A reader recently described experiencing a distressing sensitivity to noise after a long flight, which Dr. Martin Scurr identified as likely hyperacusis. This condition, where ordinary sounds become uncomfortable, intolerable, or even painful, can be triggered by various factors including loud noise exposure, head injury, migraine, or other ear and neurological issues. It is often exacerbated by existing hearing loss, as the auditory pathways attempt to compensate by amplifying sounds.
In the described case, the long flight from Australia, combined with potential Meniere's disease and the constant white noise from jet engines, may have contributed to the onset of hyperacusis. Fortunately, the reader's symptoms resolved on their own. While spontaneous recovery can occur, treatments such as cognitive behavioral therapy and sound desensitization therapy are available to help retrain the brain's response to sound and gradually reduce sensitivity.
Another reader presented with intermittent pain in their right big toe, accompanied by slight swelling, which occurs during walking. Dr. Scurr suspects this is an entrapment neuropathy, likely Joplin's neuroma, a specific form of nerve pinching near the big toe joint. This condition is typically triggered by walking, especially in tight footwear, and can lead to pain, tingling, or numbness.
Joplin's neuroma can develop from prolonged nerve compression, potentially due to tight shoes or bunions, leading to scar-like tissue that further irritates the nerve. Consultation with an orthopedic specialist or podiatrist is recommended for diagnosis. Treatment often involves corticosteroid injections around the affected nerve, and wearing wide-tipped shoes can help alleviate discomfort while awaiting treatment.
Separately, Dr. Scurr highlights the significant health risks associated with fructose, particularly from sugary drinks. The increasing prevalence of obesity, type 2 diabetes, and non-alcoholic fatty liver disease is linked to high fructose consumption. Non-alcoholic fatty liver disease, affecting a substantial portion of the UK adult population, was rarely encountered by doctors before the year 2000 but is now common.
The fructose in sugary beverages is identified as a primary culprit, leading to fat accumulation and inflammation in the liver, which can eventually progress to liver cancer in some cases. Studies indicate that consuming as little as 200g of fructose daily for two weeks can elevate liver enzyme levels. Dr. Scurr contrasts the strict regulations on alcohol with the apparent lack of awareness regarding the dangers of fructose consumption.
