The Scottish Mail on Sunday

Earache on a plane? Here is how to put it to f light...

JACKIE LYNCH

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QWHEN I fly, my right ear always becomes painful and seems blocked. During take-off and landing, I get so dizzy and disorienta­ted. It is pure misery. After about ten minutes it starts to subside, and eventually clears with a little pop. I’ve tried cleaning my ears with cotton buds, but this hasn’t helped, nor has decongesta­nt medication. Can you help?

APAIN in the ears during flying usually stems from the inequaliti­es in pressure around the ear drum rather than any issue with the ear canal, even though it feels as if the ear is blocked within the canal.

The ear drum is a thin membrane like a window that separates the ear canal (which is the part open to the outside) and the middle ear.

In order to feel comfortabl­e, the air pressure on either side of the ear drum needs to be the same, so that the drum is not pulled too far inwards. It is this that causes pain.

Keeping the pressure equal is the job of the 3cm-long Eustachian tube, which starts behind the ear drum in the middle ear and ends at the back of the nose. It allows air into the middle ear to keep the pressure equal, and allows mucus to drain out.

As the air pressure rises during a flight, it puts pressure on the ear drum from the outside, causing pain. When you yawn or swallow, the Eustachian tube opens and air can go into the middle ear, rebalancin­g the pressure and giving you an un-popping relief sensation.

If the un-popping sensation does not happen, it implies there is some dysfunctio­n in the Eustachian tube.

This happens temporaril­y if you have a cold and mucus lodges where the tube is narrowed and cannot allow air in so easily. It will also happen in someone who has allergies, or those who have a physical blockage, for example children with large adenoids.

Using decongesta­nts, antihistam­ines or nasal steroid sprays may help to allow the Eustachian tube to open more easily and quickly. Cotton buds will not help at all as they only clean out the ear canal and cannot affect the They may be similar in calories and sugar, but fresh fruit juice is preferable to Red Bull for energy. The sugars in orange juice are naturally occurring, and it’s rich in Vitamin C.

Qpressure. These should be avoided by everyone for ear ‘cleaning’, as they serve only to jam in the ear wax and can cause blockages. FOR the past 17 years (I’m now 62) I have been under the impression that I had prostatiti­s, but after recently having a bladder biopsy I have been told I have interstiti­al cystitis, and I need something called a bladder instillati­on. It’s making me miserable. Also, I thought only women got this illness?

AWHEN people talk about cystitis they are usually referring to the very common condition which is an infection of the bladder – and it is indeed far more common in women.

Interstiti­al cystitis is a far less common condition that is not caused by any infection. It causes significan­t pain in the bladder, with urgency and increased frequency of urination.

The problems treating this condition arise from the fact that we don’t actually know what causes it.

It is possibly caused by damage to the bladder lining causing irritation to the bladder muscles and nerves, and hence pain. This may be due to an auto-immune reaction, where the immune system attacks its own body.

Treatments do not offer cures but rather management aimed at reducing the number of episodes and the intensity of the pain. Medication used includes painkiller­s and antihistam­ines as well as tablets to relax the bladder muscles, such as solifenaci­n. Other medicines reduce the effect of histamine in the bladder or can repair the lining of the bladder.

Bladder instillati­ons are a way to get the medicine directly into the bladder via a urinary catheter.

Certain medicines such as hyaluronic acid can help to restore the bladder lining and reduce the pain. Local anaestheti­c can also be used in this way.

This condition is terribly distressin­g and, like other pain conditions, it is associated with a significan­t toll on mental health. It is crucial to seek specific help for this, either through a doctor or with the peer support of a patient group. Visit ichelp.org.

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