DR ELLIE CANNON: Why do I smell campfires in my nose?

SEVERAL times a year I smell a strange bonfire smell in my nostrils. I have read that this can be a sign of something very sinister. Is this true?

IF you have an altered sense of smell, it usually indicates a problem in the nose or sinuses.

Doctors call this phantosmia: patients smell odors that are not there.

The smell of smoke is one of the most common odors, but some people also smell the odor of rotting food and chemicals.

However, it doesn’t necessarily have to be something sinister.

General practitioners use the general rule that symptoms that have been present for a long time but are not getting worse are probably not dangerous.

A tumor in the sinuses can cause a change in smell, but this will get worse over time and is likely to be accompanied by other symptoms.

A common cause of phantosmia is a sinus infection or a condition called sinusitis, in which the sinuses become inflamed.

It is not uncommon for people to suffer from sinus infections repeatedly. This could explain why a person experiences a change in smell several times a year.

A change in smell can also be caused by a blockage in the nose.

Nasal polyps are fleshy tissue growths in the nose. They often block the nasal passage and are more common in later life.

Allergies cause the nose and sinuses to become inflamed. Some people experience phantosmia when there is a lot of pollen in the air.

If this happens, it is worth trying a nasal steroid spray from the pharmacy.

A salt water spray can also help flush out the nasal passages if something is blocked.

I HAVE ANKYLOSING SPONDYLITIS and used to take steroid tablets which helped control the pain. However, my doctor has told me to stop taking them as apparently steroids can thin the bones. I can now only have three steroid injections a year and I am in pain all the time. What should I do?

ANKYLOSATIVE is a chronic condition in which the spine and other parts of the body become inflamed.

It usually causes severe pain and stiffness in the back and neck, but it can also cause stiffness elsewhere.

Some patients also experience unpleasant intestinal complaints and swelling in the eyes.

There are treatments that are only intended to treat the pain, such as anti-inflammatory tablets. However, other treatments target the inflammation and prevent the condition from getting worse.

These include steroids, which can suppress the immune system and calm inflammation.

One risk of regular steroid use is that over time it increases the risk of the bone-thinning condition osteoporosis.

In addition, the danger is even greater for people with ankylosing spondylitis, who already have an increased risk of osteoporosis.

For some older patients, this can pose a significant risk of life-threatening falls.

Patients who do not show signs of osteoporosis and have benefited from a small daily dose should usually be considered for steroid treatment. When the patient is in severe pain, the benefits clearly outweigh the theoretical risks.

Patients in this situation should consider going back to their specialist and explicitly stating that they understand the risks and wish to resume steroid use.

SINCE my father passed away last year I have had trouble sleeping. I try to go to bed at the same time every night. I fall asleep right away but then wake up around 3:30am weather and stay awake for hours. What can I do?

IF you have trouble sleeping, you’re not alone: ​​millions of people in the UK struggle with this problem.

Also known as insomnia, the condition can be triggered by stress, anxiety, and grief. However, for some people, it can start for no apparent reason.

When it is fairly clear what the underlying issue is that is causing the insomnia – such as a death in the family – it is important to address that issue directly. This may involve talk therapy to help manage the symptoms of grief.

Prescribing sleeping pills is not a permanent solution and carries risks, including daytime sleepiness. Some patients also become dependent on them to sleep.

Doctors recommend improving your sleep environment, or as it is also called, your sleep hygiene.

One of the most important aspects of sleep hygiene is a comfortable, supportive mattress.

You can also purchase blackout curtains or earplugs.

There are safe and non-addictive medications that can improve your sleep.

GPs may prescribe melatonin – a sleep hormone that occurs naturally in the body – to patients over the age of 55. This is because it is thought that melatonin levels in the body decline as people age.

The NHS also recommends a sleep therapy app called Sleepio, which offers online cognitive behavioural therapy sessions – talking therapy that helps patients change the way they think – to manage insomnia.

Don’t lecture patients about the climate

IT ALWAYS frustrates me when doctors think they have the right to speak out about complex issues that are not patient-centered.

And last week was no exception when the Royal College of Physicians – a professional membership group for doctors – issued guidance urging members to talk to their patients about climate change. The college said doctors should use their place as “trusted members of the community” to warn about the dangers of global warming and “repeat it often”.

It also recommended that doctors reduce their carbon footprint by working from home and writing fewer prescriptions and tests. I wonder if anyone from the university has had a GP consultation recently. Yes, these are important issues, but they are not my patients’ priority and they shouldn’t be.

When patients are sick or concerned about their health, the last thing they need is a lecture about sustainability.

What’s Behind the Record Viagra Boom?

LAST week figures showed that the number of prescriptions for the erectile dysfunction drug Viagra is higher than ever.

According to the NHS, more than 4.5 million prescriptions for the little blue pill were written to men last year. And that doesn’t include those who buy it from their pharmacist or an online medical company.

It’s something I’ve seen myself in my operating room. Every week I hear from men who have difficulty with sexual performance. One reason for this is that the population is aging – and erectile dysfunction is more common with age.

Rising obesity and diabetes rates are also likely causes, as both conditions have been linked to the problem. However, I do worry that porn has left many men with unrealistic expectations of how often – and for how long – they should be able to get an erection, which could be part of the reason for this increased demand.

Have you recently received a prescription for Viagra? If so, I would like to know why.

Please email me at the email address at the bottom of the page and let me know what you think.

• Do you have a question for Dr Ellie Cannon? Please email DrEllie@mailonsunday.co.uk. Dr Cannon cannot enter into personal correspondence and her answers should be understood in a general context.