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Dr. Moser
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mark917 posted:
I am a 41 yr old male, i have had a constant ear pressure in my left ear for six months. my family doc gave me a z pac for ear infection and didnt work. just saw my ent who had done a nasal septoplasty on me in the past. she said she didnt see anything, partly because my blood pressure was high during visit. i take 100 mg of metoprolol daily. she did a pressure test and said my ear drums were fine and said i should have a cat scan of the brain. she pretty much just rushed me out the door, which has really scared me to death. my symptoms include hot flashes, numbness down my neck under my ear, rapid heartbeat occasionally when it flares. sweats when it flares. tingling hot sensations in my fingers and toes, and a serious case of anxiety. my perception of things is thrown off and my eyes bother me and are very sensitive. i can hold my nose and blow and liquid and air come out of tear ducts and that actually gives me some relief. I live in a constant state of dread that im about to have a stroke or heart attack. i also take 100 mcg a day of levothyroxine. i had hodgkins disease in 1991 and again in 2007. had chemo and still in remission. i have an appt. with my internist monday and have done fasting blood test. no results. i dont think this caused by my high blood pressure. i think maybe my thyroid. i also had three fillings break during chemo and have exposed cavities but no pain. just havent had the extra money to have them capped, i also have a lower left wisdom tooth that came in partially, it doesnt bother me so i havent had it pulled. any thoughts or advice would be really appreciated.
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Rod Moser, PA, PhD responded:
I can offer you a few observations, Mark, but it would not be possible to solve this clinical dilemma over the Internet, based solely on the information in your posting.

The first thing that I would like to say would be that not all of your symptoms are likely connected to one, universal diagnosis.....as you know, you have a few medical problems. Your anxiety disorder can complicate the array of symptoms you are having.

I can help you address the ear pressure.

It does not surprise me to know that six months of ear pressure is not going to be instantly solved by five days of Zithromax. Since you middle ear pressure and ear exam was normal, it is less likely that your problem is in the middle ear -- the area on the other side of your eardrum. Your problem could be in the inner ear, a place that cannot be seen on exam. One of the three main symptoms of Menieres would be ear pressure (the other would be vertigo and temporary hearing loss). Ear discomfort can originate from the neck and even dental disorders can cause symptoms to be refer to the ear because of nerve pathways. It can also come directly from the brain (one reason a CT scan was suggested).

If you ENT does not feel you have a middle or inner ear disorder, then perhaps the next step should be with neurology. Step by step, you will need a work-up...from that CT scan to imaging of your neck, sinuses, etc. Your primary care provider can coordinate those diagnostic steps.


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