EIC Medical Social Team

EIC Medical Social Team

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Honey dipper, juicer and garlic press with honey, lemons and garlic as natural medicine to aid against dry sinuses. Focus on foreground.

Dry Sinuses? Natural Remedies You Can Try at Home

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Honey dipper, juicer and garlic press with honey, lemons and garlic as natural medicine to aid against dry sinuses. Focus on foreground.

Natural medicine may aid your dry sinuses.

When it comes to the sinuses, the most common issue seems to be excess mucus. When the sinuses aren’t acting as they should and sinusitis (a sinus infection) is experienced, it generally leads to mucus overproduction and this can be a difficult issue to live with. However, as many will tell you, dry sinuses are an equally difficult problem.

During the colder months especially, we tend to look towards artificial sources of heat to stay warm. With a pellet stove, for example, we’ve found a solution that keeps costs to a minimum while also not getting too hot for any children or pets in the house. However, one of the biggest benefits of this system is also one of its greatest downfalls.

Back in the day, people would keep a pot of water on the stove to keep moisture in the air. Today, we’re doing the opposite because the stoves are sucking all the moisture from the room for every second they’re working away. For many, this lack of humidity dries the sinuses and causes all sorts of problems as a result.

Is This a Problem?

First and foremost, having dry sinuses is unpleasant so it quickly becomes uncomfortable. The longer the problem goes untreated, the bigger it becomes. Additionally, the sinuses need moisture because bacteria, fungi, and viruses are normally kept at bay by a protective layer of mucus. If this mucus has disappeared, the protection does the same and the sinuses are left vulnerable.

As you may know, this all leads to many problems, one of the biggest being a lack of smell. At first, people tend to attribute the loss of smell to something else because they can’t imagine that a stove (or any other source of artificial heat without the ability to keep moisture in the air) would cause the damage. Soon enough, a medical professional will assess their sinuses and find the problem.

Over the years, people have developed their own solutions for this issue and we have three of the most popular here today. If one doesn’t work for you, try another because the theory behind them is very positive!

  • Anti-Fungal Tea: If you’re suffering from a dry nose or dry sinuses, your liquid intake should be increased anyway so long as the liquid is water or any other responsible drink. If you can get your hands on it, there’s also anti-fungal tea and this just might prove to be a fantastic addition to your diet.Known as calendula tea, it comes from the orange calendula flower and offers all sorts of advantageous properties. For example, it acts as an anti-inflammatory, anti-fungal, and antiseptic solution. Alone, the tea should start to improve your sinuses but it becomes even more valuable when partnered with some herbs of your choosing.Since all the ingredients are natural, you can have this tea two or three times in a single day and you should notice a change to your breathing as the day goes on. If this doesn’t work, play around with the herbs you’re using or move on to another suggestion.
  • Steam Inhalation and Room Humidifiers: As we addressed earlier, they had a simple solution back in the day and it came from a pot of water. Therefore, why not take from their lead and do the same thing? Nowadays, the market holds some fantastic room humidifiers (and even whole home humidifiers!) to add moisture to the air.If you feel comfortable, you could even try steam inhalation in combination with a neti pot. Before we get ahead of ourselves, steam inhalation is where you hold your face as close to hot water as possible. With a towel over your head to increase the intensity, the idea is to inhale the steam without getting so close you harm yourself. To improve the results, add some essential oils whether this comes from tea tree oil, eucalyptus, lemon, or peppermint. As a starting point, this steam should make the walls of the sinuses a little softer (and looser).From here, you can finish with a neti pot and this is a small container used to rinse any debris you may have from the nasal cavity. With a simple saltwater solution, you leave your sinuses in a great position to become healthy once again.
  • Anti-Bacterial Tincture: If you want to fight infection and improve your sinuses, we recommend echinacea and boneset as a two-herb tincture. With a little of the tincture added to water, this should allow you to fight active infection. If you’ve never made a tincture previously, there are plenty of guides online that’ll show you how to get it right.

Summary

Regardless of which solution you try first, we urge you to keep going even if you don’t see any results the first time. Over the many years of people suffering with this issue, all three of these solutions have fantastic support in the community so they’re worth your persistence. Typically, you’ll notice a change within a few days and you don’t have to contend with the loss of smell any longer!

The Different Sinuses and their Anatomy

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Quite often, the term ‘sinuses’ is used in relation to certain medical conditions. However, there aren’t too many people who know the role of the sinuses or how they’re made up. Today, our goal is to answer both of these questions so you’re aware the next time the term is used in conversation!

Different Sinuses

Commonly shortened to ‘the sinuses’, the paranasal sinuses are small cavities filled with air inside the bones of the face; the bones of note are also found in the eyes and nasal cavity. With each sinus, it has a name that represents the bone in which it can be found.

  • Frontal: With one per side, the frontal sinuses can be located in the forehead right above the nasal bridge and eyes.
  • Maxillary: Found on each side, the maxillary sinus is inside the bone in the cheek.
  • Ethmoid: With the ethmoid sinuses, they sit just under the corner of each eye where the bone lies. In many medical diagrams, they’ll show the ethmoid sinus as one sinus but it’s actually made up of several smaller sinuses in a honeycomb shape; it can only be seen properly in CT scan images of the face.
  • Sphenoid: Again, the sphenoid sinus is located on both sides but this time behind the ethmoid sinuses. When looking head-on, they won’t be visible so a side view is required instead.

Physiology of the Sinuses

For each sinus, pink membrane will line the outside and it’s responsible for producing mucus to flush the sinus cavities. With a plate of bone and cartilage commonly known as the nasal septum, the two nasal passages are separated. However, the biology of each passage is the same starting with three small ridges of tissue which can be called a concha or turbinate. Depending on whether it’s referring to the upper, middle, or lower structure, they’re designated as superior, middle, or inferior.

When it comes to the draining, the majority of sinuses use the middle turbinate and the drainage occurs below this point. From here, it goes into the osteomeatal complex. For the system to work correctly, air needs to flow uninterrupted through both sides of the nasal passage since this allows for streaming between the nasal septum and turbinates (via the crevices).

For both the mucus and the airflow that started the process, they should end up in the nasopharynx which is a connecting part of the throat towards the back of the nose. As air continues its journey through the windpipes and into the lungs, the mucus takes a different journey and is swallowed instead.

Structures within the Nasal and Sinus Tract

As you probably know, the human body is quite simply amazing and evolution has allowed it to survive on a day-to-day basis using complex scientific principles. Therefore, it probably won’t surprise you to hear that there are some fascinating structures inside the nasal and sinus tract. Below, we have three very important examples:

  • Adenoids: As a collection of tissue much like the tonsils, the adenoids are found behind the farthest nasal cavity accessible at the very top of the nasopharynx. While most body parts and important features of the body grow as we get older, this tissue actually starts larger and then disappears during puberty. However, discrepancies in this process can leave it in tact which has the potential to require surgery.
  • Tear Duct: Often called the nasolacrimal duct, this is important for our eyes since, without it, tears would continue to build on the inside corners. When it’s in place and functioning as expected, the tears drain into the nasal cavity and this prevents excess moisture within the eyes.
  • Eustachian Tube: As our last example, the eustachian tube is required for removing any build-ups that occur within the ears; with the system all interconnected, the opening is found towards the back of the nasopharynx sidewall.

The Role of the Sinuses

Ultimately, the sinuses have many responsibilities within the ear, nose, throat, and beyond but their main role is to produce mucus. When the system is working as it should, the mucus creates a lining on the inside of the nose and this keeps it free from bacteria, fungi, and viruses. If you were to experience dry sinuses, the lack of mucus would leave the nose vulnerable to these pollutants and this leads to irritation and illness.

Over time, cilia, which are tiny hair cells, gradually move the mucus backwards towards the throat where it’s swallowed. Therefore, the steady supply of mucus always takes the same journey while protecting your nose and remaining clean at all times.

After this main function, we should also note that the sinuses are also important for our voices and to lighten the skull. With everything having a purpose, we’re able to enjoy life without consciously worrying about replacing the mucus or producing the right amounts at the right times. As we learn more about the sinuses and how they work, we get an insight into just how fascinating the human body can be!

Portrait of a mature man, possibly with single-sided deafness, giving his ear against a white background

Getting to Know Single-Sided Deafness

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Portrait of a mature man, possibly with single-sided deafness, giving his ear against a white background

One of the most serious issues presented by single-sided deafness is the loss of spatial hearing.

Single-sided deafness, or SSD, is a condition in which a person has good hearing in one ear, and non-functional hearing in the other ear. By ‘non-functional hearing’, it is meant that even with the help of some system of sound amplification, the bad ear cannot be made functional again. The most common reason for this is that a person with SSD has sustained damage to the inner ear, so amplification has no effect whatsoever on hearing ability in that ear.

Problems Presented by SSD

One of the most serious issues presented by single-sided deafness is the loss of spatial hearing. Spatial hearing allows a person to identify sounds both distant and nearby, in addition to all those that occur within 360° of the head area. Because our two-tiered auditory system is oriented to evaluate very specific information that can localize and pinpoint sounds, there is a big loss sustained when one ear is completely subtracted from that model.

It creates some difficulties for the brain, in terms of evaluating the information it receives and trying to assess what kind of information is missing. When the non-functional ear is in the acoustic shadow of the functional ear on the other side of the head, there can be significant difficulty with interpreting speech and other sounds, versus normal background noises.

This is especially true when speech or other distinctive sounds reach the non-functional ear first, and are not really ‘heard’ until the sound signal travels around to the other side of the head, to be received by the good ear. The net effects of this kind of sound reception are: a serious degradation in listening quality, difficulty with the interpretation of sounds and speech, and in a broader context, lowering of a person’s quality of life.

Another of the difficulties with single-sided deafness, alluded to above, is the condition known as ‘head shadow’ effect. What is meant by head shadow effect is a situation where sounds originating on the side of the head where the non-functioning ear is, are actually obstructed by the head itself in traveling to the other side of the head where the good ear is.

The main problem with this is that some kinds of sounds become very difficult to hear with the good ear. Low-frequency sounds are mostly unaffected in this scenario, because they have a long wavelength and they can move around the head more readily to the good ear. High-frequency sounds on the other hand, are characterized by much shorter wavelengths, and many of these are typically reflected by the head, and become altered before they reach the good ear.

Since consonant sounds occur largely in the high-frequency wavelengths, this can have a big impact on communication, because it is much more difficult to differentiate those sounds from background noises. Therefore, the biggest impact of this head shadow effect is on communication, and it causes a person with SSD to miss a great deal of what may have been said by someone, even if they’re standing close by.

Causes of SSD

One of the more common causes of single-sided deafness occurs is when surgery is necessary to remove a tumor growing in the ear. This kind of surgical removal sometimes causes such damage to the auditory nerve that a patient loses most or all hearing in that ear. If such tumors are not removed, they will continue to grow slowly, and will eventually cause damage to the ear anyway, including possible loss of hearing. However, surgical treatment can end up being just as harmful, if the auditory nerve becomes damaged.

A secondary cause of SSD is known as sudden idiopathic hearing loss, which is generally attributable to some kind of viral infection. In this scenario, a virus infects the cochlea, which eventually leads to swelling and permanent damage to the delicate structure of the cochlea. It happens fairly frequently that the ear cannot recover from this kind of damage, and the person is left with no hearing in that ear.

A third cause for SSD stems from some kind of blunt trauma to the head. In such cases, there can be a transverse fracture of the critical temporal bone, which has the effect of rendering the cochlea non-functional from that point forward. It is also possible for people to be born with hearing loss in one ear, while having perfectly good hearing in the other ear.

Solutions for SSD

One of the most effective solutions for SSD is known as a Contralateral Routing of Signal (CROS) configuration, in which a microphone is placed in the non-functioning ear, and transmits received sound signals over to a receptor in the good ear. The first of these configurations relied on a tiny wiring system for the transmission of sound between ears, but this has now been improved and refined with a wireless system that makes the whole arrangement less bulky and more effective.

There are now also two additional high-tech solutions which build upon the idea that sound received on the non-functioning side is somehow transported to the good side so that relatively normal hearing is possible. These two processes are known as bone conduction solutions and bone anchored solutions.

In the first, sound is actually transmitted through the bone of the skull to the other side of the head, and in the second, sound is transmitted by a subcutaneous implant which transmits sound through the skin to the good ear. As you might expect, these solutions can be relatively costly, but they can also be a very effective means of restoring normal hearing to someone who has completely lost hearing in one ear.

Pair of ear plugs used to guard against noise-induced hearing loss

Noise-Induced Hearing Loss

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Noise-induced hearing loss is a condition which currently affects about 10 million Americans. It is the most common preventable cause of hearing loss which is due to damage of the ear’s sensory nerve. The prevalence of noise-induced hearing loss and the number of people affected have steadily grown right along with the development of society—as more and more of man’s creations create noise pollution which damage a person’s hearing.

Probably most people understand the damage that can result from being close to a gunshot, but far fewer people are aware of potential damage from more mundane causes like leaf blowers, lawnmowers, traffic sounds, car alarms, music concerts, and even the stadium noise at a sporting event.

The truth is, any loud noises which are received by the ears over an extended period of time, no matter where they came from, can cause significant damage to the inner ear. Eventually this can lead to dizziness, ringing in the ears, some degree of hearing loss, and even issues unrelated to hearing, such as high blood pressure and an irregular heartbeat.

What is Noise-Induced Hearing Loss?

Noise-induced hearing loss is the condition which results from having an excess of sound energy reaching the inner ear. When the excess sound energy is temporary, any hearing loss is also likely to be temporary and reversible. A good example of this would be attending a loud rock concert where sound undergoes a great deal of amplification, and excess sound energy reaches every person in attendance, regardless of where they’re sitting.

It is fairly typical for someone attending a concert like this to completely recover within the next day or two, because the excess sound energy has dissipated. If that noise were to persist over a longer period of time, however, it is quite likely that the damage to the inner ear would be irreversible, and the listener would be subjected to a permanent loss of hearing.

It is also possible for excess sound energy to be so profound as to rupture a person’s eardrums, rendering them more or less deaf. Still more problems can be created if a person’s eardrums are shattered and he or she also develops severe dizziness, which is usually an sign that there is a perilymphatic fistula, i.e. an inner ear hole, created between the middle ear space and the inner ear fluid. Surgery in such cases may eliminate the dizziness, but the hearing loss is likely to remain permanent.

Pair of ear plugs used to guard against noise-induced hearing loss

Ear plugs can aid against noise-induced hearing loss.

Prevention of Noise-Induced Hearing Loss

Two of the best kinds of protection for the inner ear are the simple devices we know as earplugs and earmuffs. Earplugs are small-sized devices made of various materials, which can easily fit into the outer ear canal to block sound reception. Since they come in many different shapes and sizes, earplugs can be fitted to virtually anyone’s ears, and the fit is very important because there must be an airtight seal in the ear canal to block excess sound energy from reaching the inner ear.

Earmuffs on the other hand, are devices fitted to the head, and they cover the entire outer ear to prevent sound energy from reaching the ear canal. These devices usually have an adjustable band which allows for a tight fit, and as in the case of earplugs, a tight fit is very important so as to make a good seal against excess sound energy.

The choice of which of these devices to use for any given situation is contingent upon which kinds of sounds need to be blocked. Earplugs are much more effective in providing protection from noises in the low frequency spectrum, whereas earmuffs offer better protection against noises on the high end of the spectrum. Either one will reduce the sound energy that reaches the inner ear by between 15 and 30 dB of sound, and when the two devices are used in tandem, a person wearing them can expect to have twice as much protection than by using either one alone.

Treatment for Noise-Induced Hearing Loss

Anyone who suspects that they may have sustained noise-induced hearing loss should seek professional advice from a doctor who has been trained in ear and hearing disorders. This kind of doctor will be able to diagnose the specific condition affecting a person’s hearing, and can recommend the most effective kind of treatment program.

Unfortunately, there is no real cure for noise-induced hearing loss, because damage to the inner ear is irreversible. There are various devices available which can help restore hearing if only one ear has been affected, and there are also amplification systems such as hearing aids, which can be used in certain situations.

There’s also a great deal of very promising research being conducted by such organizations as the National Institute on Deafness and Other Communication Disorders. One of the specific areas being researched now is how using antioxidants may be able to prevent hearing loss due to noise-induced causes, and may actually be able to restore relatively normal hearing.

Early results have already demonstrated that vitamin D and aspirin can reduce the effects of hearing loss when they are used prior to the event which produces excess sound energy. Other research conducted on laboratory animals has shown that exposure to loud noises does not result in hearing loss when the animals are provided with vitamins A, C, and E before being exposed to a loud noise.

Young woman with an ear infection, such as cholesteatoma, touching her painful ear.

Cholesteatoma: What It Is and What You Need to Know

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Young woman with an ear infection, such as cholesteatoma, touching her painful ear.

Cholesteatoma is a non-cancerous growth in the middle ear.

With a name that confuses many, cholesteatoma is a delicate and troublesome problem within the ear. Describing an abnormal skin growth behind the eardrum, the middle ear, cholesteatoma is normally caused by multiple infections. However, there are other causes to note including a dysfunction in the eustachian tube.

What is the Eustachian Tube?

Running to the middle of the ear from the back of the nose, this tube is essential for our hearing. Since it allows air to reach the ear, ear pressure is equalized efficiently and our hearing works as expected. Sadly, an issue can occur with a simple cold along with allergies, sinus infections, and chronic ear infections.

With a failure in the eustachian tube, the middle ear can experience a partial vacuum and, in turn, the eardrum, or certain sections of the eardrum, is pulled out of position. As you can see, each step of the process causes another problem and it ends with a growth or cyst in the middle ear.

When left untreated, willingly or unknowingly, the size of the cholesteatoma can change while causing severe damage to the delicate bones located in the middle ear. If left for too long, hearing loss is experienced and surgery becomes one of just a few select options. Fortunately, there aren’t any serious side effects when the issue is treated which means that permanent hearing loss and muscle paralysis in the face are both unlikely. This being said, there has been cases of all three when the cholesteatoma is allowed to keep growing.

Causes of Cholesteatoma

As we’ve seen, the main causes are problems with the eustachian tube and chronic infections but there are also small numbers of people who are born with a cholesteatoma. Ultimately, this is seen as a birth defect and should be picked up on soon after birth. If children experience numerous ear infections, cholesteatoma can also become a problem at a young age.

Symptoms of Cholesteatoma

With any health issue such as this, the key information comes in knowing the symptoms so it can be recognized early. With cholesteatoma, many are actually drawn to a foul odor before anything else and this is where the ear drains fluids. After this, you might feel building pressure or a sense of fullness in the ear where the sac enlarges over time.

As with ear infections themselves, cholesteatoma will cause discomfort whether it comes through an ache in the ear, a difficulty to fall asleep at night, or a slight loss of hearing. Finally, there may be muscle weakness on the side of the cyst in addition to dizziness. If you experience any of these symptoms, we advise you to visit your doctor as soon as possible. Even if it turns out to be a simple ear infection, this will still need treatment.

Treating Cholesteatoma

As you visit your doctor, they’ll examine the inside of the ear because the signs of a cyst can often be seen early whether it’s a congregation of blood vessels or excess skin cells. If they don’t find anything but are still a little worried, they may ask for you to attend a CT scan which will show the cyst or whatever it may be causing your discomfort.

As with any other cyst, a cholesteatoma is something that needs surgery for removal. Unfortunately, cysts don’t just go away on their own; in fact, they do the opposite and grow. While you’re waiting for surgery, your doctor might suggest ear drops, antibiotics, careful cleaning, and other forms of light therapy.

During surgery, most cases are completed under a general anesthesia with the main aim of removing the cyst. If the cyst is removed, this is great news but it might not be the end of the problem depending on how serious the issue was and the state of your ear now. Typically, a second surgery will be planned at the very least to check the cyst has gone. However, you may also require a reconstruction of the damaged bones in the middle ear; this will improve your hearing and reverse other symptoms experienced. Of course, this will be judged on a case-by-case basis as not all patients would benefit from reconstruction if the damage is too severe.

In terms of the logistics, you’ll be an outpatient and a certain percentage will stay in the facility overnight as a precaution. If the cholesteatoma was extremely damaging, you might be required to stay in hospital for a few days with a course of antibiotics. On the whole, you can expect to need one or two weeks away from work. In the months ahead, check-ups and evaluations will ensure the problem has gone for good.

Summary

Although we can’t provide any prevention tips for congenital cholesteatomas, we do advise visiting the doctor as soon as you notice any of the symptoms we’ve listed. Whether it’s yourself or your child, quick action is the best way to remove the problem and ensure the middle ear bones aren’t damaged. Despite cholesteatoma being a serious ear condition, it is treatable with the right steps.

A little girl with herpangina getting her throat examined by an ENT doctor.

Herpangina: What You Need to Know

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As the known term for a blister-like ulcer within the mouth, herpangina occurs typically in childhood. Unfortunately, being an infection, herpangina can cause other health issues – we’re here to discuss what you need to know.

What is Herpangina?

In the past, the infection has been compared to hand-foot-mouth disease since they’re both viral infections found mostly in children. As a group of viruses known to affect the gastrointestinal tract, enteroviruses are to blame for herpangina. The immune system will typically jump into action as soon as it detects an enterovirus. Since young children and infants aren’t always equipped with the right antibodies, they’re more susceptible to these viruses.

When it comes to herpangina, the main issue is its contagiousness. After spotting or hearing of an ulcer in the roof of the mouth or back of the throat, you should look to treat the symptoms and have the infection cleared as soon as possible. If left untreated, it can spread around a nursery or classroom.

Herpangina Risks

Although herpangina can affect anyone of any age, those around the age of 5 to 10 years experience it most frequently. Since it’s highly-contagious, breeding grounds can form in classrooms, camps, and other locations where children regularly congregate. In the U.S., researchers have found the problem to be most common in fall and summer.

Symptoms of Herpangina

Both for yourself and your children, some health conditions can be hard to diagnose since the symptoms are very similar to other health issues. Luckily, the signs of herpangina can be spotted and tested more easily. For example, the primary symptoms one might experience include swollen lymph glands, sudden onset of fever, neck pain, difficulty in swallowing, sore throat, loss of appetite, and a headache.

For smaller children, there may be an issue with verbal communication of symptoms, but indicators include excessive drooling or vomiting. Of course, ulcers may also be visible on the roof of the mouth or towards the back of the throat. In appearance, specialists suggest a gray color with a red border for ulcers; in the majority of cases, they clear within a week.

A little girl with herpangina is given a diagnosis at the doctor's office.

Herpangina is easier to diagnose in older children who have learned how to speak and communicate their symptoms. However, in younger kids, look out for vomiting and excessive drooling.

Should I Contact a Doctor?

For many, especially with worried parents, this is the key question because you want to help your child feel better but you don’t want to exaggerate what may be a small issue. Therefore, we advise contacting the doctor if a fever measures above 106 degrees (or stays for longer than usual), if there are signs of dehydration, and if mouth sores remain for longer than five days.

Herpangina Treatment

After paying a visit to your doctor, they can typically diagnose the issue with ease since the ulcers are unique in their appearance. With a simple physical examination of yourself or your child, they can see the problem while also assessing all symptoms and your medical history. With herpangina, specialized diagnostic tests aren’t required.

Regarding treatment, the goal is to reduce the symptoms while also keeping them under control in the days ahead. Depending on your age and a number of other factors – including your medical history and symptoms – doctor’s can recommend different types of treatment. A course of antibiotics won’t be especially useful since herpangina is a viral infection.

With this in mind, the first suggestion would be acetaminophen or ibuprofen. It’s crucial that the patient doesn’t take aspirin since herpangina has been linked to the potentially life-threatening Reyes disease that is associated with a severe aspirin allergy.

Elsewhere, topical anesthetics could be used to relieve any mouth pain (and sore throat), including lidocaine. Regardless of the treatment, the doctor will suggest an increased intake of liquids with a focus on water and milk; hot drinks and citrus-based beverages will worsen the symptoms. Strangely enough, many sufferers have found popsicles to ease throat issues so this could also be advised.

Preventative Measures

Finally, you might be wondering whether you can avoid this disease altogether. First and foremost, you can take preventative measure by practicing good hygiene habits. For example, all the necessary rules apply such as covering your mouth when sneezing or coughing, washing hands after using the toilet, and washing hands before meals. If you teach your children the basic hygiene rules, you’ll decrease the likelihood of them suffering from herpangina too.

If your child currently has herpangina, remember these rules when helping them to recover. Throughout the day, wash your hands and pay particular attention before and after changing diapers or dealing with mucus. Furthermore, try to keep areas of high activity clean for your child including toys, surfaces, and their beds. To avoid becoming the enemy of all other parents, we also advise keeping your child from school or day-care while recovering too. If you follow these tips, you or your child will be back to full health in no time!

A young woman holding her head due to BPPV.

What is BPPV? (Benign Paroxysmal Positional Vertigo)

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It may look like a mouthful to say, but the medical condition known as benign paroxysmal positional vertigo (BPPV) can easily be understood by breaking it down into its constituent terms. Benign means non-life threatening and paroxysmal means that it occurs only in sudden bursts. Positional means that it is triggered by specific positions or head movements and vertigo is a sensation of dizziness. Taken altogether, someone who has BPPV would experience brief periods of dizziness, which are brought on by abrupt, unanticipated head motions.

Your Body During a BPPV Episode

Many of the issues which affect your balance originate in the inner ear, like BPPV. It starts when some of the calcium carbonate crystals which are normally carried in the gel of the utricle, somehow navigate out of that environment and into at least one of the three semi-circular canals, which are filled with fluid, and are thus also capable of hosting the crystals.

These semi-circular canals depend on fluids to determine head motions, and when the fluids become oversaturated with calcium carbonate crystals, your ability to balance is disrupted. These particulates cause excessive movement in the fluids within your inner ear, creating what we commonly know as vertigo (dizziness).

When this fluid moves, there are nerve endings inside the ear which sense that motion and transmit messages to the brain about head movements. Inaccurate signals are sent to the brain, and as a result, the BPPV patient feels dizzy and disoriented.

People Affected by BPPV

Even though you might never have heard of BPPV, it’s not an exceptionally rare condition. In fact, more than 100 out of every 100,000 people in America are affected by BPPV, most of whom are adults. The disorder rarely impacts children, and is far more prevalent in older people, particularly seniors.

The cause of the disorder is not yet understood, with most people reporting that they simply woke up one day, and as they got out of bed, realized that the bedroom was spinning all around them. Although the beginnings of BPPV are unclear, scientists and doctors have noted a correlation between the disorder and other diseases such as diabetes, osteoporosis, and inner ear infections.

A diagram of the inner ear, as related to BPPV

In diagnosing BPPV, ENT doctors look for nystagmus, which is an pattern of eye movements caused by the sensation of vertigo.

Diagnosing BPPV

It can be difficult to diagnose BPPV, because the movement of the calcium carbonate crystals does not show up on imaging scans such as magnetic resonance imaging (MRI). However, a BPPV can abruptly position their head in a way that causes the crystals to move within the fluid of the semi-circular canals, which triggers the false signals that induce dizziness.

This dizziness causes the person’s eyes to move in a very definite and predictable pattern known as nystagmus. This occurs because there is a close relationship between the eye muscles and the inner ear, which allows for a person to remain focused on immediate surroundings during head movements.

Because the false signals sent to the brain make it think the head is moving, it also mistakenly triggers eye movement, which is supposed to help maintain equilibrium. However, in this false scenario, nystagmus acts as a telltale sign.

Treatment of BPPV

Sometimes medications are prescribed as a treatment for BPPV, and in other cases, surgical solutions are recommended. But in most cases, the most effective treatment by far is relocating the wandering calcium carbonate crystals back into the utricle chamber where they belong.

The first step in this mechanical approach calls for identification of which semi-circular canal(s) the crystals have migrated to. Once that is known, a doctor will guide the patient through a series of head maneuvers which are designed to encourage the crystals to return to their original position. Self-treatment is not recommended, and it calls for a doctor who is skilled in guiding a patient through the proper maneuvers so that no damage is done to the head or neck areas.

Effectiveness of Treatment Programs

Studies have demonstrated that the success rate for properly diagnosed and guided BPPV treatment is around 90%. Once the calcium carbonate crystals have been returned to their proper position, most patients report no more than minor residual spinning sensations, and even these diminish within a couple of months.

However, it is possible for the condition to recur, and come back in full force. This usually occurs within five years of treatment, and when it does come back, it can again be treated successfully, using the gravity method of guiding the crystals back to their proper position in the ear.

An isolated ear with a swimmer's ear infection.

How to Prevent Swimmer’s Ear Infections

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Swimmer’s ear is something of a misnomer since you don’t have to be splashing around the pool or swimming to get the kind of ear infection attributed to swimmer’s ear. This ear infection is of a specific type which begins as a mild, barely noticeable itching or redness, which gradually escalates into an inflamed condition that can become very tender to the touch, and can eventually even disrupt your hearing.

You can contract swimmer’s ear infection in any number of ways, including swimming in some body of water, but also by taking a bath or shower, or even by cleaning your ears out with a cotton swab.

Causes of Swimmer’s Ear

The formal medical name for swimmer’s ear infection is otitis externa, and it occurs when water gets trapped in your ear. When that water is allowed to stay there, bacteria and sometimes fungi can grow in the ear and multiply, which then leads to an infection near the opening of the ear.

There are other causes of swimmer’s ear as well, which are not brought about by any exposure to water. If a cut or scrape occurs just inside the ear canal, that can also trigger the formation of the bacteria necessary to create an infection.

Aggressive cleaning with cotton swabs is another relatively common cause of swimmer’s ear since the swab can scratch the skin inside the ear, and bacteria can begin growing and multiplying as a result. In fact, people with excessive amounts of earwax are prone to developing swimmer’s ear, as are people bothered by eczema, which is a chronic skin condition.

Symptoms of Swimmer’s Ear

As mentioned, the first indication of swimmer’s ear is usually a mild form of itching, often accompanied by redness and swelling around the ear. When the infection begins to progress, the area becomes more inflamed and more painful. Many people who have contracted swimmers ear report that it’s extremely painful, far beyond what you might expect from such a seemingly simple medical condition.

Other symptoms can develop if swimmer’s ear is left untreated, some of which can be quite serious. Fluid build-up in the ear, swollen lymph nodes, a swollen or closed up ear, and a high fever are all symptoms that can result from an untreated ear infection. This damage is not permanent and will subside once the infection is cleared up with medication.

An ENT examines a patient's swimmer's ear infection.

The best thing to do if you have a swimmer’s ear infection is to seek the attention of your physician or ENT. They’ll be able to give you antibiotics you need to clear up the infection.

Treatment for Swimmer’s Ear

Someone who has contracted swimmer’s ear infection should take a pain reliever like Ibuprofen if the patient cannot see a doctor immediately. In some milder cases, the pain and discomfort will subside on its own, but if that doesn’t happen within just a few days, it’s always advisable to make an appointment with a physician. If you can’t get an appointment to see your doctor for treatment, you should try to get into an urgent care facility and have the infected ear examined.

To confirm a diagnosis of swimmer’s ear, a physician will take a fluid sample from the area around the ear, and the first treatment option will usually be antibiotic eardrops. If these don’t clear up the problem in a short timeframe, an oral antibiotic is likely to be the next option.

There are times however, when this line of treatment is ineffective and something else has to be tried. If ear antibiotics don’t work, it’s usually because there has been so much debris or fluid built up in the ear canal, that antibiotic eardrops cannot penetrate the obstruction. If this is the case, your doctor may attempt to clear the debris out of the ear canal by using a vacuum apparatus.

Once the buildup of debris has been dissipated, antibiotic eardrops will again probably be effective. One reason why oral antibiotics could possibly be ineffective as a means of treatment, is if the infection wasn’t really caused by bacteria in the first place, but was triggered by a fungus.

Preventing Swimmer’s Ear Infections

You don’t have to avoid swimming, bathing, or showering in order to avoid swimmer’s ear infections. One of the most effective ways of ensuring that water doesn’t become trapped in the inner ear is to wear earplugs when swimming. After showers or baths, you can lean your body toward the side which feels like it has water trapped, and shake your head somewhat vigorously. This will usually dislodge any inner ear water, and clear out the ear canals. It’s also advisable to limit your cotton swab cleaning of the ears as much as possible, so you don’t scratch the interior skin and trigger an infection.

A woman in an airplane suffers from hyperacusis, plugs her ears.

Hyperacusis: Does Pink Noise Help?

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If you’ve never heard of the term ‘hyperacusis,’ it refers to a condition in which a person’s normal tolerance to sounds in their everyday environment is severely diminished. With hyperacusis, the sound of a car braking at a traffic light can sound like a horrible screech, and a group of people applauding a speaker can sound like a huge thunderclap in a storm. In short, it’s as though someone was toying with the volume control of Life, and left it stuck on the highest setting – just about everything sounds extremely loud.

On the flip side, someone who has hyperacusis usually has lost most of the dynamic range generally associated with hearing, which means there isn’t much difference in the loudness of various sounds. For example, an actual explosion might sound very much like a book dropping off the edge of a table.

Most hyperacusis patients have a sensation of inner ear pain or a feeling of pressure in the ears which is similar to what you might feel when making a rapid descent in a commercial jetliner. On an airplane, this feeling can be easily overcome by yawning or chewing gum, but a hyperacusis patient feels this ear pressure all the time. This constant discomfort can have an enormous impact on a person’s life, affecting their job as well as their home life and relationships.

For someone with hyperacusis, operating a lawn mower, listening to the radio in the car, or running a vacuum cleaner at home may not be possible. This condition has less to do with volume, and more to do with particular sound frequencies, which can make attempts to muffle out noise entirely futile as well.

What can be done to help people who have hyperacusis?

Noise Has Color

The pink spectrum of noise is the one which most closely matches the broad range of sounds which we hear in our normal environment. That’s why treatment for patients with hyperacusis generally involves building up a tolerance to pink noise, rather than white noise, which includes higher frequencies. The higher frequencies are the ones most troubling for hyperacusis patients, so trying to build a tolerance to white noise is not nearly as effective an approach.

The goal of any program of sound therapy is to slowly and incrementally build up a tolerance to noise, but this can be a very frustrating and difficult experience for someone with hyperacusis. Many patients find that they just don’t have the patience to undergo this kind of slow therapy, and search for something that will produce faster, less uncomfortable results. If nothing helps, a patient may have few options other than to wear earplugs a majority of the time during waking hours.

A man with hyperacusis sits with headphones on, listening to pink noise at the doctor's office.

It’s important to find the right kind of sound therapy for your hyperacusis, and many patients have found that pink noise has helped them.

How Sound Therapy Works

The whole idea of sound therapy is to get a person re-familiarized and tolerant of the noises which populate our day-to-day world. Sounds are delivered to the ears by one of the several methods, like listening to CDs with recorded everyday sounds. But this can be an inconvenient kind of session for the hyperacusis patient because therapy sessions should last at least two hours per day, and if you’re stuck with one CD for that long, it can get to be uncomfortable and restrictive.

An alternative method of sound delivery calls for custom-fitted sound generators made for your head and ears and having pre-recorded pink noise sounds played for the duration of your therapy sessions. With a sound generator, you’d be free to walk around and do other things, but it can be quite expensive. Whereas a pink noise CD costs less than $100, a sound generator delivering the same pink noise sounds might cost several thousand dollars.

Counseling: A Critical Part of Hyperacusis Therapy

Whichever kind of sound delivery system you choose, there is another essential part of sound therapy: counseling. Having a trained counselor or advisor can make all the difference sometimes, which can ease the difficulties and frustrations that come with sound therapy.

To begin, any sound therapy program requires a high degree of self-motivation from the participant, since no amount of cajoling will persuade a patient to undergo the uncomfortable sessions required. There will be days when the patient wants to shorten or skip the course, or even quit the process altogether. Those are times when a skillful counselor can serve as a cheerleader, and convince the patient to keep eyes on the prize and continue to forge ahead.

It is quite normal for hyperacusis patients to feel that the therapy is hurting them instead of helping since pink noise can be torturous to their hyper-sensitive ears. At times, it takes some skilled counseling to assure a patient that the process is doing them some good, and not harming their ears at all.

It is often a long and uncomfortable process getting re-acquainted with the sounds of our everyday world, but for the patient who sticks with it, it is possible to lessen and maybe even cure the adverse effects of hyperacusis.

A women with a sudden nosebleed.

What Causes a Sudden Nosebleed?

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When an adult experiences a sudden nosebleed with no apparent cause, there could be many things that triggered it. While unexplained nosebleeds might seem serious, in most cases they aren’t.

If it turns out that there’s a specific medical condition that triggered the nosebleed, your physician will advise you on what steps to take next. If you regularly experience unexplained nosebleeds, you should notify your doctor, so that they can give you an accurate diagnosis of the causes of your nosebleeds. In this article, we will examine some of the most common causes of a sudden nosebleed, and how to treat and prevent this condition.

Quick Fix: Buy a Humidifier

Sometimes the cause of a sudden nosebleed can be something as simple as very dry air brought about by constant indoor heating. Dry air is a relatively common situation in cold weather when a heating system might be running for most of the day, with no humidifier at work to restore moisture.

Nosebleeds can also occur when someone is exposed to cold weather for a prolonged period. Both these scenarios cause the lining of the nose to dry out, crack and bleed. To prevent the indoor heating cause, you can make sure your home is adequately humidified, especially during the cold season when the heat is on. For someone who has to spend long hours outdoors, the best preventive measure is to use a nasal spray which artificially moistens the inner lining of the nose.

Underlying Medical Conditions

There are certain medical conditions which inhibit your body’s ability to form blood clots, and that can trigger nosebleeds at virtually any time. Kidney disease, liver disease, and persistent excess consumption of alcohol can all act to interfere with clotting and induce a sudden nosebleed.

This condition can also be caused by congestive heart failure, high blood pressure and hypertensive crisis, which is a sudden blood pressure escalation coupled with anxiety, breathing difficulty, and an intense headache. There are also some very common medical conditions which can contribute to the triggering of nosebleeds, such as colds and allergies, as well as just blowing your nose frequently. All these can severely irritate the nasal lining, and trigger spontaneous nosebleeds.

A young man with a tissue in his nose, from a sudden nosebleed.

Do you take blood thinning (anticoagulant) medications? If so, they might be the culprit behind your sudden nosebleed.

Blood Thinners and NSAIDs

Many medications which are used to treat pain can have the side effect of triggering nosebleeds. Included in this category are aspirin, anticoagulant medications, and nonsteroidal anti-inflammatory drugs (NSAIDS). Blood thinners like these inhibit the body’s ability to generate clots, and that means they can not only cause a nosebleed but can make it much harder to stop one that has started.

These kinds of medications are often prescribed for someone who has an irregular heartbeat, or someone who has had an actual heart attack. Since blood clots can cause a stroke or heart attack if they travel through the body and lodge near the brain or heart, people with heart conditions are often prescribed blood thinning medications which act to deter clotting.

Persistent Nose Scratching

The cause for a nosebleed can sometimes be a little more obvious, such as the case for someone who is constantly picking or scratching. This kind of activity can easily injure blood vessels in the nostrils, causing nosebleeds that seem to come out of nowhere. This kind of nosebleed is most common with small children.

What to Do With a Sudden Nosebleed

Most nosebleeds can be stopped or treated at home, without the need to seek medical treatment. If home treatment methods fail to get it under control, you should find medical attention, even though such situations are rarely life-threatening.

One technique for stopping a nosebleed is to sit down and lean forward, using direct pressure against the nostrils to pinch them closed for approximately 10 minutes. During that span, you’ll have to breathe through your mouth. It may also help to spray your nostrils with a nasal decongestant, because that constricts the blood vessels, and limits blood flow through the nose.

Once you have stopped the nosebleed, you can prevent it from recurring by using topical ointments and saline inside the nostrils. And of course, you should avoid any further irritation of the nose from scratching or nose-picking.

Especially for patients who take blood thinners, medical attention is their best option. These anticoagulants will decrease the body’s ability to clot and stop the nosebleed, and talking to your doctor will help them modify the dosage of any blood-thinning medication you might be taking or change it altogether.

If you have more than one nosebleed in the same week, that’s a definite sign that you should talk to your doctor. In most cases, sudden unexplained nosebleeds are not serious medical conditions, but when they happen more frequently in a short timeframe, they can be warning signs of more concerning health conditions.

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