Several times a year I get a strange campfire smell in my nostrils. I’ve read that this could be a sign of something really sinister. Is this true?
Having an altered sense of smell usually implies some type of problem in the nose or sinuses.
Doctors call it phantosmia: patients detect odors that are not there.
The smell of smoke is one of the most common, but some people smell rotten 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’s not necessarily anything sinister.
A general rule that GPs follow is that any symptoms that have been present for a long time but have not worsened are unlikely to be dangerous.
A tumor in the sinuses could cause a change in smell, but this would get worse over time and would probably be accompanied by other symptoms.
A more common cause of phantosmia is a sinus infection or a condition called sinusitis, in which the sinuses become inflamed.
It is not unusual to suffer from repeated sinus infections, which could explain why someone experiences 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 inflammation of the nose and sinuses, which is why some people experience phantosmia if there is a lot of pollen in the air.
It might be a good idea to try a steroid nasal spray that you can buy at the pharmacy when this occurs.
A salt water spray may also be helpful in removing anything blocking your nasal passages.
I HAVE ankylosing spondylitis and I used to take steroid pills which limited the pain. However, my doctor has told me that I have to stop taking them because steroids can apparently weaken the bones. Now I can only take three steroid injections a year and I am 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 usually causes significant pain and stiffness in the back and neck, but can also cause stiffness in other parts.
Some patients also experience uncomfortable bowel problems, as well as eye swelling.
While there are some treatments designed solely to control pain, such as anti-inflammatory tablets, others address the inflammation and prevent the condition from getting worse.
These include steroids, which can suppress the immune system and calm inflammation.
One of the risks of taking steroids regularly is that over time they increase the risk of osteoporosis, a disease that weakens the bones.
In addition, there is an even greater danger for people with ankylosing spondylitis, who are already at increased risk for osteoporosis.
For some older patients, this can put them at high risk for life-threatening falls.
Patients who do not show any signs of osteoporosis and who have already benefited from a small daily dose should generally be considered for steroid treatment. When the patient is in severe pain, the benefits clearly outweigh the theoretical risks.
Patients who find themselves in this situation should consider going back to their doctor and explicitly stating that they understand the risks and wish to resume taking steroid pills.
Since my father died last year, I have had trouble sleeping. I try to go to bed at the same time every night. I fall asleep immediately, but then around 3:30 a.m. I wake up. again and stay awake for hours. What can I do?
If you’re struggling to sleep, you’re not alone – millions of people in the UK struggle with this problem.
Also known as insomnia, this disorder can be triggered by stress, anxiety and grief. However, in some people it can start without a clear reason.
When it is fairly clear what the underlying problem is causing the insomnia (for example, a death in the family), it is important to directly address the problem. This may involve talk therapy to help manage the symptoms of grief.
Prescription sleeping pills are not a permanent solution and carry risks, such as daytime drowsiness. Some patients also become dependent on them for sleep.
Doctors recommend improving your sleep environment, or sleep hygiene, as it is also called.
One of the most important aspects of sleep hygiene is having a comfortable and supportive mattress.
It could also include purchasing blackout blinds or earplugs.
There are safe, non-addictive medications that can help improve sleep.
GPs may prescribe melatonin (a sleep hormone produced naturally in the body) to patients over the age of 55. This is because melatonin levels in the body are thought to decline as people age.
The NHS also recommends a sleep therapy app called Sleepio, which offers online cognitive behavioural therapy sessions (talking therapy that helps patients change the way they think) to manage insomnia.
Don’t lecture patients about the weather
I ALWAYS get frustrated when doctors feel they have the right to talk about complex issues that are not patient-centered.
And last week was no exception, with the Royal College of Physicians (a group of medical professionals) publishing guidance urging its members to talk to their patients about climate change. The college said doctors should use their status as “trusted members of the community” to warn about the dangers of global warming and “repeat it often”.
She 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 to a GP surgery recently. Yes, these are important issues, but they are not my patients’ priority and nor should they be.
When patients are sick or afraid for their health, the last thing they need is a lecture about sustainability.
What’s behind Viagra’s record-breaking boom?
Last week, figures revealed that prescriptions for Viagra, an erectile dysfunction drug, are at an all-time high.
According to the National Health Service, more than 4.5 million prescriptions for the little blue pill were issued to men last year, and that doesn’t include those who buy it from a pharmacy or online medical company.
It’s something I’ve seen in my own practice. Every week, I hear from men who are having trouble performing sexually. One reason is that the population is aging and erectile dysfunction becomes more common in older age.
Rising rates of obesity and diabetes are also likely causes, as both conditions are linked to the problem. However, I am concerned that many men have unrealistic expectations due to pornography about the frequency and duration of erections, which could be partly responsible for this increased demand.
Have you been prescribed Viagra recently? If so, I’d like to know why.
Please write to me using the email address at the bottom of the page and let me know what you think.
- Do you have a question for Dr Ellie Cannon? Please email DrEllie@mailonsunday.co.uk. Dr Cannon is unable to enter into personal correspondence and her responses should be interpreted in a general context.
