How can I stop getting painful ear infections?
DR PIXIE ANSWERS YOUR QUESTIONS
ONLY €1 A BIG READ FOR A SMALL PRICE
ONLY IN Good Health
12-PAGE PULLOUT INSIDE
I KEEP getting ear infections. My ear becomes blocked and the doctor has to give me antibiotics and then syringe out the fluid a week later when the infection has calmed down. So I end up paying for two GP visits plus antibiotics every six weeks. Help!
JAMES, Dublin
OTITIS EXTERNA is the name we give to inflammation of the skin of the ear canal or outer ear. Meanwhile, middle-ear infections (otitis media) affect the eardrum — rare in adults but common in children.
Around one in 100 people go to the GP each year with the problem you describe. Pain, blockage and irritation are the most common symptoms of otitis externa. The ear may also be itchy and irritated or discharge fluid. If you have a narrow ear canal, you might get infections more frequently. (You may have this from birth or it can develop over time.)
Some patients suffer repeat infections because they don’t naturally clear wax from their ears efficiently and, as you age, you build up more wax. Overzealous cleaning causes infection too, so beware of cotton buds. If your ears often get wet, this doesn’t help either.
Hot, humid environments and skin conditions such as dermatitis or psoriasis will predispose you, as will underlying issues with the immune system such as diabetes. In rare cases, more significant problems like an undiagnosed ear perforation or even a tumour can also be the cause.
Eliminate any of the aforementioned precipitating factors for starters. Topical prescription treatments — taken religiously for five days — may help in the event of a flare-up. Ask your GP to swab inside your ear to see if there are resident germs or yeasts growing there, which can be treated with a combination of topical and oral medications.
Recurrent infections may ultimately require a deep clean of your ears. Your doctor is dutifully syringing your ears, but it’s not the ideal solution. Microsuction is carried out by ear, nose and throat surgeons to remove dead skin and debris. This gives the ear canal the equivalent of an enema, and enables the attending doctor to clearly see inside the ear and rule out anything sinister. I’M 36 YEARS OLD and I’ve been married for nine months. We have been trying for a baby — but nothing is happening. What type of tests could I do to get an idea of my fertility? I have a 36-day cycle and my periods are fine. We have been putting in an extra effort around day 14. I no longer drink or smoke. My husband says I’m too stressed.
Maria, Cork
YOUR husband is right, there’s no need to panic just yet. Eighty per cent of couples fall pregnant in the first year of trying and the figure is 90 per cent by the end of year two. These are the statistics for women under 40 having regular sex and not using contraception.
Optimal sexual activity to achieve pregnancy is every two or three days, irrespective of your ovulation calendar.
The rationale behind this is it makes sex less time-constrained and lowers stress levels, which can reduce your chances around the ‘most fertile time’.
While textbook ovulation is day 14 of your cycle, that’s only technically true if your cycle is 28 days. If you have a 36-day cycle then you need to be on a different time clock — you are likely to ovulate on average ten to 16 days before your next period starts. It can get complicated if your cycle doesn’t work l i ke clockwork, which highlights the preference for regular sex every 48-72 hours rather than ‘timed’ sex.
So how can your GP help? Bloods are worthwhile. We do them in several batches. On days two to four of your cycle, you need your FSH [follicle- stimulating hormone] and LH [luteinizing hormone] levels checked. Then, on day 21 of a regular 28-day menstrual cycle (so day 29 of yours) you need your progesterone levels checked to screen for ovulation. Blood tests for rubella, thyroid function and testosterone levels are also worthwhile. Most women of your age are rubella immune because you had an inoculation in secondary school.
If you are not immune, you need a vaccination and have to put off trying for a baby for three months, as rubella is a very serious infection in a pregnant woman.
Screening your thyroid gland is important.
We frequently see women with undiagnosed thyroid problems impacting upon their ability to become pregnant.
Testosterone analysis gives us an idea of your male hormone balance, so conditions such as polycystic ovary syndrome (acne, excess hair and irregular periods are some of the symptoms) can be ruled out, as this incredibly common condition can affect fertility. Prolactin levels are also occasionally tested — excessive levels can impact fertility.
Go back to your GP and review the test results together. He or she may refer you for an ultrasound scan to assess the health of your reproductive system and take a sperm count from your partner. All of these tests give an excellent idea of potential fertility.
There are other things you can do to maximise your chances. Yes, ditch the cigarettes and curtail the alcohol, but also watch your diet. Weight has a negative impact on fertility so if your BMI is over 30 or under 19, this needs addressing. Exercise is a great way to lose weight but overdoing it also affects fertility. Reduce stress and book a holiday, to give you time to relax and try again.