My husband has been diagnosed with a deviated septum. He has had problems with his nose and throat for years — we thought it may have been an allergy. Please can you explain more about this condition?
Name and address withheld
The nasal septum is the partition that divides the nose into your two nostrils — if it’s crooked or off centre, it’s described as ‘deviated’.
Some people are born with this, others will have acquired the problem — quite easy to do as the septum is fragile, made of cartilage and bone, and so is easily damaged, for example while playing sports or even by a simple tumble in the school playground.
Fact: The nasal septum is the partition that divides the nose into your two nostrils — if it’s crooked or off centre, it’s described as ‘deviated’
Some estimates suggest that up to 80 per cent of us have some level of deviation to our septum. In many, the degree of misalignment may be so slight that it causes no symptoms at all.
But if the partition is very much off to one side, then symptoms may include nasal congestion that’s more on one side than the other, a post-nasal drip — where mucus runs down the back of the throat — poor sense of smell, recurrent nasal infections, sneezing and recurrent sinus and throat infections.
How many of your husband’s symptoms are due to the deviated septum is hard to assess, as these can also be caused by a problem stemming from the nasal lining, such as a seasonal allergy to pollen or a constant allergy to dust mites.
To clarify this we need to see if your husband’s symptoms are eased by an anti-allergy treatment. So I would suggest he tries a nasal steroid spray such as beclomethasone (available over the counter) for one to two months, or a spray containing an antihistamine (such as azelastine, available on prescription).
I would suggest you try this even if the main symptom is a constant blockage on one side of the nose, as it might reduce any narrowing caused by thickening of the lining due to allergy. Sometimes even a small improvement makes a big difference.
If the symptoms do not abate with allergy treatment, it is possible surgery to correct the septum might be needed. The surgery takes approximately 30 minutes and can be performed under local or general anaesthetic.
Symptoms: A deviated septum can cause poor sense of smell, recurrent nasal infections, sneezing and recurrent sinus and throat infections
As with all surgery, there is some risk. In this case that may include a possible reduction in the sense of smell or some alteration to the nose shape.
The decision about whether or not surgery is necessary is one that can be made only by an ear, nose and throat specialist, who can inspect the nasal airway and who will also investigate the possibility of allergy.
Be optimistic, as there is every chance your husband’s issue will be resolved once the source of his problem has been identified.
I have type 2 diabetes and was given Cialis pills for erectile dysfunction. They worked well initially, but it’s a bit hit-and-miss now and I wondered if my blood pressure tablets are to blame. I am on Metabet for my diabetes, ramipril and amlodipine for my blood pressure and simvastatin to cut my cholesterol.
Tam Aitken, by email.
Erectile dysfunction (ED), or the inability to achieve and maintain an erection, is a very common condition, particularly in older men and those with type 2 diabetes.
In diabetes, high levels of sugar in the blood can damage vessels and nerves, reducing blood flow and sensation in the penis, making it difficult to get aroused.
Levels of nitric oxide, a chemical that’s key to having an erection, can also be low in people with diabetes. The effect of blood pressure drugs on ED has been studied and the two you are taking — ramipril and amlodipine — are least likely to cause a problem.
Write to Dr Scurr
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His replies cannot apply to individual cases and should be taken in a general context.
Always consult your own GP with any health worries.
The simvastatin, which you’re taking to reduce your cholesterol, doesn’t affect erections and could actually be beneficial, by helping keep the key blood vessels healthy.
But we shouldn’t think only about your medication; we need to consider your lifestyle as a whole.
I don’t know if you are a smoker or are overweight, but if you are, addressing both of these things could help.
You should continue trying to lower your blood sugar by ensuring you take your Metabet tablets and maintaining a healthy diet. Studies suggest that regular aerobic exercise, such as jogging or cycling, may also help.
Last, but by no means least, try not to worry. Confidence is all-important here, and the fact Cialis sometimes helps, tells us your body can work well.
However, the occasional failure can damage confidence and breed anxiety, both of which can affect erectile function. So keep positive, make sure your weight and blood sugar are under control and be sure to take exercise on a daily basis, and you should see an improvement.
You may not get back the erectile function you had as a young man, but the prospects are good.
BTW, don’t be afraid to ask for help
A sudden trauma, whether physical or emotional, has lasting, life-damaging effects that none of us can resolve by going it alone — we all need help sometimes.
Last week, a close colleague, who lives in London, arrived at home at 10pm and within a minute, his doorbell sounded.
He opened the door and two men burst in, closing the door behind them so he was trapped.
They ransacked his home and knifed him in the chest and abdomen when he was hesitant about opening his small safe. He survived and was taken to hospital.
He called me, distraught, and we discussed what he should do when he was discharged.
I urged him to see a psychologist to help reduce the likely possibility of post-traumatic stress disorder. There is evidence that immediate intervention can help prevent subsequent flashbacks of the incident, and other traumatic experiences.
But some more painful life events can never be resolved, such as the loss of a child.
At the very moment I heard about the robbery, I had in my hand a new book — a tiny one, only 40 pages, not much bigger than a matchbox. It was the work of a man called Jim Lee, who was shattered by the death of his 13-year-old son, who was in a car accident.
He wrote the book, The Box, some years later to share his technique for coping with trauma, grief and loss. In effect, his method works like an immediate form of cognitive behavioural therapy for such a situation.
I recommend it.