I recently went to A&E with a very high temperature. I had my blood taken and was told that my troponin levels are 4,000. I’ve since read that this could be the sign of a heart attack, but the doctors didn’t say anything at the time. Should I be worried?

Dr Ellie Cannon replies: A troponin test is a blood test carried out if doctors suspect that someone has had a heart attack.

Troponin is a protein found in the heart muscle. Healthy people usually have very little of it in their blood, but if the heart is damaged the proteins are then released into the bloodstream.

Usually a troponin test is taken immediately on arrival in A&E and then repeated a few hours later. It’s measured either in nanograms per millilitre of blood or nanograms per litre. A score of 4,000 (a figure this high would likely be the amount of troponin in a litre of blood) is a very serious sign of a heart attack.

It is likely that anyone who presented with these levels would be kept in hospital for further tests. This might include an electrocardiogram (ECG), which involves sticking metal discs to the skin to measure the electrical activity of the heart.

An electrocardiogram (ECG) involves sticking metal discs to the skin to measure the electrical activity of the heart

However, high troponin levels are not always because of a heart attack. This effect can also be triggered by strenuous exercise or kidney disease – where the organ no longer functions properly. This is why other heart tests are always crucial.

One side of my nose fills up with fluid after eating or drinking. This has been going on for months now. What can I do?

Dr Ellie replies: Problems that occur on only one side of the nose might suggest a blockage.

Normally, symptoms triggered after eating are thought to be allergy related, and many people get congestion, a runny nose and sneezing as a result of eating certain food. However, that would not explain why symptoms occur only on one side.

Nasal polyps can be the cause of one-sided nose symptoms. These are non-cancerous fleshy lumps that grow inside the nose.

A possible cause of fluid in the nose is acid reflux – also known as heartburn

One of the most common symptoms is an overproduction in mucus, which can fill the nose. This may get worse after eating as the movement of the jaw might dislodge the mucus and cause it to flow into the nose.

Another possible cause of fluid in the nose is acid reflux – also known as heartburn.

This is caused by acid rising from the stomach into the throat and back of the nose. It typically occurs after eating and can also trigger excess mucus production.

The only way to get an answer to significant one-sided nasal symptoms would be to have an assessment with an ear, nose and throat specialist. This might involve an investigation called a nasoendoscopy, where a fine tube camera is inserted into the nostrils to see if there are any blockages or physical abnormalities, such as a polyp.

I’m 78 and last year underwent wrist fusion surgery for my arthritis. The recovery was painful, but it no longer gives me any trouble. I saw my surgeon recently and he said the wrist hasn’t fused correctly, so another operation is needed. Can I get a second opinion?

Dr Ellie replies: Nobody should ever have an operation that they don’t feel they need.

All operations carry serious risks, including infections and complications related to anaesthetics. And, in most cases, the recovery can be a long and arduous experience.

For these reasons, surgery should be carried out only if there is a medical problem which needs urgent attention.

Usually bone fusion surgery is carried out to hold joints in place. It’s a procedure offered only to those with the most severe form of arthritis – joint inflammation – that has failed to respond to other treatments. The aim is to stop the joints from moving or rubbing against each other, as this is often what causes pain flare-ups. The surgery will lead to a loss of mobility, but for many it can greatly reduce pain levels.

Since a reduction in pain is the intention of this procedure, it’s hard to understand why someone who is pain-free would require a second one.

All NHS patients are entitled to a second opinion. This is particularly important for patients undergoing invasive procedures such as surgery.

In the case of a wrist fusion, patients should ask their GP to refer them to a new orthopaedic surgeon for their opinion.

Is eczema causing you endless misery?

Treating eczema is hard work, and many patients fail to take the proper steps

I am concerned that so many eczema sufferers do not seem to know how to properly treat the itchy skin condition.

Every week I see patients of all ages with the tell-tale red rash, which can be caused by irritants in the environment but, for many, is a genetic condition. They always tell me they have tried the creams but that nothing has worked.

The truth is that treating eczema is hard work, and many patients fail to take the proper steps.

Most cases of this skin condition cannot be cured, only managed. This means that patients will need to continue putting on moisturisers every day – sometimes several times a day. Many will also need to use steroid creams too.

Some eventually give up, which, unsurprisingly, allows the rash to surge back.

How have you managed your eczema? Have you found a treatment that works for you?

Please write to me on the email address below and let me know.

Antidepressants aren’t for life   

Official guidance states most should be on antidepressent tablets for six months, but in reality many stay on them for years

I was worried when I read a report last week that linked antidepressant tablets to rare but serious heart problems in young people.

The Danish study found that patients under the age of 39 on the pills were markedly more likely to suffer life-threatening heart issues than those not taking them.

Perhaps most concerning, researchers also found that these cardiac events became more likely the longer patients were on the drugs.

It is important to emphasise these cases are vanishingly rare – the vast majority of antidepressant users will not suffer serious side effects.

But it does make me think we need to consider just how long we keep people on these pills. Official guidance states most should be on them for six months, but in reality many stay on them for years.

Have you been prescribed antidepressants for several years or more? If so, were you eventually able to come off them, or are you still on them?

I would love to hear your experiences – please use the email address on the right.