Sudden hearing loss

[crazyhoosiermama]

I've had some fullness and tinnitus in my ear recently.  The tinnitus has been going on for a few months now.  I have a history (recent) of possible labyrinthitis.  Later this afternoon, I lost most of my hearing in my left ear only.  I have no problems with my right ear whatsoever.  I am not experiencing any vertigo or dizziness, nor am I having any pain in my ear.  Just fullness and hearing loss.
I'm trying some OTC medication for ear wax buildup, even though I don't think that's the problem.  I have had several ear infections over the past couple of years, but with those I experienced horrible pain.  
Does anyone have any ideas on what this could be?  I've noticed that if I bend over, I feel a minor twinge of pain and I can actually hear better, the fullness seems to go away.
I plan on calling my dr. in the morning to have my ear checked.  But in the meantime, I thought I would post here and see if I can get any ideas.
Thank you.

[Enoch Choi, MD]

you should be done with your augmentin today

how's it going

you have insurance now, go see an ENT if it's not getting better

Swallow it down ( what a jagged little pill )
It feels so good ( swimming in your stomach )
Wait until the dust settles

You live you learn
You love you learn
You cry you learn
You lose you learn
You bleed you learn
You scream you learn

I recommend biting off more than you can chew to anyone
I certainly do
I recommend sticking your foot in your mouth at any time
Feel free

Throw it down ( the caution blocks you from the wind )
Hold it up ( to the rays )
You wait and see when the smoke clear

[Nancy T]

Oh yeah, the grown-up version of the magic antibiotic. I think they made it pink to make it more appealing to kids, because the feline version, Clavamox, is white. It saved our kitties many times (even though THEY didn't think so).

Swallow it down... it feels so good... or whatever it was that Alanis Morrissette sang!

[crazyhoosiermama]

Thanks!
I really appreciate all of your posts, comments and advice.
Actually, I'm taking Amoxicillin in pill form, so no "pink stuff".  lol  I remember that stuff though - it tasted really good for medicine!

[Nancy T]

Sorry you feel so awful. I don't remember ever having an ear infection, but I'm sure it can't be fun!

(My son, when he was little, once kept telling me he had a bee in his ear. I was puzzled until I realized that was HIS theory about why his ear hurt, but of course it was an ear infection!)

Hope you feel better soon. That "pink medicine" can work wonders. (Is amoxicillin still pink?) Thanks for posting your update, and I hope the ENT can help with your recurring ear infections. I don't know much about it, but it's important to keep those under control to avoid the infection spreading and other complications.

Best of luck, and I hope you can hear well again soon! :)

Nancy T.

[crazyhoosiermama]

I went to the dr this afternoon and was told it has turned into an ear infection (otitis media).  I was put on Amoxicillin 875 mg for 10 days.  Hopefully that will kick it.  I'm definitely planning on seeing an ENT next month, when we have insurance.  I've been having recurring ear infections for the past 2 years.

[crazyhoosiermama]

I'm having more problems now, and I believe they are sinus related.
Most of the fullness and hearing loss went away a few days ago, but then I came down with a really bad cold or another sinus infection.  Since then, the fullness and hearing loss has returned, along with ear pain.  It shoots all the way into my jaw and lower teeth.  Now I'm wondering if I have an ear infection, since I'm now experiencing pain.  I've been having nasal congestion, headaches (in the front of my head), cough, sore throat and body aches and weakness.  No fever.  I don't believe I have the flu b/c I had my flu shot in October.  I feel miserable right now.  

[Wear/a/Jimmy]

Actually, before we go crazy witht the Hearing Aid dispenser concept....

Theoritically it is fine, but legally, a hearing evaluation performed by a hearing aid dealer does not have any diagnostic value, even if done correctly.

In other words, if you went to a licensed hearing aid dispenser (BCHIS) Board Certified Hearing Instrument Specialist, and had some hearing tests done, even if they were done acurately and give those results to a physician. If the physicians makes diagnostics judgements, recomendations, prognosis or etc based on those tests results....  that is technically illegal.

The irony is, you could go to an ENT office, have the tests done by someone without any training, and the ENT can make diagnostic judgements based on those results.....  (delegation powers)  Weird I know, but that is how it works.

NOW, that said, you could go to an independent audiologist (licensed) office, that does sell hearing aids & have the diagnostic work done. Those results are and should be deemed as vallid by an ENT. The audiologist can tell you right away if the hearing loss is strictly conductive or if there is any cochlear pathology involved.  

[crazyhoosiermama]

Another thing I'd like to add.  Just today, I started noticing some pain in the back of my throat, only on the left side (bad ear side).  It feels like it's almost in my tonsil, but I can't be for sure.   I notice it mostly when I swallow.  Sometimes the pain radiates up my jaw, to my ear.  Is this "normal" with fluid behind the ears?

[Enoch Choi, MD]

Nancy T's ideas are great.  those may be ways you could get some limited information, it's important that you get seen right away

she's right "in can't hurt"  ;)

[Nancy T]

Dr. Choi's idea is even better.

[Nancy T]

I'm so sorry you find yourself in such a bind, without insurance. No one should have to make such choices. Do I pay a lot of money for a sudden problem that I couldn't anticipate, on the chance that it's something serious? Or do I risk a permanent hearing loss? It makes me so angry!

Any possibility you could find an audiologist to just do a hearing test? That's less expensive than a visit to an ENT. (I think.) How about even walking into one of those hearing-aid places that advertise with giant full-page newspaper ads every Monday and give you a FREE hearing evaluation!? See if you can get any information out of them!

But--far better--if you are thinking of calling your ENT on Monday, why not call today? Maybe they CAN offer you a discount or payment plan, to get you in ASAP. Even if the office is closed, there must be an on-call ENT you could at least talk to. What could it hurt to talk to him or her? If they are really concerned about your hearing, they may find a way to help you without waiting over the weekend. They do (or should) understand otologic emergencies.

With all that, it may well end up to be just fluid (although, as I said, if you've had suspected labyrinthitis, you may have something more serious going on, in addition to fluid). On the other hand, you could end up like me... looking back and wishing that I had been given every chance to save my hearing, small though the chances were.

(And I didn't even have fluid in my ear--my eardrums were always normal-looking--they simply assumed it was Eustachian tube trouble even though I had no history of it.)

Let us know how it all turns out. Hopefully all will be fine--but please just CALL the ENT on call and just TALK to him/her... and then you can decide what to do. As my dear stepdad says, "it can't hoit."

Nancy T.

[Enoch Choi, MD]

If you don't have insurance the local county health clinic often has arrangements to charge you based on a sliding scale according to your income level.  eg. free if no income

it's not worth losing your hearing to wait.

[OtoHNS_MD]

Fluid can be difficult to see especially with a simple monocular otoscope (small handheld scope that you use 1 eye for).  Even using binocular microscopy with higher magnification, it can be hard to see fluid.  I frequently see Nancy T's scenario where a case of suspected fluid ends up being sudden sensorineural hearing loss and 4-6 weeks later they finally see me.  I always wish I would have seen them sooner.  I think it's reasonable to ask about payment options...not everyone will be receptive to this, but in our office we usually try to give people a break when they don't have insurance.  

[crazyhoosiermama]

Thanks for the further information.
I've been reading about middle ear effusion and everything seems to point to it.  I obviously have a bulging ear drum, which means I have fluid in my middle ear.  Doesn't this alone cause some hearing loss, ringing in the ear and fullness?  I've noticed this morning, since I woke up, that my throat is sore ONLY on the left side (bad ear side).  I am also having some pain in my ear and jaw.  
I will consider calling my ENT Monday.  I need to talk to them about payment options, however, since I do not have insurance at the moment, and money is very tight.  I would have no hesitation seeing the ENT if I had insurance.  But I'm sure the cost of seeing a specialist, plus any tests they might run...well, that can be costly, and I honestly do not have the money.  I understand my health is important, but really, what do you do if you can't afford it?  I will have insurance next month, which is why I was going to just wait it out until then.  
But I guess I just don't understand why all this extra testing is necessary when I obviously have fluid in my middle ear, which can lead to all of these symptoms.

[Wear/a/Jimmy]

"Hey W/a/J, also, what is it about humming to yourself, and if the sound is louder in your affected ear, that leans toward a conductive loss? Is that right? "

Yes, this is basically a silly webber test. I use the "humm to yourself" technique when teaching audi technichians in Thailand. The vibration of the larynx essentially does the same as a tunning fork. But I use a tunning fork or a bone ocilator (sp) when working with patients.

Theoritically the OP could Hum and if the humming lateralizes or is heard more so in the "sick/complaint" ear then the hearing pathology should be attributed to a middle ear pathology. If the sound is actually heard louder in the NON-complaint ear, then the pathology should be localized within the cochlea of the complaint ear.

Trouble is, when you are dealing with mixed losses, these rules start to fall apart and can get confusing. So as mentioned in threads before, one should use the "cross checking" principle, and make sure various test back up findings in order to make a concise diagnosis.

This is to say otoscopy is a valid tool, but it should be combined with others.

[Nancy T]

What the doctor (OtoHNS_MD) said is exactly right.

I don't understand why GPs are not taught that this can be an emergency. Why don't they have little books they carry around in their pockets called "This Is an Emergency," and under ENT it would say "sudden hearing loss with possibility that it's sensorineural!" Why don't ENTs get the word out to the GP types? I saw two GPs within the first five days of my hearing loss, but wasn't sent to an ENT and diagnosed until a month later. Too late.

The ENT immediately put me on 60 mg of prednisone, which I think is the standard treatment and dose (it must be a high enough dose), tapering off over two weeks. It didn't help my hearing at all (and may not have, even if done imemdiately--it's true that treatments are controversial and the outcome always uncertain, since not much is understood about sudden sensorineural hearing loss). But your best chance of saving hearing is in the first few days.

Best of luck and I hope your hearing returns. Please let us know.

Nancy T.

[OtoHNS_MD]

The reason it is so important to distinguish a simple middle ear effusion (fluid) from sudden sensorineural hearing loss (SSNHL) is that the sooner you treat sudden SNHL, the more likely you are at full recovery.  I agree with the above comments.  I would not wait a month because it could be too late by that time.  Some people with SSNHL end up with permanent hearing loss even with early (same day of onset) treatment.  Some people have full resolution even without any treatment.  The treatment is even somewhat controversial.  If this happened to me, I would seek immediate attention with an ENT, obtain an audiogram (with tympanogram) and if it looked like SSNHL, start a high dose of steroids asap (again, the treatment is somewhat controversial).  If the hearing still did not return, I would obtain an MRI.  Another treatment option is intratympanic steroids which require placement of an ear tube (this too is controversial).  

When I see a patient with suspected sudden HL, I call the audiologist and get them in that same day.  I do consider this an otologic urgency...if not emergency.

[Nancy T]

There is something called the Rinne and Weber tests, I don't know exactly which is which or what they prove, but they're something with the tuning fork that the GP SHOULD know how to do in the office (do you agree, W/a/J?), and these tests should give an indication whether your hearing loss is conductive (e.g., fluid) or sensorineural and thus requiring an audiologist and ENT. Did your GP do anything like that--using a tuning fork and asking which ear you can hear a sound better in?

If not, I agree with W/a/J. Fluid is certainly possible, but again, with your background of possible labyrinthis and tinnitus, I would not take such chances. It's YOUR hearing. YOU are the one who would have to live with a sensorineural loss the rest of your life, not your GP. A basic audiology test is not that expensive.

My GP had me try Afrin nasal spray and told me (without doing ANY tests whatsoever), "Ears can take a long time to unplug." I now see her sometimes at the library where I work. I'm sure she doesn't remember me, but I wish I could tell her, "I've been waiting 8 years for my ear to unplug. Do you think it'll happen anytime soon now?"

Hey W/a/J, also, what is it about humming to yourself, and if the sound is louder in your affected ear, that leans toward a conductive loss? Is that right?

Also, crazyhoosiermama, do you find that if you plug up your good ear you can still understand people talking in your problem ear if they just speak louder? Or do you have trouble understanding speech in the bad ear regardless of the volume?

But none of these things, I think, substitute for an audiology evaluation.

Nancy T.

[Wear/a/Jimmy]

Your GP is playing the odds. No hearing evaluation was done, you really have no idea if this hearing loss is related to fluid or not. Logistically it could be, but until you have a complete audiometry test done, complete with bone scores.....  it is a guess as to if the fluid is the culprit.

Knowing what I know, I would not be satisfied with a guess.

"Don't let a GP tell you it's fluid UNLESS they prove it"

Words to live by, the magical otoscope can not tell you diddle regarding hearing loss, severity or type. It does give some information, but it sure does not give all.

[crazyhoosiermama]

I went to see my family dr. today and she looked in my ears and said my left eardrum is bulging quite a bit, so obviously there is fluid back there.  She said the fluid was clear, no sign of infection, so she did not put me on antibiotics.  She told me to take Sudafed and my Flonase nasal spray and give it a month.  If it hasn't cleared up by then, then she wants me to see an ENT.  She also explained that in the meantime the eardrum could rupture, and that this is fine.  So I am going to wait and see what happens.  Since it's not painful, I don't have a problem doing that.  It's more annoying than anything!

[Nancy T]

Call your EAR doctor IMMEDIATELY in the morning, or even tonight if it's not too late. Don't let a GP tell you it's fluid UNLESS they prove it. With your history, you need to be on top of this. Sudden hearing loss should be considered a medical emergency. Don't just talk to your GP, talk to your OTOLOGIST, in other words an ear specialist, and call them as soon as they open tomorrow and tell them you have had a sudden hearing loss in your ear. They should get you in the same day.

Nancy T.

[crazyhoosiermama]

I wanted to add that I recently got over a sinus infection and bronchitis.  I know that sinus problems can cause ear trouble.  I'm highly suspecting that I have fluid in my middle ear.  I've been done with antibiotics for over a week now (10 day dose).  I'm not currently having any sinus issues, just some sneezing and a bit of drainage.