Dr Tom Smith 

Doctor, doctor

Dr Tom Smith answers your questions
  
  


Q: My father had a heart attack two years ago and although he changed his eating habits, he now has a significant paunch. I read that a certain measurement around the abdomen predicts a greater chance of heart attack - is this true?

A: There are two distinct types of obesity - you can be an 'apple' or a 'pear'. Apples put on weight round their middles, and pears round their hips. Apples are at higher risk than pears of heart attacks and strokes. The critical waistline measurements (above which your risk starts to rise steeply) are inches for men and 36 inches for women. Diet alone isn't enough - exercise is the key. Walking a bit more every day is a good start. Your father should have his blood pressure and his blood lipid profile (cholesterol levels) checked regularly and treated if they are abnormal. As he has already had a heart attack, he should surely be on a healthy living regimen devised for him by the practice team - you need to encourage him to follow it.

Q: My eyes water a lot. I'm told that my tear ducts are blocked, but my doctor doesn't suggest any treatment. What can be done?

A: It depends on how they are blocked. If it is due to catarrh from the nose, then that has to be treated, usually in the first instance with a decongestant spray. If the block is an actual narrowing of the ducts, then they can be opened by a surgical probe (though this is not always successful). If it's because your lower eyelids are lax (and are folding outwards), then they can be repaired, too. Talk more about it with your doctor.

 

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