It makes me very tired and often breathless. Will I need to take this for the rest of my life or could my heartbeat go back to normal? 

A - I suspect your irregular heartbeat is due to atrial fibrillation (AF). In this, the heart muscle does not contract in a co-ordinated way, leading to a very irregular, often fast heartbeat and pulse. 

There is also turbulence of the flow of blood within the heart and this can increase the risk of clots forming in the chambers. 

If one of these travel and block one of the arteries in the brain, it can cause a stroke. 

This means people with AF are at five times increased risk of having a stroke. 

In order to try to prevent this, anticoagulant (blood thinning) medication is given, either with warfarin or one of the newer drugs such as rivaroxaban. 

Your breathlessness and tiredness are almost certainly caused by your abnormal heartbeat and treatment with drugs such as ACE inhibitors (ramipril, for example) and beta-blockers (such as bisoprolol) may improve it. 

The warfarin you have been given won’t help with your heart but it will significantly cut your chance of having a stroke and you may well need to continue with this for the rest of your life. 

Q - I need to get up several times in the night to go to the toilet. It’s not too bad if I don’t have a drink from 3.30pm onwards but feel this is probably too long to go without fluid. 

What is this level of sleep deprivation doing to me and is there anything I can do about it? 

A - Needing to go to the toilet several times in the night can be a sign of a urine infection or a problem with your bladder, where the muscle contracts when the bladder is holding only a small amount of urine. 

It may also be a sign of a medical condition such as diabetes. In men, it can also be a sign of an enlarged prostate. 

Going without fluids for more than 12 hours is not healthy and can lead to dehydration. 

You really should see your doctor and have tests to sort out the underlying reason. 

An infection can usually be easily treated with antibiotics and muscle relaxants can be helpful in allowing the bladder to hold more urine.

Please make an appointment at your surgery as soon as you can. 

Q - I developed phimosis earlier this year and my doctor prescribed clotrimazole and betamethasone which didn’t work. Is circumcision the only solution to this problem? 

A - Phimosis is the medical term for being unable to pull back the foreskin from the head of the penis. In most boys, the foreskin cannot be retracted until the age of five and in some it may not be possible to pull it back completely until aged 10. 

In children, a tight foreskin is usually a problem that occurs at birth but in your case it sounds as if you were able to retract your foreskin normally until earlier this year. 

This suggests that you may have developed a skin condition known as lichen sclerosus or balanitis xerotica obliterans. 

The skin of the foreskin becomes inflamed and thickened and it may become attached to the underlying glans penis. 

The inflamed skin does not stretch and to make matters worse it can become scarred, which can make it more difficult to pull it back. 

The cause is not known but it may be an autoimmune condition, where the body’s own immune system attacks the cells of the skin. 

In the early stages it may be possible to stop inflammation and scarring with strong steroid creams (only available on prescription). 

Trying to stretch it with mechanical devices can unfortunately make the inflammation worse and if it is really difficult to pull the foreskin back, the best option is usually circumcision. 

If you have a health question for Dr Rosemary please write to her in confidence at The Northern & Shell Building, 10 Lower Thames Street, London EC3R 6EN or email health@ express.co.uk. Dr Rosemary’s reply will appear in this column. She regrets that she cannot enter into personal correspondence and that, due to the volume of letters, she cannot reply to everyone. Find out more about Dr Rosemary at drrosemaryleonard.co.uk