Ear Syringing

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We have a waiting list for Ear Syringing appointments, please speak to reception if you need this service.

Guidelines for ear syringing

Small amounts of ear wax are made all the time and form a protective coating to the skin in the ear canal. A plug of wax is not a serious problem and only needs removing if it is causing symptoms such as dulled hearing.


Removing plugs of ear wax

Ear drops will often clear a plug of wax.

Ear syringing may be required ONLY if ear drops do not work. 

However, ear syringing IS A LAST RESORT.

What NOT to do

  • Do not try to clean the canal with cotton buds etc. This has the effect of pushing the wax deeper inside. 
  • Do not use cotton wool in the ears after you have applied the drops as this stimulates the ears to produce more wax.

Ear drops

Ear drops to soften wax are available from pharmacies, (e.g. sodium bicarbonate, almond oil or olive oil ear drops). A few drops of the oil, and inserted into the ear canal will soften the wax and help to break it up.  You will need to tilt your head or lie on one side for at least 10 minutes after inserting the drops. The drops MUST be inserted 2-3 times a day for at least 2 weeks. If you cannot get help to instil the drops, it might be easier to use a dropper (available from a pharmacy).

Preventing the build up of wax

Some people are prone to developing wax plugs. This may be prevented by putting some wax softening drops in each ear once or twice a week.

If you have a build-up of wax and have used oil regularly for a minimum of ten days and it has not improved your dulled hearing, please contact the surgery and discuss the option of ear syringing. Syringing is usually painless. Lukewarm water is squirted into the ear canal to dislodge the wax. Some people feel dizzy after ear syringing but this quickly settles. Occasionally you may develop an inflammation in the canal following syringing, causing itching and discomfort. This can be treated with ear drops available on prescription.

Ear syringing may not be advised if you have certain ear problems, in particular recurring infections or perforation. This will be assessed by the nurse at your appointment.

The appointment with a nurse will just be for ear syringing. If you need other tests carried out (e.g. blood pressure or blood tests), you will need to advise the receptionist at the time of booking the appointment so that extra time can be allowed.

Diabetic Clinic

This is run by our nursing team offering advice and general health checks to patients diagnosed with diabetes.

Counsellor

We have a counsellor and a cognitive behaviour therapist. You can self-refer into these services.

Please ask for a leaflet at Reception or go to www.derbyshirehealthcareft.nhs.uk or click on the Self Refer button.

Contraception

IMPLANTS – arm

Nexplanon Patient Information Leaflet 

Implant-Fitting-Checklist-Consent-Form

COIL – Intra-uterine device (copper coil) & Intra-uterine systems

Copper coil – Patient Information Leaflet

Mirena coil -Patient Information Leaflet 

Coil-Fitting-Checklist-Consent-Form-V2 

Preparing for your Coil-fitting Appointment

We strongly encourage you to watch the video found on the sexual health matters website which is linked below. This gives you a lot of useful information about intra-uterine methods:

www.yoursexualhealthmatters.org.uk/contraception/coil-fitting-appointment

You will then need to make a “10 minute pre-fit telephone consultation” with one of the coil fitting doctors (Drs Fenwick or Jennison) before you book in for a coil fit. This allows you to discuss your contraceptive needs, the pros and cons of the coil, and make an informed decision.

If you have any unusual discharge or have had a change in your sexual partner in the last 12 months you may need to have swabs taken with the nurse before the fitting appointment is booked.

You should print, read and sign the Coil Fit – Checklist Consent form above and bring this along to your fitting appointment.

Coil-fitting Appointment

A coil-fitting appointment usually takes about 30 minutes. Please make sure you have plenty of time for your appointment and that you have had something to eat beforehand. Where possible find childcare for small children.

Ideally a coil is fitted between day 3-12 of your cycle to ensure you are not pregnant and the neck of the womb (cervix) is more likely to be a little open and therefore the coil is easier to fit. It can be fitted outside these dates in some circumstances.  Your doctor will discuss this with you.

It is very important that there is no possibility that you are pregnant at the time of a coil-fitting

If you are having a new coil fitted please avoid having intercourse from the first day of your period or make sure you have used contraception very carefully for at least three weeks before your appointment.

If your appointment is for a coil change, you need to avoid intercourse for the week before fitting in case, for any reason, a new coil can’t be inserted once the old one has been removed. If your coil is out of date however, you should avoid intercourse for three weeks before the appointment.

Please take 1g Paracetamol (two tablets) and/or 400mg Ibuprofen about 1 hour before your appointment as you may experience abdominal cramps similar to period pain, post fit. Please bring a sanitary towel to your appointment as you may have some bleeding/spotting.

Before the coil is fitted, you will have an internal examination to determine the size and position of your womb. This is to ensure the coil can be put in the correct place. An internal measurement of the length of the womb is made and then the coil is inserted. The coil-fitting takes 15-20minutes. The vagina is held open with a speculum, like during a smear test, and the coil is fitted through the cervix into the womb.

After your Coil-fitting Appointment

You may get some crampy period type pains for a few days after a coil fit. You should avoid strenuous exercise for the rest of the day that the coil is fitted on. The pain should settle with simple pain relief such as Paracetamol and/or Ibuprofen as above. If it doesn’t, please call the surgery to speak to a GP.

It is quite normal to have unpredictable or sometimes heavier bleeding after a coil fitting, but if the bleeding is very heavy and prolonged or you develop smelly discharge or pain this could be a sign of infection, so please call us to discuss these symptoms.

Avoid using tampons for the first four weeks after the coil fit. After that it is fine to use them but be careful when you remove them not to pull the coil threads too.

With the hormone coil, it is normal to have some irregular bleeding for the first few months but if you are concerned about this at all, please contact one of the doctors.

If you have had a copper coil fitted you are protected from pregnancy as soon as the coil is in place.  If you have had a hormone coil fitted, (mirena/kyleena/jaydess) it needs to be in place for 7 days before you are protected.  We advise however that you should continue using condoms or continue contraceptive pills for four weeks. This is because the time of greatest risk of expulsion (the coil falling out) is in the first few weeks after fitting.

We do not ask you to return for a coil check, but you should have been taught how to check for your coil threads at the fitting appointment. You should perform this check 4 weeks after the coil is fitted. You can feel the threads by placing one leg on the side of the bath and inserting a finger into the vagina, upwards and backwards. You will be able to feel the threads (coarse hairs/soft wire consistency) around the cervix. (The cervix feels like the end of your nose with a dimple in it).  If you can’t feel the threads, please see a nurse or GP as soon as possible and use additional contraception such as condoms until your coil fit has been checked.

Removing the coil is a very simple and quick procedure that rarely causes much discomfort (even if the fitting was painful). You should avoid intercourse for seven days before a planned removal to avoid any risk of pregnancy.  Please contact the surgery to make an appointment if you would like to have your coil removed at any time.

Citizens Advice

Derbyshire Districts Citizens Advice Bureau can give you free, confidential, impartial and independent advice and information on a wide range of subjects.
Telephone Advice Line: Mon-Fri, 9am-4pm, 0808 278 7954 or further information please see the website.

At Appletree Medical Practice we have a Citizens Advice clinic in the surgery on alternating Wednesday mornings, restarting 13th April 2022. For more information please call 0808 278 7954.

Child Health

All babies are invited for a 6 week post-natal medical check with a GP.  Immunisations start at 8 weeks; Immunisation information can be found on www.nhs.uk.

Anticoagulation Clinic

Patients who are on Warfarin, a drug used in the prevention of the formation of blood clots in the blood vessels, require regular blood tests. The nurses are trained in anticoagulation monitoring and in the dosing of warfarin.

Antenatal Clinic

This clinic is run by the midwife. When you become pregnant you will be given an appointment at which she will ask you a few questions and carry out some general health checks. You will be seen regularly throughout your pregnancy by the midwife.