He was so looking forward to this trip to Malaga, after all the city was the hometown of Pablo Picasso, and he was a big fan of his work.
Joseph felt some discomfort on day 3, kind of a very mild pain, on and off. Swimming in the pool and in the sea was so joyful that he kind of forgot about it until on the flight back to London he felt some pain in the left ear when the airplane was descending. Getting back to the routine and work took his attention away from his ear, but the discomfort was there. Eventually, he decided to call his GP.
Do you relate to this story? Continue reading to learn more about Joseph's experience.
At the local surgery in London
"How long you have had this pain in your ear, and how do you rate your pain from 1 to 10, one being the least pain and 10 being an unbearable pain", the GP asked.
"It started about 3 weeks ago when I was on vacation, it started as a discomfort, I thought it may be water trapped in the ear, you know, but then on the flight back to London, I felt a sharp pain. Right now it is about 2 or maybe 3, it fluctuates, and it feels more severe at night", Joseph replied.
"Do you have any other symptoms?, the GP asked.
"Yes, it feels itchy, and my hearing has dropped in that ear, and I noticed a ringing sound in my left ear since yesterday". Joseph replied.
"Have you taken any medicines?", the GP asked the patient.
"No, nothing, I thought it was some water in the ear and it's going to go away". Joseph replied.
"Ok let me take a look at your ear", the GP said. "hummm, I cannot see your eardrum, you need to clean this ear wax before I can figure out what is going on".
Joseph visited a microsuction ear wax removal in our clinic in Crystal Palace the next day.
In the HearingNow clinic...
Joseph is still in mild to moderate pain, and his hearing is still reported poor in that ear. Here is what I observed through video otoscopy (see Image-1). There was no surprise why the hearing was low, the ear canal was fully packed with dense ear wax.
Image 1 - Dark and dense compacted ear wax fully occluding the ear canal
The compacted ear wax was removed through a microsuction procedure and we found something else. I put the camera in the ear so Joseph can also see what is going on. He shouted, "Oh my ear!"
White pale-yellow material indicated that there had been a fungal ear infection (or Otitis Externa) formed behind the ear wax blockage. One of the common reasons for such a condition is when water manages to get behind a blockage of ear wax (e.g. when you are swimming) and trapped in the ear. In the ear canal, it is dark, it is warm and there is always some bacteria in the sea, river or even swimming pool water. So it is a perfect condition for the bacteria to populate and grow and make a fungal infection.
Image 2 - Ear canal packed with a fungal infection material
The fungal ear infection requires a GP's attention to prescribe antibiotic spray. So I attached the above picture to a report and forwarded it to the GP. Joseph also received a copy of the report so he could follow up with his GP.
But more importantly, he agreed to clean out the infection with microsuction. I cleaned out the fungal infection with microsuction safely. Eventually, I could see the eardrum. Only then did he feel relieved because a. the pain was eased down and he could hear much better. usually at this stage the hearing of the impacted ear is not fully restored, I'd say about 80 to 90 per cent of the hearing is usually restored after cleaning the infection out. It highly depends on the extent of the fungal infection.
Post-procedure
Joseph visited his GP and received the antibiotic spray for his ear. He used it for a week, 3 times a day and after 3 weeks he booked a free follow-up in our clinic.
He could hear much better with no pain or discomfort. The buzzing sound (tinnitus) was also gone. You can see the picture of his eardrum at the follow-up meeting below.
Image 3 - Patient's eardrum after the antibiotic spray treatment
Conclusion
Different people have different habits in looking after their health. Some are proactive and preventive, some are reactive. In our clinics, some come for ear wax microsuction before they go on vacation. They want to make sure that a. their ears are clean and healthy so they will experience no problem on the flight when the cabin pressure changes, and b. they want to make sure that when they enjoy a swim at the sea or a swimming pool they don't have to be worried about water getting trapped in their ear and get into medical complications on a vacation.
Others may be reactive, they report to our clinic when there is pain, hearing impairment or a problem in their ears.
Similar to mouth and teeth hygiene, one could adapt to a proactive cleaning routine if one experiences a regular need for ear wax cleaning.
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