Should I ask for a second opinion, or go straight to A&E(ER)

[Glo53]

Had a bout of ear infection some 6 mths ago, which including dizziness and loss of balance. 6 weeks agoWhilst staying through at y parents home I began to suffer pain, swelling, loss of hearing and noise in my right ear, and by the time I could get into see a Doctor I was willing to do anything to stopp the pain.I was seen by a GP at my parents practice and he give me some antibiotics in the form of tablets and drops accompanied with some strong pain-killers. I had to take the tablets with food, but unfortunately, I couldn't keep anything down and vomited for a period  of three days until I stopped taking the pain-killers and substituted these for Ibuprofen and paracetamols.(The doctor did say to go back and see him if needed).

However, feeling so poorly I just wanted to be in my own home(was unable to look after elderly parents 82yrs &91yrs) and went to see mt own doctor, who thought it was healing and I could return to work, although I did advise him that I still felt fullness and hearing loss in my ear, he assured me that this would clear. Still not feeling a 100% agreed to go away on a weekend which had already been booked for months with friends to the Lakes, whilst there I began to feel poorly and my balance when, I also had a high temp and began convuling. My friends called in an emergancy doctor into see me and she immediately gave me a cause of antibiotics and an injection to stop the dizziness and sickness(with tablets if needed, so I go be transported back home).The doctor also stated that I had an awful lot a debri in my ear which needed to come out, and asked why I had not been referred on ENT Dept.

Not being able to go back to work I attended my own doctor to advise him of my sudden illness and what the doctor had said to me, my won doctor felt that there was no need for a referral to ENT and informed me to purchase(as it is cheaper over the counter) some Sodium Bicarbonated drops and appearedn not to listen when I was trying to explain that I still felt fullness, swelling and loss of hearing in my right ear. He assured me that my ear was healing once more(this was Wednesday). The following day I begaan to get awful pain again as my ear began to swell up once more causing such pain and discomfort, loss of hearing and noise in my ear....Pain killers would go away near to reduce the pain etc, I tried hot and clod compresses to try and ease the pain. I couldn't get into to see the doctor but was offered to be seen by the nurse Friday tea time, although she had to ask the doctor on site to have a look at it(guess what only my doctor), he quickly look in my ear(ignored what I was saying about swelling etc etc)and told the nurse to prescribe me OTOMIZE spray(anti fungal, I believe) with a parting comment that I he shouldn't be seeing me again.

However, nothing appeared to make any difference and I was climing the walls in severe pain and discomfort, I didn't know whether to go to A&E given that I am being treated by the doctor. Needless to say I was on his door step first thing on the Monday morning and waited until after surgery to be seen by him. The doctor now believes it to be an infection in my glan around the ear and has given me more antibiotics and pain killers, but still states that I do not need a referral to ENT. Although continued to say that if the pain gets so unbareable to take myself off to A&E(specially the one that has a good ENT Department), as in some cases an abscess may form. I have been taken to antibiotics since Monday and the pain and discomfort had not eased up much....WHAT SHOULD i do?

I would appreciate any assistance, thank you for reading such a long e-mail. Glo

[Enoch Choi, MD]

thanks for letting us know.

Some people with cellulitis need a long course of antibiotics, but it sounds like this is taking so long that an ENT could provide some advice.  Ask for a referral.  The concern would be that you have a parotid gland problem, such as sialodenitis (stuck salivary gland stone) or parotiditis or worse, parotid cancer (very unlikely).

[Glo53]

I said I would let you knoe how I got on.........I completed my third course of antibiotics, only to be given another course upon my return to see the doctor. I questioned whether this was a good idea, as this would be my 4th lot, he stated that it would be OK. He give me this other course of antibiotics as my ear is still slightly swollen(around the gland area) and I an still have pain, not all the time, but appears high up at the end of the cheek bone(just in front of the top of my ear(if that makes sense). What do you think will happen if this 4th lot of antibiotics don't clear it, should I accept yet another course(he stated that it can take up to sick weeks, or ask for further investigation? I am also still using the Otomize spray.

[Enoch Choi, MD]

Thank goodness the pain has lessened.

Yes, if you don't have a hole in your eardrum, irrigating your ears is ok.

[Glo53]

I forgot to mention that the nurse took a swab(as I also have fluid in my ear and the nurse could hear my ear crackling when she took the swab), but the collection van had already gone and she wasn't sure if the swab would last over the weekend. I now have some dicharge which is thick and dirty in colour, is this OK and should I continue with the Otomize ear spray?

[Glo53]

Thank you for your reply. I thought I would just write to say that the severe pain in my right ear is beginning to subside and feel more managable, although it is still painful with slight swelling, I  can at least chew foods within reason. Alhough,I still feel fairly unwell in my self , and still have the feeling of fullness, loss of hearing and ringging/gushing noises in my ear, and fingers crossed that by the time I finish the antibiotics on Sunday that most of these other symptoms will have disappeared, which will be such a relief after all these weeks of pain and discomfort. I also REALLY want to get to work, as I miss it, and my period of sickness is really making my normally good sickness record look really bad.

However, Thank you again and I will let you know how I get on when I return to see my doctor next week, if not before. Glo

[Enoch Choi, MD]

Your doctor is right in that pain that doesn't improve with antibiotics can represent an abscess since an abcess is walled off and the body can't send antibiotics in there to kill the bacteria.  But this is pretty uncommon.  I'd call him and let him know how you're feeling and get some advice.  Even if it's middle of the night, he should have someone on call.