Q: I have recently noticed a terrible musty smell and taste in the back of my nose and mouth when I inhale. Also, my left nostril feels swollen and breathing through it is harder than before. However, my doctor doesn’t see anything wrong. I don’t have any dental problems and my oral hygiene is very good. What do you think?
Dr. Ellie answers: The nose, mouth, and sinuses are very common places to get an infection. Due to the presence of bacteria or other microbes in these areas, this can cause an unpleasant odor.
There may be an infection in the nose, throat, tonsils, or even the sinuses. This can be treated with salt water rinses or you may need antibiotics. There are also nasal washes such as Sterimar or NeilMed, which are available at most large pharmacies.
Tonsil stones can be the cause of an odor in the back of your mouth. Mucus, debris, and food can get trapped in the crevices of your tonsils, causing small, hardened lumps, called stones, that can smell.
Nasal polyps, which are very common small growths, can be removed with steroid sprays.
Gargling with salt water can help eliminate them.
Having one nostril more blocked than the other could indicate that there is a nasal polyp there. These are very common small growths.
They do not usually generate a bad odor, but they can alter the sense of smell. Nasal polyps can be cured with steroid sprays.
If this feeling does not go away, then it is important to have a more detailed examination.
There is a particularly rare type of cancer called nasopharyngeal cancer that grows in the back of the nose and mouth and can cause unilateral nasal blockages and changes in smell.
Q: For the past five years I have had constant breast pain. When it started, the chest developed blisters, which disappeared after a week. But since then the pain has been endless. They did ultrasounds on me but they didn’t find anything abnormal. The pain radiates to the shoulder and down the entire arm. What is your advice?
Dr. Ellie answers: If the pain started after a week of blistering, it is most likely a problem related to shingles. Shingles causes a rash that usually lasts about a week and then forms blisters.
It is often associated with a unique electric shock or cigarette burn type of pain.
Unfortunately, for some people, this pain will continue once the rash has gone and this is called postherpetic neuralgia.
This diagnosis would not be seen on an ultrasound or any investigation, but would be confirmed if a doctor had seen the blisters in the first instance and the pain sounded like postherpetic neuralgia.
This pain often worsens when the skin is touched or pressed, so wearing a bra every day could aggravate the problem.
Any breast symptoms that persist should be investigated, but after five years of symptoms and investigations it is imperative to seek symptom relief even if there is no clear answer.
As neuralgia is a very specific type of pain, it usually requires different treatment than normal pain. Since the area will be very sensitive to touch, it may be helpful to place a protective layer over the breast.
I would recommend trying adhesive wound dressings, which are purchased at most pharmacies.
You can also get local anesthetic dressings, which will need to be prescribed. These relieve pain only in the specific area and are recommended for neuralgia.
Doctors also offer specialist medications for this nerve pain and you can ask your GP or pharmacist about trying one.
Not only could this offer a solution, but it would also point to a clear diagnosis if it works.
Q: I recently had a blood test and was surprised when they told me I had an underactive thyroid. I am 76 years old, I have always been healthy and lead a very active life. I was prescribed a medication called levothyroxine, but I hesitate to take it because I don’t feel like I need it. That I have to do?
Dr. Ellie answers: The thyroid gland produces a hormone called thyroxine, which can be supplemented with levothyroxine tablets.
Thyroxine controls and influences many processes in the body, from hair growth to heart rate. As a result, an underactive thyroid can cause a number of different symptoms ranging from weight gain and tiredness to memory problems and depression. It is often caused by an autoimmune disease, in which the immune system attacks its own body.
An underactive thyroid can lead to high cholesterol levels, heart disease, and even heart failure. These complications can occur in patients who have never experienced symptoms, so it is important to take levothyroxine regardless of how you feel at the moment.
The good news is that the medication also has very few side effects, although some patients may experience sweating, chest pain, and headaches if the dose is too high. I would advise you to tell your GP that you have concerns about taking the tablet, so that they can give you all the information you need to feel comfortable starting treatment.
Now even teenagers feel pressured by porn
It’s an uncomfortable truth we can no longer ignore: online pornography is warping teen brains.
Last week, a report by Parliament’s Women and Equalities Committee concluded that the first time many young people learned about sex was through pornography. MPs added that the content teenagers viewed online exposed them to an “unacceptable risk of harm”. I could not agree more.
Online porn is warping teenagers’ brains, writes Dr Ellie Cannon
I have seen this damage in my own office.
I’ve met teens so anxious that their sex lives won’t live up to what they see in online videos that they’ve needed therapy as a result.
Schools need to address this by teaching kids to distinguish between normal, healthy sex and the harmful, unrealistic stuff in porn.
Sugared Easter eggs? Who knows!
Did we learn anything during the pandemic about public health messages?
It appears not, after an NHS trust last week advised its patients not to “eat an Easter egg in one sitting”.
The statement, which was posted on social media, stated that this seasonal sweet should be enjoyed “in moderation” to protect against the risk of obesity and type 2 diabetes.
I don’t see the value in this at all: a holiday gift won’t make anyone overweight or trigger diabetes.
These NHS edicts seem condescending and are unlikely to make much difference to people’s habits. Additionally, if we constantly tell patients how to live their lives, they are less likely to listen when the message is important (for example, how to protect yourself against a deadly new virus).
It is no surprise that the NHS Trust has since removed the message.