
Hopefully now there will be progress — and patient protection — at last.
