Dear Dr. Roach: How austere are circadian nosebleeds? My ancestor had agitation (he was consistently acrimonious his nose), and I’ve had circadian right-nostril bleeding with clots, and saw an ENT physician who hesitated to use cautery, adage it ability do added abuse than good. Now, my 50-year-old nephew has aloof started to accept blood-soaked nostrils. Aloof what is bleeding, and why? — A.A.
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Sixty percent of bodies accept accomplished a nosebleed, while alone 10 percent accept appropriate medical attention. There are abounding accessible causes, and I can alone guess. However, the ancestors history of assorted bodies with cogent nosebleeds should accompany up the achievability of an aberrant condition: Osler-Weber-Rendu syndrome, which I discussed some months ago, and which requires able consultation.
For best bodies with nosebleeds, though, the bleeding comes from aloof beneath the lining of the nasal septum, area several arteries appear together. In accession to adenoids picking, added accepted causes of nosebleeds are dry air, medications (like nasal steroids) and agony to the face. During a nosebleed, angular advanced (to anticipate burning blood) and compression both adenoids shut to finer stop it appropriate away.
Recurrent nosebleeds should alert a appointment to an ENT physician, and I would never admonish arguing with a surgeon who tells you he doesn’t appetite to operate, alike if the operation (cautery) is almost minor.
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An antibacterial balm or apparent petrolatum can advice accumulate the lining of the adenoids clammy and anticipate recurrence.
Dear Dr. Roach: I accept been demography Paxil for years to calm my all-overs and depression. I diaphoresis a lot at night. When I abate off the pills, the night sweats stop, but I acquisition my all-overs returns. My doctor said I would accept to booty the pills for the blow of my life. I admiration if you could let me apperceive how to barrier this affectionate of night-sweat problem. — A.
Night sweats is a accepted and acclaimed ancillary aftereffect of Paxil (paroxetine). They go abroad afterwards a few weeks (or alike months) in best people, but in you, they haven’t. On the added hand, it sounds from your letter as if Paxil is additionally alive able-bodied to ascendancy your anxiety.
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How can you boldness this? All the medications in the chic of Paxil (including Prozac, Lexapro, Zoloft and others) can account night sweats, but one medication can affect a being actual abnormally from another. The aboriginal catechism is whether it’s safe to try alteration medications. It sounds like the assurance affair would be account discussing with your doctor.
It ability be alike bigger to try nonpharmacologic advice for your all-overs from a mental-health professional. Cognitive behavioral therapies and added nondrug treatments are able for all-overs and accept no medication ancillary effects.
Dear Dr. Roach: My granddaughter has had fleas in her beard for added than three years. They had dogs in the house. Her mother and sister had some in their beard at the time. The dogs are continued gone. No one abroad has a problem. But she continues to get them. The treatments get rid of them for a while but again they appear back. The doctor says that this happens sometimes. There charge be article that can be done. Any ideas? — M.S.P.
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Fleas don’t commonly alive on humans. But they will chaw bodies if there is annihilation abroad around. She needs to be advised at the aforementioned time as the home is professionally exterminated.
DR. KEITH ROACH is a amalgamated columnist with North America Syndicate Inc., P.O. Box 536475, Orlando, FL 32853-6475.
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