General Question

newtscamander's avatar

Another question on pain management...

Asked by newtscamander (2825 points ) November 26th, 2012

I have had some kind of virus for the last 3 weeks and a fever developed four days ago, so I went to the doctor to get a sick note. It’s basically a cold that sticks around, but I wanted to get myself looked at because of the fever. She looked at my ears, as I’ve had very extreme ear pain, and saw that my right eardrum was basically dented or stretched outwards from the pressure coming from my blocked sinuses. She gave me homeopathic medicine to help unblock the sinuses and relieve the ears of the pressure, but it still hurts horribly (I started taking the medicine three days ago) and I would rather like to get rid of the pain. Can I cool my ear/ should I keep it warm? I’m taking ibuprofen as often as it is allowed, but the pain remains constant. The side of my face is swollen and the pain spreads down to my jaw and even my teeth hurt. Sinus infections always tend to be very intense and they only get better slowly, I have them a lot and have often taking antibiotics against them also, but this is worse than any sinus infections I’ve had, they’ve never spread to my ears. Has anyone here on fluther had any ear problems similar to mine or even the same?
Thank you in advance.

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24 Answers

WestRiverrat's avatar

Consult an Ear, Nose and Throat (Otolaryngologist) specialist.

marinelife's avatar

It sounds like an ear infection. Definitely consult an ENT specialist. Your hearing could be at risk.

Judi's avatar

it is probably time for antibiotocs instead of just a homeopathic remedy

JLeslie's avatar

You need antibiotics. Go to a doctor that is not going to give you some sort of homeopathic thing, but the real pharma stuff. Fever and swollen and she can visibly see extreme signs of infection is nothing to play with. Ibuprofen should give you some relief both pain and fever, but you need to get rid of the infection. Beside oral antibiotics you can be prescribed eardrops that have steroids and antibiotcs, or just steroids, that will give you some pain relief.

I agree with @marinelife eventually your hearing could be at risk. I don’t know enough about ears to know if what your doctor saw with your eardrum is typical for an infection. If it is I think a regular GP or PCP would be fine, but if it isn’t then I would agree a specialist is better.

If it were me I would go tonight or tomorrow, I would not wait, if that means urgent care (not ER if you can avoid it) or a regular GP that is what I would do. The antibiotics will not kick in for 48–72 hours so every day counts, and they can prescribe the topical relief I mentioned in the form of drops.

Coloma's avatar

Yes. I get sinus infections a a few times a year, mostly in the fall when my allergy sensitivity is the highest. I have had double ear infections before and an antibiotic is mandatory to clear them up.
I usually ask for the Z-pak. It is a miserable thing to deal with.

Actually I am sick today and wondering if it is a sinus infection starting. Get thee drugs, asap!
Also, rest a lot, drink lots of fluids and alternate between hot steamy baths//compresses, and cold compresses. Moist heat penetrates the sinuses and helps them to drain.

Adirondackwannabe's avatar

@scuniper I’d recommend a visit to the ER if it gets any worse. Swelling of the ear drum is not a good sign, or swelling along your face.

poisonedantidote's avatar

While my toothache was going on, I found that cool water helped the pain caused by inflamation. Other than that I have no idea.

Tropical_Willie's avatar

See a E.N.T. specialist and get antibiotics. That’s what should done when I was 14. Ended up with a ruptured ear drum.
Doctors don’t usually give homeopathic medicine, doctor of what?

Coloma's avatar

@Tropical_Willie Yes, many do. . My doctor has always pushed the hot/cold sinus treatments and saline rinses along with the antibiotics. Theses are very helpful for relief even if you need the medication too. Just because you are on an antibiotic doesn’t mean there are not other compatible and helpful treatments that go along with the drugs, just as being on an antibiotic for a wound doesn’t mean you don’t need to still keep it clean and tended to.

newtscamander's avatar

@Tropical_Willie The doctor I saw was a GP, actually many doctors in Germany like prescribing homeopathic medicine- at least in my experience and from what I’ve heard- Germans are very catious with antibiotics.
I managed to get an appointment at my ENT specialist, which is probably also good because he knows of my history with sinus infections and has already experienced how hard it is for me to get rid of them…. So I hope I will be getting something a little stronger and the pain will stop!
And thank you!

Coloma's avatar

@scuniper I’m sure you know too that untreated sinus infections can seep through and cause brain infections as well. I had a friend who ended up with a brain infection once from an untreated sinus infection. It was a bad situation and it took weeks for her to get better.
She was feeling dizzy, blurred vision, extreme headache, vertigo like symptoms.

hearkat's avatar

I am glad that you are scheduled to see a specialist. It is possible to have fluid in the middle ear cavity without infection, but considering your fever and acute pain, it is probably infected and antibiotics are likely to be prescribed. @Coloma is correct, in some cases untreated ear and sinus infections can lead to meningitis.

In the interim, applying heat to that side can help ease the discomfort and pressure. Steam from a bath or shower to help loosen the mucus and open the upper respiratory passages can also be helpful. Hot teas and soups also help. I find that massaging my sinuses – you’ll feel raised areas and discomfort when you press on them – also helps loosen the pressure and fluid buildup. Try to sleep with that side up, also, so gravity can help with the drainage.

I hope you recover quickly!

KNOWITALL's avatar

Doctor asap!

I’ve had a ton of sinus infections and ear infections, you may want to try keeping a vaporizer in your main rooms in future, it helped me and some friends very much.

Buttonstc's avatar

After this current crisis is resolved, you may want to consider doing something of a more preventetive nature.

Since you keep having repeated sinus infections, it’s obvious that you’re sinuses are not draining properly.

Do some research on a procedure called “Balloon Sinuplasty” which has had good results and a very low risk factor. This is because it is far far LESS invasive than typical sinus surgery.

It’s basically like Angioplasty (tyically used for heart blockages) for the sinus pathways. They have a tiny little balloon attached to a scope which is threaded thru and gently expanded to open up the sinus passages for better drainage.

It is so much better than the typical cutting and stuff which has been the standard treatment for years. That can leave scar tissue and leave things worse than before.

With the newer procedure about the worst that can happen is that it might need to be repeated in the future. It’s very low risk for side effects or bad outcome.

Ask the specialist about it as well as doing some research about it on your own.

newtscamander's avatar

I’m scheduled for another appointment with my ENT in 2 days time, as he was also rather worried, but until then I’m supposed to apply heat and take the antibiotics he prescribed. I’m already feeling a little better. So that was the right decision, thank you for all your suggestions, my ENT is looking into minimally invasive surgery, like @Buttonstc suggested, and he will decide after checking my sinuses on Friday. And @Coloma, I wasn’t aware that a sinus infection can affect the brain- I just knew that it is not without risk to leave a sinus infection untreated.

JLeslie's avatar

I am so glad he prescribed the antibiotics for you, sounds like he did it without even seeing you for an appointment. Make sure you take them perfectly. If it says three times a day that means every 8 hours, not breakfast, lunch, and dinner. Also, check if they need to be taken with food or without. If with food, then also double check there is not warning to not take with milk/dairy products. Moreover, you must finish all pills prescribed.

If you don’t have a history of ear infections, I don’t believe you will need any surgery or have ongoing worries about this. If you are an adult, I don’t think allof a sudden you developed ear infection chronic problems. It isn’t impossible, but I would wait and see if you correct it with the antibiotics and the problem is done.

In my late teens I had a strep infection, strep throat, and I did not take enough antibiotics the first time, so I felt better, but then after stopping the emed, became ell again. The whole thing was repeated again, sick, not enough meds, sick again. I was sent to ENT and they said I had bad tonsils, all sorts of crevices the bacteria was hiding in. It just made no sense to me all of a sudden at age 19 my tonsils were a problem, that suddenly I have more hiding places for bacterias, I had never been sickly. Moreover, I was raised by a mom who doesn’t like surgery, and had refused surgery multiple times for a hysterectomy. Anyway, since I was being obstinate my GP sent me to an infectious disease doctor, and he also did not like the idea of surgery. He prescribed me a different antibiotic and realized I had not been taking the proper dose of the other antibiotic that had been prescribed. I finally got rid of the infection, never have had strep throat again, and rarely am sick, just like I never had been to begin with.

Buttonstc's avatar

In the original details, the OP mentioned that he has sinus infections A LOT.

To me that indicates a chronic condition due to poor drainage. Sinuses and tonsils are two different things.

Balloon sinuplasty isn’t surgery as we traditionally understand it. Obviously since it involves threading a scope up there, it’s classified as minimally invasive but it’s not surgery since there is no cutting being done.

hearkat's avatar

To add to what @Buttonstc states regarding the OP’s self-reported history of frequent sinusitis; we do see adults who develop chronic ear problems after not having issues in childhood. Even in cases where the otitis media is not chronic, but is acute to the point where the tympanic membrane is bulging (as the OP mentioned the Primary Dr described it), it may be better to simply make an incision and drain the fluid (a myringotomy without the placement of tubes, which can be performed in the office with local anesthesia on adult patients) rather than to risk the eardrum rupturing, which may not heal as well as a tiny, specifically-positioned incision and could result in long-term hearing issues.

I would defer to the opinion of well-trained and experienced physician, based on the results of the examination they performed at the initial visit and at the follow-up scheduled a few days from now. I’ll also remind readers that the OP is in Germany, where the culture is different attitudes regarding medicine and surgery than the US.

JLeslie's avatar

@Buttonstc I failed to remember that. Chronic sinus problems would need to be addressed. Thanks for pointing out what I had missed.

@hearkat I didn’t say it was impossible, I only meant I think doctors can be quick to want to do something. Something that makes money, and if they are surgeons, they like to schedule surgeries. I recently did a hearing test that I refused to do three times on two separate appointments before giving in to the doctor, and it was pointless. I guess he made his money, he can feel his chart is complete. I feel quasi raped every time I give into a doctor when I see no clear reason, and then find out I was right. I don’t think I have ever, when I felt strongly I was correct, come out of a test with some discovery where the doctor’s desire to do a test was worth it or gave me any significant information. There is a tremendous amount of over testing and over diagnosis in America; that is a fact, not just my opinion. One day I will probably get very sick or wind up dead, because I didn’t go along with a doctor, which will be my fault, I take responsibility for it, and for being a high maintenance patient, but after years of unnecessary testing it is hard to know whether to listen to myself or the doctor.

Doctors need to start testing there best guess first, and not all possibilities all at once. I understand differential diagnosis, but it is overboard here. It costs the system and the patient a tremendous amount of money and we are the ones giving up our time and being poked, radiated, and run around. I just paid a lot of money for an MRI in hospital that was completely unnecessary and would not have ever been done if the ENT had visited me first. In fact, I never would have needed to pay for a neurologist either.

As far as the ENT who wanted to take out my tonsils back whe. I was a teen, their rule was 4 strep throats mean reason to remove the tonsils. But, they did not really listen and think about my specific history, the ID doctor did. I did not have four separate illnesses, I had one that was never cured, because of I did not take enough medicine. It was a teaching hospital, those ENT docs like to practice their surgeries. The ID doctor probably does not do surgery. That might sound awful, but that is how it seems to me as a patient.

hearkat's avatar

@JLeslie – I don’t completely disagree with you, and have known many incompetent health care providers in my day. Yes, over testing does happen in the US – which is why I added the reminder that the OP is in Germany. In general, I try to remind myself that most people aren’t as knowledgable about health and medicine, and/or as not as perceptive about their own body as I am, and so it may not be wise for them to dispute their health care providers. There are many horror stories about people who have attempted to self-diagnose. Then I stress the patient’s option to seek another opinion.

As for your own hearing tests, I don’t know the specifics of your case, so I can’t address why the physician might have wanted them performed so close together. I can say that with the ears and hearing, some symptoms present similarly, but only the Audiological results can differentiate between various conditions. Not much money is made on hearing tests, once you reduce the amount on the bill to what the insurers actually pay, and deduct what the practice pays for the audiologist’s salary and benefits, plus the overhead for the space and test equipment.

JLeslie's avatar

@hearkat I agree with you that a second opinion is usually the best, especially when it is something that really affects ones health. Some issues aren’t very dire, and then an opinion, well, costs more. When I had a cancer scare I wound up in the end with 4 opinions. I remembered the OP was in Germany, which is why I was sure to write I was talking about the US.

I won’t bother to give all the details about what hapened to me, because I feel like it will take the Q even more off course, and I already feel badly about my vent. I tend to get very wound up on the topic.

Now, what I do wonder is mega antibiotics were every tried for the OP’s sinus troubles? Since Germany is so conservative about prescribing antibiotics? I am assuming they have been considering this has been a chronic problem.

newtscamander's avatar

Since the antibiotic is really helping and the pressure is going back, my ENT has decided against surgery after checking thoroughly today.
@JLeslie I am taking them carefully ;) And also: I just turned 18 last month, so I wouldn’t really see myself as an adult, and I’ve had ear infections for all of my childhood, which my ENT knows… thus making it easy for him to decide when antibiotics are needed, because he can evaluate what an extreme infection is in my case.

JLeslie's avatar

I’m glad you are feeling better. :) Since this has been throughout your childhood you might actually grow out of the chronic problems. The next few years will probably give a final answer whether to take more drastic measures.

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