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DR ELLIE CANNON: Why do I get the smell of bonfires in my nose?
SEVERAL times a year I get a strange bonfire smell in my nostrils. I’ve read this could be a sign of something really sinister. Is this true?
GETTING an altered sense of smell would usually imply some sort of problem within the nose or the sinuses.
Doctors call this phantosmia – where patients detect smells that aren’t there.
The smell of smoke is one of the most commonly reported, but some people experience the scent of rotting food and chemicals.
The smell of smoke is one of the most commonly reported symptoms of phantosmia
A more common cause of phantosmia is a sinus infection
However, it is not necessarily anything sinister.
A general rule that GPs follow is that any symptom which has been around for a long time but has not worsened, is unlikely to be dangerous.
A tumour in the sinuses could cause a change in smell, but this would get worse over time, and would likely be accompanied by other symptoms.
A more common cause of phantosmia is a sinus infection or a condition called sinusitis, where the sinuses become inflamed.
It is not unusual to suffer repeated sinus infections, which might explain why someone would experience a change in smell several times a year.
A change in smell could also be caused by a blockage in the nose.
Nasal polyps, fleshy growths of tissue inside the nose, often block the nasal passage and become more common in later life.
Allergies cause the nose and sinuses to be inflamed, so some people experience phantosmia if there is a lot of pollen in the air.
It would be worth trying a steroid nasal spray from the pharmacist when this arises.
A salt water spray may also be helpful to flush out anything blocking the nasal passages.
I HAVE ankylosing spondylitis and used to take steroid tablets which limited the pain. However, my doctor has said I have to stop taking these because apparently steroids can thin the bones. I’m now only able to get three steroid injections a year, and I’m in pain all the time. What should I do?
ANKYLOSING spondylitis is a long-term condition that occurs when the spine and other areas of the body become inflamed.
It typically causes significant pain and stiffness in the back and the neck but it can also cause stiffness elsewhere.
Some patients also experience uncomfortable bowel issues as well as swelling in the eyes.
While there are some treatments designed purely to control the pain, such as anti-inflammatory tablets, others tackle the inflammation and stop the condition from flaring up.
These include steroids, which can suppress the immune system and calm inflammation.
One risk of taking regular steroids is that, over time, they raise the risk of the bone-thinning condition osteoporosis.
Moreover, there is an even greater danger for those with ankylosing spondylitis, who already have an increased risk of osteoporosis.
For some elderly patients, this can put them at high risk of life-threatening falls.
Patients who do not have any signs of osteoporosis and have already benefited from a small daily dose usually should be considered for steroid treatment. When the patient is dealing with a lot of pain, the benefits clearly outweigh the theoretical risks.
Patients who find themselves in this position should consider going back to their specialist and explicitly stating that they understand the risks and want to go back on steroid tablets.
SINCE the death of my father last year I’ve struggled to sleep. I try to get to bed at the same time every night. I fall asleep straight away, but then at around 3.30am I wake up again and stay up for hours. What can I do?
IF you have difficulty sleeping, you are not alone – millions of people in the UK struggle with this issue.
Also known as insomnia, the condition can be brought on by stress, anxiety and bereavement. However, for some people, it can begin for no clear reason.
When it’s fairly clear what the underlying problem causing the insomnia is – such as a death in the family – it is important to directly tackle this issue. This might involve talking therapy to help manage the symptoms of grief.
Prescribing sleeping tablets is not a permanent solution and carries risks, including drowsiness throughout the day. Some patients also become reliant on them to sleep.
Doctors recommend improving your sleeping environment – or your sleep hygiene as it’s also called.
One of the most important aspects of sleep hygiene is having a comfortable, supportive mattress.
It might also include getting blackout blinds or ear plugs.
There are safe and non-addictive medicines to help improve your sleep.
GPs can prescribe melatonin – a sleep hormone that naturally occurs in the body – to patients over the age of 55. This is because it is thought that melatonin levels in the body drop as people age.
The NHS also recommends a sleep therapy app called Sleepio, which provides online cognitive behavioural therapy sessions – talking therapy that helps patients change they way they think – to manage insomnia.
Don’t lecture patients on climate
IT ALWAYS frustrates me when doctors think they have the right to speak out on complex issues that aren’t patient-centred.
And last week was no exception when the Royal College of Physicians – a professional membership group for doctors – issued guidance urging members to talk to their patients about climate change. The college said doctors should use their place as a ‘trusted member of the community’ to warn about the dangers of global warming and ‘repeat it often’.
It also recommended that doctors reduce their carbon footprint by working from home and cutting back on prescriptions and tests. I wonder if anyone from the college has been in a GP consultation recently. Yes, these are important issues, but they are not my patients’ priority and nor should they be.
When patients are sick or scared about their health, the last thing they need is a lecture about sustainability.
What’s behind the record viagra boom
LAST week, figures revealed that prescriptions for the erectile dysfunction drug Viagra are at an all-time high.
According to the NHS, more than 4.5 million prescriptions for the little blue pill were given out to men last year. And that doesn’t include those who buy it from their pharmacist or from an online medical firm.
It’s something I’ve seen in my surgery myself. Every week, I hear from men who are struggling to perform sexually. One reason for this is that the population is ageing – and erectile dysfunction becomes more common in later life.
Rising rates of obesity and diabetes are also probable causes, as both conditions are linked to the problem. However, I do worry that many men have an unrealistic expectation due to porn of how often – and how long – they should be able to get an erection, which could be partly to blame for this increase in demand.
Have you recently got a Viagra prescription? If so, I’d love to know why.
Please write to me using the email address at the bottom of the page and let me know your thoughts.
- Do you have a question for Dr Ellie Cannon? Email [email protected]. Dr Cannon cannot enter into personal correspondence and her replies should be taken in a general context.