I am a 39-year-old man. I very much enjoy swimming in the Mediterranean and in pools. But I find that exposure to the water disrupts my hearing when I swim for a long time. Are there any ways to prevent my problem? C.W., Hod Hasharon Clinical communications specialist Yehudit Goldberg replies: Both children and adults suffer from time to time from an accumulation of water in the ears after swimming for long periods. This accumulation can cause infections in the exterior ear and the ear canal leading to the inside of the ear. The causes are bacteria and fungi, and they are liable to cause problems in the quality of hearing.It is very important to try to remove the water from the ears. The best way is to hold the head to one side and shake it, and then repeat the motion for the other ear; one can also try to dry the water with a tissue that will absorb it. You can also try drying out the ears with a hair dryer, but this has to be done carefully, using a very low temperature, especially for children with this problem.Another method is to spread out a towel on top of a cushion, and position your head with each ear lying on the towel. Lie there for a while until the water drains out.Make sure never to use a cotton swab on a stick, because it can cause damage and dirt to go deeper into the ear. Children who have undergone operations for “buttons” in their eardrums to allow water to seep out must use suitable earplugs in their ears when they swim. In principle, children under age seven who remain in the water for over a half hour should wear earplugs when they go into the water.A child who suffers from an accumulation of water in his ears should go to an ear, nose and throat specialist for a hearing exam to see if any damage to hearing has resulted.I have a nine-year-old son and a sevenyear- old daughter. During the last year, my son has been pulling out his eyelashes and eyebrows, and then pulls out the hair on the top of his head in a straight line in the middle.I know it is called trichotillomania, but I don’t know what to do about it. He is very intelligent, and my wife expects him to excel in his schoolwork. Could this be the reason for the problem? What can be done about it? We took him to a psychologist, but we were not impressed. What should we do? R.S., Tel Aviv Prof. Alan Apter, head of the department of psychological medicine at Schneider Children’s Medical Center in Petah Tikva, comments: This disorder is well-known in children.Usually it occurs on its own, but sometimes it can occur together with an anxiety disorder, obsessive-compulsive disorder or stress.The prognosis is usually good.The best treatment is habit reversal therapy, which was developed by Doug Woods at the University of Wisconsin. It should be delivered by a psychologist with special training in this area.My six-year-old daughter has twice had urinary infections since starting first grade. I finally figured out that it might be because she tries not to urinate in school, as the toilets are not kept clean by the maintenance staff. She doesn’t like to go there and holds it in until she comes home. I have complained to the principal, but it hasn’t done much good. What are the causes of urinary infections in young children, and could it be holding urine in? M.B., Lod.Dr. Roxanna Kalper, head of the pediatric nephrology service at the Dana-Dwek Children’s Hospital at Tel Aviv’s Sourasky Medical Center, says: Yes, it is possible. Holding in urine for any reason can cause urinary infections in children.When a child tries to hold it in but some drips out onto the underwear, this serves as a fertile field for the growth of bacteria, which can enter the bladder. There are other reasons, however. These include constipation, which in a girl can cause E. coli bacteria to reach the urinary system.Another possibility is worms in the intestinal system.Take her to a pediatrician to investigate the actual cause. If unpleasant toilets are reason for the infection, you must be more insistent that the school keeps them clean and welcoming. Your daughter should be encouraged not to hold urine in; insist that she empty her bladder as soon as she feels it has filled up. If bacteria are detected in a urine culture and general urine tests, antibiotics will be prescribed.But not every type of bacterium in urine constitutes a urinary infection. All the results have to be considered. Introducing “good bacteria” such as lactobacillus from Bio yogurt is also a good idea. If the situation does not improve, consult a pediatric nephrologist. ■ Rx for Readers welcomes queries from readers about medical problems. Experts will answer those we find most interesting. Write Rx for Readers, The Jerusalem Post, POB 81, Jerusalem 91000, fax your question to Judy Siegel-Itzkovich at (02) 538-9527, or e-mail it to email@example.com, giving your initials, age and place of residence.