Blocked ears (wax) self-care guidelines for patients
Earwax
Earwax is a normal build-up of dead cells, hair, foreign material such as dust, and natural wax which forms a protective coating on the skin in the ear canal. The quantity of earwax produced varies greatly from person to person.
A doctor or nurse can look into the ear canal and confirm a plug of earwax has formed, though this isn’t always necessary. A plug of earwax is not a serious problem, more a nuisance. You only need to remove earwax if it is causing symptoms such as dulled hearing or when fitting a hearing aid.
Do not put anything in your ear if you have pain or if you are aware that you have a perforation (hole in the ear drum)- see your nurse/GP.
Do not try to remove wax using a cotton bud or any other small item – this only stimulates the wax secreting glands – to make more wax – and gives a serious risk of infection and perforation! Nothing smaller than your elbow should go into your ear!
Note: If you think you have ear wax, do not try to clean the ear canal with cotton wool buds. This can make things worse, as you will push some earwax deeper inside. It may also cause an ear infection.
Ear drops alone will clear a plug of earwax in most cases. Put 2 or 3 drops of ordinary olive oil down the ear 2 or 3 times a day for 2-3 weeks. This softens the wax so that it then runs out of its own accord without harming the ear. You can continue for any length of time, but 3 weeks is usually enough. Surprisingly, you will not necessarily see wax come out. It often seems to come out unnoticed.
If you are prone to repeated wax built up you can continue to use olive oil drops twice a week to prevent recurrence.
If olive/almond/coconut oil does not work you can buy drops from pharmacies.
How to use ear drops:
- Warm the drops to room temperature before using them
- Pour a few drops into the affected ear
- Lie with the affected ear uppermost when putting in drops
- Stay like this for 10 minutes to allow the drops to soak into the earwax.
Bulb syringing is a safe, alternate way to remove ear wax. Bulb syringes can be easily purchased from a pharmacy and allow you to clear your ears from wax in your own home.
If your ears are painful or have fluid coming out of them, or if you have a hole in their ear drum (perforation) or have recently had surgery on your ear you should see a doctor or nurse and don’t use this method.
Bulb Syringing:
Instructions for Bulb Syringing:
Use olive oil drops twice a day for at least 14 days prior to bulb syringing. Or alternatively use sodium bicarbonate ear drops purchased from your pharmacy (please read the manufacturers leaflet.)
- Wash your hands.
- Use a bowl of cooled, boiled water that is warm to the touch, not too hot or too cold. You can use 50% water 50% vinegar if you would like as this has an anti-inflammatory effect due to acetic acid in the vinegar.
- Prepare the syringe by squirting water in and out of it a few times.
- Gently pull your outer ear “up and out” to help straighten out the canal, which will allow better access for the water
- Tilt your head so the ear to be treated is upmost.
- Place the tip of the syringe into the opening of the ear.- Do NOT push the syringe further into the ear and gently squirt one or more bulb syringes of water into your ear. (This might be best done in the shower so that the excess water will run into the bathtub and not on your floor)
- Allow the water to remain in your ear for at least 60 seconds. Gently tilt your head in the opposite direction and wiggle your outer ear
Ear irrigation is only recommended in the rare occasions where ear drops and bulb syringing has failed to work. Ear syringing can lead to ear infections, perforated ear drum and tinnitus (persistent noise) and therefore it is only performed in exceptional circumstances. If you think you have persisting wax despite taking the above measures please make an appointment with your doctor or nurse to discuss.
For patients who are not physically able to self-manage please discuss with the surgery.
Children & Young Peoples Out of Hours Advice Line
Cheshire and Wirral NHS Partnership Trust’s children and young peoples out of hours advice line, provides mental health services to children and young people, their families and concerned professionals outside of usual business hours.
All Clinicians you speak to are trained in different backgrounds and have experience and knowledge of a range of mental health difficulties.
> Are you a young person struggling with your mental health?
> Are you worried about your child’s mental health?
> Are you an adult working with a young person and are concerned about their mental health?
Contact our advice line for advice, support and resources.
Mon – Fri 5.00pm – 10.00pm
Weekends 12.00pm – 8.00pm
01244 397644
You can also visit http://www.mymind.org.uk/ to find out more information about children and young peoples mental health services.
You In Mind
YouinMind.org is an online platform helping you find mental health and wellbeing services in Cheshire.
Simple in design and easy to use, YouinMind.org is designed to connect those with mental health needs with local providers and online resources that they would otherwise be unable to find.
Whether you’re looking for professional support like counselling or wish to join a community group to improve your wellbeing, there’s something for everything on our website. Search by condition and postcode to discover suitable services near you.
At YouinMind.org, our goal is to make mental health services in Cheshire more accessible. We know that finding the right support can be a challenge; that’s why our platform is dedicated to signposting you to relevant services.
Our team works closely with local providers to keep our platform up-to-date and to make sure their services reach those that need it. If you run a mental health service, please get in touch so we can include you on our database.
Since launching in May 2017, we have partnered with over 150 providers and list more than 700 mental health services (accurate as of May 2018). We are currently commissioned NHS South Cheshire CCG and NHS Vale Royal CCG and we work in close partnership with NHS West Cheshire and NHS East Cheshire CCG.
Visit YouinMind.org, and find the mental health support you need.
Children & Young Peoples Advice Line
If you are worried or concerned about a young persons mental health, you can now access mental health advice and support outside if usual working hours by calling the Cheshire and Wirral Partnership NHS Foundation Trusts advice line.
Children and Young Persons Mental Health Advice Line Information Poster
Children and Young Persons Mental Health Advice Line Information Leaflet
Tiredness and Fatigue
Tiredness and Fatigue
Feeling exhausted is so common that it has its own acronym, TATT, which stands for “tired all the time”.
We all feel tired from time to time. The reasons are usually obvious and include:
- too many late nights
- long hours spent at work
- a baby keeping you up at night
But tiredness or exhaustion that goes on for a long time is not normal and can affect your ability to get on and enjoy your life.
Unexplained tiredness is one of the most common reasons for people to see their GP.
Some reasons you could be feeling tired might be:
- Not getting enough exercise.
Sitting in one position for long periods of time can sap your energy, even if you’re watching the TV or using the computer. Your body equates the stillness with going to sleep. - Poor posture
A lot of your energy goes on keeping you upright. Your spine can be put out of alignment by bad posture, such as:
-hunching forwards
-lumping in your seat
-cradling your phone
The more out of balance your spine is, the more your muscles have to work to compensate.
- Constant Worrying
If you’re fretting about something all day long, your heart rate and blood pressure rise, and your muscles tighten, leading to fatigue and aches.
Try: setting aside some time to concentrate on your worries. Try to think of positive solutions, then put the worries out of your mind.
- Exercising too much
Regular exercise is good for you, but working out intensively every day may not be good for your energy levels, especially if you’re a beginner or trying to get back in shape.
Try: taking a day off between strenuous bouts of exercise. However, don’t leave more than 2 or 3 days between sessions, or you might fall out of the regular exercise habit.
If you have difficulty falling asleep, a regular bedtime routine will help you wind down and prepare for bed.
Few people manage to stick to strict bedtime routines. This isn’t much of a problem for most people, but for insomniacs, irregular sleeping hours are unhelpful.
Your routine depends on what works for you, but the most important thing is working out a routine and sticking to it.
- Sleep at regular times
- Make sure you wind down before bed
- Try a warm bath before bed
- Write a ‘to do’ list for the next day to clear your mind of any distractions
- Read a book or listen to music
- Make sure your bedroom is dark and between 18°c and 24°c
- Relaxation exercises such as yoga or light stretches
If you have tried some of the techniques and you still feeling tired or fatigued and are concerned, visit your GP who will ask you questions about your lifestyle and may even decide carry out some simple tests for common issues such as anaemia.
Sunburn
Sunburn
Sunburn is damage caused to the skin by UV rays (sunshine).
The skin becomes red, warm, sore and tender. It may start to flake and peel after a few days, and will usually fully heal within 7 days.
Sunburn is usually mild and short-lived, but it’s important to try to avoid it because it can increase your risk of developing skin problems in later life, such as ageing (wrinkling) and skin cancer.
It can be easy to underestimate the strength of the sun when you’re outside. The wind and getting wet, such as going in and out of the sea, may cool your skin, so you don’t realise you’re getting burnt.
You should always be aware of the risk of sunburn if you’re outside in strong sunshine, and look out for your skin getting hot.
- Apply sunscreen
Apply a good amount of sunscreen of at least factor 15 and four-star UVA rating. You should follow the guidance on the bottle of how often you should reapply.
After swimming or being in water, you should always reapply sunscreen after you’ve got out and dried off, even if you use water-resistant sunscreen. - Spend time in the shade
Stay in the shade between the hottest hours of the day 11am & 3pm. - Cover up
Wear suitable clothing and sunglasses - Drink plenty
Drink plenty of water or juice throughout the day to keep hydrated. - Take extra care
You should take extra care in the sun if you:
– have pale, white or light brown skin
– have freckles or red/fair har
– tend to burn rather than tan
– have many moles
– have a family history of skin cancer
If you do get sunburnt follow these steps to try and ease your discomfort.
- Cool your skin by having a cold bath or shower or by holding a cool flannel or sponge to it
- Use lotions containing Aloe Vera to soothe and moisturise your skin
- Drink plenty of water to cool you down and prevent dehydration
- Take painkillers such as ibuprofen or paracetamol to relieve pain
Contact your GP or call NHS 111 if you feel unwell or you’re concerned about your sunburn, particularly if you’re burnt over a large area or have any of the more severe symptoms listed below.
You should also see your GP if a young child or baby has sunburn as their skin is particularly sensitive.
Signs of severe sunburn can include:
- blistering or swelling of the skin
- chills
- a high temperature (fever) of 38C (100.4F) or above
- dizziness, headaches and feeling sick – symptoms of heat exhaustion
Special burn cream and burn dressings may be needed for severe sunburn. These are available from your GP or nurse at your GP surgery.
Optician Services
Optician Services
If you are having problems with your eyes, visiting an optician is the best place to start.
Optometrists are highly trained to recognise abnormalities and conditions that could be causing your eye problems. They will prescribe and fit glasses and contact lenses, and, if necessary, they will refer you to a GP or a hospital eye clinic for further investigations.
If you are having problems with your eyes, visiting you optician is the best place to start.
Optometrists are highly trained to recognise abnormalities and conditions that could be causing your eye problems. They will prescribe and fit glasses and contact lenses, and, if necessary, they will refer you to a GP or a hospital eye clinic for further investigations.
You can find your local opticians by visiting NHS Choices.
You’re entitled to a free NHS sight test if you:
- are under 16
- are 16, 17 or 18 and in full-time education
- are 60 or over
- are registered as partially sighted or blind
- have been diagnosed with diabetes or glaucoma
- are 40 or over and your mother, father, sibling or child has been diagnosed with glaucoma
- have been advised by an eye doctor (ophthalmologist) that you’re at risk of glaucoma
- are a prisoner on leave from prison
- are eligible for an NHS complex lens voucher – your optician can advise you about your entitlement
You also qualify for a free NHS sight test if you:
- get Income Support
- get Income-based Jobseeker’s Allowance
- get Income-based Employment and Support Allowance
- get Pension Credit Guarantee Credit
- get tax credits and meet the criteria
- get Universal Credit and meet the criteria
- have a low income and are named on a valid NHS HC2 certificate for full help with health costs
Dental Services
Dental Services
Everyone should be able to access good-quality NHS dental services. There is no need to register with a dentist in the same way as with a GP because you are not bound to a catchment area.
There is no need to register with a dentist in the same way as with a GP because you are not bound to a catchment area.
Simply find a dental practice that’s convenient for you, whether it’s near your home or work, and phone them to see if there are any appointments available.
Dental practices won’t always have the capacity to take on new NHS patients – you may have to join a waiting list, look for a different dentist who is taking on new NHS patients, or be seen privately.
You can find the most convenient dentist to you via NHS Choices.
If you think you need urgent dental care, try contacting your usual dentist as some practices offer emergency dental slots and will provide care if clinically necessary.
You can also call NHS 111, who can put you in touch with an urgent dental service.
Do not contact your GP, as they will not be able to offer urgent or emergency dental care.
Dentistry is one of the few NHS services where you have to pay a contribution towards the cost of your care. The information on this page explains what you may have to pay for your NHS dental treatment.
- Emergency dental treatment – £20.60
This covers emergency care in a primary care NHS dental practice such as pain relief or a temporary filling. - Band 1 course of treatment – £20.60
This covers an examination, diagnosis (including X-rays), advice on how to prevent future problems, a scale and polish if clinically needed, and preventative care such as the application of fluoride varnish or fissure sealant if appropriate. - Band 2 course of treatment – £56.30
This covers everything listed in Band 1 above, plus any further treatment such as fillings, root canal work or removal of teeth but not more complex items covered by Band 3. - Band 3 course of treatment – £244.30
This covers everything listed in Bands 1 and 2 above, plus crowns, dentures, bridges and other laboratory work.
For more information about charges you can visit NHS Choices.
Drink Less
Drink Less
It’s one thing to enjoy a drink to unwind at the end of a long day.
But when that turns into two or three every night, you can end up drinking too much without even realising.
That can affect your body in all sorts of ways – putting on weight, disturbing your sleep and increasing your chances of developing high blood pressure, liver problems, heart attack and some types of cancer.
It’s easy to reduce those risks, with some help.
Current advice for men and women is to drink fewer than 14 units of alcohol a week and to spread drinking over 3 days or more if you do.
The One You Cheshire East Service has put together a whole host of tips and guidance, alongside community support services to help you keep your drinking under control
To access this free service you can:
Visit:The One You Website
Freephone: 0800 085 8818
Sprains and Strains
Sprains and Strains
Sprains and strains are common injuries affecting the muscles and ligaments. Most can be treated at home without seeing a GP.
Its likely to be a sprain or strain if:
- you have pain, tenderness or weakness – often around your ankle, foot, wrist, thumb, knee, leg or back
- the injured area is swollen or bruised
- you can’t put weight on the injury or use it normally
you have muscle spasms or cramping – where your muscles painfully tighten on their own
For the first couple of days, follow the 4 steps known as RICE therapy to help bring down swelling and support the injury:
1.Rest– stop any exercise or activities and try not to put any weight on the injury.
2.Ice– apply an ice pack (or a bag of frozen vegetables wrapped in a tea towel) to the injury for up to 20 minutes every 2 to 3 hours.
3.Compression– wrap a bandage around the injury to support it.
4. Elevate– keep it raised on a pillow as much as possible.
To help prevent swelling, try to avoid heat – such as hot baths and heat packs – alcohol and massages for the first couple of days.
When you can move the injured area without pain stopping you, try to keep moving it so the joint or muscle doesn’t become stiff.
After 2 weeks, most sprains and strains will feel better. Avoid strenuous exercise such as running for up to 8 weeks, as there’s a risk of further damage. Severe sprains and strains can take months to get back to normal.
Speak to a pharmacist about the best treatment for you. They might suggest tablets, or a cream or gel you rub on the skin.
Painkillers like paracetamol will ease the pain and ibuprofen will bring down swelling. However, you shouldn’t take ibuprofen for 48 hours after your injury as it may slow down healing.
You can find your nearest pharmacy at NHS Choices.
If you have a sprain or strain that’s taking longer than usual to get better, an appointment with a Physiotherapist might be of benefit.
You don’t need a GP appointment to book physiotherapy. You can book this direct at the reception desk by filling in a form stating what the problem is which will then be triaged by the physio department and they will offer you an appointment if appropriate.
