Otitis Media

First of all Dr. Nagler, I really want to thank you for being so incredibly generous with your time and experience and expertise. This site is very lucky to have you.

All I wanted to ask, and I hope this doesn't seem like I'm seeking specific medical advice, or certainly not a diagnosis, is this. The GP I saw about ten days after my T/ringing started did diagnose me with OM, and fluid in the middle ear. He had me take some OTC decongestant type medicine, which did nothing, and if nothing changed advised me to see audiologist, which I did. And she said nothing, other than giving me a hearing test, and that was that. I don't know what has caused my T, which I admit is fairly mild. It wasn't an explosion or a rock concert, but it could have been years of headphones, although if anything I'd been listening less and less as I got older, and there was certainly no upsurge in recent usage on my part to seemingly set it off. But I will definitely say that my ears have never been terribly robust, and they had been acting strange for 6 months to a year before the T finally began, with a lot of clicking, and a few other odd sensations, although no pain or irritation. I would definitely consider myself someone who could have ear/tube/fluid issues, if those possibly might be the cause. I have some ear troubles as a kid.

But as of now, I have not had any meaningful follow-up on my original diagnosis of fluid in the ear, as the audiologist did nothing nor even asked me about anything. It was just the hearing test and that was it. I'm not even sure why I went. So what do you think I should do? I should definitely go see the best ENT guy I can find, shouldn't I? And get to the bottom of my possible ear/fluid/tube problems? Because as today, almost four weeks into it, I haven't gotten any follow up on that. And my ears are still crackling like I just got off a plane. Stupid question, I suppose. I just wanted to see what you thought. Any advice would be greatly appreciated. Sorry for running on so long.

And thank you.

 

@Littlebailey posted:

First of all Dr. Nagler, I really want to thank you for being so incredibly generous with your time and experience and expertise.

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You are most welcome.

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This site is very lucky to have you.

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And we all very lucky to have this site. Trust me on that one. I have been on sites wherein the moderators apparently think that having tinnitus is an excuse to be rude to one another. And where folks are all-too-ready to take out their frustrations on any clinician who has the unmitigated gall to actually care. It's almost as if the coward's cloak of Internet anonymity empowers total jerks to act like exactly who they are and insult anybody and everybody they damned well please. I'm not saying I'm perfect - far far from it. But up to the founding of this board, on-line tinnitus support has in many ways been a cesspool. So I offer a toast to @Markku, @Steve, and the gang for creating an environment where anybody of good heart can speak his or her mind in an atmosphere of respect and tolerance. And wherein anybody whose interests lie elsewhere ... can take a hike.

OK. Off my soapbox.

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All I wanted to ask, and I hope this doesn't seem like I'm seeking specific medical advice, or certainly not a diagnosis, is this. The GP I saw about ten days after my T/ringing started did diagnose me with OM, and fluid in the middle ear. He had me take some OTC decongestant type medicine, which did nothing, and if nothing changed advised me to see audiologist, which I did. And she said nothing, other than giving me a hearing test, and that was that. I don't know what has caused my T, which I admit is fairly mild. It wasn't an explosion or a rock concert, but it could have been years of headphones, although if anything I'd been listening less and less as I got older, and there was certainly no upsurge in recent usage on my part to seemingly set it off. But I will definitely say that my ears have never been terribly robust, and they had been acting strange for 6 months to a year before the T finally began, with a lot of clicking, and a few other odd sensations, although no pain or irritation. I would definitely consider myself someone who could have ear/tube/fluid issues, if those possibly might be the cause. I have some ear troubles as a kid.

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So as I see it, the operative words in the above paragraph are: "I don't know what has caused my T, which I admit is fairly mild." With that in mind, my approach would be to take your tinnitus completely out of the equation and make sure that any correctable problems in your auditory system have been addressed. That would include following up with your ENT to make sure that your otitis media has been adequately treated and that any other potential causes for you tinnitus have been either identified or ruled out.

Once that has been accomplished, then what you are left with in terms of your tinnitus might be best termed a "nuisance." It can be a HUGE NUISANCE or a little nuisance. And what you do about it should be dictated by one and only one thing - how much of a nuisance it is. Since in your own words your tinnitus is "fairly mild," then what I'd do after following up with your ENT is get off this board and go about the important business of having a great life, knowing that if your tinnitus ever did become severe and intrusive, there are effective ways to address it.

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But as of now, I have not had any meaningful follow-up on my original diagnosis of fluid in the ear, as the audiologist did nothing nor even asked me about anything. It was just the hearing test and that was it. I'm not even sure why I went. So what do you think I should do? I should definitely go see the best ENT guy I can find, shouldn't I? And get to the bottom of my possible ear/fluid/tube problems? Because as today, almost four weeks into it, I haven't gotten any follow up on that. And my ears are still crackling like I just got off a plane. Stupid question, I suppose. I just wanted to see what you thought. Any advice would be greatly appreciated. Sorry for running on so long.

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Done. See directly above.

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And thank you.

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De nada.

The best of all good things to you!

Dr. Stephen Nagler