For months I’ve had ear ache and once I transfer my head, I hear crunching sounds. I take painkillers 4 instances a day for arthritis (I’m 73) however I can’t go on like this. Are you able to assist?
Marie France, Liverpool.
Ache affecting the face and head is notoriously tough to diagnose, however the truth that you additionally expertise arthritic ache in your neck and backbone leads me to consider that your cervical backbone — the vertebrae within the neck — is essential to your troubling signs.
The crunching sounds you describe if you transfer your head are often known as crepitus.
Joint sounds and bone cracking could be a regular a part of motion, particularly as we become older, probably as a consequence of put on and tear within the joints.
In your case, these noises could also be as a consequence of osteoarthritis affecting the seven vertebrae within the neck — that are numbered C1 to C7 (the ‘C’ standing for cervical).
The vertebrae prone to be inflicting your issues are C1 and C2, on the high of your backbone. C1 is positioned on the base of the cranium — its position is to bear the burden of the cranium. C2 ‘interlocks’ with it and permits for rotational motion, so we will flip our heads.
The crunching sounds you describe if you transfer your head are often known as crepitus. Joint sounds and bone cracking could be a regular a part of motion, particularly as we become older, probably as a consequence of put on and tear within the joints
Whereas there are shock-absorbing discs between all different vertebrae of the backbone, there isn’t any disc in between C1 and C2.
From what you might have described in your letter, I counsel the ache in your ear and facet of your head is because of strain on nerves of the spinal twine at that time, brought on by irritation as a consequence of arthritis.
A telling signal of this could be in the event you expertise some aid by mendacity flat in your again, with a rolled pillow behind your neck. Equally, rolling your head gently to 1 facet, as this quickly relieves strain on the nerves.
You say you might have a hospital appointment for subsequent 12 months, so I’m hopeful that you just’ll quickly see a spinal surgeon or a neurologist.
I’ve had a bitter style in my mouth for months, which takes the pleasure out of consuming. I’m being handled for prostate most cancers with goserelin, however my GP doesn’t assume that is associated. My dentist can’t discover something improper with my mouth, both.
Barry Chamberlain, by e-mail.
It may be depressing when food and drinks give no pleasure — and it’s a typical drawback. The situation you describe is named dysgeusia, and it’s estimated that greater than 10 per cent of us will endure from it sooner or later, although happily it’s often a short-lived drawback.
Not too long ago, I had a affected person who, following a tough dental extraction, was handled for every week with two antibacterial medication, metronidazole and amoxicillin. For the following month he skilled a bitter style in his mouth however it will definitely resolved itself, because the remedy was clearly the trigger.
Certainly, dysgeusia is often a side-effect of remedy, though in uncommon circumstances it may be an indication of vitamin or mineral deficiencies.
(Simply as not often, it may be an indication of an underactive thyroid, liver issues, gum illness or a mouth or throat an infection — the care of your GP and dentist counsel these will not be relevant in your case.)
It may be depressing when food and drinks give no pleasure — and it’s a typical drawback
In terms of mineral deficiency, probably the most generally attributed to dysgeusia is zinc — it is a drawback for many who are significantly malnourished or who’ve a intestine illness or persistent an infection that causes malabsorption (once more, unlikely in your case, as these would have been recognized).
So again to the remedy. As many as 200 medication could cause dysgeusia. Goserelin, the drug you’re being handled with, is given to decrease ranges of hormones secreted by the pituitary gland within the mind — and hormone-altering medication (together with hrt) are identified to trigger dysgeusia.
I might counsel that these hormonal modifications — a vital a part of your therapy — would be the trigger. I hope understanding this places your thoughts comfortable.
Write to Dr Scurr
Write to Dr Scurr at Good Well being, Day by day Mail, 9 Derry Avenue, London W8 5HY or e-mail: drmartin@dailymail.co.uk — embody contact particulars. Dr Scurr can’t enter into private correspondence. Replies ought to be taken in a common context. Seek the advice of your individual GP with any well being worries.
For my part: Crimson tape impedes our sufferers’ care
Most GPs and greater than half of hospital docs really feel that the gulf between major and hospital care is harming sufferers, in keeping with a latest survey performed on behalf of the British Medical Affiliation.
It additionally discovered {that a} main explanation for that is the bureaucratic obstacles that hinder referrals.
Once I entered follow in 1974, all I needed to do to refer a affected person for a specialist opinion was ship a letter — the affected person would then obtain an appointment card within the publish.
There was not a lot improper with that system however it was regularly eroded, first by the arrival of the inner market — a cost-cutting technique that meant sufferers may solely be referred to companies with which the GP had a contract — and by an explosion in forms.
Now, GPs largely do not know who will see their affected person after a referral. Worse, they should chase these up when sufferers have heard nothing for weeks, and inevitably some circumstances worsen within the interim.
We’d like a radical rethink to handle the executive roadblocks impeding affected person care: bureaucratic rigidity just isn’t extra essential than immediate care of the human beings affected by unwell well being and tragedy.
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