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DEAR DR. ROACH: About two or three months ago, I had a cracking sound in my right ear, and it hurts intermittently. This happens several times a day, day and night. I saw my doctor who told me it was nothing. He told me to take Sudafed twice every 24 hours. It lets go when I take it. Can you help me calm my mind? – MM
REPLY: The two things that first come to mind with an uncomfortable cracking in the ear are something in the ear canal, like dried wax, or a problem with the Eustachian tube.
An exam should have shown wax in the ear, so I think the problem is the Eustachian tube, which connects the middle ear to the back of the throat to maintain even pressure. Sometimes the pressure equalization is accompanied by a crunching sensation, often accompanied by a yawn or other wide opening of the mouth, followed by improvement in hearing. If the Eustachian tube is not functioning properly, the pressures do not equalize and there may be a feeling of pressure in the ear that is not relieved.
The eustachian tube can be blocked by allergies or a cold, and pseudoephedrine or another decongestant is an effective treatment. Antihistamines can also be tried and may be particularly helpful in people with high blood pressure or sensitive to decongestants.
If the symptoms go away, you can rest easy on your mind, but if not, it is worth going to your usual doctor or perhaps an ear, nose and throat specialist. There are other possible causes, such as TMJ disorders.
DEAR DR. ROACH: My brother and I are planning a trip. I need my daughter to come with me, and she has Crohn’s disease and takes Humira. We have discovered that everyone taking the flight must be vaccinated against COVID-19. Her doctor is concerned that she may be having a reaction. What is your opinion? – EK
REPLY: Many people with immune diseases or who take drugs that affect the immune system are concerned about COVID-19 vaccines. These vaccines have not been well studied in this population, so there are no reliable data. The type of immune suppressant has a big effect on the effectiveness of the vaccine.
Based on the limited data and our knowledge of how these drugs affect the immune system, I can offer some general rules. The first is that vaccines are still generally safe and that there is no more risk of a reaction in a person taking an immunosuppressant like adalimumab (Humira) than in a person not taking any medicine. Second, people on immunosuppressants are at greater risk of contracting a complicated COVID-19 disease and should be especially encouraged to get the vaccine. Third, the vaccine is certainly better than not getting a vaccine, but probably less effective than it is in people without immune system problems. So even people who have received the vaccine should continue to be very careful as long as COVID-19 is circulating in their community.
Finally, while there is a theoretical risk that autoimmune diseases, such as Crohn’s disease, could flare up due to transient activation of the immune system due to the vaccine, the reality is that it rarely, if ever, occurs. never.
One final note: if you see someone wearing a mask even when it isn’t necessary, remember that it could be someone taking medication for their immune system, which makes the vaccine potentially less effective – or maybe she can’t take the vaccine at all. Perhaps he is a caregiver for such a person. Please have a little patience and understanding.
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Dr Roach regrets not being able to respond to individual letters, but will fit them into the column whenever possible. Readers can send questions by email to [email protected] or by mail to 628 Virginia Dr., Orlando, FL 32803.
(c) 2021 North America Syndicate Inc.
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