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NOSEBLEED in Kids: 3 THINGS YOU NEED TO KNOW(+A home care checklist download)
Nosebleed in children are worrying.Causes may be many and management of pediatric nose bleeds can be tricky .Read about nose bleed in adults here .
As a parent, it’s heartbreaking and you feel terribly upset.
It’s actually very common.
And not as worrying as it looks.
As an ENT surgeon nosebleed are some of the most frequent emergencies we attend.
The most important advice in cases involving children is rarely medicine.
I felt a little info about first aid home care for nosebleed would be useful.
Why does it happen?
Most often it’s due to nose picking.
Nose picking is easily the most common reason for nosebleed in children.
Luckily nosebleed in children are hardly ever life threatening.
But just knowing the why is not good enough .
Parents need to be aware of danger signs.
The signs below show when you need to visit the emergency.
#IMPORTANT TIP 1
THE DANGER SIGNS WHICH YOU SHOULD KNOW
- Massive nosebleed which cause difficulty breathing
- Massive nosebleed , which doesn’t stop even after the home-care described below.
- You find nosebleed has made your child pale, tired or disoriented.
- Nosebleed occur repeatedly, often and in very large amount without any trauma
- Child has undergone a recent nasal surgery
- Child has some tumour in the nose
Doctors will focus more on the child’s breathing and hemodynamic stability ,than the nosebleed.
This means the child might need intravenous fluid support, blood transfusion, moist oxygen inhalation
Identification of the site and cause of nosebleed, is of importance only after making the child stable.
WHAT CAUSES NOSEBLEED
IN CHILDREN:
- Blowing the nose very hard
- Injury to your child’s nose during playing
- Broken bones
- Temperature and humidity changes make the inside of your child’s nose become dry.
- Juvenile nasopharyngeal angiofibroma
WHAT COULD BE THE CAUSE OF FREQUENT NOSEBLEED IN CHILDREN?
Mostly systemic causes
- Bleeding disorders,coagulopathies:Haemophilia A, B, Factor IX deficiency(Von Willebrand disease)
- Leukemia
- Hereditary Haemorrhagic telangiectasia(HHT)
A study had found at least 1 episode of nosebleed occur
- In 30% children less than 5 years
- 56% children aged 6 to 10 year
- Children younger than two years rarely have nosebleed.
Child abuse is another worrying cause of recurrent nosebleed in children.
That’s a potential red flag for healthcare providers.
50% Adults with nose bleeding has the history of nosebleed during childhood.
#IMPORTANT THING NO.2
WHAT IS THE BEST WAY TO STOP A NOSEBLEED AT HOME?
How to stop Nose bleed
Make your child sit down and bend forward and pinch the soft part of their nose.
- Make your child breathe gently through the mouth
- Do this for at least 5 minutes.Most nosebleed stop by a maximum of 10 minutes of pinching the nose this way
- Bending in front, helps to drain blood down the nose and prevents trickling to the back of the throat .Trickle to the back of throat can cause vomiting and more bleeding.
- You should pinch just above the nostrils
- Place an ice pack on the bridge of your child’s nose
- Avoid nose blowing
- You can apply antibiotic ointment, petroleum jelly,nasal drop.
ANTERIOR EPISTAXIS
Nosebleed in children most commonly occurs from the front part of the nose.
This is known as anterior epistaxis.If its not controlled at home you might need to visit, the emergency of your nearest hospital.
WHAT OTHER WAYS WILL THE DOCTOR STOP THE NASAL BLEEDING
CAUTERY
- Chemical cautery – silver nitrate, TCA
- Electric cautery
- Laser photocoagulation
- Indication – if bleeding site is identified by noting
- Active bleeding
- An eschar
- Prominent vessel
CHEMICAL CAUTERY
- Agent – silver nitrate commonly used
Anaesthesia – LA
- 4% lidocaine within adrenaline or 4% lidocaine with 0.5 phenylephrine or by 10% cocaine
TECHNIQUE
- Circumferentially around the bleeding site and then the real offending bleeding vessel
Disadvantage –
- Repeated cauterization required
- Ulceration or septal perforation
ELECTRIC CAUTERY
- Indication active arterial bleed not controlled by silver nitrate
- Bipolar cautery preferred over unipolar cautery
- If aggressively performed a hole may be formed in the septum
- For posterior bleeding , it has to be stopped using a 30° endoscope and cautery
- In children – cautery should be used under GA.
CARE AFTER CAUTERY
- Local antibiotic ointment x 10 days
- Avoid nose blowing/ picking
- To keep the mouth open while sneezing
ANTERIOR PACKING
INDICATION
- If cautery is not possible
- If obvious site can not be identified
- If bleeding not controlled by cautery.
- Mechanism
- Adequate pressure to the bleeding site
- Thrombosis of bleeding
- Anaesthesia LA/GA
MATERIAL USED
- Absorbable substance
- Oxidized cellulose
- Gelatin sponge
- Surgicel
INDICATION
- In bleeding disorders
- Hereditary telangiectasia
Mechanism of action:All the absorbable packs help the blood to clot .They give a matrix for the platelets and fibrin particles interlinks. This way the bleeding from the nasal cavity can be stopped
ADVANTAGE
- Dissolves spontaneously
- Trauma of pack removal eliminated
MEROCEL PACK: This is in between an Absorbable nasal pack and ribbon gauze.This is made of biocompatible , polyvinyl alcohol sponge material which helps to stop bleeding .It has a very high-capacity for absorption .
Provides a mild pressure and tamponade effect after insertion in the nasal cavity .This tamponade effect helps to stop the bleeding.
It may be kept for upto 5 days , but under antibiotic cover.
Advantage:
- Highly hydrophilic and can absorb blood upto 21 times its volume
- Soft , compressible, easy to insert
- Very little trauma during insertion and removal
- Easy to cut and shape according to size of nasal cavity
Disadvantage:
It’s expensive.
Nasal bleeding which needs high tamponade effect to stop , may not be controlled
RIBBON GAUGE PACK
- Impregnated with antibiotic and vaseline.
– Layered placement of the pack filling
COMPLICATION OF ANP
DURING PACKING
- Vasovagal attack
- Blind packing aggravates bleeding ,as the friable mucosa is traumatized.
- Pushed into throat
WHILE PACK IS PREVENTION IN THE NASAL CAVITY
- Epiphora, or watering of eye
- Secondary sinusitis.Infection of the sinuses.
- Anosmia, sleep apnea
- Toxic shock syndrome
DURING REMOVAL OF PACK
- Vasovagal attack
- Further bleeding
Posterior nosebleeds:
Originate toward the back of the nasal passage, near the throat.Occurs mostly in elderly as hypertensive epistaxis.
Posterior nosebleeds are less common than an anterior nosebleed. But they can be serious and can cause a lot of blood loss. Children do not usually get posterior nosebleeds.
But if it does occur, they can be serious .Posterior epistaxis can cause significant blood loss and collapse.
In children it can occur following trauma to nose.
This causes the nasal bone to break and injury to the sphenopalatine artery .This sphenopalatine artery at the back of the nose can cause profuse bleeding.Thus is a serious emergency and needs urgent medical intervention.
HOW CAN FREQUENT NOSEBLEED IN CHILDREN BE MANAGED?
Consultation with your doctor is important in case of frequent nosebleed.
Careful history: Generally there is the history of prolonged bleeding after minor trauma, teeth extraction etc.
The child may be having other signs of frequent bleeding:
- Pinpoint bleeding spots under the skin (purpura)
- Repeated bruising
- Swollen painful joints
- Bleeding from other places, blood in urine, blood in stool
Investigation:
- Complete haemogram
- BT, CT, platelet count
- Prothrombin time/Activated Partial Thrombosis tin Time
- Hess’s test, factor VIII and IX assay
Treatment:
- Treat the cause
- Stop bleeding
- Cautery is contraindicated
#IMPORTANT THING NO.3
NOSEBLEED PREVENTION
If your child gets nosebleeds frequently.After a full checkup if you find its due to nasal crusts and nosepicking.
There are a few things which you can do to help stop nasal crusting.
The less the crust, less will be the childs tendency to pick his/her nose.
Te following measures will help reduce drying and crusting.This in turn will significantly decrease the nose picking and the chances of getting a nosebleed:
- Use a humidifier in your bedroom while sleeping, especially when the air is very dry.
- Keep your child’s nose moist using a saline nasal spray.
- Teach your child to stop picking his/her nose, clip their fingernails to avoid injury.
- Explaining to your child about the possibility of a doctors visit ,with nose bleed may help them not to pick their nose.
I hope you found this post helpful.
Please share and help another parent.They will thank you for this.
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Protected: PROBIOTIC FOOD:WHY YOU NEED IT
Mindful Living: Art of a More Productive Life
Are you Multitasking?
The hectic pace of modern living would have made ancient men tired?You take our multitasking so seriously, that not doing a million things before breakfast, makes you feel guilty. I am a multi thinker.Multitasking is a natural progression.All women, especially mothers have to try multitasking, to be able to manage it all.
But how healthy is this Habit?
Is Multitasking good for you? Not Really! As we increasingly multitask our ability to truly concentrate dwindles.The more technology dependant you are the bigger is it a challenge to concentrate. I am a doctor, mother, wife of a child specialist, teacher in a medical college and a blogger.I really love all that I am blessed to be doing.
But the regular grind of household chores is a real job.Keeping the house clutter free, managing my home and workload keeps me, breathless…literally. For the last few months, I was having shortness of breath, palpitations and had started to worry about a multitude of things. On top of that, we experienced the aftershocks of the Earthquake that left Nepal with thousands dead and injured.
The Nepal Earthquake was devastating..mindfulness meditation helped me calm down
Alone at home with my 3-year-old, I did what any mommy would do.Grabbed the water bottle, and rushed out in the open grounds with the baby in my lap. We suffered 2 more vibrations over the next 3 days but none was as bad. The news about Nepal kept coming. The total devastation there as made me take stock. Gratitude for the life we have here now is uppermost. Before the earthquake hit Nepal, I had read a book Love the home you have by Melissa of The Inspired Room.
The overall tone of the book has a lot to do with living in the present and being thankful for all the blessings you have now. Tomorrow is a dream, the past has gone, but today well lived will make our life here on this earth worth it.
A lot of my friends, relatives, and patients complained of a feeling of panic and light-headedness in the days after the quake. Since I too was suffering from similar complaints related to Post-traumatic stress disorder, a solution was urgently needed.
I tried the many relaxation and mindfulness techniques for calming an anxious mind. Some worked well and others not so much.
Then I discovered mindfulness!
So what exactly is mindfulness?
The word literally means being aware of one’s own mind.
The formal definition of mindfulness:
Intentional acceptance and non-judgemental focus of one’s attention on emotions, thoughts, sensations occurring in the present.This can be achieved by training in meditation practices. Mindfulness is a concept having its root deep in Hinduism. The Sanskrit term Smriti and Buddhist term sati mean to remember….not the past but a conscious remembrance of the present.That’s where mindfulness comes from.
Mindfulness signifies the presence of mind and being attentive to the present.The mind which does not fritter between thoughts, but concentrates on one thought at a time! A clear, conscious, focused mind is what mindfulness aims to make. Seriously this was easier to write, than do.
As with most things in life which are worth doing, the going for this too was definitely not easy. Whenever I started to concentrate on this post, 10 different things that needed doing, rush through my mind.
All of us mothers have to manage so many stuff that we forget,to really focus! Life rushes by. I have tried to give you some ideas about the methods which worked.As I get more mindful I will be adding them here to really become mindfully yours. So here goes.
5 Best ways to be mindful for your inner wellness(absolutely essential for sanity)
1) Stop and breathe slowly every morning: 5 minutes to 25 minutes (according to time you have) close your eyes and focus on your breathing.While doing this initially you will find your mind wandering.Just catch hold of the wandering thought and refocus. Just imagine your brain is a naughty child always in search of new stuff, but you have to be strict ! Close your eyes and visualize a black dot in front of you and concentrate.
2) Stop multitasking.Easier said than done. It takes at least 15 minutes for us to concentrate deeply.Multitasking often decreases your capacity to really give your best to a job. Refocus scattered thoughts.So the Pomodoro technique of working in blocks of 20 minutes work.
- Do one thing at a time
- Do it deliberately, concentrating on it and complete it
Read this article If you want to know who is likely to try multitask
3)Take time out. When doing any job, if you find your mind wandering too many times..take a break and try.Often it’s some other chore nagging you from your subconscious brain. You can either do that chore first then get on with the new job with full attention. The other way is to write down whatever that needs to be done so that you are not distracted by trying to keep remembering. Have a daily ritual for
- Housework…mindfully, Love the home you have (Thanks Melissa
- Cook..mindfully.Will definitely taste better
- Exercise
- What you do when you get up in the morning
- What you do just before going to bed
- What you do just before/after exercising
- Being grateful
- Be happy
The art of mindful living.Image @Healthwealthbridge
4) Eat well mindfully. Up to 75 % of overeating is emotional eating. Mind-body disconnect during eating causes excessive eating and binges. Savoring each morsel of food helps in decreasing cravings and improve satiety.Mindful eating is great for your mind and awesome for your Body! We see and smell the appetising food, taste the true flavors , eating is a truly sensory experience.
5) When interacting with others be mindful. You become the good company and a better judge of character. While researching this mindfulness practice I came upon this article where videos help you become more conscious of your inner self. Often in the race of life, you forget to breathe deeply. Health benefits of mindfulness are many most significant is its effect on stress hormones.
Mindfulness-based meditation therapy has been found to decrease stress hormones[3].
Chronic stress is responsible for many of your health problems and mindfulness can help you. But if you are reading this post you must have already realized that you are blessed to have this life.Living in the present and really appreciating every moment is mindful living.
Mindfulness has been described as “paying attention in a particular way: on purpose, in the present moment, and non-judgementally.”(2)
Traditional cognitive behavioural therapy(CBT) targets dysfunctional thoughts. Mindfulness-based CBT helps individuals learn, to become aware of their own thoughts, feelings and bodily sensations in the present.Awareness and acceptance are more important than taking action.1 I know it’s easier to say than do.Believe me I struggle with this every moment of every day. When I cuddle my baby I wish I could bottle up these golden moments.But forever is only in our minds.So I cherish every moment I spend with loved ones …always.
That’s a start to walking the mindful path. Are you Mindful? Have you ever participated in a mindfulness session? Write to me and tell me about your mindfulness efforts. Live well mindfully.
REFERENCE:
1)Biologic effects of mindfulness meditation: growing insights into neurobiological aspects of the prevention of depression.J Psychiatry Neurosci. 2011 Mar; 36(2): 75–77.
2)Kabat-Zinn J. Wherever you go, there you are: mindfulness meditation in everyday life. New York (NY): Hyperion; 1994.
3)Matousek RH, Dobkin PL, Pruessner J. Cortisol as a marker for improvement in mindfulness-based stress reduction.Complement Ther Clin Pract. 2010;16:13–9.[PubMed] [Ref list]
4) Chronic stress:32 Relaxation Techniques Dr. Amrita Basu Healthwealthbridge
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Ultimate Nutrition tips to fight Flu and Improve immunity
Modern medicine as well as alternative medicine both agree when it comes to the role of diet to improve immunity.
Rest and medicine plays a big role,but the role of a well balanced diet cannot be stressed enough.
Food has been a large part of nature’s arsenal to fight various disease from ancient times.
Improving your overall nutrition is a way to fight all the pesky viruses and bacterias which lurk around like villains , waiting for your natural defences to become weakened.
The micronutrients(essential nutrients in your diet which are required in micrograms for normal metabolic functions of your body), in your diet like vitamins ,minerals , can help to improve our body’s defence mechanism.
They help prevent disease as well as heal your body when you fall ill.
Deficiencies of vitamins, minerals and other micronutrients, not only make you susceptible to infections, but also increases the chance of complications.
Micronutrients are critical for your immunity.They help you fight against the microbes and produce an effective immune response.
How nutrients in the flu diet help?
- Interferon production and improves action of phagocytic cells.
- Anti-microbial barriers of skin, mucus membranes, tears, saliva, gastric juice.
- Antibody response and optimized cell-mediated immunity.
- Micronutrients such as vitamin C, A, B-5, B-6, B-12, and folic acid trace elements such as iron, zinc, selenium, copper and others are essential for optimizing white blood cell production and immune function.
Infections in turn make the deficiencies worse by decreasing absorption,assimilation and increasing losses .
So does this mean you will never fall ill if you are having vitamin supplements?
The answer now becomes tricky.
It has been seen that children with malnutrition, often suffer recurrent episodes of cold,stomach problems .They seem to be specially susceptible to all germs that affect people in their immediate environment. Contagious diseases are often spread by touch ,respiratory droplets.In order for our body to fight invasion by germs, the body’s defence mechanism should be sufficiently primed to fight an assault.But when everyday functioning of the body is compromised by nutritional deficiencies ,it becomes difficult to cope during infections. Since prevention in a holistic manner is the goal of modern medicine. A well balanced diet comprising of all the super powerful anti-inflammatory food groups ,will definitely help keep you healthy even during the dreaded flu season.
Top 10 food to fight flu and improve immunity
- Fruits and vegetables, truly these are miracle food.Read my post , Fruits and vegetables..nature’s multivitamins for a quick idea about how they are helping you everyday
- Green Tea or its active ingredient, epigallocatechin-3-gallate (EGCG), are natural anti-inflammatory molecules,affecting both innate and adaptive immunity
- Walnuts,Almonds:Rich in omega 3 fatty acids,they help in increase the good fat (HDL) in our body and decrease inflammation
- Other sources of omega 3 fatty acids:chia seeds,flaxseed,fish
- Drink plenty of water about 4 to 6 litres in warm climates.Water helps to flush the toxins from our system,and is essential for most bodily functions.
- Ginger :popular for its medicinal properties offers relief from congested nose and throat when added to tea, soups etc.
- Onion
- Garlic:The pungent odour of these helps to clear blocked nose.Add crushed garlic cloves chopped onions in soups,dal for a soothing mouthful when you have a cold.
- Spices from the Indian kitchen like turmeric helps to bolster your immunity.Curcumin (diferuloylmethane) is an orange-yellow component of turmeric (Curcuma longa),having anti-inflammatory effects. Curcumin has a potent immunomodulatory agent and can modulate the activation of our innate and adaptive immune functions.
- Chicken soup for the cold:old’s wives tale,but true!Chicken soup with crushed garlic, chopped onion and ginger, with black pepper to garnish.Chicken is a popular source of the semi-essential amino acid Cysteine.Cysteine has powerful antioxidant properties.It is a major constituent of glutathione ,the body’s natural antioxidant enzyme ,helping to fight the oxidative damage from diseased condition.
What else can you do to improve immunity
- Boost up your immunity with multivitamin supplements(after consultation with your doctor),when you are feeling low.
- Get plenty of sleep
- Avoid stress
- Think positive
- Pray..the power of prayer is the secret ingredient which makes the doctors work easier.
Take care and stay fit.
Also, read
Reference
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How is the Health of the Nation: The report is an eye-opener!
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Aeroplane Ear :How to prevent it
Do you fly a lot? Does your ear pain in the aeroplane ? Do you have severe ear pain even after Flying? Can you prevent It?
The Good news:
Yes you can prevent it.
When my little girl was 1 year old we traveled to Jaipur by plane. Among many travel worries, I was especially thinking about ways to keep her awake and ear pain-free while traveling. I knew all the basics but it was still a challenge. So that’s when I decided to write a post for all of you mommies who travel by plane with children. I think when we know why things happen we are much more effective at preventing unwanted events and prevention of airplane ear runs top of my list during air travel.
- What you will find here
What is this condition? - Why do your ears get blocked in an Aeroplane?
- Who is more likely to get Aeroplane Ear?
- What can you do during the flight to prevent blocked ear?
- How can you prevent very young children from getting airplane ear?
- How can you unblock your ears after the Flight?
- When should you visit a Doctor?
What is Aeroplane Ear?
Pain in the ear, popping ear, blocked ear during air travel is the most common medical problem faced by flyers. Airplane ear is the better-known name for Barotitis media or Aerotitis media. Airplane ear or Barotitis media is the condition where there occurs damage to the ear due to difficulty in adjustment of the air pressure between Middle ear and External ear.
Why do your ears get blocked in an Aeroplane?
I have to go into a bit of physics for a proper explanation. Please excuse the science Lecture! As you know according to Boyle’s Law : The pressure and the volume of an enclosed mass o gas are inversely proportional. When the plane rises in the air, there is a progressive decrease in air/atmospheric pressure. Basically at 18,000 ft above sea level, the air pressure is half that at sea level.During the rise through the atmosphere , as the pressure falls ,a particular mass of air in an elastic structure expands .Similarly during descent, the air contracts and the volume of cash decreases.
So what happens in the ear during Flying?
Imagine your ear is made up of 3 rooms.The outermost part of the ear which connects the entryway with the other rooms is the external ear.This is the part involving your ear canal. The ear drum separates your external ear from the middle ear, where the small bones (malleus, incus, stapes), which help transmit sound live.The ear drum is somewhat flexible and can move with change in volume of air in the middle ear. Two windows oval window (covered by stapes footplate) and round window (covered by round window membrane) connect your middle ear and the inner ear.
The inner ear has your hearing and balance apparatus It’s called the labyrinth. A tube connects your middle ear with the part of your oral cavity behind the nose (nasopharynx) .It’s called the Eustachian tube.Easily the most important structure which helps keep up the normal air volume inside your middle ear. It’s through your Eustachian tube that air enters or exits to equalise air pressure between outside atmosphere and your middle ear.
What happens during Ascent?
Air pressure outside falls. Middle ear pressure falls. Air in your middle ear expands (following Boyle law) This excess air pushes the tympanic membrane outwards to its natural limit.This is normally followed by escape of air through your Eustachian tube. Movement of the ear drum may be restricted due to scarring (previous infection).This may cause ear pain during ascent.
What happens during Descent?
Air pressure outside rises. Middle ear pressure rises. Air in your middle contracts and volume decreases (Boyle law). The ear drum moves inwards. (retraction). The opening of your Eustachian tube must be opened to allow air from the nasopharynx to enter and adjust the volume.The Eustachian tube will open with swallowing movement. If this mechanism fails (if you fall asleep, or have a cold), or is delayed, the increasing pressure difference closes the naspharyngeal end of Eustachian tube.When the pressure difference is more than 90 mm,Hg, your tubal dilator muscles are unable to open the Eustachian tube and it stays locked.The ear then feels blocked.
Barotrauma occurs during flying due to:
Very rapid air pressure changes.Sudden ascent/descent. 2) Blocked Eustachian tube.
It may also occur in:
- Divers
- Hyperbaric oxygen chamber
- Decompression and compression chambers
Who is more likely to get Aeroplane Ear?
Anybody who has some nasal or Nasopharyngeal problem which blocks the Eustachian tube.
Acute infection in the nose.
Chronic infection in the nose
Rhinosinusitis
Nasal allergy
Vasomotor Rhinitis
Malformation of nose
Nasopharyngeal tumour.
Sleeping during ascent or descent
Small narrow Eustachian tube; infants toddlers.
How will you know whether you are developing airplane ear?
Symptoms ( most common)
Discomfort in the ear
Ear pain
Muffled hearing
Blocked ear/fullness of ear
Severe complaints
Excruciating pain in ear
Severely blocked ear
Ringing, buzzing sound in ear (Tinnitus)
Severe Hearing loss
Spinning sensation (Vertigo)
Bleeding from ear
When to see a doctor?
Aeroplane ear:when to see a doctor.Image courtesy David Castillo Dominic @freedigitalphotos.net
If you have any of the severe problems.Or if the symptoms persist even after …..hours “check..
What will your doctor See?
An ENT surgeon may do an otoscopic examinations to see your ear drum.
Signs on otoscopy:
- Invaginated/retracted ear drum
- Congested ear drum
- Solitary or multiple blood filled blisters on your ear drum
- Haemotympanum
- Signs of serous otitis media
- Ruptured ear drum, with blood clot.
Otoendoscopy may also be done where you will also be able to see these findings along with your doctor.
Are there any long term complications ?
Rarely the ringing sound in ear or tinnitus may be permanent.
If inner ear barotrauma occurs hearing loss may not improve
What other tests can you do?
Pure tone audiometry: to check your hearing and rule out inner ear barotrauma Tympanometry:To check the air pressure in the middle ear.and find out if there is any fluid.
Aeroplane ear:How to prevent it during flights
- Don’t fall asleep during flying, specially during ascent or descent.
- Avoid flying if you are having a severe cold.If emergency then use a Nasal decongestant spray just before takeoff and landing.Also take a decongestant orally, before getting on the .Dont use over the counter sprays .They may cause even more problem in the long run.
- Take plenty of chewing gum so that you can actively help in Eustachian tube opening during flight.The chewing and swallowing movement helps to open Eustachian tube.
- Try Valsalva maneuvre.This is a pressure equalizing technique which helps to pop the ear.You can try this if repeated swallowing and yawning doesn’t help.
- Pinch your nostril, take a mouthful of air,close your mouth and try to gently direct the air into the back of your nose.Imagine you are trying to blow your nose gently. You should feel a pressure buildup.But do not let the air out.If you hear a pop you will know the ear is unblocked.You can also close your nose and mouth and try swallowing .Donot try to do all this if you feel pain in ear.
What can young children do to prevent aeroplane ear?
Very young children have difficulty during fflying.Often you will find them irritable crabby , pulling at their ears and may also cry incessantly. This is because the Eustachian tube in infants and very young children are not mature enough to handle the extreme change in pressure.
How to prevent Aeroplane ear in young children.Image courtesy Jeffrey Betts at MMT
- But you can help them too.
- Dont let them fall asleep.
- Play with them.
- Carry a few pacifiers so that the suck and swallow reflex constantly works.
- Talk to your baby doctor whether a decongestant oral medicine is advice able for your child.
- A plain saline nasal drop given just before take off and landing helps to increase the swallowing movement and equalise pressure effectively.
What can you do to unblock the ear post flight?
Continue the Valsalva maneuvre/pressure equalizing technique
Normally it’s self healing and gets better within a few hours to few days.
If symptoms are uncomfortable and persists , or the ear doesn’t pop you should visit a doctor specialised in ear diseases
If your nose is blocked , avoid forceful nose blowing and take steam through your nose.This helps to relieve nasal congestion and open up the Eustachian tube.
What your doctor may advice?
- Nasal spray; decongestants/steroids
- Oral decongestants
- Oral antihistamines
- Non steroidal anti inflammatory drugs for relieving pain
- Once medication have improved Eustachian tube function Valsalva maneuver helps to force open the blocked tube.Surgery is rarely needed.
If fluid in the middle ear persists even after 3 months myringotomy (incision in the ear drum) is done to drain the fluid.
If the perforation in ear drum does not improve after 3 months tympanoplasty to repair the eardrum may be needed. I hope next time you are flying you will be carrying some chewing gum or hard candy with you.
Write to me at dramrita@healthwealthbridge.com or comment below to let me know how your ears fared this time.
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Disclaimer:The purpose of this article is for educational purpose and should not be taken as professional medical advice.When in doubt always visit your doctor.
