Very Painfull Ear Infection

[StickKettleOn]

Hello punters.

I have been suffering with an ear infection for 6 weeks now. I cant hear from my ear and the pain/swelling is slowly spreading around the back of my ear and down my neck slightly. I have been to the doctors 5 times and the hospital once over 6 weeks as follows.

1st visit to (apparantley) ear specialist doctor; Diagnosed with absess and infection in my ear. Antibiotics/anti inflamitorys given.

2nd visit to doc; Absess gone, dried puss on my ear drum left. Doc removed most of the puss from canal, but could not tackle the stuff on my eardrum. eardrops given to remove puss.

3rd visit to doc; Infection back together with lots of puss and wax. More pills given.

Hospital visit; Ear syrnged after being told infection has gone. Told all wax/puss removed sucsessfully. Three days later, i cant hear.

4th visit to doc; Told that dried puss is glued to ear drum and too risky to hoover out using his little machine. Rubbing alchohol given to drop into ear 3 times a day to burn out puss.

5th visit to doc; Infection and absess back in full glory. Pills given with the promise that 'we will just keep trying different antibiotics until we get to the bottom of it"

Now it is more painfull than ever. I cant hear a thing from this ear and it throbs like a bar_stard. I cant even clench my jaw, as it hurts too much.

Im not sure what i am trying to gain by posting on this forum... I suppose I am hoping that someone with medical knowledge may read this and offer advice - or indeed if anyone has had a problem like this previously, how did you stop it?

Any advice would be appreciated. Its started to worry me a little tonight - if it gets much worse, who knows what the outcome may be? I have visions of waking up tommorow morning in serious trouble... It realy does not feel right at all.

Many thanks in advance.

[Briggsy]

I hope you are attending one of the best hospitals in Bangkok. If not, you absolutely should be. I could tell you some stories.

[chuchok]

Did you see an ear nose and throat doctor?

[StickKettleOn]

Local doctor in kanchanaburi - claims to be ear, nose and throat speacalist and reinforces this with pictures of ear, nose, throat all over the suregery. Came highly recomended by a couple people in my local town, 20k away.

I can handle the pain just about.... but now the worry is starting to kick in which is worse than the pain to me. As Briggsy hinted on, you hear stories of silly things like this getting much, much worse and leading to serious trouble. Im having visions now of the infection spreading to my bloody brain, or being the catalyst of a tumour. Silly I know, but it just doesnt feel right, y'know?

Come to think of it - that last paragraph is rather silly but again, something just doesnt feel right about this.

[chuchok]

Sheryl will give you a good answer.

[coldcrush]

Vincent Van Gogh sorted his out....anyways I would say Bumrungrad does good they helped me with my throat...

Edited January 16, 2007 by lopburiguy

[StickKettleOn]

sheryl? Im hoping you are a medical guru my dear.... post away if you can, ta.

[britmaveric]

Vincent Van Gogh sorted his out....anyways I would say Bumrungrad does good they helped me with my throat...

I second that - I think you gave the locals ample time to sort it - time to head to BKK.

[Sheryl]

The problem seems to be that he did not do a culture and sensitivity test on the pus to find out exactly what bug you have and what drug it is sensitive to. As you are finding out the hard way, "trial and error" has its drawbacks, especially when your hearuing is at stake,

IMO, as a health professional, any doctor who did not get a culture the at least after the first course of antibiotics failed (if not to start with) is either not competent or working in a hospital without adequate laboratory facilities (and even then, he should have told you so and sent you elsewhere).

Change doctors and, unless you are sure the hospital you have been going to has proper lab facilities, change hospitals.

Go to an ENT speciliast in one of the larger international standard hospitals, bringing complete records with you, and INSIST on:

1. a culture and sensitivity test at once, and

2. a different class of antibiotic to take in the interim (the results of the culture will take about 2-3 days).

Don't know where you are, if in Bkk then there are plenty of hosps and docs to choose from, go to the websites and be sure to get an ENT specialist with board certification or a fellowship/residency in ENT rom a medical college in the West.

feel free to PM me if I can be of further help, and don't delay. Your permanent hearing could be at stake.

[StickKettleOn]

Thanks Sheryl for the detailed reply. The local ENT doc did suggest on the last visit that he performs a test on the pus. However in the same breath, he also said that he could only do so in a lab environment which he did not have. That was when he suggested another course of pills. Actualy i have been on the same pills all along.... The first pills he gave me, he gave me again with a new course of pills and so on - to the point where I am taking 4 antibitics right now.

Alarm bells did start to ring when i suggested to have my ear syringed before i went tot he hospital. He shifted in his seat, made a few excuses about being uncomfortable doing this as the results may leave me very dizzy for a few days - so he offered instead to give me a syringe, the correct steryile water and a thermometer to ensure the water was a certain temperature.... and do it myself at home! I declined, and it was at that point he gave me a bottle of rubbing alcohol.

I agree with all of you - time i go to a BKK hospital. It is immposible for me to go for 3 days I hope it will not get too much worse in that time.

Thanks you Sheryil, i may well Pm you over the coming days if thats ok.

[Jamie]

Have you had problems with ear infections in the past? Did the doctor say if you have fluid buildup behind the ear drum, like from a middle ear infection? There is a possibility they could do a myringotomy (put a tube in your ear drum) to help with drainage. They do this generally in children, but adults have it done too. It's recommended when there has been little response to antibiotics.

[billd766]

You have my utmost sympathy.

Just before the New Year i saw and felt that my right ear was getting fat, red and hot so on the Saturday I went to the local village doctor who is probably a GP rather than a specialist. (I have ear infections since the early 60's).

She said I had an ear infection (good guess) and gave me some pills and Ethyromicin as I am alleregic to penicillin. Went back the next day for more pills and didn't feel much better. By Tuesday night the pain had gone along from my right ear and up my head so I stopped taking all the pills and told her the next day. All I was taking was Tylenol for the headache.

I went back on the Friday and by now it had gone over the top of my head and down to my left ear. She gave me some anti allergy pills and by the middle of the next week I felt OK again.

I have no idea what the problem was but thankfully it has gone now.

In your case I would suggest you get down to Bangkok for a day or so and go to Bumrungrad or a similar hospital and get better treatment.

For those of you who have never had and ear infection I am both happy and jealous because them earaches cause serious pain.

[Sheryl]

SKO:

A lab environment that can't perfrom a culture isn't much of a lab, to say the least. If it was in a so-called hospital, then the hospital wasn't worthy of the name. the only surprise is that they even had an ENT specialist and I am inclined to doubt how qualified he was.

Anyhow, run don't walk away from there, never use that "hospital"again, and get thee to Bangkok and a proper specialist with adequate lab support. Be sure to bring list of all the drugs and treatments tried to date.

Technically speaking -- by the book -- cultures should be obtained for all infections before selectig an antibiotic, altho the most likely one can be prescribed to start with while waiting for the culture results if the infection is severe or the patent very uncomofrtable.

In practice, to save time and money, many providers will go ahead treat presumptively, i.e. assuming that the organism that is most commonly responsible for that type of infection is at fault. It's not strictly by the book but it's common, I often do it myself, and it's not unreasonabe if it is a common type of infection. But only as a first try -- if no response then a culture is an absolute must.

You have gotten substandard care and sufered the consequences. Hopefully not too late to undo the damage. Get to Bkk & good luck

[wca01]

I would strongly recommand the "Ear-nose" department of Praram 9 Hospital in Bangkok.

In my opinion the best "ear" doctor in town. He also treated our former PM.

WCA

[cathyy]

Anyhow, run don't walk away from there, never use that "hospital"again, and get thee to Bangkok and a proper specialist with adequate lab support. Be sure to bring list of all the drugs and treatments tried to date.

And after 6 weeks, with him stating the pain and redness is spreading behind the ear, I'd fear mastoiditis. THAT will probably take IV antibiotics to eradicate, as do all bone infections.

[Briggsy]

Local doctor in kanchanaburi - claims to be ear, nose and throat speacalist and reinforces this with pictures of ear, nose, throat all over the suregery. Came highly recomended by a couple people in my local town, 20k away.

I can handle the pain just about.... but now the worry is starting to kick in which is worse than the pain to me. As Briggsy hinted on, you hear stories of silly things like this getting much, much worse and leading to serious trouble. Im having visions now of the infection spreading to my bloody brain, or being the catalyst of a tumour. Silly I know, but it just doesnt feel right, y'know?

Come to think of it - that last paragraph is rather silly but again, something just doesnt feel right about this.

With the greatest of respect, rural Thais will recommend doctors on price, a charming manner and how well-known he/she is. They very rarely recommend on qualifications, medical competence, available facilities and experience. Please go and see a specialist at one of the better Bangkok hospitals. 2 have been mentioned in this thread already.

[StickKettleOn]

Jamie – No previous ear infections for me that I can recall. Maybe as a child, but I can’t remember. I’m certain that if I had something as mind blowing as this I would remember.

Billd766 – I agree, ear infections are far worse than you could imagine as it’s not just the ear, its pretty much one side of your head that hurts.

Sheryl – The doc I have been seeing is just a local GP who also claims to specialize in ETN. It’s not a hospital that I visit. He said that a culture test would be the best way forward but also said he couldn’t do it. He suggested a visit to the hospital. I went while I was on holiday in Hua Hin but by then the pain had gone, the doc at the hospital gave me the all clear and I just had a syringe clean out to remove the dry puss. The infection/abscess came back immediately.

Wca01 – thanks for the suggestion. I’m in BKK on Friday and will visit either Praram or Buminggrad.

Cathyy – I just went on wikipedia to check out ‘mastoiditis’ and I have to say it sounds almost exactly the same as my symptoms. For a kick off, the pain is very deep inside my ear which suggests middle ear and my bone around the top of the ear hurts, and also a small section of my jaw bone really hurts. My jaw has now swollen up maybe half inch all down one side. One particular quote from wikipedia has got the old bum cheeks going……” If untreated, the infection can spread to surrounding structures, including the brain, causing serious complications”

Briggsy – you are probably right. This guy was strongly recommended to me but he has turned out to be bloody useless. As others have said, he should have taken a different approach after the second or third visit. He is probably just generous at local weddings and parties etc, and they recommend him on charm.

I’m off to the hospital tomorrow anyway. The pain now is unbearable almost and I can’t even eat as to move my jaw is agony. I have not closed my jaw for 4 days now and also my right tonsil has swollen up.

On top of all of this, I have had conjunctivitis (spelling?) for 4 weeks and have been using tropical eye drops for this time. I’m in the wars! The doc says the conjunctivitis is not related to my ear abscess/infection, but this is the first time in my life I have had either of them – simple coincidence?

Cheers all for the advice, very much appreciated.

[Jamie]

Wow, you are a sorry case. I hope you get this sorted out. At least ask for some type of pain killer to get you through the next few days when you go to the doctor tomorrow...until you can go to Bangkok.

[bruce3404]

I've had similar problems. In fact, I just got back from the ENT at Bumrungrad. My problem is a fungus infection. My first Dr in the US incorrectly diagnosed an infection and gave me antibiotics. I went to an ENT in the States and my problem was properly diagnosed. He suggested that I use liquid Lotrimin (3 drops, twice daily); although it is typically used for athlete's foot, it works and it's cheap. BUT, my problem has been recurring, so I thought I'd get another opinion here. The DR Hoovered out both ears, suggested I wear earplugs when I shower and do not swim. He also put an antifungal gel in my ears and told me not to wear earplugs when I sleep (that'll be tough here in BKK!). Anyways, look into the possibility of a fungal infection and do come to BKK for treatment. You are surely going thru hel_l!

[Sheryl]

OK, if the doc at least told you a culture was needed that redeems him a bit but IMO he should have gone a step further and arranged for one to be done ast the nearest lab. He certainly should have been able to draw the sample, put it in transport media and send it off to a Bkk lab or hospital...which would have probably prevented much of what you are now going through.

Just for everyone's info: anythime you are suffering from an apparent infection that doesn't respond to the medication given, INSIST on a culture and sensitivity being done. If you are told they don't have the facilities, ask them to send the sample somewhere that does, or go at once yourself to well equipped hospital.

To echo what Cathyy said, you may indeed now need a course of IV antibiotics. If the hospital recommends this, AGREE. If you don't have hospitalization insurance and cost is a constraint, see if you can come in once or twice a day as an outpatient to receive it and stay in a nearby guesthouse.

[StickKettleOn]

Thanks for the further advice. The fungal angle sounds interesting. As i mentioned i cant go to BKK untill tommorow but i did just come back from the local ENT doc. I suggested that it may be a middle ear infection, but he insisted it is not. He went on to say that all of the swelling is outside of my ear drum -if it was a middle ear infection, the swelling outside of the ear drum would be slight, apparently.

I asked about the swelling on my jaw close to my ear, and he maintains this is the nerve endings reacting to the pain close by.

Using a pair of tweesers, he dipped a cotton ear plug into some liquid antibiotics and then put in my ear cannal. He says the canal has swollen up that much that he needed to open it up a little. Apparently this should help. I pulled it our after 2 hours as the pain was too much to handle. I told him i am going to BKK tommorow, but he has requested that i go back to see him tonight one last time before i go. He didnt charge me today, and he's not charging me tonight.

[leisurely]

Blimey. Not charging you, that's big of him. When you do go back, ask for some strong painkillers, I just responded on your last thread. If you do need to have IV's and can't stay in hospital, PM me, perhaps you could stay with us?

[StickKettleOn]

Leisurley... on first reading that i wasnt sure if you where joking? Very kind and touching offer to let me crash at your place, very kind. I know a hotel on soi 4 however which is ok and only 500B night, close to bumingrad. I have a friend who stays there. Thank you so much anyway - sweet offer!

Yep i could have used some stronger painkillers to get me through the rest of today and the bus journey to BKK tommorow. It may sound daft, but the pain is twice as bad when i have to talk as obviously i have to move my jaw, where half of the pain is... and i will of course be nattering away all morning tommorow.

By the way, I hope it sounds like i am not making a mountain out of a mole hill here - this realy is one of the most painfull things i have ever been through. I had no idea an ear infection could be so acutley painfull. This forum has once again been very helpfull.

Thanks all for the advice, especialy Sheryll. I'll update this thread when i return from Bangkok.

Cheers

SKO

[kiwiTV]

For the record: I find that the newish Eye, Ear, Nose and Throat Hospital on the corner opposite the Southern Bus Station is of excellent standard. A bit lacking on English skills until you get to the doctor however, they are extremely helpful and plenty of "nurses" around to make up for any lack of English. Again, once you get to see the doctors, their English is excellent.

Cost is pretty reasonable, on par with average private general hospital in Bangkok and you are sure to get a real specialist. They certainly have all the equipment too.

Website is http://www.eent.co.th/ which gives you the open times and contact information in English otherwise it is mostly Thai.

It is quite a large hospital and has inpatients too.

[chingching]

Good Luck Stick. Scary all the diseases there are too catch.

[Dakhar]

I have to apologize,

I just read this thread, and I did not comment much on the pain killer issue.

Here is the deal, I am a docotorate level Audiologist consultant in Thialand. I am the only doctorate level Audiologist in Thailand. Audiologist specialize in ear diagnostic studies etc.

I can help you see the best ENTs in BKK, if not in Thailand.... the co. that I work for has strong relations with essentially all the ENTs in Thailand. We supply diagnostic equipment, and train their staff to use the equipment. You are also welcom to stay at our place if you would like. I will even make sure you get transported to the hospital etc. Don't worry about acomadations. We have a training center, that has apt. style rooms, showers etc we can put you up there.

PM, etc. such that we may exchange cell phone information if you would like.

Secondly....

I still do not know what type of infection you have. It sounds as though you have an infection within the EAC, external auditory canal.... or ear canal. If so, the cotton in the ear approach is what it usually done. Although, it is a little more advanced than what you have gone through. What is placed in the ear basically is a medicated tampon. (complete with a string and all) This is what is used for a infected ear canal. If this is all that you have, you are in luck.

A middle ear problem should be diagnosed with a machine called a tympanometer. It applies pressure within the ear canal (slight amount). No ENT worht a baht does not have a tympanometer. Heck, I think I have a portable one in the back of the car right now!

Any how, good luck and if you want my help just let me know.

[leisurely]

Any news yet? Wishing you better

Leisurely

[StickKettleOn]

Hi all

many thanks for all of the advice in this rather painfull matter. Thankfully I did not need to go the hospital as a new round of different antibiotics killed the infection almost overnight and the pain has now gone. My jaw, which swelled up very big, has now come back to normal. Im amazed at how quickly it just got better - I was in agony every day and then bingo, i awoke and it had gone.

So, thanks again.

Cheers, SKO.