Ear infections

[JR8]

I seem to have something of a recurring problem with ear infections. I seem more prone to them when I'm in Singapore, but am imagining that that's down to climate here.

I have quite recently learned that you're apparently not meant to use ear-buds to clean out your ears of any wax. This is something that I am in the habit of doing.... I mean if it's that problematic then why are they called 'ear-buds'... ...

I've been looking into it further, and was surprised to read that (apparently) many infections self-resolve after a few days. I'm rather torn between such a 'wait and see' approach, and the alternative of going to my doctor and him almost certainly putting me on antibiotics. I have the tube of topical cream I was prescribed last time (Zaricort), but the ear canal is so swollen I can't get an ear-bud in to apply it!

I have been treating it with H2O2 (lie on side, fill ear-canal with peroxide/3%, leave for 20 minutes, repeat for 5 days) but at this point in time can't tell if that is resolving anything.

Does anyone else else here have experience with this problem? Since I haven't used the swimming pool for a week or so, I am thinking that this has been caused by getting water in my ears when simply showering!

I perked up a bit when I came upon this suggestion:
'Home Remedies for Ear Infections'
10. Breast Milk
Breast milk has natural antibodies that can help speed up the healing process of any kind of ear infection. It will alleviate swelling and discomfort and can get rid of an ear infection within one or two days. This remedy works for both children and adults.
Using a dropper, put a few drops of breast milk into the affected ear. Repeat the process every few hours as needed.
http://www.top10homeremedies.com/home-r ... ion.html/3

... but have no wish to trigger a divorce!

Does anyone have any suggestions, or is it off to the doc and antibiotics for me?

[Steve1960]

I am also a regular sufferer and have been for years. Being a competitive swimmer in my teens didn't help. Now almost every time I take my daughter swimming at Toa Payoh pool I get an ear infection a day or so later.

My mother used to pour a little warm olive oil in my ear when I was younger. Not sure if that was just an old wives tale thing or even if it is wise to do so!

If it's mild I do wait a few days and see if it self heals, often it does. I don't 'fiddle' with my ear at all just let it alone for a few days.

If it's more than a mild infection, which yours seems to be, I head to the Doc.

Oh, and I never use ear buds to clean inside my ears.

[Steve1960]

Actually the wife is still breast feeding the baby so I could try that without triggering a divorce

[nakatago]

I'm normally good with self-medicating (I have a modicum of understanding of basic treatments and drugs and stuff and the sense to know my boundaries) but infections are one thing I would always leave to medical doctors.

And in your case, it's been already five days. Definitely worth a doctor's visit.

FFS, I assume you have good insurance so you might as well use it instead of prolonging the agony. I'd only treat myself for such cases if I know I need to tide myself over until I reach the clinic.

[JR8]

I'm normally good with self-medicating (I have a modicum of understanding of basic treatments and drugs and stuff and the sense to know my boundaries) but infections are one thing I would always leave to medical doctors.
And in your case, it's been already five days. Definitely worth a doctor's visit.
FFS, I assume you have good insurance so you might as well use it instead of prolonging the agony. I'd only treat myself for such cases if I know I need to tide myself over until I reach the clinic.

No it's been 2 days I think. The H2O2 treatment is suggested to extend to 5 days, hence right now, 2 days in, I can't tell if it is working (apols if that wasn't clear).

@Steve. Yes I've heard of 'the olive oil treatment'. I imagine it's about the oil dissolving the wax? As a child in the UK the doctor would flush your ears out using a huge syringe of warm water, and Oh the gunk that used to come out! :-O

Public swimming pools are notorious for being bug-filled. Mind you, the sea if surprisingly so too. For example, when I'm off diving, after each day when I'm back on-shore and showered off I rinse my ears with fresh water, get that out, and then use a product called Swim-Ear (alcohol, to help lower the surface tension and get any water out, + glycerine, as a moisturiser). One would hope that you'd get less ear infections simply taking a shower, than by spending up to three hours a day in plankton filled soup, but it doesn't seem to be the case. Swim-Ear might be a solution for you as a preventative, but for me at this point in time unfortunately it's too late. p.s. You can even find suggestions on the web for making an 'ear-dryer' at home. Rubbing alcohol and glycerine, you wouldn't have thought it could be that hard to DIY... But I still wouldn't have thought of using it after simply taking a shower.

[QRM]

I used to get a lot of ear infections and as I had a brain tumour removal via the ear, ( basically the ear looks normal but there is nothing but a titanium plate and a load of fat from my tummy stuffed in there.) so getting an infection on that side is always a bit of worry. I found always swimming/showering with ear plugs helped a lot.

If I feel a pain brewing, I live on lempsip for two days as the decongestant will clear the Eustachian tube allowing any potential goo to flow out, rather than fester inside.

Seems to work.

[PNGMK]

I have similar issues.

After swimming put a drop of alcohol in to dry out and kill microbes (spirits - i.e. ethanol).

Don't put anything like a bud in your ear at all - it took me a year to wean myself of this but it makes a big difference. Learn to sit still and feel the wax being pushed out of your ears by the tiny movements of the hairs in the canal.

Colds and flus really bugger up my ears as well and I'm basically deaf on my RH side so I'm a bit cautious around my ears.

[taxico]

I seem to have something of a recurring problem with ear infections. I seem more prone to them when I'm in Singapore, but am imagining that that's down to climate here.

...I've been looking into it further, and was surprised to read that (apparently) many infections self-resolve after a few days. I'm rather torn between such a 'wait and see' approach, and the alternative of going to my doctor and him almost certainly putting me on antibiotics. I have the tube of topical cream I was prescribed last time (Zaricort), but the ear canal is so swollen I can't get an ear-bud in to apply it!

i'm sorry i didn't see this earlier - i no longer check in here as regularly as the other sub-forums...

without a doctor peering into your ear with an otoscope, it's difficult to say if you need to apply or take any medication.

generally if the discomfort is not extreme (eg, decent sleep, minor to no sound sensitivity, neck not enlarged), and you're not feverish, etc... i suppose you could wait it out.

if your cream can't be applied, it's time to get new medication that can be dripped into your ear.

if you're worried, it might pay to do a culture to figure out what's growing where and how to best treat it (although zaricort is both an anti-inflamm and anti-fungal).

anyhow, i hope it's all cleared up by now.

[JR8]

Update:

My local GP referred me to a specialist. The simplest way of giving a summary is Copy/Pasting an anonymised version of a recap of the experience I wrote to my wife when I got home :
--------------------------------
'In brief he used a sucker/vacuum probe thing to vacuum ‘white goo’ off my eardrums. There was a screen on the wall so I got to watch the action up real close!

I then went back into the waiting room where he treated my ears with H2O2/peroxide. Bit weird as this was in front of others. So first one ear, and I had to sit with my head tilted to the side looking like a spazzer, and then he came back after 10-15mins and did the same to the other ear. So for 20-30mins no one wanted to sit next to spazzer-matsal...

Then I went back in and he inspected my ears again and did some more ‘vacuuming’. Then he said I have a middle ear infection and that he wanted to put the camera probe up there (via my eustachian tube/throat I imagine) to check and that would be an additional $3-400. And could I wait 2 hours until he had a time slot for that? I replied that I was referred to him for external ear-cleaning, and that I have no health insurance for any of these works, I’m paying 100% from my own account, and asked if it was *really* necessary.

So he relented, and said that he would put me on medicine and that should relieve it, and that if it didn’t to return to him again. He faxed a ‘letting of findings’ to [my local referring doctor]. He gave me a hard-copy to deliver to [the latter] too. By now I think he was realising that I was neither rich nor some cash-cow to be milked (a la xxx hospital [where I was an expensed in-patient in Europe, and got every suggested treatment, experimental and otherwise, but all very expensive - until I received a highly informed 2nd opinion that it was completely unecessary]). He applied some triple component cream (steroid, anti-fungal, and antibiotic) cream to my ear canals and that was me done. He said he would prescribe the medicine required but volunteered that it would be cheaper to get them from my neighborhood GP, he would charge $90 for them. He also gave me a discount on one line on his bill of something like 50% off $150, so about $75, and kept repeating I mustn’t tell anyone. So that was me in total $315 lighter, but better than the suggested ... circa $800 it was heading for...

He wanted me to make a follow-up appointment in 2 weeks right then. I suggested that if the treatment doesn’t work *then* I’ll make an appointment. I.e. I’m not going to book now to go back and pay maybe $500 to tell him I’m fine... I left feeling I’d received good advice and immediate treatment, but was, well, like at [xxx, per prior experience], being treated like a cash-cow to be milked to the max.

So on the way home I dropped in on [local doctor], explained to the receptionist, and she suggested I have a quick word with the doctor. Luckily she let me jump the perennial queue of about 6-7 people! So in I went, very briefly outlined the morning to him, and asked for the prescription. He remarked ’Yes, they [the prescription] will *certainly* be cheaper from me’, so that was that, in and out in five minutes. Cost $42 (i.e. under half what the specialist would have charged).

Ouch still, but $350 is better than the $850 it would have been!'
-----------------------------------------------


So I'd like to raise a few cautionary points from this experience:
- I was referred to this specialist by my local doctor. I would have been quite happy seeing a 'local' specialist, but it turned out to be the Presidents ENT specialist (no less), with fees to match.
- It felt like there was an automatic presumption that I'd be billing any fees, and so would agree to any proposed treatment, ad hoc, whether they were a part of the original scope or not.

=> I'd suggest if you are not on medical insurance here, and get referred to a private specialist, that right at the outset you politely explain that all costs are coming from your own pocket. Resolving this 'simple ear infection' has already cost me about $500, and it is no better yet!

==> Oh, and *don't* use cotton ear-buds to 'clean' your ear-canals!

[PNGMK]

The probe vaccuuming was very helpful for my issue a few years back. The bill was about the same.

[JR8]

Ok, thanks noted.

Can you believe it, he gave me a DVD of the procedure, but I really haven't the stomach or even curiosity to watch it!?

It's not that I'm squeamish, but it's just like ....why would I want to!?

[taxico]

your (every) GP earns a commission from each successful referral. this money doesn't just magically appear in his/her bank account from nowhere.

you are at liberty to not buy any medication, or refuse any/all treatments offered by the doctor.

you are allowed to (you should) ask for a prescription and shop around. you are allowed to ask for a letter to shop around for a doctor.

sure, they won't be pleased, but they're not the ones paying the bill, so what do i care?

at the end of the day, as long as you realize doctors in private practice in singapore are businessmen/women first, and are used to patients doing (almost) everything they say, and you should not behave unquestioningly, you will be alright.

[JR8]

Thanks Taxi, no I didn't know that.
It's going to sound naive but I would have expected a GP to have to 'disclose an interest' when prescribing 3rd party treatment that earned him commission.

- This'll explain why the consultant laughed in disbelief when I declined the 2nd intervention (up into the middle ears).
- And why my GP laughed when I recounted this to him, and also when I told him I declined the prescription from the consultant, as I knew he, the GP, would charge maybe half as much.

Shame, I thought I got on very well with my GP. but I feel rather used.

[AuntieMabel]

That sounds quite similar to my experience - I got a really bad ear infection at the end of October. I went to a GP at the International Medical Centre clinic, who gave me some antibiotics and some ear drops to clear the build-up of wax. A few days later it got so bad I had to go to A&E at Gleneagles, who gave me painkillers and gave me two recommendations of ENT specialists. I ended up at Acsent ENT at Mount Elizabeth, who hoovered my ear out and stuck a camera up my nose. Total bill $760 for a 15 min appointment, plus more antibiotics and ear drops. He recommended me a follow-up, which was $250 for a five minute appointment in which he looked in my ears then told me I was fine.

Fortunately I have insurance.

[JR8]

Wow - it's almost like they have a table of fees, as if I hadn't have declined the nose-tube thing, and follow-up that's where my bill was heading.

More importantly, just for the record, the ear infection I had fully resolved with the above described treatment. [Doesn't of course mean that limiting the treatment of an ear infection is the way to go for everyone, but perhaps highlights that some aspects of treatment might not be adding towards the outcome].