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911DOC
911DOC, Board Certified Dr.
Category: Medical
Satisfied Customers: 5087
Experience:  Emergency Medicine Physician
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About four weeks ago I was diagnosed with strep throat, put

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About four weeks ago I was diagnosed with strep throat, put on Z-pak which did not clear it up and then put on Clindamycin (I'm allergic to penicillin) for 10 days. A couple days into the strep throat treatment, by left ear closed off and I went to an ENT was told my ear was infected and Eustachian tube blocked and was told to use Afrin and Flonase nasal sprays as well as to finish the Clindamycin. About of week and a half later my ear began to open up and I was able to hear again. For the next two weeks my hearing improved to almost normal and then a few days ago my left ear began to itch and felt like there was extra wax and/or fluid in it, so I tried to carefully use a Q-tip on the outer portion of the ear. I felt some swelling and what felt like maybe a small bump inside my ear and it felt irritated. When I woke up the next morning, my ear was in pain, swollen shut (cannot hear at all from it) and there was a small amount of clear thick liquid that oozed from it for awhile. The next day (yesterday) I went to a different ENT. He tried to suction out some of the gunk inside, but said it was too swollen shut to get it all. He said I appeared to have an outer ear infection and put a cotton wick inside to help open the canal and prescribed Ciprodex drops (4 drops 3 times a day for 10 days). I have a few questions:
1. Does this diagnosis sound correct?
2. How dangerous is this in regard to possible permanent hearing loss if at all?
3. How long will it typically take for swelling to go down and for me to be able to hear again (hearing is 99-100% gone in that ear right now)?
4. Are there any dangers (mainly with hearing damage) with using the Ciprodex as some internet sites seem to suggest?
5. Is something like Burow's Solution a better choice to use instead of the Ciprodex (either because it's safer or because it helps both bacterial and fungal issues)? And is it possible and safe to use the Burow's Solution ALONG WITH the Cirpodex I am currently using if I was to purchase some?
Thank you in advance for your information.
Submitted: 11 months ago.
Category: Medical
Expert:  911DOC replied 11 months ago.

911DOC :

yes, the diagnosis sounds correct.

911DOC :

this is not dangerous for your hearing, it is now an external otitis, outer ear infection, should clear up fine with the wick and ciprodex and will not affect hearing

911DOC :

swelling should get much better over 24-36 hours if you use the drops correctly

911DOC :

no, there is no danger of hearing damage with ciprodex, it is a topical steroid, it affects the skin of the outer ear only and also has a topical antibiotic

911DOC :

since this is applied to the skin the amount of systemic absorption is minimal and will not affect your hearing

911DOC :

no, burrow's solution is not a good idea

911DOC :

you are on the correct medication which will treat your external otitis

911DOC :

you need to listen to your ENT doctors

911DOC :

they trained for five years after graduating medical school to do what they do

911DOC :

the external otitis which you have now was probably caused by the q tip

911DOC :

breaking the skin

911DOC :

do not use the burrows solution with the ciprodex

911DOC :

you have a wick in your ear and the ciprodex is all you need

911DOC :

you need to just do what your ENT has asked you to do

911DOC :

this will take a bit of time

911DOC :

but please do not add things here and there and second guess your second ENT

911DOC :

external otitis is common, is often diagnosed in the ER, and is treated exactly as you are being treated.

911DOC :

but for now, simply let this medicine do it's job

911DOC :

there is no way to hurry this along and you are being properly treated.

911DOC :



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Best

Expert:  911DOC replied 11 months ago.
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Customer: replied 11 months ago.
OK, just confirm though...It's been out 30 or 31 hours since I've seen the Dr. and began treatment and I still have pretty significant pain to where I can barely chew, and still have no hearing in that ear. That should still be of no concern at this point?
Expert:  911DOC replied 11 months ago.
No sir, it IS of concern, and if you have diabetes it is of even greater concern, but that information was not included in your original question. Pain with chewing may mean you also have a dental infection. It may mean you need a CT scan. It may mean many things, or it may mean that your infection is taking a bit longer to heal than normal. As it is Friday night and you are likely unable to speak with your ENT then I would go to the ER under the following circumstances....
1. new fever
2. new headache
3. increased pain with jaw opening or chewing
4. difficulty swallowing

but at the botXXXXX XXXXXne, if things are not getting better and they may be worse and your pain is what you say it is then no one online will be able to tell you if this is a problem or not as you will need AT THE LEAST an exam by a physician, and you might need much more than that. if you were to come to the ER tonight, based on your story and your exam I might order a CT scan of the temporal bones to rule out infection of the bone lining the ear canal. I would certainly check your glucose and look in your ear and your mouth. Simply no way to tell online. I am sorry for that. I hope this has been helpful, I would take a good look at that link above from mayo clinic.

best
Customer: replied 11 months ago.
Thank you for the info. I was diagnosed about a year ago with mild diabetes. My A1C has been between 7 and 7.3. Doctor has not put my on any medicine and just recommended diet and exercise. I would say the pain ranges from maybe 3-7 on a 1-10 scale throughout the day. The pain in chewing feels like its from the swelling in the left ear and that general area. When I bite down the swelling causes pain in the ear and around it. I saw the doctor and started treatment around 2PM yesterday, and its 930PM now the next day. I told the ENT of the mild diabetes but he didn't seem concerned about it or say anything further. He just said to treat it as I described and to follow-up with my regular ENT this coming Monday for him to remove the ear wick and check the ear. I don't seem to have a fever or headache, or difficulty swallowing...just the ear pain and some difficulty and pain with opening and closing my jaw to chew. So I'm torn whether I need to go to the ER now or what, or just wait it out and see my ENT Monday.
Expert:  911DOC replied 11 months ago.
okay, that's reasonable. it sounds like you might do well with some Tylenol for pain, but if you do develop any of the symptoms above I would go to the ER, especially fever/headache/neck pain or difficulty swallowing.

in the meantime I would hold steady with the plan you have.

the diabetes means that with some infections your body may take longer to clear them, but with the numbers you mention I do not think this will be a big problem.

Let's hope the morning brings some relief.

best
911DOC, Board Certified Dr.
Category: Medical
Satisfied Customers: 5087
Experience: Emergency Medicine Physician
911DOC and 8 other Medical Specialists are ready to help you
Customer: replied 11 months ago.
Thank you so much. I will hold off with the ER for now if you don't guess I will suffer any adverse consequences from it-especially hearing loss. Have a great evening.

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