My sister, who has dementia, has tinnitus in one ear – apparently it is called abnormal tympanic membrane tinnitus. Do you have any tips for managing it?
Tinnitus can be incredibly distressing. Patients describe it as a constant buzzing or ringing that comes from inside the head. It tends to be more common in people who have other ear problems, such as hearing impairments or recurrent infections.
In abnormal tympanic membrane tinnitus, it is the ear drum that is causing the problem. The ear drum is the flexible thin wall connecting the external and middle ear which helps transfer sounds through the canal, so we can hear it. If it is damaged or gets stiff, the sound transferred can become distorted. This is why patients hear sounds that aren’t actually there.
You can suffer a similar effect if the ears are full of fluid, either due to an infection or a wax blockage. Treatments to manage tinnitus, unfortunately, may not be as effective for someone with dementia. For example, relaxation techniques or tinnitus training, which involves wearing a noise-generating device which aims to reduce the contrast between the tinnitus and silence.
Tinnitus tends to be more common in people who have other ear problems, such as hearing impairments or recurrent infections (file photo)
But there are other ways you can do this, for instance by trying to drown out the tinnitus with background noises like the radio, natural world sounds or classical music.
Anxiety and depression also makes tinnitus much worse, and it’s common for people with dementia to suffer both. Using medication that keeps someone calm without being sedated may be worthwhile, and it may be worth discussing this with a GP. Patients also find their symptoms worsen with exhaustion, so good, deep sleep is essential.
If this is a problem, it’s worth exploring the option of sleeping tablets – at least temporarily – with your doctor.
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I am 85 and very active, but have suffered very stiff calves and aches in my lower legs for three years. I’ve been tested for arterial disease but told that, although my test was positive, because I can walk I don’t have it. Stretching exercises do not help. What do you suggest?
Arterial disease is essentially a problem with the arteries – the vessels that supply the body with oxygen-rich blood. When the legs are affected, doctors call it peripheral vascular disease.
Similarly to heart disease, it happens when the arteries are damaged and get narrower, reducing the blood supply. The most typical sign is a pain in the legs that stops when you walk – doctors call this claudication. Most patients would describe this as a pain, rather than stiffness or aches. The cramps usually kick in after walking a distance, usually in the calves.
To measure the function of the arteries, doctors check the pulses in the feet and legs and look for cold, pale skin. We also take a measure of blood pressure called ABPI. But there are many other causes of pain in the legs which are more common.
Stiff calves and aches could result from a problem with veins in the legs – which carry blood away from the feet and back to the heart – rather than arteries. This is called chronic venous insufficiency and it is more common in older age. It causes leg aches, ankle swelling, cramps and sometimes a brown tinge under the skin of the ankles.
Stiff calves and aches could result from a problem with veins in the legs – which carry blood away from the feet and back to the heart – rather than arteries (file photo)
If doctors suspect it, they will refer patients for an ultrasound called a duplex to examine the veins, performed in the vascular department of a hospital. The type of treatment offered depends on the severity of the symptoms. Patients could try compression stockings, which encourage blood flow in the veins. Exercise also helps, as every move of the leg muscle will help the flow of blood.
If the pain is worse when walking long distances, try doing ten-minute bursts of walking throughout the day. There are plenty of other leg exercises that help too, such as lunges and squats, as well as stretching routines like yoga.
I keep getting woken up during the night by a blocked nostril which makes it difficult to breathe. It stops during the day, but I get a runny nose after showering and hoovering. Do I have an allergy?
It’s very common to experience symptoms that only occur at night – especially a sore throat and runny nose. Lying down in bed increases pressure on the head and neck, making us even more uncomfortable.
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Those with a nasal blockage, a very runny nose and lots of sneezing around certain triggers could well have an allergy.
Pollen and dust can spark off the symptoms, as can more unusual triggers.
The easiest way to work out if you’re suffering an allergy is to take an antihistamine tablet for one to two weeks, and see if the symptoms subside.
Antihistamine tablets are well-tolerated for most people, so this is a safe and quick way of determining an allergy.
Testing is available privately and sometimes on the NHS, but this doesn’t always offer a conclusive answer.
Nasal polyps can also cause frequent symptoms affecting the nose. These are small, fleshy growths within the nostrils that are usually benign. They cause snoring and loss of sense of smell, as well as runny or blocked nose.
People with nasal polyps often say they feel as though they have a constant cold. GPs can usually diagnose them during an examination, and then treat then using a steroid nasal spray.
The back ache that could signal pancreatic cancer
Sex And The City actor Willie Garson, pictured above, who reportedly died from pancreatic cancer. About eight in ten patients with this disease are diagnosed late, says Dr Ellie
The death of Sex And The City actor Willie Garson, reportedly from pancreatic cancer, has made me think of a few people close to me who’ve also recently succumbed to the illness.
I think of a tell-tale sign they had, which most of us would dismiss as nothing: back pain.
In the majority of cases it isn’t serious, but it can be a warning of pancreatic cancer, especially when the pain is in the upper or middle back. I’ve warned about this for a few years as an ambassador for the charity Pancreatic Cancer Action. About eight in ten patients with this disease are diagnosed late, so can’t be cured, and just seven per cent live for more than five years. If you’ve got back pain, it’s probably because you spend too long sitting at a desk.
But don’t count on it – check with your GP, just in case.
Don’t forget those other jabs…
Recent Government figures show uptake of the MMR jab, which protects against deadly measles, mumps and rubella, has dropped by two per cent (file photo)
Another disturbing piece of Covid collateral damage is becoming clear: too few children are having the other, life-saving vaccines that ought to be routine.
Recent Government figures show uptake of the MMR jab, which protects against deadly measles, mumps and rubella, has dropped by two per cent, while the number of teenagers who have had jabs against cervical cancer and meningitis has fallen 20 per cent.
Research published last week showed that, internationally, the failure to have MMR jabs adds up to tens of millions of unprotected babies at risk of contracting potentially lethal infections. It is a direct effect of school closures and children being sent home to self-isolate.
It’s up to parents to make sure children aren’t missing out. If yours have, contact your local school immunisations team who will have information about catch-up programmes.
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