My hearing goes on flights then returns on landing. But it hasn’t after my most recent trip – I’ve been home for two weeks and I still can’t hear properly. Do I need an ENT appointment?
Ken Hartfield, Wellington, Somerset.
This is very common – known medically as eustachian tube dysfunction. The eustachian tube connects the middle-ear cavity, which lies behind the eardrum, to the nasopharynx, the space at the back of the roof of your mouth.
Each time you swallow, a valve at the inner end of the tube opens and closes, equalising the air pressure in the middle ear with that outside.
When the aircraft ascends, the pressure within the cabin is lower than at ground level. The result is that the pressure in the middle ear is higher than in the cabin, causing that sense of deafness or partial blockage that many of us get when flying.
Usually swallowing during the flight equalises the pressure and hearing returns to normal – or it does so on landing, or shortly after. However, it seems your eustachian tube has been blocked – I suspect by some mucus from your nasopharynx.
It should clear by itself, but if it doesn’t, there’s a handy device you can buy relatively cheaply from your local chemist or online.
Known as Otovent, it consists of a small balloon attached to a plastic nozzle. You simply place the nozzle in one nostril, then press the other nostril shut with your finger. Then, keeping your mouth shut, you blow hard to inflate the balloon to the size of a grapefruit. I’d suggest trying this at least three times a day.
When an aeroplane ascends, the pressure within its cabin is lower than at ground level – which can cause a sense of deafness or partial blockage while in the air
This puts pressure into the eustachian tube, helping to open up the passages and let air in and out of the middle ear. It’s also worth using a nasal decongestant spray such as Otrivine (or any other with 0.1 per cent xylometazoline) to clear your nostrils first.
This is generally effective but, if it doesn’t help, your GP can refer you to an ear, nose and throat (ENT) specialist, if necessary.
I’ve been taking aspirin since having a stent put in for angina seven years ago. In my most recent medication review, I was told that prolonged use of blood thinners can cause stomach ulcers and to take omeprazole to prevent this. Is this true?
Jennifer Lynch, Colchester, Essex.
Angina is chest pain – and often breathlessness – caused by narrowing of the arteries that supply the heart. In your case a stent (essentially a tiny tube) was inserted to widen one of these arteries and improve blood flow to the heart.
You would have been prescribed aspirin to reduce the chance of blood clots forming in the arteries and in the stent itself – either of which could lead to a heart attack.
Aspirin does this by blocking cyclooxygenase, an enzyme involved in the production of prostaglandins, which are compounds involved in clotting.
But prostaglandins also protect the stomach’s delicate lining against stomach acid.
Taken long-term, aspirin reduces this protection, which can result in irritation – and stomach ulcers and bleeding, which can in some cases be fatal.
The risk of such bleeds increases with age. Omeprazole protects against this by reducing the amount of acid in the stomach and its prescription is, in my view, a reasonable precaution.
Of course, a balance must be struck between the risk of bleeds and taking an extra drug. In reducing stomach acid, omeprazole can reduce absorption of vitamin B12, calcium and magnesium: the main risk being osteoporosis. There’s also an increased risk of infections as stomach acid kills off bugs.
All of these factors must be considered – so make sure your GP offers you a regular medication review every six or 12 months.
IN MY VIEW: Green mucus doesn’t mean what you think
It’s that time of year when lots of patients come to see me about how to best take care of the respiratory infection that’s troubled them for some days.
Usually they ask for antibiotics or, at the very least, if antibiotics might help – the thinking is that their mucus is now green and this means that what might have started as a viral infection is now bacterial.
If your mucus is green, it can be a sign it’s been colonised by harmless bacteria that are always around us
This is untrue and there are many reasons for mucus to become discoloured. For instance, green can be a sign it’s been colonised by bacteria that are always around us, but are harmless and not part of the infection.
However, an infection that seems to go into a second phase with the return of fever, feeling more ill and possibly having sweats and headaches probably does mean it’s become a bacterial infection.
That’s a reason to prescribe an antibiotic and, if it’s possible, send a sample to a lab (though not usually done on the NHS these days). Then speak to the patient three or four days later, when the results become available, to confirm the correct antibiotic has been given for the bacteria involved.
[Notigroup Newsroom in collaboration with other media outlets, with information from the following sources]
