Q: Do you know of any good, safe ways of dealing with swimmer’s ear? I can usually feel it coming on (often within a couple of days of clearing out earwax or swimming in a lake or pond). I’d like to be able to clear it up before I need to see a doctor and get some antibiotics.
A: When water gets trapped in the ear, it can lead to an infection in the outer ear. This is called otitis externa, or more commonly swimmer’s ear. It often occurs after getting water in the ear or injuring it with a cotton swab or fingernail.
To tell if the pain is from the outer ear or from the middle ear (behind the eardrum), pull gently on the earlobe. This will increase the pain from swimmer’s ear but won’t change the pain from a middle-ear infection (otitis media).
If you have pain from swimmer’s ear, you need to see a doctor. Prescription eardrops containing a corticosteroid and an antibiotic or an anti-fungal agent can clear up such infections quickly.
Prevention is your best medicine, though. Rinsing the ear with a few drops of a solution of half white vinegar and half rubbing alcohol can help dry out excess moisture after swimming.
Q: More than a decade ago, I had a colonoscopy. Not liking that procedure, I chose to use Cologuard at the usual recommended 10-year retest. Both times, the tests were negative. Now, three years later, I asked my doctor to give me a referral to a gastroenterologist for my next Cologuard. She hemmed and hawed about the use of Cologuard, finally stating that her medical group is no longer using Cologuard because of “the inability to correlate the information provided by that test with the outcomes of a colonoscopy.”
My only option if I want a noninvasive screening would be to use an immunochemical fecal occult blood test yearly. Is this test reliable?
A: People at high risk of colorectal cancer due to family history or previous polyps should have regular colonoscopies. Other folks may benefit from a FIT (fecal immunochemical test). This over-the-counter home test reveals blood in the stool. A study published in the Annals of Internal Medicine (Feb. 26, 2019) showed that such tests detect up to 80% of cancers.
A colonoscopy detects up to 95% of colorectal cancers. FIT can be adjusted to pick up 91% of tumors, but it will also flag false-positive cases. Anyone who tests positive on a FIT will need a follow-up colonoscopy.
Q: Is there an alternative to amitriptyline as a sleeping pill? I worry about it because I have read on your website that it is an anti-cholinergic drug that could affect memory.
I can’t get to sleep. When I do, I keep waking up. Some nights I only get two to three hours of sleep.
A: Amitriptyline is a sedating antidepressant. It does have powerful anti-cholinergic activity and could affect cognitive function.
A nondrug option is cognitive behavioral therapy. It is considered an effective approach for chronic insomnia (Annals of Internal Medicine, Aug. 4, 2015). Other ways to get to sleep include acupressure, melatonin and herbs such as chamomile, valerian, ashwagandha and passionflower. To learn more about these and other strategies, you may wish to consult our online eGuide to Getting a Good Night’s Sleep. It is available in our health guide section at peoplespharmacy.com.