Q: A day after flying, I start feeling inner ear pressure and become very ill. My head hurts, and I feel dizzy and so nauseated that I vomit. Some symptoms last six months. My doctor put “pressure equalization tubes” in my ears, which helped but kept falling out. Now he wants to try larger tubes, but they require general anesthesia. Any advice?
— Linda, via email
A: If you fly twice a year, you’re spending most of the year feeling sick, so put on your big-girl pants and get a second opinion — as you should with any surgery. When you do, ask about other options, including whether the procedure can be done under a local anesthetic. But let’s clarify the problem so everyone knows why you’re having this trouble.
When you fly, your ears are subject to wild air-pressure swings. During takeoff, as cabin pressure plummets, pressure builds in your middle ear, where the eardrum is. A little air bubble is released through your eustachian tubes (tiny canals that connect the middle ear to your nose and throat) and you feel a little “pop,” then the pressure on either side of your eardrum equalizes. A similar process happens during landing.
Swallowing releases one of these little air bubbles. That’s why repeatedly swallowing, sucking on hard candy or yawning helps during takeoff and landing.
Unfortunately, your case falls into the “doozy” category; for some reason, your eustachian tubes aren’t up to the bubble-passing task. Usually, it’s temporary and happens when people fly with a cold or ear infection that has swollen their eustachian tubes. But for you, it’s chronic, and that persistently unequal pressure affects your balance, making you dizzy and nauseous. The tubes your doc suggests will keep your ears ventilated.
Have you tried taking a decongestant pill or nasal spray well before flying? If you have and still get that sick, the larger tubes may be worth it. You may have other options, but the bus takes such a long time to get anywhere, and a trip to Hawaii is out.
Q: I just got a routine blood test. My hemoglobin is high (15.2 g/dL), and so is my hematocrit (44.1 percent). Are these “highs” anything to worry about? — Lisa, Tahoe City
A: You’re wondering if you have too much of a good thing. Truth is, your hemoglobin and hematocrit are only “high-ish.”
Hemoglobin is a protein in red blood cells that carries oxygen and makes the cells red. The normal range for women is 12 to 15; you’re just a smidge above that. (For men, it’s 13 to 18.) Hematocrit is the percent of red blood cells in your blood, which should be 37 percent to 48 percent in women; you’re right in that range. (For men, it’s 45 percent to 52 percent.)
Our question is what your red blood cell count is, since it’s related to these two test results. We’re guessing it’s in the same high-normal ballpark. Talk to your doctor about repeating the tests to double-check your results, especially if your RBC is above 5.4 cells/mcL (for men, above 6.1).
We think it’s worth probing a little to see if there’s something lurking below the surface. For instance, kidney problems can produce a plethora of red cells if they release too much of a protein called erythropoietin, or EPO. But our best guess: You live at Lake Tahoe — which is about a mile above sea level, where there’s less oxygen in the air. Your body accommodates by making more hemoglobin to deliver more oxygen to your cells.
Q: My son was diagnosed with schizophrenia about 17 years ago. Staying on his medications has always been an issue. Are there any nutritional things he can do to either cut down on some meds or do better with those he’s on?
— Sally, via email
A: There’s a lot of interest in reducing the use of psychotropic meds for schizophrenia because of the drugs’ side effects. As many as 37 percent of people who take them have metabolic syndrome —a cluster of symptoms (including high blood pressure, big waists and insulin resistance) that can lead to heart disease, stroke and type 2 diabetes.
There’s some evidence that taking omega-3 supplements may allow people who have schizophrenia, like your son, to take less medication. Even better, omega-3s help prevent heart disease and stroke. While they certainly aren’t a cure, we think they’re worth a shot. We like the DHA form of omega-3s (and prefer algae-based supplements to fish oil) and recommend 600 mg to 900 mg a day. However, be sure to discuss this with your son’s doc.
The YOU Docs, Mehmet Oz and Mike Roizen, are authors of “YOU: On a Diet.” Want more? See “The Dr. Oz Show” on TV. To submit questions, go to www.RealAge.com.