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.

A man receives a check-up for middle ear infections.

Treatment for Chronic Middle Ear Infections

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A middle ear infection, also known as ‘otitis media,’ is an infection or inflammation that occurs inside the eardrums.  This can cause sinus issues, among others.  Generally speaking, people with middle ear infections pick them up from colds, coughs, sore throats, and other respiratory problems. Of course, the word ‘chronic’ suggests this is an ongoing problem, which is why we want to address the treatment side of things today.

With ear infections, doctors like to wait at least two months to three months before classifying it as ‘chronic.’ ‘Acute’ ear infections usually only last for a few weeks. Typically, those with an acute infection will experience fluids accumulating behind the eardrum.

These fluids can remain behind the eardrum for a few months. If the fluid stays in place for a prolonged period or there’s some form of negative pressure, the patient will continue to see problems long into the future. Over time, the middle ear may develop a hole in the eardrum, leading to more severe issues. Doctors talk about middle ear infections in terms of months as opposed to days or weeks because chronic middle ear infections typically start without pain or any real symptoms. As time goes on, the ears may pop after sustained pressure and result in hearing loss.

Before talking about the treatments and what you can do to alleviate the issue, we should note that infants and young children are particularly prone to middle ear infections. In fact, three in every four children will experience a middle ear infection before their third birthday.  As the canal that connects the back of the nose/throat to the middle ear, the ‘Eustachian tube’ is more horizontal and much shorter when children are younger. For the microorganisms that cause infection, a shorter tube allows them to enter the middle ear faster.  In combination with a young child’s weaker immune system, and children find it hard to stave off.

A young girl gets checked for middle ear infections by a doctor.

Young children are more susceptible to middle ear infections due to a shorter Eustachian tube that allows bacteria easier access to the middle ear.

Treating Middle Ear Infections

In the majority of cases, antibiotics will be the first course of treatment. Even though there’s no real evidence to suggest their effectiveness in treating otitis media, since most middle ear infections are viral, they can remove various symptoms and make it easier for the infection to resolve itself.  Antibiotics usually fix the problem in around five days. Doctors often prescribe amoxicillin, allowing you to get back on your feet in no time.

After medication, many children and adults require grommets, which are also an option if the middle ear infection doesn’t clear up immediately. Grommets are tiny tubes placed inside the eardrum that aid with drainage. As we discovered earlier, the problem worsens when the fluid doesn’t drain away, so grommets could stop the negative spiral of events that makes otitis media worse.

Under general anesthesia, these grommets can be installed in around 15 minutes and are left inside the ear for several months. With the eardrum open, the middle ear infection can heal fully, and the grommet will eventually be pushed out. You typically won’t feel any pain, and the majority of grommets are removed between six months and a year after being installed.

If the problem is too severe for either of these solutions, surgery is recommended if there aren’t any other solutions available. With this option, the idea will be to remove the infected tissue and the areas causing the recurring pain and discomfort. Once these problem areas have been eliminated, an intact eardrum can then recreate a middle ear space as found in healthy ears.  Hearing can then be restored.

At first, you may find it strange that hearing is the last thing to be restored, but the first two steps are pivotal to stop the infection from returning. If these two steps aren’t met at the beginning, anything else done to improve hearing will be futile. If the infection comes back after the hearing is restored, hearing can be lost again so this is why the order of priority has been developed in this way.

In most cases, the problem will clear itself up with the help of antibiotics. If this doesn’t work, your doctor should discuss more great solutions so you can move forward with your life without worrying about infection and discomfort in your ears.

A little boy with pet allergies cuddles up next to a puppy in a green beanbag chair.

Pet Allergies: Causes and Prevention

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Some things stay controversial, and the debate over pets and allergies has been going on for some time. Can you have pets when you have allergies? How will it affect you? Why do pets trigger allergies in the first place? Since our furry, feathery friends can add so much to our lives, it seems sad we should be restricted due to such a common health issue like pet allergies.

What Causes Pet Allergies?

Before we go any further, we should note that everybody is unique so will have different types of pet allergies and different things that set off the condition. For example, some people might be allergic to just dogs while others are allergic to cats, horses, hamsters, guinea pigs, mice, rabbits, gerbils, and even birds.

When it comes to pet allergies themselves, they commonly develop in children, but they can also show at any stage of life. Even if you had a cat for the first twenty years of your life with no problems, you could still get a cat at 40 and suddenly see a reaction. Regardless of when it develops, pet allergies are what we call ‘allergic asthma.’ Proteins from their skin, known as ‘dander,’ irritate your immune system.

If you’re sensitive to these particular proteins, the immune system overreacts after touching or inhaling the allergen and this releases histamine thus leading to an allergic reaction. If you have allergies or asthma, the release of histamines will worsen the symptoms.

A little girl and a french bulldog touch noses, showing that pet allergies don't have to stop you from owning a furry or feathery companion.

If you have pet allergies and want to become a pet owner, fear not! There are ways to control pet dander and allergens in your home. You can also speak to a vet or your allergist to see if there is a compatible pet for you that won’t irritate your allergies.

An Overview

Unfortunately, family pets can be a trigger of allergy and asthma attacks, but this doesn’t mean you need to give up your pet or put your dream of having a pet aside just yet. First things first, talk with your doctor, and they should be able to assess the severity of your case. From here, you should consult with your vet. Since physicians aren’t typically trained giving you advice for living with pets, professional vets will probably provide you with the best opportunity to live harmoniously.

As you work with your vet, they’re likely to present you with tips that’ll lessen the effects of having the pet and, hopefully, reduce the symptoms you see. For example, regular vacuuming to control pet dander will be necessary, as will keeping your pet from your bedroom. Considering you need to avoid the allergen to prevent an allergy attack, it’s best to keep your pet from living spaces, so you have allergen-free sections of your home.

Furthermore, your vet will recommend keeping all bedding clean while also considering dust mite covers, and this is because dust mites enjoy eating pet dander. As an alternative solution, you can try some shampoos and sprays on the market that have been designed to neutralize all dander. Ultimately, it’s about being sensible and doing all you can to avoid pet dander from ruling your home.

Talk To Your Doctor or Allergist

If the tips above haven’t helped or you’ve tried them before, it’s now time to talk with your doctor again because they should help you to find what’s actually causing the allergy symptoms. Rather than assuming the pet is the cause, the doctor should be able to test for pet allergies to see the primary contributing factor to your allergies. From here, they can suggest advice, or you may find that your condition just doesn’t allow you to live safely with your current pet. If you need to find a new home for your friend, your vet should be able to help you with this.

As we’ve said previously, this doesn’t mean you can’t have a little companion by your side because all pets are different. While all dogs (and other pets) shed, some will shed less than others. These pets may be more compatible with your health concerns. With these hypoallergenic pet breeds, you might be able to live comfortably by applying the tips listed previously.

Ultimately, we recommend spending time with the type of pet you wish to adopt so you can learn whether you can both live happily together. If the pet doesn’t trigger your allergies, you may just have found a new home for a pet and a happy future for yourself. Before committing though, we recommend taking them home and spending time together in different environments just to be sure.

The word "tinnitus" is spelled out with wooden block letters.

Tinnitus: Treatment and Symptoms

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According to the most recent report, tinnitus affects around 50 million people in America (to some extent). For the most part, people learn to live with the condition, but there are solutions available. This being said, some medications will make the issue worse which is why we recommend talking to a medical professional before you take action. For example, large doses of aspirin are a bad idea, and thousands of people go wrong every year thinking it will work.

What Is Tinnitus?

Firstly, we should address how tinnitus affects us and the best way to describe it would be a constant noise disturbance coming from inside your ears. Whether it’s a ringing or a whistling, the tinnitus patient is the only person who hears the sounds, making the condition border on maddening.

For most people, it’s a high-pitched ringing that causes the frustration, but you should know it doesn’t generally mean anything larger. Although there are misconceptions that tinnitus is a signal of something deeper in the ears or brain, this isn’t normally the case. As mentioned, only the sufferer will hear the noise, but there are rare cases where the noise comes from a musculoskeletal movement which will allow others to hear it too.

Symptoms

Ultimately, the only real symptom is the problem itself: the perpetual ringing in your ears. However, it’s important to note that the pitch and formation of the sound can differ from one person to the next. While some people note a low-pitched screech, others will suggest a clicking, chirping, hissing, whistling, whooshing, buzzing, pulsing, static, roaring, and perhaps even a musical tone to the sound.

Through the day and night, the volume can fluctuate, and patients notice it most at night. Tinnitus worsens at night mostly because they have nothing else to distract them. When at work and talking to people, we’re concentrating on other things but, when we’re trying to go to sleep, the ringing becomes the center of attention.

A young woman holds her hand up to her ear, looking like she is in pain. Tinnitus can be unbearable if left untreated.

Tinnitus can be caused by number of things, including loss of the ability to hear certain frequencies, a traumatic experience with loud noises, or a product of the aging process. However, there are a number of treatment options available that help patients with the physiological and psychological effects of tinnitus.

Causes

A little later, we’re going to take you through the treatment for tinnitus, but we first need to know the cause of the condition. With the word ‘tinnitus,’ we have a term that describes the actual sound regardless of its cause, which is important to remember. For proper treatment, it’s important to locate the cause to prevent the condition from returning.

If we were to look at averages and the most common problem, this would come down to damage/loss of the sensory hair cells in the cochlea of the inner ear. While the aging process is typically responsible for this, it can also occur after exposure to loud noises for an extended period. However, the sound we experience will alter depending on the loss of certain audio frequencies.

Once the brain receives fewer external stimuli around the lost frequency, it must adapt and replace the sound itself, and this is thought to be the reasoning for tinnitus. Since the auditory system isn’t providing all the right sound frequencies, the brain has to pick up the slack.

Elsewhere, other causes include traumatic brain injuries, ear infections, head/neck injuries, foreign object in contact with the eardrum, cardiovascular diseases, middle ear issues, temporomandibular joint (TMJ) disorders, and diabetes. As we said earlier, some medications will exacerbate the tinnitus, and these include some antibiotics, diuretics, aspirin, and ibuprofen.

Treatment

If left untreated, tinnitus can lead to social isolation, depression, anxiety, and other problems, so treatment is important. With tinnitus, the first step will always be to locate the cause of the issue. After doctors run their tests and discover the problem, they’ll care for the ear infection, drop the ototoxic medications, treat the TMJ problems, etc.

There is no apparent cure for tinnitus induced by old age, so the focus moves to dealing with the sound and making it more bearable. With tinnitus retraining therapy (TRT), this retrains the auditory system, so the tinnitus sounds are accepted rather than disrupting your hearing. Although success isn’t guaranteed, 80% of people find some level of relief from tinnitus with TRT.

If this doesn’t work, your doctor will start dealing with the side effects such as depression, anxiety, and social isolation. With cognitive behavioral therapy (CBT), this ensures depression doesn’t get on top of tinnitus patients. Finally, ENT doctors suggest sound therapy, which exposes patients to constant low background noise to counteract the unpleasant inner ear audio disturbances. With some, they find relief in hearing aids because they amplify external sounds and drown out the tinnitus.

A young woman wrapped in a blanket suffers from a chronic cough.

Chronic Cough? Sinusitis May Be to Blame

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Of all the things we experience in life, there are few more frustrating than a cough. At first, we hope it will last for just a couple of days before then disappearing. After several weeks, this is the time you should go to see a doctor because your body is telling you something.  With coughs caused by viral infections or an upper respiratory infection should disappear within a week.  Any cough that lasts longer than a week, a chronic cough, suggests an underlying health condition. Of course, this could be asthma, which is a common issue, but there’s another health problem we’re starting to learn more about as time goes on: sinusitis.

The Link Between Chronic Cough and Sinusitis

According to various ongoing studies and research, we now know that sinusitis is a bigger problem than we first thought. In fact, back in a 2005 Mayo Clinic study, at least 33% of all chronic cough sufferers were suffering from sinusitis (some form of inflammation of the sinuses). In the twelve years since then, this number has increased, but there are now solutions available.

If you’re wondering why this inflammation causes a cough, it comes from what we call ‘postnasal drip.’ Here, your sinuses will produce too much mucus to be of any use so some will drip backward into the throat and this triggers the cough reflex. In the medical world, this has a name of its own; upper airway cough syndrome (UACS). As a side effect of having sinusitis, this creates the link with your chronic cough, meaning you need to treat the sinusitis before anything else.  If left untreated, the cough will keep returning time after time.

Allergic Rhinitis

While on the topic, we should also discuss allergic rhinitis (inflammation concentrated in the nose).  It’s caused by allergens such as mold, pollen, and dust mites. With millions of people suffering from allergies in the US, this is now a huge issue and it just so happens that postnasal drip is a symptom of the problem. As we know, this will soon lead to a chronic cough which persists until you receive treatment.

Generally speaking, patients with sinusitis and rhinitis-related coughs experience a worsening of the symptoms when the sun goes down. Since we go to bed and lie down to get some rest, this horizontal position can cause a disruption in the throat which makes sleeping somewhat difficult. Furthermore, we normally have something else to focus on throughout the day. When we’re trying to go to bed, we tend to concentrate on the things that are preventing us from resting, and this places all the emphasis on the cough.

A young woman suffering from chronic cough holds a tissue to her nose, underneath her umbrella.

Seek professional treatment for a chronic cough as soon as you can, as these symptoms often point to more serious health concerns, such as asthma and sinusitis.

Treatment

As mentioned before, treating the cough alone in these situations is a little pointless because it won’t be long before postnasal drip brings it back again. Therefore, you need to consider tackling the cause of the issue which is the sinusitis.

If you’ve been experiencing the symptoms for more than 12 weeks, you’re now past the ‘acute’ phase and are progressing into the ‘chronic’ phase. At this stage, antibiotics aren’t likely to act fast enough, which is why some form of therapy may be required. Treatment options include including anti-inflammatory nasal sprays and the like. If the problem persists and starts to affect your life dramatically, you should see your doctor for a consultation for balloon sinuplasty.

How balloon sinuplasty works: after inserting a small camera into the nasal passage, a balloon is then sent up before being inflated.  This inflation procedure works similarly to opening blocked arteries during heart surgery. Compared to more traditional options, this is less invasive and will only see you out-of-action for a couple of days.
From here, you can then treat the chronic cough (if it still exists) as you would a normal cough. Safe in the knowledge the postnasal drip has stopped, you can treat the cough without worrying about it returning anytime soon.

Ultimately, you know your body better than anybody else.  Only you know when the cough is unusual in duration and severity. If you pay attention to the length of a cough, by marking it on the calendar, you’ll soon learn the right time to see a medical professional and find the underlying issue.

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