My complaint is that my ears always feel plugged. I have tried several different medications such as antibiotics, prednisone, nasal sprays, and others. Most don’t work. The one I am currently trying works sometimes but not all the time. My doctors have even gone as far as ordering a CT scan but nothing abnormal was found. Please help me!

DEAR READER:
If you have been diagnosed by several ENT physicians with Eustachian tube dysfunction, then I must assume they are correct. However, that doesn’t mean there is no help for you despite the steps you have taken. For your and my readers benefit, I will first discuss what this disorder is and then go into the various treatment options.

Eustachian tube dysfunction is caused by a chronic blockage of the Eustachian tubes that leads from sinuses to the ear drum and equalizes pressure within the ear. When a blockage occurs it cuts off the space from the outside environment which creates a vacuum that can pull the eardrum backward into the ear leading to pain, pressure and/or hearing loss. A common, temporary cause of this is flying. “Popping” the ears can reduce or resolve the symptoms.

In long-term blockages, fluid can accumulate within the tube causing worsened symptoms and a feeling of the ear being plugged. (If bacteria gets into the fluid, it can lead to a middle ear infection.) Common causes of Eustachian tube dysfunction (ETD) include inflammation or irritation of the nasal lining (due to the flu, colds, etc.), pollution, cigarette smoke, nasal allergies and more. Obesity can lead to fatty deposits near the passageway of the Eustachian tube and rarely, more serious conditions such as nasal polyps, a skull base tumor or a cleft palate can be the cause.

ETD is most common in children because of an anatomical narrowing and flattening of the Eustachian tube. By about age six, this changes into the common down-sloping shape seen in adolescents and adults.

Treatment depends on the cause. Allergies are a leading cause so most physicians attempt to reduce the inflammation and allergic response. Allergy medications, nasal decongestants and steroids such as prednisone, are commonly used. Self-inflation techniques may be advised in order to re-establish equalized pressure. The easiest way to do this is to blow up a balloon. It can even be done several times a day if needed. If these fail to provide results, further investigation is needed to determine the underlying cause.

If the dysfunction persists (as yours has), surgery may be an option. There are several types but which one is done depends on the cause and severity of symptoms. Another important factor is whether or not there is a significant amount of fluid present.

Speak to your physician about whether surgery is an option.

To give you related information, I am sending you a copy of my Health Report “Ear Infections and Disorders”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

DEAR READER:
Tinnitus affects more than 12 million Americans. It is recognized as a ringing, roaring, clicking or hissing in the ear. Causes vary but are often the result of hearing impairment, such as through the noise exposure at your workplace. It can also be a common side effect of many medications.

Your first step is to see an audiologist or otolaryngologist to determine the cause for the tinnitus. Perhaps hearing aids are all that will be required. They are well-advanced in comparison to the large units of a few years ago, and provide great relief for many patients. Maskers might also be recommended to over-ride the ringing you may be hearing. If the problem is medication-induced, simply discontinuing the offending drug should solve the problem. If it is the result of other health issues, these issues should be addressed.

Lipo-Flavonoid is the over-the-counter dietary supplement I probably referred to in a past column. The supplement was specifically developed to relieve the symptoms of Meniere’s disease that includes tinnitus, dizziness and hearing loss. It should be available at your local pharmacy or department store.

To give you related information, I am sending you a copy of my Health Report “Ear Infections and Disorders”. Other readers who would like a copy should send a self-addressed, stamped, number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

He will have to stand in one place with his hands against the wall for support until his vision returns. He has seen a neurologist and a cardiologist. The cardiologist suggested syncope (fainting) and the neurologist saw nothing on an MRI.

My son is desperate to find out what is wrong with him. After a little online research of our own, we are thinking POTS, or orthostatic intolerance. His symptoms occur upon standing. What do you think?

DEAR READER:
Some children and adolescents experience pre-syncope, a feeling they are about to faint. They may complain of dizziness and a feeling that the room is spinning. There may be episodes with adequate time to slump to the floor or sit in a chair, while at other times a person may fall to the floor without warning. The feeling is frightening for an adult and overwhelming for a child, so I can understand his anxiety.

An irregular heartbeat can be a trigger. When the condition occurs, the ventricles don’t have adequate time to fill with blood before that blood is automatically pumped throughout the body. The body reacts to the decreased blood supply by shutting down, causing fainting to occur.

Abnormalities in the structure of the heart can cause near-or-true syncope also. An outflow obstruction restricts the flow of blood out of the left ventricle of the heart. Certain cardiac conditions such as aortic stenosis or myocarditis will diminish the flow of blood through the aorta, causing symptoms of syncope.

A drop in blood pressure on standing or when a child has been standing for an extended period is known as orthostatic hypotension. Blood pools in the legs, preventing it from return to the heart in adequate supplies. Simply put, when the heart doesn’t get adequate blood in, it can’t pump adequate blood out. Syncope results.

The vagus nerve is essential for the function of numerous body parts. When stimulated by conditions such as stress or pain, blood vessels dilate. This leads to a slower heart rate in susceptible individuals, resulting in syncope.

Still other conditions such as inner ear disorders, low blood sugar, head injury and voluntarily holding one’s breath can create like symptoms.

A common thread to some syncopal conditions is an inadequate supply of blood to and from the heart. Therefore, I feel your son should be seen by a cardiologist who specializes in pediatrics. While I understand he may not feel comfortable in a “pediatric” setting, I feel he will be better served there. Based upon his history, he may require lab work, a tilt table test, echocardiogram, or other appropriate testing before an accurate diagnosis can be made.

Because I mentioned ear infections as a possible cause, I am sending you a copy of my Health Report “Ear Infections and Disorders”. Other readers who would like a copy should send a self-addressed, stamped, number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

Several years ago I had a bad cold and blew my nose quite hard and often. Following this I developed a blood flow noise in my left ear.

Concerned it was something serious, I made an appointment with my ear-nose-and-throat specialist. After a thorough examination, he told me that my Eustachian tube had been forced open, likely due to my frequent and hard nose blowing. I was told that it may never close back up but I could try deep sea diving which would put pressure on the tube and might close it or I could just learn to live with it. (I used to be a deep sea diver, so this suggestion wasn’t completely outlandish.)

It has been fifteen years since the diagnosis and I still have the problem. I have learned to ignore it but know it is nothing serious. If I have a cold, the sound gets a little louder.

I know this is not always the problem if someone develops blood flowing noise in one or both of their ears, but given the alternatives, this is a much better diagnosis. I still urge everyone to see their physicians because it is the ONLY way to be sure of what is causing the noise.

I hope this helps the woman and her husband and anyone else who may have the problem.

DEAR READER:
This was not an option I had considered. Thank you for writing to inform both me and my readers of this possibility. Keep up the good work.

To give you related information, I am sending you a copy of my Health Report “Ear Infections and Disorders”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

First, I have a worn hearing aids for about five years. They are digital with the battery section behind, not in, the ear and a small plastic tube inside the ear. I have had itchy ears for sometime but since wearing the aids my ears flake and peel daily. I have used peroxide to make sure there is no infection and anti-itch creams, lotions and salves but nothing helps. My ears continue to peel. My doctor says it is not psoriasis but could only suggest a different cream.

The other problem I have is a persistent itch in one spot on my back by my right shoulder blade. It occasionally hurts. It seems to have started right around the time I developed shingles eight years ago.

Do you have any suggestions on either of these issues?

DEAR READER:
Itchy ears are very common. Hearing aids are one of the main causes, especially among the elderly. Some individuals may experience an allergic reaction to the plastic the aid is made from or from the polish that many companies use. Another cause may simply be that the aids are rubbing your ears causing irritation.

I suggest you try wiping the hearing aids carefully with alcohol before wearing them. It is also important to keep them clean to so they maintain good working order. Another option would be to try smaller aids that do not wrap around the ear. This will reduce fiction and may eliminate or reduce the peeling.

As for your chronic back itch, I believe you may be correct that shingles was the cause. Shingles causes inflammation and irritation of the nerves of the skin. In some instances this can cause permanent damage called post-herpetic neuralgia (PHN). Often this condition results in pain, numbness or tingling but an itchy sensation is not common.

PHN is not harmful in most instances, but if you are truly bothered, I recommend you see a neurologist who can examine and test you. He or she can determine the cause of the problem and recommend appropriate treatment.

To give you related information, I am sending you a copy of my Health Report “Ear Infections and Disorders”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

I remember as a child using ear drops, heating pads and bags of heated rock salt. My question to you is will these tubes dissolve or need to be removed as he grows older? Will they affect his balance and equilibrium during everyday activities and sports? I am completely clueless about this. Please help.

DEAR READER:
Tubes placed in the ear are surgically implanted through the eardrum to allow fluid to escape easily rather than building up causing infection. They will not dissolve and in most cases fall out after about a year or so. The tubes are minute and chances are, he will never know when they have fallen out.

As far as affecting his balance, yes it will affect it, but in a positive way. An ear infection is basically a build up of fluid within the ear, often behind the eardrum. This can push on the sensitive ear parts causing pain, swelling and a loss of balance. With the tubes in place, this fluid can freely drain away which means no infection, swelling or balance problems.

I, too, as a child remember the drops and heated water bottles. Thankfully today, our children and grandchildren do not have to suffer as we did. Repeated middle ear infections can cause permanent damage and hearing loss. Drops and heating pads merely made the infections more bearable. Tubes, however, are helping these unfortunate repeat sufferers to avoid these risks.

DEAR READER:
How fast improvement is seen varies from person to person and is dependent on the severity of the problem. Some may experience improvement within a few days or weeks while others may not see results for up to six months. There is also the set of individuals for whom the product does not work.

If you have not done so, I urge you to see your doctor regarding your dizziness. This can be a symptom of benign conditions such as vertigo as well as potentially serious disorders such as heart disease. Once the cause has been determined, appropriate treatment can begin. Lipo-flavonoids should only be used for harmless but annoying conditions. Dizziness associated with heart disease should be treated by dealing with the underlying disorder.

To give you related information, I am sending you copies of my Health Report “Coronary Artery Disease” and “Ear Infections and Disorders”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 per report to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

I want to know why doctors no longer give penicillin shots when they work. I was right and it helped my hearing but my doctor made me change to another physician anyway. I am not a doctor, but know that this shot can help many people, has helped many people and works right away on lots of ailments. Please tell my why doctors make us suffer when a simply penicillin shot will cure us right away!

DEAR READER:
You were beyond inappropriate to beg and cry to your doctor for a shot that you did not need. While “divorcing” a patient is a last resort, I have to agree with your doctor in this case. Rather than determining the cause of your hearing loss and taking your doctor’s advice, you behaved in a dangerous and childish way.

Antibiotics, such as penicillin, are over-used and because of individuals such as yourself, drug-resistant bacteria are on the rise. Penicillin is not a cure-all. It should only be used to treat moderate to severe bacterial infections that do not resolve on their own with modest care; this is true for all antibiotics.

As for you claiming to be right, this is debatable. Most people will recover from minor ailments, sometimes even major ones, because they believe something will work. You may have simply believed that the penicillin shot would work so after having it, you recovered. Chances are it was coincidence that your hearing returned after having an inappropriate shot.

Penicillin shots are no longer given for many reasons, but the top two are severe allergic reaction and over-use by individuals who don’t have bacterial infections.

I urge you to control your behavior and listen to your new doctor’s advice. If you disagree with it, you can always seek a second opinion but before insisting on a treatment that may cause more harm than good, you need to know what is causing your problem. Only then can your doctor treat you appropriately. This is true for everyone. While you do not have to take your doctor’s recommendations, it is important that you hear what he or she has to say and find out possible risks from both the illness and treatment.

To give you related information, I am sending you a copy of my Health Report “Ear Infections and Disorders”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

Would you know of an herbal remedy or natural cure I might try?

DEAR READER:
Tinnitus is defined as a noise, ringing, clicking, or buzzing in the ears that affects more than 12 million Americans. Common causes are ears blocked by wax and damage from loud noises such as from lawn mowers, engines and heavy equipment.

Tinnitus isn’t an actual condition, but a symptom of an underlying problem such as injury to the ear, a circulatory system disorder or simple, age-related hearing loss. Less common conditions are Meniere’s disease and acoustic neuromas. Some antibiotics, cancer medications, diuretics, and almost 200 other medications are linked to tinnitus.

The most common type of tinnitus is known as subjective, caused by problems in the outer, middle or inner ear where tiny hairs move as a result of sound wave pressure. Tinnitus results when the hairs become bent or broken. It may be present constantly, some of the time or in one ear or both.

Avoid alcohol, loud sounds and other triggers. If you are bothered while attempting to sleep, try turning on music (or better still, static) from a radio at a low volume. If you are on any medication that is linked to tinnitus, ask your physician to switch you to another drug.

Herbal remedies include feverfew, Hawthorne, rosemary, ginkgo biloba and essential oils. Vitamins and mineral remedies include magnesium, vitamins A and C, and bioflavonoids. I am not sure how effective vitamins, minerals or herbs might be. The only thing I can say is that they should not cause any harm if taken according to packaging recommendations.

An over-the-counter drug known as Lipo-Flavonoid, has met with success, according to a number of my readers.

Because you indicate nothing can be done for your tinnitus, I interpret you have seen an ear-nose-and-throat specialist. If not, that is your first step. Determine the reason for this annoyance and demand an understandable explanation of why nothing can be done. If you remain dissatisfied, request a second opinion from your primary care physician.

To give you related information, I am sending you a copy of my Health Report “Ear Infections and Disorders”. Other readers who would like a copy should send a long, self-addressed, number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

DEAR READER:
Ear wax is secreted by glands in the skin that line the canals of the ears. Its purpose is to trap dirt and slow the growth of bacteria. Why some individuals seem to produce more wax than others is unknown. Blockages can occur when people attempt to clean their ears themselves, most often with the aid of swabs. As a general rule, this process simply pushes any wax into the ear canal and against the drum causing pain, fullness and hearing loss. The practice should never be done.

There are safe, practical solutions for removal. You can try using mineral oil, baby oil, Debrox or Murine Ear Drops, which soften the wax allowing it to be removed easily with a bulb syringe filled with warm water to flush the wax out. This method is similar to that used by physicians and shouldn’t harm the ear drum. There are also products that can be used every four to eight weeks as a preventive.

A much safer and recommended method is to make an appointment with your physician. While this might appear to be unnecessary, your physician can examine the outer ear, remove any wax with a small instrument, or flush it away. He or she can also determine if the debris you claim is painful to remove is truly wax. There are several ear conditions that can cause dried skin build-up that resembles wax. In my opinion, this is a more likely cause of your ear problem and may require prescription creams.

Your hearing is extremely important so don’t attempt to insert any instruments into the ear canal yourself. A rule of thumb is never to put anything smaller than your elbow in your ear.

To give you related information, I am sending you a copy of my Health Report “Ear Infections and Disorders”. Other readers who would like a copy should send a self-addressed, stamped, number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.