THE DOC REPLIES

I’m going on a long drive to the south of England soon. What’s the best way to prevent car sickness?

This can be a problem on a long journey. Keeping well hydrated throughout the journey will help. Avoid large meals and alcohol before travelling. Sitting in the front seat should help. Often back seat passengers can suffer from symptoms more as they feel more enclosed. Make sure the car is well ventilated, and try to relax – music may help. There are over-thecounter medications available. Many people use acupressure bands usually around wrists. There is no scientific evidence to show they work, but they do seem to help some.

I’m a 56-year-old woman and recently I’ve developed bad acne on my face and neck. What could it be?

Acne can develop later in life and is not just the affliction of teenagers. It may be the result of hormone imbalance or sometimes be a reaction to cosmetics. Using hypoallergenic products may help. There are a variety of products available over the counter to treat acne and, failing that, your GP will be able to prescribe some topical cream or antibiotics which may be of use.

My three-year-old grandson sleeps with his head under the covers. Is there a chance he could suffocate?

It is very unlikely that your grandson would suffocate from sleeping with his head under the covers. The body is very good at regulating itself and if he is not getting adequate ventilation he will likely become more restless and move into a position where he is breathing more freely.

Are cod liver oil capsules worth taking?

Cod liver oil contains high levels of Vitamin E, Vitamin D and Omega 3 fatty acids. Many patients take it to help with joint problems and it is thought to have antiinflammatory properties. It can also be helpful for cardiovascular health. However, if you are eating a healthy, balanced diet which contains oily fish then you may well be obtaining enough of these vitamins and fatty acids. It is important to say that, if you are taking cod liver oil that you do not exceed the recommend doses, as Vitamin A can build up and reach harmful levels. Pregnant women especially should take care of this.

I enjoy eating pickled mussels but recently I ate a jar and my face swelled up like a balloon. What happened?

It sounds as if you have had an allergic reaction either to the mussels themselves or to some ingredient in the pickling fluid. If I were you I’d be cautious of eating them again.

What exactly is a perforated eardrum and how do I know if I have one?

The ear drum is a membrane which separates the external ear from the middle ear. A perforated drum can be the result of a middle ear infection, where pressure builds up, or as the result of blast injuries or sometimes due to pressure changes during air travel. It can also happen in some sports. Usually there is pain involved with perforation. Many people will experience short-lived hearing loss and some ringing. Most of these symptoms will pass and the ear drum will usually heal

spontaneously.

Is smoking a cigar and not inhaling better than smoking cigarettes?

Popular opinion is that smoking cigars is safer than cigarettes. This is probably because cigar smokers will say they don’t inhale. However, both cigars and cigarettes contain nicotine which can lead to tobacco dependence and, even if not intentionally inhaling, nicotine can be absorbed through the lining of the mouth. All tobacco smell contains chemicals which can cause cancer. If you are smoking cigars then this does increase the risk of several different types of cancer especially affecting the mouth, throat and lungs. If at all possible, give up smoking altogether.