When I was younger and in the club scene, I did a lot of cocaine. It’s been about two years since I have used, but I notice from time to time I’ll get a nosebleed that takes quite some time to stop and results in a large amount of blood loss. I haven’t told my doctor. What can I do to repair the damage?
John Portland, ME
As a physician working in L.A., I can tell you this is not an uncommon problem. Cocaine or anything used intranasally (crystal, K, etc.) can cause significant changes in the blood vessels of the nose, making it easier for them to bleed. The vessels also can enlarge, which makes the bleeding more profuse and occasionally difficult to control. I recommend the use of a topical antibiotic or even Vaseline. These can be applied several times during the day and at night to speed the healing. Dry environments (the desert, airplanes, homes with dry heat) can also worsen the situation. Using a room humidifier at night can improve things. If episodic bleeding persists, you should consult with an E.N.T. (ear, nose and throat) specialist. Occasionally, nasal drug use can lead to a perforation of the septum, which requires surgical repair. —TM
My boyfriend is always complaining that my breath isn’t the best. I brush multiple times a day, scrub the heck out of my tongue, rinse, floss and rinse some more, and he still complains. For some reason, I don’t notice. What is the problem and what can I do to fix it?
“Stinky” in Seattle, WA
Sounds like you’re in a bit of a stinky situation, my friend. Your bad breath, or halitosis, is an unpleasant condition for both you and your partner. Some people in your condition are not even aware there is a problem, which is common. Certain foods, such as onions and garlic, can cause this problem. Despite the fact that you brush and floss, particles of food remain in the mouth. I recommend the use of a Water Pik, as there are many bacteria in the mouth that can be stirred up when flossing, causing an odor to persist. I recommend adding peroxide, salt and herbs, such as camellia seed, lavender and eucalyptus, to the Water Pik mixture. Adding these elements can significantly reduce the odor and get you and your partner back in close proximity. Dry mouth can also be a cause of bad breath. A local infection in the respiratory tract, chronic sinusitis and a postnasal drip can be at play, too. The most common causes of chronic sinusitis and postnasal drip are food and environment sensitivities. These allergies can be tested by either blood or skin testing, which you will want to discuss with your doctor. As far as mouthwash, you might consider a special antimicrobial rinse with fluoride. In the meantime, make an appointment to see your dentist! —PF
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For the last year or so I’ve noticed that I get less and less sleep. I just turned 34 and am wondering if this has anything to do with getting older. It’s so bad that no matter how tired I am, it takes me a great deal of time to fall asleep, and even when I do, I wake up multiple times, resulting in only four or five hours of sleep a night. What can I do to get a good night’s rest?
Raphael Orlando, FL
One in three adults occasionally has insomnia. More females than males suffer from insomnia; however, the effects for everyone are the same—very unpleasant! There are two forms of insomnia: primary and secondary. Most cases are secondary to other diseases, such as heart, thyroid and lung disease, sleep apnea, anxiety, as well as caffeine, tobacco and alcohol use. In relation to age, it has been shown that people over 65 are likely to have difficulty with sleep. People prone to sleepless nights are those under a lot of stress, who are depressed, working nights or changing work hours and traveling from time zone to time zone.
The first thing you want to do is evaluate your lifestyle and make the appropriate changes to reduce stress. Added exercise and proper nutrition can help in this quest. Also, there are many medications used to help aid in a good night of rest. But a word of caution: Some of these medications are also addictive. If you want to avoid medications altogether, you can try select herbs: valerian, kava kava and chamomile can all assist in sleep. I often use extra magnesium and even meditate prior to beginning my sleep ritual. Guess what? I’ve never rested better. —PF
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