I was diagnosed with neck cancer 20 years ago and had an operation to remove the tumour and lymph nodes and a course of radiotherapy. Ever since, I’ve had a problem with ear wax, especially on the side where my tumour was. What can I do?
Radiotherapy is very effective at obliterating cancers but it can come with long-term side effects.
Most commonly it can lead to skin problems in the area targeted and where moisture is produced, which is why it often leaves patients with an extremely dry mouth.
Ear wax is a mixture of dead skin cells, oils and dirt that normally shifts out of the ear when we move the jaw. A build-up of this in the ear canal is a well recognised complication of radiotherapy to the head and neck.
To remove excess wax, first use softening drops made from sodium bicarbonate or olive oil. For some, the drops alone – available at most chemists – are enough to allow the wax to pass out.
Ear wax is a mixture of dead skin cells, oils and dirt that normally shifts out of the ear when we move the jaw. A build-up of this in the ear canal is a well recognised complication of radiotherapy to the head and neck. (File image)
The second stage involves a healthcare professional clearing out any remaining wax using water irrigation or microsuction, which is like a tiny vacuum cleaner with a microscope.
You might have heard of ear syringing, but doctors don’t use this technique because it risks damaging the ear drum.
We also don’t tend to remove ear wax in GP surgeries any longer. Instead, many patients will be referred to a specialist ear, nose and throat clinic, or they can opt for services provided by high street opticians and pharmacists.
You can’t stop ear wax from building up, but you can avoid making things worse by not using cotton buds and ear plugs, which just jam the wax in further.
Last month I took antibiotics to clear up a urine infection, but now I constantly feel the need to go to the toilet, even when my bladder has just been emptied. Could there be a problem with the nerves in that area?
Most women suffer one urinary tract infection, or UTI, every year. The symptoms are usually easily and quickly treated, but if they aren’t there is likely to be something else going on.
Typical signs of a UTI would be passing a small amount of water frequently and/or having the urge to go to the toilet all the time. Many say they get a burning feeling when they go, while for others it’s just uncomfortable.
Doctors can look for a UTI using two methods.
The first is what’s known as a dipstick test, performed in the GP surgery. This tells us if an infection is likely but doesn’t allow us to see the bacteria within the urine. The second is a laboratory test where the bacteria and infected blood cells are examined under a microscope.
If a UTI has not cleared up, the dipstick test would not be enough and a laboratory test is needed to check if bacteria is still present. A UTI may need to be tackled with more than one course of antibiotics, or a different type.
If the laboratory test comes back negative, it could be a sign of something else.
Menopausal changes in the bladder and urethra can cause symptoms similar to signs of a UTI. The same is true of thrush and even constipation – a full bowel pressing on the bladder can affect the flow of urine.
Bladder and ovarian cancers are known to cause symptoms that may also mimic a UTI, hence it’s always worth pursuing more tests – just in case.
Since I started going through the menopause, my hair keeps breaking and shedding. A friend suggested I try taking a Biotin supplement. Will this help?
Concerns about hair loss and other changes in the way it looks and feels are among those I hear most frequently in practice.
And they are not dismissed as something purely cosmetic – hair changes can be a telling sign of health problems and deficiencies.
The quality and thickness of hair is often related to the amount of iron in the body. Doctors measure this by assessing long-term iron stores, called ferritin.
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Ferritin levels must be high enough for someone to have good quality, thick hair. This is why hair supplements will usually contain iron, to boost the body’s stores.
I recommend a patient takes iron if they are concerned about their hair, unless they find the side effects – stomach upsets and constipation – difficult.
Menopausal changes affect hair because of the drop in the female hormone oestrogen, which is important for hair growth.
For this reason, breastfeeding women also find their hair gets thinner.
If the hair change is hormone-related, it will most likely improve with a course of hormone replacement therapy.
Thyroid disease is another common cause of hair thinning and hair loss. If there’s been a very significant change in the loss of hair, it’s worth asking your GP for a blood test to check for thyroid problems. Once you have a diagnosis, it is easy to treat.
Don’t fall for the bold claims made on the labels on vitamins and supplements. While these are unlikely to cause any harm, they won’t do much for your hair.
Biotin is a B vitamin, found in eggs and meat, and known to be important for healthy cells and growth of hair skin and nails, but most people will get enough from their diet. Some patients find zinc and Vitamin D helpful.
With something like this, I encourage my patients to try different things and keep a note of what works and what doesn’t.
Beware a false negative on your DIY Covid test 
If you are suffering Covid symptoms and get a negative result from a DIY test, I’d recommend you get another one done at a walk-in centre. (File image)
A reader wrote to tell me they’d suffered a cold and lost their sense of taste and smell. Recognising this as a classic Covid symptom, they took a test but it came back negative.
Firstly, it’s important not to rule out Covid. Even the most accurate test, a PCR, sometimes gives a false negative result.
This can particularly be the case when you have to take a swab yourself at home, as it can be tricky to do correctly.
If you are suffering Covid symptoms and get a negative result from a DIY test, I’d recommend you get another one done at a walk-in centre.
Of course it might not be Covid – changes to your senses of smell and taste are not uncommon after a regular cold.
However, if things don’t return to normal after a few weeks, make an appointment to see your GP as it could be a sign of something more serious.
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Your tips to get through an MRI
Last week I answered a reader’s question about how to face up to an MRI scan when suffering with claustrophobia and a fear of loud noises.
Many of you who have similar anxieties wrote in to share your tips for coping.
Staff in MRI units often offer headphones so patients can listen to music, but readers recommended also wearing an eye mask as this helped to block out what was going on even further.
There are also upright MRI machines, which are less enclosed. The patient walks in and stands still while being scanned. I’d always thought this was a private-only service, but a number of readers said they’d had success in getting an NHS referral for one.
So if you really do need a scan, and genuinely can’t cope with a traditional MRI, speak to your GP or specialist about whether you might be able to apply to be analysed by one of these machines instead.
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