Since the pandemic, for at least a few hours a day I can smell smoke – although there’s nothing burning. It can happen wherever I am – at home, at work or in the car.
An ENT check of my nose and an MRI head scan revealed nothing. Is there any treatment or course of action?
One of the main symptoms of Covid was the loss of, or changes to, the sense of smell.
While it seemed like a brand-new thing, in fact we saw this symptom prior to Covid with other colds – and both continue to trigger it.
Typical smells to ‘imagine’ are chemicals, rotten food or, indeed, smoke or burning.
Anosmia refers to the smell sense completely going. When you smell things that aren’t there, it is called phantosmia.
It is reassuring to have had a normal MRI brain scan and an ear, nose, and throat review, as a tumour in the brain or nose could be a cause.
But more often it may come from long-term inflammation or infection in the nose, such as benign growths called polyps or chronic sinusitis.
One of the main symptoms of Covid was the loss of, or changes to, the sense of smell
Congested airways can become pockets of stale air which, in turn, allows infections to come and go – this can lead to nasty smells. Monthly episodes may coincide with times of inflammation or infection.
A steroid nasal spray can be bought from the pharmacist which can reduce inflammation that may be pressing on the nerves which control smell, so this may help the issue. A saline or seawater spray or sinus rinse can do the same.
Swelling of the nose and upper airways can often come from allergies such as dust mites, pollen or pets. A regular antihistamine may help.
All my life I have suffered from constipation, despite having a healthy diet, drinking plenty of fluids and being quite active. Recently a colonoscopy showed haemorrhoids. Surgery has been suggested – do you think I should go ahead with it?
Haemorrhoids and constipation are inextricably linked. Straining because of constipation puts a large amount of pressure on the back passage, causing engorged blood vessels inside the anus to form.
These swellings are also unlikely to heal if the constipation is not resolved.
Haemorrhoids would not normally be treated by surgery unless someone was having significant problems with them, such as bleeding or pain.
Long-term laxatives would be advised for chronic constipation. In older people, these can cause worse side effects, including cramps, bloating and nausea – but the benefits outweigh any risk.
It’s also important to eat plenty of fruit containing sorbitol – dates, prunes, peaches and apricots.
If getting the recommended 30g of fibre a day is difficult, top up with a psyllium husk supplement or bran.
Many people don’t realise there are different types of laxatives, both on prescription and to buy over the counter.
Bulk-forming laxatives such as ispaghula – Fybogel is a common brand – are good and can help initially. Then an osmotic laxative can be added in, which make the stool softer to pass, such as macrogol or lactulose. There are also stimulant laxatives such as senna or bisacodyl.
A different combination and dose of laxatives should work for everyone.
Recently I was diagnosed with a hernia in the right side of my groin. I was offered surgery but I don’t want it – I’m 90 and I’m just grateful to have reached this wonderful age. What should I do instead?
A hernia occurs when an internal part of the body pushes through a weakness in the muscle or tissue surrounding it, causing swelling or a lump. The groin is a common place as there is not much muscle there and so it’s naturally quite weak – here it is an inguinal hernia.
About a quarter of men will get an inguinal hernia at some point in their lifetime. If the hernia is not causing any pain, then opting to watch and wait, rather than undergo surgery, is perfectly reasonable.
If at any point it does become uncomfortable, the worry is it has become strangulated.
This is a medical emergency and the patient needs to go to A&E.
Some men find a hernia belt or special support clothing can be helpful. It presses against the hernia, keeping it from popping out. These are available from pharmacies and sometimes on prescription.
Avoiding constipation is also important, as this reduces excess pressure on the abdomen wall which can enlarge the hernia.
Ignore RSV jab at your peril
I’m worried that many people eligible for a new life-saving vaccine have not taken up the offer.
Last autumn, the NHS began offering a first-of-its-kind jab for respiratory syncytial virus (RSV), a nasty winter bug which puts thousands in hospital every year and can kill.
It is available for people aged 75 to 79, as well as those who turned 80 before September 1, 2024.
Last autumn, the NHS began offering a first-of-its-kind jab for respiratory syncytial virus (RSV), a nasty winter bug which puts thousands in hospital every year and can kill
Anyone eligible should have already received an invitation. However, it appears that only around half actually took up the offer. So last week the NHS announced it would send out invitations again to those who didn’t get it the first time.
Patients have told me they were unsure about it because they’d never heard of RSV. That won’t stop you catching it, and without the jab you could end up severely unwell – or worse.
I urge anyone who gets an invitation to get the jab.
Fighting spirit of our new minister
I’m very impressed by the new health minister, Ashley Dalton, who was appointed last week in the wake of the resignation of Andrew Gwynne MP over a series of highly offensive WhatsApp messages.
This would make her new role a difficult one at the best of times, but she is already facing her own health challenges. Ten years ago she was diagnosed with breast cancer and, last year, had more surgery to remove tumour cells.
New health minister, Ashley Dalton, who was appointed last week in the wake of the resignation of Andrew Gwynne MP over a series of highly offensive WhatsApp messages
Last month she said the disease had returned and spread throughout her body. While she won’t require treatment just yet, it does mean that her condition is likely incurable.
When most people hear ‘incurable cancer’, they believe it means the end of life. But there are tens of thousands of Britons in the same situation as Ms Dalton. Some give up work, but many keep going.
The fact that Ms Dalton has chosen to take on such a role in the face of her diagnosis is a testament to her resolve and commitment to public service. I wish her all the best.
