JBader
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2 months ago
in Ear Wick - Not That Bad? on Is There Food?
I too would like to agree with WickerGirl. About 22 days ago, I started down the road to a nasty ear infection. I am an ER nurse and have access to lots of help . . . or so I thought. One day my left ear was tender. I thought, 'its no bid deal. I go back to work in a couple of days, I'll just have someone look "into" it then.' That was a bad idea. I awoke the next morning to a closed Eustacian tube. I could not hear out of my left ear at all and when I looked in the mirror, my ear was swollen out the side and bright red. I looked like the freak from Goonies. I went into the ER that morning to see one of my ER connections. The ARNP who works minor care looked into my ear and said that she could barely visualize my ear drum utilizing the otoscope. "This is not good," I thought. She prescribed me a Z pak to take care of the infection. The pounding and pressure in my ear was unbearable. The pain wasn't so much pain from the infection itself, but the pressure that was building in my ear and felt like it needed release. I felt the best when the otoscope was in my ear, because it was keeping the canal open. After the first day the swelling went down and after the second day, the pressure was a little more manageable. By the fifth day I was feeling like a champ and thought that we had the deal done. Two days later I started feeling an increase in pressure and after a few hours, the pain was back, a few hours more and the throbbing was building again. I went back and saw the ARNP she added cortisporin drop to my recovery regimen. But said I should probably have one of the physician's take a look because if it didn't improve in a couple of days, they were going to have to do a CT scan of my head to rule out Mastoiditis. Now just to explain how bad that sounded to me, let me digress and tell another short story.
The night before we had a 3 year old come into the ear that had an ear infection that was untreated for two weeks. That’s right mom and dad waited two whole weeks to take their 3 year old to see a doctor for ear pain. The infection had gotten so bad, it spread to the temporal bone of the ear, the mastoid, and had infected it. This can be bad enough. Treatment includes several days of inpatient hospital admission for IV antibiotic therapy and in some cases surgery to remove the infected bone, but that isn’t all that happened to this poor baby. The infection also spread to the brain and caused an abcess there that required surgical intervention by a pediatric neurosurgeon.
So I went and had the ER physician look and described my pain, and in fact I had been having tenderness of the area behind my ear, down my neck, including the joint where my jaw connects to the skull. After looking in my ear, the physician says, “I am about 90% sure that it’s mastoiditis. I don’t think we should wait a little longer, I think you need to have the CT done now.” So we went ahead and did the CT scan. Guess what? Results: NAF (No Acute Findings) in other words, it wasn’t mastoiditis. Yeah . . . but the hell is it. Week two, two antibiotics down now, no improvement. I see a different physician in the ER and they start me on Augmentin oral medication. A week later, not too much difference. At this point I call my PCP (primary care physician) and ask if there is anything he can do for me. Can he admit me get me some antibiotics and pain medication. Let’s get this thing over already. He says, he wants to see me in his office and have his in-office-ENT (Otolaryngologist) have a look see. So I go in and my doctor looks in the ear and is amazed to find that after two weeks with three antibiotics including the Augmentin that my Eustacian tube is still swollen shut and I am still in that much pain. So he decides to add CiproDex ear drops to the mix and he shoves a culturette (basically think Q-tip with long handle that is sterile for purposes of growing bacteria in a lab to determine what type of organism an infection is) deep into my ear, which as a lot to the emmense amount of pain I was already feeling. He says if the results show a better antibiotic he will call me and change the script I am taking. Otherwise, he wants to see me again next Monday. Now mind you I keep telling all these doctors that I don’t think the drops are getting to the infection because of the swelling, because I can feel the fluid pool in my ear and even after lying down and massaging the ear, the liquid still spills down my neck when I sit back up. He wants to hear nothing of it though. So its been 22 days total. I go back and see my physician again to tell him there is still no change that I can discern. He has me see the ENT physician he was going to have me see last time but didn’t. Guess what he says after looking at my ear through an otoscope and a special microscope made just for the ear? “I can’t believe after all this time and drugs you’ve taken your ear is still this swollen.” He gets the results of the culture from my PCP and tells me that I have “pseudomonas ar***.” Basically I have a type of fungal infection in my ear that is resistant to a lot of antibiotics, but CIPRO should have cleared up and that is what he usually prescribes. I asked could I have gotten this from the sinus infection I had just prior to getting the ear infection? He tells me he doesn’t think so. It is more likely that I touch a person or surface that had the organism growing on it and transferred it to my ear at some point. I was offended because I wash my hands before entering and before leaving every patient’s room. He could see my consternation and said that just because I did, doesn’t mean everyone else does and I could have touched a counter after someone else that had it and transferred it. Regardless we had the culprit and how to treat it, but if CIPRO was the best drug and that is what I had been taken how come I wasn’t noticing any improvement. He said it was possible because my canal was so swollen shut that not all of the antibiotic was reaching the infection. YOU THINK?!?!?!?!?!?!?! So he said he was going to put a wick in. He also told me, “this is probably going to hurt a lot, but it will help absorb the drops and deliver it to the infection, which will make you feel better in the long run.” Great lets do it. So he gentle places the wick in the grip of his otic forceps and procedures to slowly ease it into my ear canal. Now I am not going to lie. It didn’t make me feel all warm and gooey inside, but it wasn’t nearly as bad as I thought it was going to be when he placed it in there. I was relieved when he said it was in. Then he had me tilt my head to the side and instilled several drops of sterile water to make it expand and hold it in place. When the really cold drops hit the wick and it expanded, I instantly felt a great amount of relief. Probably the best my ear had felt in a while. The wick actually helped to hold open the canal. Not only could I now take the CiproDex ear drops and have them be absorbed into and down the canal, but it was holding open my canal which relieved a great deal of the pressure sensation that was building.
I am now on my second day of taking (and by taking I mean actually getting) CiproDex ear drops and Cipro tab orally and I am already feeling a great amount of relief. I wish I had been able to get all of this squared away early on.
The night before we had a 3 year old come into the ear that had an ear infection that was untreated for two weeks. That’s right mom and dad waited two whole weeks to take their 3 year old to see a doctor for ear pain. The infection had gotten so bad, it spread to the temporal bone of the ear, the mastoid, and had infected it. This can be bad enough. Treatment includes several days of inpatient hospital admission for IV antibiotic therapy and in some cases surgery to remove the infected bone, but that isn’t all that happened to this poor baby. The infection also spread to the brain and caused an abcess there that required surgical intervention by a pediatric neurosurgeon.
So I went and had the ER physician look and described my pain, and in fact I had been having tenderness of the area behind my ear, down my neck, including the joint where my jaw connects to the skull. After looking in my ear, the physician says, “I am about 90% sure that it’s mastoiditis. I don’t think we should wait a little longer, I think you need to have the CT done now.” So we went ahead and did the CT scan. Guess what? Results: NAF (No Acute Findings) in other words, it wasn’t mastoiditis. Yeah . . . but the hell is it. Week two, two antibiotics down now, no improvement. I see a different physician in the ER and they start me on Augmentin oral medication. A week later, not too much difference. At this point I call my PCP (primary care physician) and ask if there is anything he can do for me. Can he admit me get me some antibiotics and pain medication. Let’s get this thing over already. He says, he wants to see me in his office and have his in-office-ENT (Otolaryngologist) have a look see. So I go in and my doctor looks in the ear and is amazed to find that after two weeks with three antibiotics including the Augmentin that my Eustacian tube is still swollen shut and I am still in that much pain. So he decides to add CiproDex ear drops to the mix and he shoves a culturette (basically think Q-tip with long handle that is sterile for purposes of growing bacteria in a lab to determine what type of organism an infection is) deep into my ear, which as a lot to the emmense amount of pain I was already feeling. He says if the results show a better antibiotic he will call me and change the script I am taking. Otherwise, he wants to see me again next Monday. Now mind you I keep telling all these doctors that I don’t think the drops are getting to the infection because of the swelling, because I can feel the fluid pool in my ear and even after lying down and massaging the ear, the liquid still spills down my neck when I sit back up. He wants to hear nothing of it though. So its been 22 days total. I go back and see my physician again to tell him there is still no change that I can discern. He has me see the ENT physician he was going to have me see last time but didn’t. Guess what he says after looking at my ear through an otoscope and a special microscope made just for the ear? “I can’t believe after all this time and drugs you’ve taken your ear is still this swollen.” He gets the results of the culture from my PCP and tells me that I have “pseudomonas ar***.” Basically I have a type of fungal infection in my ear that is resistant to a lot of antibiotics, but CIPRO should have cleared up and that is what he usually prescribes. I asked could I have gotten this from the sinus infection I had just prior to getting the ear infection? He tells me he doesn’t think so. It is more likely that I touch a person or surface that had the organism growing on it and transferred it to my ear at some point. I was offended because I wash my hands before entering and before leaving every patient’s room. He could see my consternation and said that just because I did, doesn’t mean everyone else does and I could have touched a counter after someone else that had it and transferred it. Regardless we had the culprit and how to treat it, but if CIPRO was the best drug and that is what I had been taken how come I wasn’t noticing any improvement. He said it was possible because my canal was so swollen shut that not all of the antibiotic was reaching the infection. YOU THINK?!?!?!?!?!?!?! So he said he was going to put a wick in. He also told me, “this is probably going to hurt a lot, but it will help absorb the drops and deliver it to the infection, which will make you feel better in the long run.” Great lets do it. So he gentle places the wick in the grip of his otic forceps and procedures to slowly ease it into my ear canal. Now I am not going to lie. It didn’t make me feel all warm and gooey inside, but it wasn’t nearly as bad as I thought it was going to be when he placed it in there. I was relieved when he said it was in. Then he had me tilt my head to the side and instilled several drops of sterile water to make it expand and hold it in place. When the really cold drops hit the wick and it expanded, I instantly felt a great amount of relief. Probably the best my ear had felt in a while. The wick actually helped to hold open the canal. Not only could I now take the CiproDex ear drops and have them be absorbed into and down the canal, but it was holding open my canal which relieved a great deal of the pressure sensation that was building.
I am now on my second day of taking (and by taking I mean actually getting) CiproDex ear drops and Cipro tab orally and I am already feeling a great amount of relief. I wish I had been able to get all of this squared away early on.