Q I am a 28 year old unmarried female. Of and on I’ve been having chest pains with a gap of months, since the year 2000. It feels as if a finger is deeply poking inside my body. Initially, it was on the right side, occurring at a different point every time. Since last year, it has shifted to the left side. Now, the pain pattern has changed, it spreads. These days, sometimes the pain is in the lower chest, sometimes near the armpit and sometimes in the upper chest (all on the left side).
I’ve no palpitation, no perspiration during the pain but yes I get upset sometimes because of continuous pain. I do have phlegm occurring. Lack of fresh air in the room sometimes makes it difficult to breathe. Slowly sipping water and deep breathing relaxes me at that time. The pain does not start during tension.
According to the x-ray, ECG and echocardiography reports, there is no heart or chest problem. Please give me some suggestions.
A I presume you have consulted your physician who advised the investigations you mentioned. I cannot answer your question with confidence without finding out detailed history and an examination. however, I do not think of any serious illness on the basis of data provided.
Dr S. Ali Arslan
Liaquat National Hospital
Q Do you know of any reason why I have bleeding on the inside of my ear, nothing was stuck inside or there has been no head trauma. When I insert my fingertip into my ears, it comes out red with fresh blood which does not drip out but it does cover the finger. However, I am on the Nicorette CQ patches to stop smoking, could this in anyway be related to the patches?
A Bleeding from the ear is a very rare condition. The most common case is trauma, usually external trauma or head injuries. But the local trauma that is ear cleaning with cotton buds, use of sharp objects like pencils, keys, hair pins to scratch the ear can cause bleeding. Even fingers with enlarged nails can cause this problem. Bleeding disorders are not related with such problems.
Please do not insert your finger tips or any other object in your ears. If you refrain from touching your ears for a couple of weeks, your complaint will most likely disappear by itself. It would be even better if you consult some ENT specialist for local examination and, if required, ear toilet or cleaning.
The side effects of Nicorette are diarrhoea, thirst, heartburn, indigestion (dyspepsia), dizziness, difficulty in breathing (dyspnoea), hiccups, unpleasant taste, mouth irritation, sensation of a lump in the throat, headache, difficulty in sleeping (insomnia) and nausea. In case of Nicorette CQ patch, you can add local skin reactions to the list. There is no relation between ear bleeding and Nicorette CQ patch.
Dr Mubasher Ikram
Aga Khan University Hospital
Identities of the questioners are being withheld on request.
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