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    Ear Infection and Ringing
    Skribilo05 posted:
    Approximately eight days ago, I noticed a distinct ringing in my left ear. Five days later, I was diagnosed as having an infection in the ear from a build up of fluid (I think my doctor said that was the cause). He prescribed Azithromycin, which I have been taking. I took two pills the first night (as directed),and now I have been taking one every day. Yet, the rining and pain has continued. I realize that this is only the third day of treatment, but shouldn't the symptoms have subsided by now? The ringing is a major hindrance to my daily life, especially at night. When should this go away?

    Thanks, Marissa
    Rod_Moser_PA_PhD responded:
    I have absolutely no way to predict when (or even, if) your tinnitus will resolve since I do not know the medical details of your case, nor can I confirm or dispute your doctor's belief that your ear infection is the cause of the tinnitus.

    Azithromycin is considered a ten-day course, even though you only physically take the medication for five days. So, you are really only 30% completed with your course of therapy -- too soon to know if this will work.

    Yes, tinnitus is a major hinderance to daily life....I have had it myself for about 8 or 9 years, now. Hopefully, yours will not follow this chronic pathway.

    See your doctor again in ten days, or better yet, see a good ENT if your tinnitus has not resolved.
    Skribilo05 responded:
    I really appreciate your quick response to my issue. I feel as though I have an extreme fluid build up in my ear (which my doctor stated). I had never had any Tinnitus before the development of this infection. I actually saw an ENT about two days after the ringing started, and he didn't diagnose anything. The ENT thought that I might have suffered from some hearing damage, but he did a test and said that I have perfect hearing. It was my GP who found the fluid build up and infection. I am just finding all of this to be really odd, since I have never had any major ear troubles before now, but I am only 19.
    Rod_Moser_PA_PhD responded:
    There can be HUNDREDS of causes of tinnitus, so let's hope that your tinnitus is due to the fluid (effusion) or infection. If this is the cause, your tinnitus will be temporary. At age 19, you are certainly less-likely to have some of the other causes. Fluid can take it's sweet 'ol time draining and be reabsorbed, so this can take a month or more.

    I am puzzled by the exam discrepancy between your GP and ENT. The ENT tends to have better equipment and more experience in diagnosing middle ear effusion, but if the GP feels he saw it, then you have to assume he knows what he is doing. Unless your GP did a pneumatic otoscopy (blew puffs of air against your eardrum using a little bulb syringe attached to the otoscope), I can tell you that a visual assessment of fluid is definitely not as accurate as observing eardrum movement using this simple pneumatic test.

    One test that your GP or ENT can do is a tympanogram. This is another check for middle ear effusion similar to the pneumatic otoscopy test.
    Skribilo05 responded:
    Once again, I sincerely thank you for your help. My ENT did not really look very hard or do any tests (other than the one for hearing loss). He did say that my ear looked red, but he did not do anything further. It doesn't seem as though my antibiotic is working, but I realize that I have probably not given it enough time. Do you think that this could be allergy-related? I bike approximately ten miles per day, and as of late I have noticed that I get allergy-like symptoms while riding. I can certainly feel fluid or pressure (and pain) in my ear, but I am not sure what could have caused it. Also, I am supposed to fly to New York next week; would a plane trip make things worse? Thanks again.
    Rod_Moser_PA_PhD responded:
    Regarding your exercise (bike riding)....

    Exercise increases blood supply to all parts of the body. Along with this increased proliferation of blood, comes tissue engorgement...this is why your skin becomes red or flushed. When the tissue engorgement is around your eustachian tubes -- those tiny ventilation tubes that run from your middle ear space (the area on the other side of your eardrum) to the back of your throat -- it may cause the tubes to malfunction.

    If the eustachian tubes clog, your ears may feel full and stuffy, your hearing could be a bit muffled, like they need to "pop". If the e-tubes lock in the "open" position (they are normally closed and only open briefly when we swallow), you may hear your own voice or an echo.

    As long as this exercise-induced eustachian tube dysfunction resolves after you cool down, there is no need to be concerned.

    Could allergies be contributory? Yes. Allergies can certainly cause eustachian tube problems.

    Is it safe to fly? Depends. If your eustachian tube is functioning properly -- regulating middle ear pressure -- there should not be a problem flying. However, if you have middle ear effusion (fluid), flying could be problematic. You may need to get this okay from your doctor -- someone that knows your particular case.
    PaulBell007 responded:
    You and I are suffering from almost the exact same thing. Monday, July 20, I woke up with the exact same symptoms: pain, crusty, swollen ear, ringing. I waited 4 days before hitting the ER for treatment. They also gave me Azithromycin, along with Vicodin for the pain, Ibuprofin for the swelling and CVS brand Claritin for decongestion. After a day, I was back in the ER because the pain and swelling became even worse. Deep throbbing also accompanied the tinitis. The Vicodin did almost nothing. I was lucky if it would knock me out for 15-20 min of sleep. On my second visit they gave me Percocet for the pain and a trial size of Falcon pharm brand ear drops which have worked somewhat, but like you the ringing is still there. I've also been using a $16 Wal-Mart heating pad in 10-15 min intervals and that has helped with some swelling and pain and even moved some of the fluid. I'm in about day four of my treatment now. Let me know how yours is working, Thanks, Paul
    Hecklerx responded:
    hello all I too have the same problems, but looks like I am further along. a month ago it started with a cold then week 2 I had "under water" like hearing, so I went to my Dr. he gave me levaquin for 10 days. they thought I might of had pneumonia, but over the week end with the meds, I welt way better,but the ringing,buzzing the dr described it to a tee for me. I asked the dr after the 10th day of meds and he sent me to ent. now I get to wait a week waiting to see the next dr, and get A hearing test and check but now im really scared, no one has got relief from what started as a mucus/flow issue, well as directed, I use a neti pot to flush, and it runs through, and all i blow or spit out is clowdy, but not 1/2 dollar size blak chunks anymore. oh, its my left ear as well, and i am on oxygen since an accident yrs ago, i take oxicotin and percocett and that has not phazed the ear. the throbbing MAN i would do bout anything to stop this,ill keep in touch n check back specialy after tues visit and is this having trouble staying Awake?im not sure if its cause ive missed so many nights asleep being tormented with pressure or something?

    thanks $ sharring medicate responsibly Jeff
    AngieD35 responded:
    I'm so glad that i'm not the only one. My circumstances are a bit different, though. When I was a tot, I had spinal mentingitis. It affected my hearing so that all my life i have been hearing impaired. I have also had tinnitus all my life. However, neither the tinnitus nor the hearing loss have been much of a hinderance. About 2yrs ago, I visited a friend who live way out in the boonies and the next day I noticed my ear was 'stopped up'. I also noticed that the tinnitus was louder in my left ear. Very much a hinderance. My physician told me that I had fluid build up in my inner ear and put me on Lodrane D 12 hr. It took a while, but the 'stopped up' feeling went away and it took even longer for the loud ringing to go away. About 2 weeks later, I got a cold and ANOTHER ear infection. I got back on the Lodrane, only this time, I also got a bad case of vertigo. At the ER, I was given valium, benedryll and something for naseau. I went to see my reg. doctor after another bout of vertigo (not as bad as the first). He told me I could take the lodrane long-term. He gave me Lodran D 24 this time. The last time I went to the er, I had to go by ambulance the vertigo was so bad. The ER doctor told me that there was no fluid build up and that the vertigo was a likely side effect of the infection. He told me to take meclizine 4 times a day and just rest. It's been almost 2 weeks since then and I haven't had any more dizziness. I dd read some reviews on the Lodrane 24 and found out that many people had vertigo as a side effect. I also noticed that sometimes i feel like there's pressure in my inner ear and that benedryll helps that wonderfully. So now i'm taking benedryll and meclizine 4 times a day. Those are the only meds I'm taking. The problem is that the ringing is still so loud and I have to have constant noise around me. The Dr''s say that there's no cure for tinnitus and that I should go to an ENT. No insurance and the one time I did go a few years ago the bill was $400 dollars. I'm getting really bothered by this because it doesn't seem to want to go away this time. Any suggestions?
    Rod_Moser_PA_PhD responded:
    Tinnitus Treatment Options in a Nutshell?

    Tinnitus is a very complex medical condition, since these aberrant noises can be generated from any part of the ear and even the brain. Ideally, finding the cause of tinnitus would be very helpful in finding an appropriate treatment, but unfortunately this is not an easy job. Even after exhaustive medical tests, a cause is often not found. However, this does not mean tinnitus cannot be treated.

    The first and most important step is to see an ENT specialist that has expertise in tinnitus management?.not all ENTs like to deal with tinnitus. Many large, university-based medical centers have tinnitus clinics run by a collaborative team of medical experts. Even if you need to travel to a nearby or distant city to find one of these centers, you may find it a great resource.

    Not all tinnitus treatments are appropriate for everyone?s tinnitus, and not all of them will work for you. Often it is a combination of complimentary treatments that may offer you the best chance of quieting this annoying condition.

    Medications: Antianxiety drugs, like Xanax and Valium have been successfully used for tinnitus. Many people reject trying them because it would appear that their tinnitus was ?in their heads?, but they really can help. Although these and other medications may not cure tinnitus per se, they can help you cope with those noises. Other drugs like s steroids, antidepressants, antihistamines, anticonvulsants have been used. Otic injections of lidocaine (an anesthetic) have also been used for tinnitus therapy.

    Electronic Devices: Hearing aid-like masking devices used to block sounds can help eliminate the perception of tinnitus. Special hearing aids can often be tuned to help block tinnitus. Cochlear Implants are also being investigated to manage tinnitus in some people.

    Therapy: Cognitive therapy (a type of counseling) is often recommended as adjunct therapy in tinnitus management. Biofeedback is a relaxation technique that helps the body reduce reactions to tinnitus. Tinnitus Retraining Therapy (TRT) is another avenue for the chronic tinnitus-sufferer. Using counseling along with special low-level background sounds, TRT can be quite successful.

    Alternative Treatments: Herbal preparations like Ginkgo biloba, flavonoids, vitamin/mineral combinations, homeopathic remedies have all been hyped as tinnitus breakthroughs, but unfortunately, the responses may be only anecdotal?.in the mind of the believer. Scientific studies have not proven them to be successful. Acupuncture, magnets, and chiropractic adjustments appear to fall in the same scientifically-unproven category. People should be very aware of false claims of success with these and other alternative methods. I even heard a radio ad today for a "tinnitus cure", which there are no cures in most cases.
    msllove replied to Rod_Moser_PA_PhD's response:
    I unfortunately am suffering from this as well. I had some bubbling feelings around late July of 2010. I tried Ear candeling... NEVER USE THOSE.... they made it worse causing the wax to pool over my ear drum.. I started using them in November. By Christmas I couldnt pop my ear open anymore and about a week later I had this awful High frequency noise. I have googled it over and over. It says that there is a lack of natural noise for the ear to hear.. so in turn it makes up its own. Which makes sense because many people that lose there hearing hear this noise. My mother and aunt and grandfather all suffered fromt his but I am only 30 years old and never really did anything to affect my hearing.... I have had ear infections hear and there. My ENT looked in my ear and showed me what it looked like... THe wax had covered my ear drum and hardened... so He had me put warm mineral oil in my ear numerous times a day for a week then he vacuumed out the wax that was softened over my ear drum. He also gave me Azithromycin. On the day he vacuumed out my ear he saw my ear drum which is thick with infection. He gave me more Azithromycin. The idea is . the infection goes away.. so will the noise. I have the pain and the pressure. Sometimes its worse at times. I take xanaz to try to settle my nerves. I have spoken with many people who have had similiar or the same situation. They say once the infection is gone the ringing went away but it took at least a month. I am trying to keep my chin up but it does get to me ...But I try to stay hopeful that It will go away.. the people I spoke with said it does take a few rounds of antibiotics...I hope this helped someone out there... I will try to get back and speak of my progress. I hope you all have found releif..........Dr. Moser... this seems logical yes? The infection goes away so the noise goes away?
    msllove replied to Skribilo05's response:
    I just saw the date of this...did you ever find releif?
    dhmh_ replied to Rod_Moser_PA_PhD's response:
    Hi..First off my left ear was plugged and I went to a ENT dr. and I had a large amount of hardened wax on ear drum so they used the vaccum to suck it out..which was a relief but then 2 days later I started with a slight ringing in that ear..Could it be because of the tramanic experience of that instrument brought on the ringing?Its not so bad during day but at night its annoying..She told me that the wax had kind of changed shape of eardrum but it would go back to normal.Also when I scratch outside of ear the sound is magnified..My hearing is back to normal though..I am very confused..Before I had the clogged ear i was on the Z-pak from fri-tues and then went to ent dr. that thurs..Hope to get your advise if you would..thanks..
    Rod Moser, PA, PhD replied to dhmh_'s response:
    Yes, if you have a significant wax impaction lying against your eardrum, or had additional trauma during a removal procedure, this can cause ringing (tinnitus), however, so can a hundred or so other things. If your ENT is correct, your tinnitus should resolve in a week or two....whenever the inflammation has resolved. This is just a guess, however, since I do not know the details of your case or have the ability to look in your ears myself.

    What was your doctor treating with the Z-pak? If the eardrum could not be seen (due to a wax impaction), it is really impossible to accurately diagnose a (middle) ear infection. Z-paks are not used simply for "clogged ears".

    See the ENT again if the ringing persists....
    dhmh_ replied to Rod Moser, PA, PhD's response: primary dr.was treating me for a sinus infection besides the ear wax..he also wanted me to use a stool softener to loosen the wax;but it didnt work and I think thats how my wax got pushed farther in.Now can the Z-pak cause ringing in ears?I read that it can have these side affects.Its been Its been 13 days since first dose of Z-pak..But what is it when i scratch or touch outside of my ear..the sound is magified?Is it the hair cells in side my ear?I still feel a faint dizzy but nothing like I was before the wax was removed.The ent dr. suggested hydro preoxide to clean ears as a preventative measure.She said every week but since I had this done the 17th (thursday) how long should i wait to start this maintance?In a couple of weeks?I am asking you cause I am on a fixed income and a high-deductable any info is appreciated.Please and thanks!

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