Repeated accumulation of fluid in my middle ear
Question:
Thanks very much for sharing that, Don. I will give it a try. Richard Clark
– Hide quoted text — Show quoted text – I’ve been reading the notes in this post and I rarely offer advice. But I have had a problem with fluid in my middle ear for years. I’ve seen many ENT’s over the years, but went to one last year who prescribed a nasal spray which will open my Eustachian tubes. My right ear is the only one that I have this problem with. You have to use the nasal spray for about a week, then start every day holding your nose shut and blowing. The nasal spray will allow the Eustachian tubes to "pop" open and the fluid to drain. I am quite amazed that this nasal spray works for me and finally after many years, I can finally get relief from the moisture that gets in my right ear. The nasal spray is called Rhinocort Aqua (budesonide). By prescription only. Don — "Prayers go up, Blessings come down." My chronic condition is otitis media, which means that fluid repeatedly accumulates in my middle ear even after being removed. The problem began when I unwittingly took an airline flight a couple of years ago before I had gotten over a cold. When I landed both ears were ‘plugged up’ and remained this way for several weeks. At that time I went to a doctor and had my conditioned diagnosed. I then waited for another month or so, hoping that the ears would clear by themselves, which one of them did. Finally I decided to have an ear doctor lance the eardrum of my other ear and blow the fluid out through that temporary new opening. The eardrum healed in two weeks and all was well for a few months. Then the ear filled back up with fluid even though I had taken no more airplane trips. So I had the lancing procedure repeated, and this time the middle ear filled back up with fluid within a few weeks instead of a few months. Now it seems that my only option is to have a sixteenth-inch long, hourglass shaped ’tube’ installed in my eardrum, but this is a process I am reluctant to have done, mainly because I’ve been told that the ‘tube’ will naturally be excreted by my eardrum within a few months, and I expect that my ear will then fill up again, and I will have to have the procedure repeated every few months for the rest of my life. And what if, one time, the doctor slips up and pushes the ‘tube’ in too far when he’s installing it and the thing ends up rattling around inside my middle ear? I specifically asked him, via a faxed message, whether or not the thing could be blown out along with any fluid that might accumulate, and he chose not to answer the question. So is there anyone reading this who might have actually found a solution to a problem like mine? My doctor tells me that there is no harm in leaving the fluid in my middle ear permanently if the muffled hearing in that ear doesn’t bother me too much, but I’m not sure this is true. I’ve had ringing in that ear for more than a year, and I don’t think that’s a good sign. The key problem I have, as I understand it, is that my Eustachian tube is not functioning as it should. Whether this is due to infection in it, or excess mucous, or a combination of the two, I don’t know. So I guess one of my main questions is, if I attempt to clear up that Eustachian tube by avoiding foods to which I might be allergic and taking some kind of antibiotic – would amoxycillin be best? – would these treatments be more effective if I have a tube in my ear, or not? Finally, has anyone had any good effect from the two herbs that are supposed to help this condition — ambrosia and one other that I can’t remember.
Response:
What you describe is more complex than a question of just muffled hearing. The tube you describe is a common technique for preventing recurrent middle ear infections in children and is relatively safe. I say "relatively" because any procedure that involves putting a foreign body inside part of your body may have other problems associated with it. The risk of the ear tube going in too far is possible but not likely. I review medical complications for a living as a physician risk manager and I can tell you that this is not a complication that has crossed my desk to date. So I suppose that while it can happen, serious harm is exceedingly rare. The ringing in your ears may be related to a fluid buildup in another part of your ear, or it may be related to chronic injury from noise exposure or it may be "idiopathic" — doctor jargon for saying "we don’t know what the heck caused it." You may have any number of reasons for eustachian tube dysfunction: antibiotic resistant bacteria in your middle ear, chronic inflammation from allergies or chemical irritation, or just anatomical variation to name a few. By anatomical variation, I mean the diameter and angle of your eustachian tubes. Children get more middle ear infections because of anatomical features to their eustachian tubes that resolve as they get older. In theory, adults can resolve this ‘difference’ to varying degrees. Antibiotics are a short-term fix, but if used over time tend to select for germ resistance and then become useless if you get a more serious infection. There’s a lot more that can be said about this, including the pros, cons and alternatives to over the counter medications, presciption drugs and vitamins/herbal remedies. I used to be a flight surgeon for combat pilots so I’m familiar with a lot of the choices. I’m not going to take up more bandwidth with a long discussion here, but if there is truly interest in this subject I’ll put out a short course on middle ear problems by email to those requesting it. Anyone interested in this subject should send an email I’m pretty busy with seeing patients and doing clinical risk management so I’ll only put this out if there’s enough interest. Put your vote in for this if you Gerard Steve Rebagliati, MD
– Hide quoted text — Show quoted text – My chronic condition is otitis media, which means that fluid repeatedly accumulates in my middle ear even after being removed. The problem began when I unwittingly took an airline flight a couple of years ago before I had gotten over a cold. When I landed both ears were ‘plugged up’ and remained this way for several weeks. At that time I went to a doctor and had my conditioned diagnosed. I then waited for another month or so, hoping that the ears would clear by themselves, which one of them did. Finally I decided to have an ear doctor lance the eardrum of my other ear and blow the fluid out through that temporary new opening. The eardrum healed in two weeks and all was well for a few months. Then the ear filled back up with fluid even though I had taken no more airplane trips. So I had the lancing procedure repeated, and this time the middle ear filled back up with fluid within a few weeks instead of a few months. Now it seems that my only option is to have a sixteenth-inch long, hourglass shaped ’tube’ installed in my eardrum, but this is a process I am reluctant to have done, mainly because I’ve been told that the ‘tube’ will naturally be excreted by my eardrum within a few months, and I expect that my ear will then fill up again, and I will have to have the procedure repeated every few months for the rest of my life. And what if, one time, the doctor slips up and pushes the ‘tube’ in too far when he’s installing it and the thing ends up rattling around inside my middle ear? I specifically asked him, via a faxed message, whether or not the thing could be blown out along with any fluid that might accumulate, and he chose not to answer the question. So is there anyone reading this who might have actually found a solution to a problem like mine? My doctor tells me that there is no harm in leaving the fluid in my middle ear permanently if the muffled hearing in that ear doesn’t bother me too much, but I’m not sure this is true. I’ve had ringing in that ear for more than a year, and I don’t think that’s a good sign. The key problem I have, as I understand it, is that my Eustachian tube is not functioning as it should. Whether this is due to infection in it, or excess mucous, or a combination of the two, I don’t know. So I guess one of my main questions is, if I attempt to clear up that Eustachian tube by avoiding foods to which I might be allergic and taking some kind of antibiotic – would amoxycillin be best? – would these treatments be more effective if I have a tube in my ear, or not? Finally, has anyone had any good effect from the two herbs that are supposed to help this condition — ambrosia and one other that I can’t remember.
Response:
Thanks for that info, Eric. BTW, a local pharmacist suggested that I might with good effect combine Allegra and the Loratadine I am now taking. (As you probably know, psuedoephedrine is the active incredient in Allegra.) I hope the guy knows what he’s talking about. Richard
No…the active ingredient in Allegra is "fexofenadine", not even CLOSE to pseudoephedrine. Both that and loratidine are antihistamines, and neither has a direct decongestant action…unless you’re talking about Alegra-D, which does contain a decongestant. But so does generic Sudafed, over the counter, which will save you a lot of money over the price of a prescription co-pay. Mark, MD
Response:
Pseudoephedrine sounds like it might have a common chemical linkage with ephedra tea, no? And I’ve read that ephedra tea can be quite hazardous.
It’s a decongestant which is chemically very closely related to ephedrine (the active ingredient in ephedra tea). However, it’s quite a bit safer and as a regulated OTC pharmaceutical, it doesn’t suffer the chief problem associated with ephedra supplements and herbals, namely that the amount of active ingredient per dose can vary wildly (from ineffective dose to toxic dose). Nonetheless, it should be avoided if you have high blood pressure, and it shouldn’t be used long-term. But short-term usage in recommended doses isn’t particularly risky.
Response:
Thanks for that info, Eric. BTW, a local pharmacist suggested that I might with good effect combine Allegra and the Loratadine I am now taking. (As you probably know, psuedoephedrine is the active incredient in Allegra.) I hope the guy knows what he’s talking about. Richard
– Hide quoted text — Show quoted text – Pseudoephedrine sounds like it might have a common chemical linkage with ephedra tea, no? And I’ve read that ephedra tea can be quite hazardous. It’s a decongestant which is chemically very closely related to ephedrine (the active ingredient in ephedra tea). However, it’s quite a bit safer and as a regulated OTC pharmaceutical, it doesn’t suffer the chief problem associated with ephedra supplements and herbals, namely that the amount of active ingredient per dose can vary wildly (from ineffective dose to toxic dose). Nonetheless, it should be avoided if you have high blood pressure, and it shouldn’t be used long-term. But short-term usage in recommended doses isn’t particularly risky.
Response:
I’ve been reading the notes in this post and I rarely offer advice. But I have had a problem with fluid in my middle ear for years. I’ve seen many ENT’s over the years, but went to one last year who prescribed a nasal spray which will open my Eustachian tubes. My right ear is the only one that I have this problem with. You have to use the nasal spray for about a week, then start every day holding your nose shut and blowing. The nasal spray will allow the Eustachian tubes to "pop" open and the fluid to drain. I am quite amazed that this nasal spray works for me and finally after many years, I can finally get relief from the moisture that gets in my right ear. The nasal spray is called Rhinocort Aqua (budesonide). By prescription only. Don — "Prayers go up, Blessings come down."
– Hide quoted text — Show quoted text – My chronic condition is otitis media, which means that fluid repeatedly accumulates in my middle ear even after being removed. The problem began when I unwittingly took an airline flight a couple of years ago before I had gotten over a cold. When I landed both ears were ‘plugged up’ and remained this way for several weeks. At that time I went to a doctor and had my conditioned diagnosed. I then waited for another month or so, hoping that the ears would clear by themselves, which one of them did. Finally I decided to have an ear doctor lance the eardrum of my other ear and blow the fluid out through that temporary new opening. The eardrum healed in two weeks and all was well for a few months. Then the ear filled back up with fluid even though I had taken no more airplane trips. So I had the lancing procedure repeated, and this time the middle ear filled back up with fluid within a few weeks instead of a few months. Now it seems that my only option is to have a sixteenth-inch long, hourglass shaped ’tube’ installed in my eardrum, but this is a process I am reluctant to have done, mainly because I’ve been told that the ‘tube’ will naturally be excreted by my eardrum within a few months, and I expect that my ear will then fill up again, and I will have to have the procedure repeated every few months for the rest of my life. And what if, one time, the doctor slips up and pushes the ‘tube’ in too far when he’s installing it and the thing ends up rattling around inside my middle ear? I specifically asked him, via a faxed message, whether or not the thing could be blown out along with any fluid that might accumulate, and he chose not to answer the question. So is there anyone reading this who might have actually found a solution to a problem like mine? My doctor tells me that there is no harm in leaving the fluid in my middle ear permanently if the muffled hearing in that ear doesn’t bother me too much, but I’m not sure this is true. I’ve had ringing in that ear for more than a year, and I don’t think that’s a good sign. The key problem I have, as I understand it, is that my Eustachian tube is not functioning as it should. Whether this is due to infection in it, or excess mucous, or a combination of the two, I don’t know. So I guess one of my main questions is, if I attempt to clear up that Eustachian tube by avoiding foods to which I might be allergic and taking some kind of antibiotic – would amoxycillin be best? – would these treatments be more effective if I have a tube in my ear, or not? Finally, has anyone had any good effect from the two herbs that are supposed to help this condition — ambrosia and one other that I can’t remember.
Response:
The ear canal has a slight upward slope from the external opening, so’s water doesn’t naturally run into it. Rinsing your ears under a running shower nozzle would get much more water into the canal than cleansing the ear with a cloth and then rinsing with a cloth. You normally don’t need to swab/cleanse the canal. I’ve known folks who clean out ear wax with alcohol. Ear wax is part of the normal defense against dirt and belongs in the ear. If it is impacted, a doc should remove it.
My internist uses water pressure (from a sort-of squeeze bottle) to remove earwax, and suggests letting water from the shower run in there periodically to help keep it cleaned out. Not sure this is such a good idea…
Response:
My chronic condition is otitis media, which means that fluid repeatedly accumulates in my middle ear even after being removed.
You may have damage to your eustachian tube. The use of the tube is to allow time for it to heal. I any case, it is my understanding that a permanent or "straight" tube can be put into your ear for a long term solution. You just have to avoid getting water in the ear. Michael
Avoid getting water in the ear? That sounds very iffy. You can avoid getting water in the ear most of the time, but how do you avoid getting water in the ear all the time? I sometimes get water in the ear when I take a shower, I suppose it could happen other ways too, besides swimming, like maybe getting caught in a downpour outdoors.
Response:
- Hide quoted text — Show quoted text – My chronic condition is otitis media, which means that fluid repeatedly accumulates in my middle ear even after being removed. You may have damage to your eustachian tube. The use of the tube is to allow time for it to heal. I any case, it is my understanding that a permanent or "straight" tube can be put into your ear for a long term solution. You just have to avoid getting water in the ear. Michael Avoid getting water in the ear? That sounds very iffy. You can avoid getting water in the ear most of the time, but how do you avoid getting water in the ear all the time? I sometimes get water in the ear when I take a shower, I suppose it could happen other ways too, besides swimming, like maybe getting caught in a downpour outdoors.
The ear canal has a slight upward slope from the external opening, so’s water doesn’t naturally run into it. Rinsing your ears under a running shower nozzle would get much more water into the canal than cleansing the ear with a cloth and then rinsing with a cloth. You normally don’t need to swab/cleanse the canal. I’ve known folks who clean out ear wax with alcohol. Ear wax is part of the normal defense against dirt and belongs in the ear. If it is impacted, a doc should remove it. The turns and angles in the canal can trap water at the ear drum (swimmers ear)after swimming or blasting your ear with the shower. Tilting your head to each side can help make sure that water empties after swimming and doesn’t remain in the ear to cause bacterial or fungal infection. Chronic infections are not something to experiment with, as the inner structure is close to lots of important stuff, like the brain. Here’s a good anatomy lesson: http://www.bartleby.com/107/229.html
Response:
Dear Richard, Your problem is more common than you think. Having worked at an airport pharmacy for some years, I have heard this many times. In australia we have a product called Demazin which fixes this really well. You need to take it for 6 week periods. It contains pseudoepehedrine and dexchlorpheniramine. IT is not suitable for everyone eg high blood pressure. More info email me at www.healthystyle.com.au
– Hide quoted text — Show quoted text – My chronic condition is otitis media, which means that fluid repeatedly accumulates in my middle ear even after being removed. The problem began when I unwittingly took an airline flight a couple of years ago before I had gotten over a cold. When I landed both ears were ‘plugged up’ and remained this way for several weeks. At that time I went to a doctor and had my conditioned diagnosed. I then waited for another month or so, hoping that the ears would clear by themselves, which one of them did. Finally I decided to have an ear doctor lance the eardrum of my other ear and blow the fluid out through that temporary new opening. The eardrum healed in two weeks and all was well for a few months. Then the ear filled back up with fluid even though I had taken no more airplane trips. So I had the lancing procedure repeated, and this time the middle ear filled back up with fluid within a few weeks instead of a few months. Now it seems that my only option is to have a sixteenth-inch long, hourglass shaped ’tube’ installed in my eardrum, but this is a process I am reluctant to have done, mainly because I’ve been told that the ‘tube’ will naturally be excreted by my eardrum within a few months, and I expect that my ear will then fill up again, and I will have to have the procedure repeated every few months for the rest of my life. And what if, one time, the doctor slips up and pushes the ‘tube’ in too far when he’s installing it and the thing ends up rattling around inside my middle ear? I specifically asked him, via a faxed message, whether or not the thing could be blown out along with any fluid that might accumulate, and he chose not to answer the question. So is there anyone reading this who might have actually found a solution to a problem like mine? My doctor tells me that there is no harm in leaving the fluid in my middle ear permanently if the muffled hearing in that ear doesn’t bother me too much, but I’m not sure this is true. I’ve had ringing in that ear for more than a year, and I don’t think that’s a good sign. The key problem I have, as I understand it, is that my Eustachian tube is not functioning as it should. Whether this is due to infection in it, or excess mucous, or a combination of the two, I don’t know. So I guess one of my main questions is, if I attempt to clear up that Eustachian tube by avoiding foods to which I might be allergic and taking some kind of antibiotic – would amoxycillin be best? – would these treatments be more effective if I have a tube in my ear, or not? Finally, has anyone had any good effect from the two herbs that are supposed to help this condition — ambrosia and one other that I can’t remember.
Response:
Pseudoephedrine sounds like it might have a common chemical linkage with ephedra tea, no? And I’ve read that ephedra tea can be quite hazardous. But maybe I’ll give Loratadine a try. Thanks all for the thoughtful advice. Richard Clark
– Hide quoted text — Show quoted text – I would not recommend anyone take pseudoephedrine long term. This drug has a stimulative effect and can eventually lead to insomnia, tremors, palpitations and anxiety. Loratadine is a much better drug to use for blocked eustachian tubes. It can be bought over the counter at chemists and one tablet gives you 24 hour relief. Regards, Maree Dear Richard, Your problem is more common than you think. Having worked at an airport pharmacy for some years, I have heard this many times. In australia we have a product called Demazin which fixes this really well. You need to take it for 6 week periods. It contains pseudoepehedrine and dexchlorpheniramine. IT is not suitable for everyone eg high blood pressure. More info email me at www.healthystyle.com.au My chronic condition is otitis media, which means that fluid repeatedly accumulates in my middle ear even after being removed. The problem began when I unwittingly took an airline flight a couple of years ago before I had gotten over a cold. When I landed both ears were ‘plugged up’ and remained this way for several weeks. At that time I went to a doctor and had my conditioned diagnosed. I then waited for another month or so, hoping that the ears would clear by themselves, which one of them did. Finally I decided to have an ear doctor lance the eardrum of my other ear and blow the fluid out through that temporary new opening. The eardrum healed in two weeks and all was well for a few months. Then the ear filled back up with fluid even though I had taken no more airplane trips. So I had the lancing procedure repeated, and this time the middle ear filled back up with fluid within a few weeks instead of a few months. Now it seems that my only option is to have a sixteenth-inch long, hourglass shaped ’tube’ installed in my eardrum, but this is a process I am reluctant to have done, mainly because I’ve been told that the ‘tube’ will naturally be excreted by my eardrum within a few months, and I expect that my ear will then fill up again, and I will have to have the procedure repeated every few months for the rest of my life. And what if, one time, the doctor slips up and pushes the ‘tube’ in too far when he’s installing it and the thing ends up rattling around inside my middle ear? I specifically asked him, via a faxed message, whether or not the thing could be blown out along with any fluid that might accumulate, and he chose not to answer the question. So is there anyone reading this who might have actually found a solution to a problem like mine? My doctor tells me that there is no harm in leaving the fluid in my middle ear permanently if the muffled hearing in that ear doesn’t bother me too much, but I’m not sure this is true. I’ve had ringing in that ear for more than a year, and I don’t think that’s a good sign. The key problem I have, as I understand it, is that my Eustachian tube is not functioning as it should. Whether this is due to infection in it, or excess mucous, or a combination of the two, I don’t know. So I guess one of my main questions is, if I attempt to clear up that Eustachian tube by avoiding foods to which I might be allergic and taking some kind of antibiotic – would amoxycillin be best? – would these treatments be more effective if I have a tube in my ear, or not? Finally, has anyone had any good effect from the two herbs that are supposed to help this condition — ambrosia and one other that I can’t remember.
Response:
I would not recommend anyone take pseudoephedrine long term. This drug has a stimulative effect and can eventually lead to insomnia, tremors, palpitations and anxiety. Loratadine is a much better drug to use for blocked eustachian tubes. It can be bought over the counter at chemists and one tablet gives you 24 hour relief. Regards, Maree
– Hide quoted text — Show quoted text – Dear Richard, Your problem is more common than you think. Having worked at an airport pharmacy for some years, I have heard this many times. In australia we have a product called Demazin which fixes this really well. You need to take it for 6 week periods. It contains pseudoepehedrine and dexchlorpheniramine. IT is not suitable for everyone eg high blood pressure. More info email me at www.healthystyle.com.au My chronic condition is otitis media, which means that fluid repeatedly accumulates in my middle ear even after being removed. The problem began when I unwittingly took an airline flight a couple of years ago before I had gotten over a cold. When I landed both ears were ‘plugged up’ and remained this way for several weeks. At that time I went to a doctor and had my conditioned diagnosed. I then waited for another month or so, hoping that the ears would clear by themselves, which one of them did. Finally I decided to have an ear doctor lance the eardrum of my other ear and blow the fluid out through that temporary new opening. The eardrum healed in two weeks and all was well for a few months. Then the ear filled back up with fluid even though I had taken no more airplane trips. So I had the lancing procedure repeated, and this time the middle ear filled back up with fluid within a few weeks instead of a few months. Now it seems that my only option is to have a sixteenth-inch long, hourglass shaped ’tube’ installed in my eardrum, but this is a process I am reluctant to have done, mainly because I’ve been told that the ‘tube’ will naturally be excreted by my eardrum within a few months, and I expect that my ear will then fill up again, and I will have to have the procedure repeated every few months for the rest of my life. And what if, one time, the doctor slips up and pushes the ‘tube’ in too far when he’s installing it and the thing ends up rattling around inside my middle ear? I specifically asked him, via a faxed message, whether or not the thing could be blown out along with any fluid that might accumulate, and he chose not to answer the question. So is there anyone reading this who might have actually found a solution to a problem like mine? My doctor tells me that there is no harm in leaving the fluid in my middle ear permanently if the muffled hearing in that ear doesn’t bother me too much, but I’m not sure this is true. I’ve had ringing in that ear for more than a year, and I don’t think that’s a good sign. The key problem I have, as I understand it, is that my Eustachian tube is not functioning as it should. Whether this is due to infection in it, or excess mucous, or a combination of the two, I don’t know. So I guess one of my main questions is, if I attempt to clear up that Eustachian tube by avoiding foods to which I might be allergic and taking some kind of antibiotic – would amoxycillin be best? – would these treatments be more effective if I have a tube in my ear, or not? Finally, has anyone had any good effect from the two herbs that are supposed to help this condition — ambrosia and one other that I can’t remember.
Response:
My chronic condition is otitis media, which means that fluid repeatedly accumulates in my middle ear even after being removed. The problem began when I unwittingly took an airline flight a couple of years ago before I had gotten over a cold. When I landed both ears were ‘plugged up’ and remained this way for several weeks. At that time I went to a doctor and had my conditioned diagnosed. I then waited for another month or so, hoping that the ears would clear by themselves, which one of them did. Finally I decided to have an ear doctor lance the eardrum of my other ear and blow the fluid out through that temporary new opening. The eardrum healed in two weeks and all was well for a few months. Then the ear filled back up with fluid even though I had taken no more airplane trips. So I had the lancing procedure repeated, and this time the middle ear filled back up with fluid within a few weeks instead of a few months. Now it seems that my only option is to have a sixteenth-inch long, hourglass shaped ’tube’ installed in my eardrum, but this is a process I am reluctant to have done, mainly because I’ve been told that the ‘tube’ will naturally be excreted by my eardrum within a few months, and I expect that my ear will then fill up again, and I will have to have the procedure repeated every few months for the rest of my life. And what if, one time, the doctor slips up and pushes the ‘tube’ in too far when he’s installing it and the thing ends up rattling around inside my middle ear? I specifically asked him, via a faxed message, whether or not the thing could be blown out along with any fluid that might accumulate, and he chose not to answer the question. So is there anyone reading this who might have actually found a solution to a problem like mine? My doctor tells me that there is no harm in leaving the fluid in my middle ear permanently if the muffled hearing in that ear doesn’t bother me too much, but I’m not sure this is true. I’ve had ringing in that ear for more than a year, and I don’t think that’s a good sign. The key problem I have, as I understand it, is that my Eustachian tube is not functioning as it should. Whether this is due to infection in it, or excess mucous, or a combination of the two, I don’t know. So I guess one of my main questions is, if I attempt to clear up that Eustachian tube by avoiding foods to which I might be allergic and taking some kind of antibiotic – would amoxycillin be best? – would these treatments be more effective if I have a tube in my ear, or not? Finally, has anyone had any good effect from the two herbs that are supposed to help this condition — ambrosia and one other that I can’t remember.
Response:
My chronic condition is otitis media, which means that fluid repeatedly accumulates in my middle ear even after being removed.
You may have damage to your eustachian tube. The use of the tube is to allow time for it to heal. I any case, it is my understanding that a permanent or "straight" tube can be put into your ear for a long term solution. You just have to avoid getting water in the ear. Michael
