Rx For Readers: Flying with ear infections?

Readers get answers to their health questions.

Interor of a passenger airplane (photo credit: INGIMAGE)
Interor of a passenger airplane
(photo credit: INGIMAGE)
A colleague at work recently had an operation on her ear because she had a hole in her eardrum, she said, because she had an ear infection while flying to the US.
A support had to be implanted because the eardrum was concave, and her hearing has been affected. I never heard of such a problem. It is common? What does one do if one has an ear infection before getting on a plane? Is there anything to do to prevent a perforated eardrum? Does this happen to children as well, and they are more likely to have ear infections than adults?
-H.B., Jerusalem
Dr. Ronen Perez, a hearing expert at Jerusalem’s Shaare Zedek Medical Center, replies: Most of us can feel the cabin pressure change in our ears while flying, especially during aircraft ascent and decent. When there is an ear infection, the effects of the pressure change may be enhanced due to clogging of the Eustachian tubes.
These connect the middle ear and the area behind the nose and are responsible for equalizing ear pressure. Flying when you have an ear infection may cause severe pain when taking off and landing, and in some cases may cause dizziness, ringing in the ears, perforation of the eardrum and even sensorineural hearing loss in rare cases. So if it is possible, it is preferable to postpone a flight for a day or two if one has an acute ear infection. If the flight cannot be postponed, I recommend using a nasal decongestant spray before and during the flight, swallow frequently and avoid falling asleep before landing. In any case, in the event of an ear infection before a flight, I recommend seeing an ear doctor. In some cases, we will even make a small hole in the eardrum and this will cancel the effect of the pressure change during the flight. These complications may also occur in children who generally have more ear infections than adults.
Regarding your colleague, many more details are needed for me to exactly understand her situation. I assume she had a retraction of the eardrum which in some cases may be a sign of chronic ear disease. Such a retraction may cause hearing loss and one of the options for treatment is by surgery using cartilage of other material to support the middle ear.
I am a woman in my 60s, in good health. Can you explain why my fingernails go through such extreme cycles? They are either healthy, strong and nice-looking, or brittle, weak and flaking. Is it to do with the season of the year? My diet remains constant, as does my use of detergents, and I take very few medications. And yet there are these extreme changes in the condition of my nails, from wonderful to poor, and back. A bit of a mystery. M.J., Jerusalem Dr. Julian Schamroth, a veteran Jerusalem dermatologist, comments: Nails do have a life cycle of their own. As infants, our nails are very thin and pliable and are quite transparent, with age; the nails become thicker and harder. As one matures into middle age, the nails often develop longitudinal ridging, flaking and splitting. All this is a normal process and cannot be avoided. If one’s nails are in such a state, then minor injury, such as from strong soaps or detergents, or from repetitive “knocks” such as piano playing, will tend to exacerbate the problem. Even excessive washing of the hands, resulting in frequent cycles of wetting and drying of the nails, can contribute to the problem.
These nail changes are almost never the result of calcium or zinc deficiency. In fact, most of the nail is composed of protein, with very little mineral content. Diet plays a very small part in such nail deformity. Occasionally, fungal infections of the nail, bacterial infections adjacent to the nail, or eczematous conditions of the skin proximal to the nail can cause nail deformities. These can usually be treated by a dermatologist. However, other disorders such as psoriasis of the nails or genetic nail dystrophies cannot be treated.
For minor nail flaking, there are some topical preparations such as Emtrix, which may help. Alternatively, Vaseline applied three times daily for a month may also improve the situation.
As for why your nail condition seems to go in cycles, it could be due to periodic minor trauma or frequent cyclical washing. There is no natural cycle in nails which could account for this.
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 9100002, fax your question to Judy Siegel-Itzkovich at (02) 538-9527, or e-mail it to jsiegel@jpost.com, giving your initials, age and place of residence.