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By
Dr David Delvin
YOU AND YOUR EARS
It's an unfortunate fact that as you get a little
older, your ears tend to give you more trouble. This is because
- like almost everything else in the body - the areas are subject to
a bit of 'wear and tear' as the decades go by.
The biggest cause of 'wear and tear' is
"NOISE!" People are subjected to far too much noise
in today's society - and alas it often damages their ears and harms
their hearing. So, whatever age you are, do please do everything
you can to protect yourself from excessive sound levels. For instance:
* If
there are road works in your street, keep your distance from the
pneumatic drills!
* If
anybody in the family wants to play the hi-fi at top volume, keep
well away from the speakers.
* If
you go to a concert or a gig, consider getting seats which are well
back from the musicians - even a classical orchestra can produce
sounds which are loud enough to damage the ears.
* If
you happen to go in for shooting - as many people of retirement age
do - then always, always make sure that you wear ear protectors (in
Britain, shooting is a really common cause of deafness in the right
ear - but very rarely in the left one!).
* In
any situation where there is a lot of noise - like a gym, for
instance - don't be embarrassed about putting a couple of ear plugs
in your ears.
* If
you have to spend a lot of time in noisy places, it's worth
investing in a personal stereo - so that you can blot out the
racket, and just have soft, soothing music in your ears.
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SOME
COMMON EAR CONDITIONS THAT YOU SHOULD KNOW ABOUT
The reason for avoiding noise is, of course,
to avoid deafness - which so often affects the over-50s. But
before we move on to deafness, let's have look at half a dozen or so
common ear conditions, any of which might affect you. Here
goes:
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WAX
Earwax is a bit of a problem for millions of British people.
Everybody produces a bit of wax, but a lot of us have a genetically determined
tendency to make lots of it. Result: you can't hear
anything!
Fortunately, earwax is easily treated.
The excellent drops which you can buy from any chemist (such as
Waxsol, Cerumol or Otex) will soften and dissolve it. But if
it has got very hard, then the only way to get rid of the wax is to
get a doctor or nurse to syringe it for you.
Incidentally, please DON'T try and dig the wax
out with hairpins or other objects. Contrary to what many people
think, it is not a good idea to stick things into the
'lughole'. That is likely to damage the delicate tissues of
the ear.
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EARACHE
Fortunately, this gets less common as you grow older. It
is usually caused by a germ - which gets into the interior of the
ear after working its way up the tube which leads up from the throat
to the cavity of the middle-ear region.
Initial treatment is with aspirin, Paracetamol
or Nurofen, plus warmth to the ear. Many doctors give
penicillin or other anti-biotics, but there is controversy about how
soon they should be used.
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OUTER
EAR INFLAMMATION
Also known as 'otitis externa', this is pretty
common in the retirement age group. It causes itching and
soreness, and a discharge from the ear. It's commoner in
people who have spent time in the tropics,. and it tends to be made
worse by swimming - particularly in pools in warm climates, where
there may be the odd 'bug' in the water!
Otitis externa needs treatment by a GP or an
ENT consultant. Usually the doctor will clean out the ear and
prescribe special drops. Sometimes it's necessary to put a
'wick' into the interior of the ear to help it recover. Most important,
however itchy the ear, don't poke any hairpins etc into it!
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SORE
PLACES IN THE EAR
Lumps and raw spots on the ear are common, particularly
in the over-50s - especially in those who have been exposed to a lot
of sun during their lives. If you get any unexplained lump or
sore place on your ear and it doesn't clear up within a week, please
do have it checked out by your doctor - because (to be frank) there
is a risk that it could be a skin tumour.
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TINNITUS
The word 'tinnitus' just means 'noises in the
ear'. It's NOT a disease - just a symptom of something
wrong. Incidentally, many people think it's called
'tinnitis' - but it isn't; the spelling is 'tinnitus'.
You can see that the important thing with
tinnitus is to find out what's causing it. Possible
causes include:
* An
insect in the ear - very RARE in the UK!
* Aspirin
and similiar drugs
*
Presbyacusis (see below) - this is the form of deafness often seen
in the over-50s; it is often associated with tinnitus
*
Wax (see above)
*
Fluid in the middle part of the ear
* Damage
by noise
* Damage
from diving
*
Meniere's disease (see below)
*
Labyrinthitis - a common inflammation of the inner part of the ear
(see below)
In many cases, the cause of the noise cannot
be found. Where this is so, you'll need specialist medical
help to come to terms with the noise and find ways of dealing with
it.
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VERTIGO
The word 'vertigo' means the kind of giddiness
in which things actually seem to spin round you. It is often
due to problems in the balance mechanisms of the inner part of the
ear. Possible causes include labyrinthitis and Meniere's disease
(see below).
There is also something called 'Benign
Positional Vertigo', which often develops in the second half of
life. What happens is that you move your head - and then you suddenly
feel awfully giddy. The cause is believed to be tiny 'stones'
in the fluid of the inner part of your ear. Fortunately, ENT surgeons
have developed a way of curing the condition by carrying out a manipulation
called 'Particle Reposition Manoeuvre'.
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MENIERE'S
DISEASE
People with Meniere's disease suffer
recurrent attacks of deafness, tinnitus and vertigo. These
attacks are very upsetting - but (thank heavens) patients feel OK in
the intervals between bouts. The cause of Meniere's seems to
be a disturbance in the fluids which circulate in the inner part of
the ear.
Initial treatment is with anti-vertigo drugs
and (usually) salt restriction. If these measures fail, there
are surgical operations which can be tried - but alas the results
are variable.
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LABYRINTHITIS
This is a common condition, in which a person
suddenly becomes very giddy, and may feel sick as well.
Sometimes they go a bit deaf for a while. This disorder (which
is also knows as 'vestibulitis') is thought o be due to a
virus. So not surprisingly, there are sometimes little
outbreaks, in which several people develop the same symptoms.
Antibiotics will not help, but fortunately
labyrinthitis usually gets better of it's own accord, over a few
weeks.
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CATARRH
Catarrh in the back of the throat is notorious
for causing all sorts of symptoms in the ears; deafness, 'popping',
discomfort and sometimes slight giddiness.
The commonest cause is smoking. Catarrh can't
be treated with ear drops - because they wouldn't get through the
ear drum. So the most common way of treating it is with nose
drops.
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DEAFNESS
Deafness in the second half of life is very common.
Frequently, it's due to one of the causes mentioned above - like
catarrh or ear wax. Fortunately, these are easily cured.
BUT - the type of deafness which affects so many
people over the age of 55 is - I'm sorry to say - not easily put
right. It's called 'presbyacusis', and it's due to 2 things:
*
Loss of hair cells in the delicate part of the ear called the
'cochlea'; and
* Loss
of fibres in the nerve that carries hearing impulses.
The effect of this degeneration is that high-pitched
sounds are lost, to begin with. One result of this is that you
can't hear consonants clearly - just vowels. This is irritating!
People who suffer from it are always saying: 'Don't mumble
- speak up!'
If you seem to be getting this kind of
deafness, it's essential that you go to a doctor and have your ears
checked out. If necessary she can send you to an ENT consultant.,
You may well be offered an audiogram - which is a test that assesses
the hearing loss at various pitches.
Sometimes, a curable cause of deafness is found.
But in many cases, you have to consider the possibility of a hearing
aid.
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HEARING
AIDS
Hearing aids help a lot of people in the
over-55 age group. But you have to remember that they are unlikely
to give you perfect hearing. All they can do is make faint
sounds a lot louder.
Please don't rush into buying one. Where
hearing aids are concerned, it's rather easy to be ripped off.
Take your time, so that you get the device that really is best for
you.
In the UK, you have 2 choices:
*
You can get a FREE NHS hearing aid; or
* You
can buy one from a private firm - which may cost you quite a lot (up
to £2,500).
If you want to have an NHS aid, then ask your
GP to refer you. Health service hearing aids are OK, but they come
in a rather limited range. They are improving in quality, but
in some areas it may take several months to obtain one.
If you decide to go for a private aid, then
you'll probably be able to obtain it very quickly. You'll have
no difficulty in obtaining the exact type you want (for instance, an
unobtrusive one!), but you'll have to pay quite a lot for the privilege.
Please DO see a doctor before you buy a
private hearing aid.
Because of some rather dodgy things that
happened in the past, the work of hearing aid 'dispensers' has
been regulated by the Hearing Aid Council since 1968. For
details of the code that they are supposed to follow, please read
the excellent leaflets / website of the Royal National Institute for
Deaf People (RNID) - see below:
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ANALOGUE
AND DIGITAL HEARING AIDS
The new digital hearing aids are better than
the old analogue ones. Fortunately, the NHS is gradually going
over to digital.
Before you decide whether you're going to go
for an NHS aid or not, it's a good idea to find out what sort of aids
are being provided in your area. You see, it varies a lot from
one region of the UK to another.
Ask your GP or your local ENT clinic to tell
you whether the hearing aids supplied in your area are analogue or
digital. I'm afraid that I cannot tell you what's going on in your
part of the country, but I understand that:
* In
Wales, all the NHS aids are (or soon will be) digital.
* In
Scotland, none of them is - yet;
* In
England, it varies greatly from Trust to Trust;
* In
Northern Ireland, it depends what funding is available locally.
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LISTENING
DEVICES
Newspaper ads often feature cheap things
called 'Listening Devices'.
These may seem very attractive, because they
cost as little as £15! But they are not - repeat NOT - hearing
aids. Furthermore, the people who sell them are not bound by
the regulations of the Hearing Aid Council.
So you probably won't be surprised when I say
that I DON'T recommend buying one.
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THE
RNID WEBSITE
Finally, can I suggest that you now look at
the Royal National Institute for Deaf People (RNID) website?
Obviously you already have access to the Internet
- or you wouldn't be reading this! You'll do yourself a favour
if you read what the RNID have to say about deafness - and about
hearing aids. Their excellent website is: www.rnid.org.uk
Good luck and good hearing!
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Q
Is it really true that
men's ears get BIGGER as they get older?
A
Yes, it is! I used to
think this was a folk-myth. But several years ago the British Medical
Journal published a careful study which showed that many males have ears
which slowly get larger after the age of 50. No one knows the
reason for this, and there's nothing much than can be done about
it. Happily, most men don't seem to mind very much!
Q
My granddaughter wants to
get her ears pierced. But are there any dangers in having this done?
A
Traditional piercing through
the lobe is reasonably safe, when done by a qualified operator -
though there is a small risk of infection or bleeding. It's a
totally different matter when people go in for the current day
fashion for having the UPPER part of the ear pierced. This may
cause 'collapse' of the ear cartilage (that is, the gristle), so
that you end up with spaniel-type ears for life!
Q
I'm 62, and I recently had
some sort of inside-the-ear tumour called an 'ACOUSTIC
NEUROMA'. But I don't understand what it is.
A
An
acoustic neuroma is a growth which usually causes one-sided deafness
and tinnitus - and maybe balance problems. Fortunately, if
it's caught early and removed, the outlook is very good.
Q
My little niece gets a lot
of earache. Could I catch it off her?
A
Unlikely. Though
earache can be caused by germs, it doesn't really spread from person
to person in the same way that (say) measles does.
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Q
My golf has been badly
affected by tendon trouble in my wrist. Could an osteopath
help?
A
I think it would well be worth
having (say) one session with an osteopath, to see if he/she can produce
some improvement. This shouldn't cost more than £25 to £35.
Q
Both my mother and grandmother
died as a result of breaking a hip in a fall. Could there be
any family tendency to fragile bones?
A
Yes! You may all be liable to osteoporosis - the 'bone
thinning' condition which is so very common after age 50. Please
ask your GP to arrange tests - also see archived GP article on this
website.
Q
I recently started a relationship
with a delightful man, though I am over 60. The result has
been PAIN whenever I pass urine! Why has this happened?
A
You have cystitis, or a urinary
infection - this is very common when a woman resumes sex after a long
time. Your GP will be pleased to give you treatment. She
may also suggest a cream which you could apply 'down below' - in
order to reduce the risk of this problem recurring.
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