Question to general practitioner Maarten: Earache and ear infection
Maarten Vasbinder lives in Isaan. His profession is general practitioner, a profession that he mainly practiced in Spain. On Thailandblog he answers questions from readers who live in Thailand.
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Dear Martin,
I have pain in both my right and left ear. These are (unfortunately) problems that return almost every holiday, but now it is very extreme. The complaints in my right ear have been going on for a long time. For this I also went to the GP in NL, who gave me acidic ear drops, after which the complaints were kept to a minimum.
Now I arrived in Phuket last Friday and my left ear has been bothering me ever since. I have been dripping with the acid ear drops since Saturday, but it has become so bad (pressing pain, can hardly hear anything), that I went to a private clinic on Monday morning.
An inflammation in my left ear has been diagnosed here, and I have been given Dexylin ear drops and Bactoclav – 1000 tablets. I take this drop and swallow it obediently, but it is now Wednesday evening and the complaints have not become less. In fact, on Monday my ear sometimes popped open, but since Monday evening it has been continuously “closed”.
In addition, since yesterday when equalizing I hear a loud squeaking sound, as if you are deflating a balloon, in my right ear and air seems to escape.
I am now looking for the sequel. Should I trust this doctor's judgment and give it a little more time or go back to him? Or should I go to a hospital or do something else?
What's your advice?
Regards,
B.
*****
Dear B,
It is essential for an otitis externa (inflammation of the ear canal) that the ear is clean. Otherwise drops will do nothing. I always spray my ears. ENT doctors suck them clean, but that is much more painful.
The danger is an eardrum perforation in both, although this is extremely rare. I've never seen that in 25 years and I saw about 700 cases a year.
What sometimes helps is to put hydrogen peroxide (H2O2) in the ear and let it work for a few minutes. A lot of dirt comes loose.
Antibiotics play a minor role in these types of infections and the bacteria, usually a pseudomonas, is multidrug resistant. Ciprofloxacin 2 times a day a tablet of 500 mg during a week sometimes helps. However, antibiotics are usually not necessary. However, it should be used with caution in the elderly.
An anti-inflammatory is also useful, for example Naproxen 3 x daily 300 mg after eating.
Try it for a few more days and if it doesn't go away, visit an ENT doctor. No diving or swimming underwater for the time being. Don't use earplugs either.
Is it better, put a drop of vinegar in both ears every day before and after swimming. Even if you don't swim, because apparently your ears are sensitive. That can prevent a lot of trouble.
Yours faithfully,
Dr. Maarten
Do you have a question for Maarten and do you live in Thailand? Send this to the editor: www.thailandblog.nl/contact/ It is important that you provide the correct information (see list at the top of the page).