So Confused

[Cassie Thompson]

My name is Cassie. I'm a healthy 24 year old woman who is happily married to the love of my life. I enjoy being outside (even in the Wisconsin winters?), playing with my dog, and spending time with my family.


It's been three months since I've felt normal. It all started with fluid in my ear a few days between Halloween. I was kept up all night with a constant thudding. My husband took me to urgent care and they told me to just take sudafed and flonase.

A week went by and my thudding didn't stop and I was having terrible pressure in my left ear. I went back to the doctor and I had a ear infection and sinus infection. They put me on augmentin.

I finished those and went back in because I still wasn't feeling well. They diagnosed me with Eustachian tube dysfunction (something I've always had)and told me to keep taking flonase and sudafed, insisting it would go away.

By the time I got am ent referral my blood pressure was way high (thanks to the sudafed). She said I looked congested and had me do a ct scan, told me to stop sudafed but put me on bactrim and had me stop the sudafed, even though my sinuses didn't look swollen and everything looked normal.

My ears still ring and have the thudding three months later. Is it worth it to go back to the ent i saw before? I recently went to an oral surgeon because my TMJ has been flaring up really bad again. When I was younger they wanted to do bite correction surgery. He put me on a muscle relaxer. Could my tinnitus be tmj related?

So tired of not getting a straight forward answer.

 

[Hotaru]

Hi, Cassie. I am 26 and I too have ETD and T and the doctors don't care. The only difference between us is that I've never had ETD in my life, or allergies. I'm not even allergic to poison ivy. I had TMJ when I was 20, but I got a custom mouth guard/retainer from my old orthodontist and I've been better from that since. But the ETD, I've been to 3 different doctors, going on my 4th, and they keep saying it'll clear up in time and here's some more antibiotics and steroids. That obviously doesn't help, so why do doctors keep doing this to us? I would think something like this deserves tests and scans. I'm sorry you had to join this club.

 

[AnxiousJon]

Tests and diagnosis
By Mayo Clinic Staff
Your doctor can usually diagnose an ear infection or another condition based on the symptoms you describe and an office exam. The doctor will likely use a lighted instrument (an otoscope) to look at the ears, throat and nasal passage. He or she will also listen to your child breathe with a stethoscope.
Pneumatic otoscope
An instrument called a pneumatic otoscope is often the only specialized tool a doctor needs to make a diagnosis of an ear infection. This instrument enables the doctor to look in the ear and judge how much fluid may be behind the eardrum. With the pneumatic otoscope, the doctor gently puffs air against the eardrum. Normally, this puff of air would cause the eardrum to move. If the middle ear is filled with fluid, your doctor will observe little to no movement of the eardrum.
Additional tests
Your doctor may perform other diagnostic tests if there is any doubt about a diagnosis, if the condition hasn't responded to previous treatments, or if there are other persistent or serious problems.

• Tympanometry. This test measures the movement of the eardrum. The device, which seals off the ear canal, adjusts air pressure in the canal, thereby causing the eardrum to move. The device quantifies how well the eardrum moves and provides an indirect measure of pressure within the middle ear.
• Acoustic reflectometry. This test measures how much sound emitted from a device is reflected back from the eardrum — an indirect measure of fluids in the middle ear. Normally, the eardrum absorbs most of the sound. However, the more pressure there is from fluid in the middle ear, the more sound the eardrum will reflect.
• Tympanocentesis. Rarely, a doctor may use a tiny tube that pierces the eardrum to drain fluid from the middle ear — a procedure called tympanocentesis. Tests to determine the infectious agent in the fluid may be beneficial if an infection hasn't responded well to previous treatments.
• Other tests. If your child has had persistent ear infections or persistent fluid buildup in the middle ear, your doctor may refer you to a hearing specialist (audiologist), speech therapist or developmental therapist for tests of hearing, speech skills, language comprehension or developmental abilities.

What a diagnosis means

• Acute otitis media. The diagnosis of "ear infection" is generally shorthand for acute otitis media. Your doctor likely makes this diagnosis if he or she observes signs of fluid in the middle ear, if there are signs or symptoms of an infection, and if the onset of symptoms was relatively sudden.
• Otitis media with effusion. If the diagnosis is otitis media with effusion, the doctor has found evidence of fluid in the middle ear, but there are presently no signs or symptoms of infection.
• Chronic suppurative otitis media. If the doctor makes a diagnosis of chronic suppurative otitis media, he or she has found that a persistent ear infection resulted in tearing or perforation of the eardrum.

http://www.mayoclinic.org/diseases-conditions/ear-infections/basics/tests-diagnosis/CON-20014260
So the difference between "acute otitis media", and "otitis media with effusion" is the difference between needing anti-biotics and not needing them. So a doctor that can tell the difference between the two is pretty important.

 

[AnxiousJon]

ETD is caused by poor function or blockage of the eustachian tube, including:

• Inability of the tiny hairs inside the ear to remove fluid and infection
• Poor squeezing function within the eustachian tube
• Narrow eustachian tube—in infants
• Adenoid tissue blocking eustachian tube—in children
• Swollen nasal secretions that cause a blockage
• Tumors—in adults

This last one, tumors, interests me. If you were suffering from this, it would probably cause most doctors to mis-diagnose. Probably a MRI/CT scan will show this. There must be a doctor attentive enough to listen to you when you tell him other treatments are not working, and put you through a scan.
@Hotaru
@Cassie Thompson
Source: https://cancercarewny.com/content.aspx?chunkiid=100683

 

[Cassie Thompson]

Hotaru I'm so sorry! I agree with the doctors part. It's very difficult and frustrating when they can't figure anything out! Feels like you spend money upon money only to go down the drain.

I did recently go to an oral surgeon for my TMJ. He's having me get a mouth guard and put me on some muscle relaxers for night time. I still get a random thud, but it doesn't last as long or happen as often as it did before.

I hope you both have had a good week! Keeping you both in my thoughts!

 

[Dr. Ancill]

Most doctors do care and will look for a treatable cause in a young patient like you. However, there is no treatment directly for tinnitus so you can't blame your doctor for not being able to 'cure' you. So in that case, each different doctor tries to improve you according to their own specialty in the hope something works. I hope your tinnitus improves and that you improve or recover. The trouble for you is there is no straightforward answer. For my tinnitus, which is age and hearing loss related, there is nothing that can be done medically.