Ask Dr Mel: Blocked nose and blood clots

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Every week we bring you expert advice from Woman's Weekly's health expert Dr Melanie Wynne-Jones, a GP from Stockport with 26 years' experience. This week she answers questions on a blocked nose and polyps.

Q One side of my nose has felt blocked for months, but it doesn't hurt. Can I ignore it?

A No, you need to see your GP, although it's unlikely to be anything to worry about. I'm assuming you haven't accidentally 'lost' anything up your nose - quite common in children!

Our nostrils are divided by a gristly septum and lined with tissues that swell - for example, if we have a nasal allergy or cold - making both sides feel blocked. Allergies are often triggered by pollen, house dust and pets, and also produce running, itching and sneezing. One side can feel blocked if the septum is deviated (bent to one side), either because it's developed that way, or as the result of a nose injury.

If this is the cause, you might benefit from surgery to correct it. But you definitely need an internal telescope examination of your nose to rule out polyps. These are hard-to-see greyish growths that block the nasal passage, and are commoner in people with allergic noses.

They're usually benign, although they sometimes produce a discharge or bleed, but occasionally they're potentially cancerous, so they should always be removed to check, as well as to relieve the blockage - you'll need a general anaesthetic for this procedure. Unfortunately, benign polyps often recur.

Q I'm due to have a hip replacement soon. How can I reduce my risk of a blood clot afterwards?

A You're right to be concerned - without preventive treatment you have almost a 1-in-2 chance of developing a potentially fatal deep-vein thrombosis (DVT) after hip surgery.

DVTs can develop because we produce extra platelets (blood-clotting cells) to counteract bleeding after an operation, and as we're less mobile, blood can stagnate in leg and pelvic veins. Infections, dehydration, hormone treatment and a family tendency to DVT increase our personal risk, as does more than three hours' continuous travel in the four weeks before surgery.

National guidelines say pre-operative checks for all surgery should include an assessment of your personal DVT risk. For hip surgery, and many other types of operation, it's now routine to be given daily blood-thinning heparin injections under the skin once you're admitted to hospital. Your district nurse will continue these at home for up to four weeks.

You'll also be given special compression stockings to wear to help blood keep moving inside your veins - some hospitals also use pneumatic compression machines. Staff should check your legs regularly for signs of DVT, such as pain, swelling or redness, and if you develop it, you'll need several months' treatment with anticoagulant medication such as warfarin.

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Advice given here is for general information only and is correct on date of publication. Please seek help from your own GP if you have a medical problem.

By Dr Melanie Wynne-Jones

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