I was recently weighed and measured at a hospital appointment – and was shocked to find that, at 82, I’ve shrunk from being 5ft 6in at school to 5ft 3in now. I have arthritis all over. Is this to blame?
Sally Launchbury, Oxon.
This phenomenon puzzles many people but there is a simple explanation, which comes down to how the anatomy of your spine changes as you age.
There are two things going on here: first, the fibrous discs that act as shock absorbers between the vertebrae in the spine dry out and become thinner, a natural deterioration that, cumulatively, leads to a loss of inches over time.
A similar degenerative process affects the bone of the vertebrae. Here, microscopic changes in bone structure – accelerated in people who have osteoporosis – result in shrinkage of each of the vertebrae, also contributing to the loss of overall height.
One study, published in the American Journal of Epidemiology, suggested women lose more height than men (Stock Image)
It happens to all of us.
One study, published in the American Journal of Epidemiology, suggested women lose more height than men (possibly due to bone loss related to menopause).
For both sexes, the loss begins from around the age of 30, accelerating with age, with men losing on average 3cm (just over an inch) between the ages of 30 and 70, and women, 5cm (nearly 2in). This increases to 5cm for men and 8cm (over 3in) for women by the age of 80.
You may also notice, along with loss of height, that your abdomen appears to protrude more.
This is not necessarily because you are fatter, but because the contents of your abdomen are now squashed down, as the distance between the end of your ribcage and your pelvis has been reduced.
You don’t mention which type of arthritis you have, but it seems to me unlikely that this has played a major role in your loss of height – because although it can affect the facet joints in the spine, it will have little or no bearing on the vertebrae and the discs between them.
It’s the age-related changes in these that are the key to your loss of height.
A tiny nodule was discovered in my right lung during a CT scan for an unrelated issue last June. I’ve had it monitored, with more scans planned in December. Having had many CT scans and X-rays over the years, I’d prefer to have future monitoring done by MRI. But would this be as effective as CT scans?
Malcolm Buchan, Peterhead, Scotland.
What you describe is known as an incidentaloma – essentially a lesion discovered while undergoing investigation for something else: in your case, a CT scan highlighted a small nodule (which could be a growth) in your lung.
While this had not caused symptoms, it’s merited a follow-up to be on the safe side.
Usually, incidentalomas involve monitoring scans, perhaps every year or so. The thinking is that because imaging is non-invasive and is justified on the grounds of being cautious, any risks from scanning are outweighed by the benefits of early detection of a change. Clearly you are concerned about ongoing CT scans, which do involve exposure to radiation and the effect is cumulative.
However, the amount of exposure from each scan is small, the equivalent of between a few months and a few years of exposure to natural radiation from the environment, according to the NHS.
The difference with MRI is that it does not involve radiation, so you avoid that potential hazard.
Although I am not a radiologist, I have no doubt that most experts would agree that future monitoring by MRI is suitable and will prove no less effective in detecting any changes in the lesion.
In my view… We must plan for these part-time GPs
Increasing numbers of GPs are opting to work part-time – a three-day week is common. This reflects an understandable emphasis on the importance of work-life balance, a phrase unheard of in 1973 when I became a junior hospital doctor.
In those days, we lived in the hospital, on a ‘one in two’ rota – working every day and alternate nights and weekends, which amounted to 102 hours a week.
Increasing numbers of GPs are opting to work part-time – a three-day week is common (Stock Image)
A year or two later, the 88-hour week was brought in. This presented an opportunity because these new rotas meant there were more hours than people to fill them and almost every colleague worked as a locum on ‘spare’ nights and weekends. The drive and energy to do so was partly to increase our income (two years after starting work I was able to buy a flat). But our extra work also reflected the commitment to our vocation and desire to gain experience.
True, those early days often did seem to be a relentless grind with only a modest income; but we accepted this as the price to pay for what would come later – a better income, job security and a secure future.
I am not sure that young GPs feel the same way. Nor do some of them, at least, have the same sense of vocation as we did.
The genie is out of the bottle, however, and we can’t go back to how things were.
But this is ever more reason for the powers that be to plan better for a future workforce who will work only part-time.
Write to Dr Scurr
Write to Dr Scurr at Good Health, Daily Mail, 9 Derry Street, London, W8 5HY or email: email@example.com. Dr Scurr cannot enter into personal correspondence. Replies should be taken in a general context. Consult your own GP with any health worries.