The Saga of Doug’s Ear

I’d mentioned “travails” as well as “travels,” didn’t I? Well, amongst the major travails of the summer was the Saga of Doug’s Ear. I know a number of people who heard about the beginnings of this Adventure in Diagnostic Medicine and have kindly asked for updates, so thought I’d post the Whole Thing.

The first bits here are my original postings of things as they happened—I’ll add the update at the end.

[late June]

OK, this sounds ridiculous, but–

It’s 110-plus these days in Scottsdale, and no one goes out without a coat of sunscreen. Doug’s in the habit of using spray-on sunscreen, with which he mists his whole head, particularly his ears, since he works outside a lot, and fries easily. So we ran out of the Neutrogena spray-on sunscreen we normally use, and when I was at the store later in the day, the store was out of it, too. So I shrugged and bought a can of Banana Boat 80 SPF, figuring that would tide us over until I found the Neutrogena stuff again.

All right. So Doug picks up the can, shakes it, points it at his left ear–and instead of emerging in a fine mist, as he’s accustomed to, the liquid shoots out in a pinpoint stream, striking him directly in the eardrum. Certain amount of consternation, hilarity on the part of witnesses [cough], and swabbing, followed by syringing with hydrogen peroxide (on advice of RN daughter). So he woke up the next morning with tinnitus–ringing in the ear–which has gotten rapidly worse. (Naturally, this happened Friday, so it was the weekend by the time he was convinced it was a problem, and didn’t get in to see the doctor ’til yesterday–you can judge how bad it was, by the fact that he actually _went_ to the doctor voluntarily). Doctor says the eardrum is reddened, and it -may- be an infection–prescribed antibiotics and says wait ten days, and if it doesn’t improve, see an ENT specialist.

It’s driving him crazy, though–he says it’s not a hearing _loss_, at all; on the contrary, everything in that ear sounds painfully loud, so that eating dinner in a quiet restaurant is like eating in the middle of a rock concert, and the ear itself is making constant loud racket, which Doesn’t Stop. Ever. Having read about people who wake up one day with tinnitus that never, ever stops, he’s more than a little worried, as well as harried by the racket. I’m keeping all my appendages crossed that this _is_ an infection, rather than something inexplicable, since if it is, chances are good that it can be cleared up without residual damage. But all good thoughts would certainly be appreciated! From his description, it looks like the kind of thing that drives people to bang their heads against walls in the vain hope of making it stop–and I do hope it doesn’t come to that.

[later post]

It isn’t physical pain–it’s hyperacusis. Even normal ambient sounds–like his own footsteps–are horrifyingly loud, in addition to his ear generating incessant siren-like wails on its own. And it just. doesn’t. stop. Awful.

[early July]

The noise was so bad during the night that Doug asked me to take him to the ER—this kind of concerned me, since he wouldn’t normally go within miles of a hospital unless he had a severed artery.

The doctor who checked him over thought there was a possibility that he might have a dissecting aneurysm in the carotid artery (which would naturally be a Very Bad Thing), and sent him for a CAT-scan with dye, telling him that there would be a sort of “warm, flushed” feeling when they injected the dye.

He said there was. In fact, he said it felt exactly as though he was wetting his pants, and he was convinced he had—but luckily hadn’t. Still more luckily, he wasn’t having an aneurysm, and we tottered home at dawn.

On the upside, the ER visit got him through a terrible night, and he was sufficiently exhausted that he actually slept for a few hours during the morning. (He’s barely slept in the last five days, and it shows. He’s lost something like ten pounds this week, and he isn’t a beefy person to start with.)

[mid-July]

Well, the saga continues [wry g], but things are looking much better.

Doug wound up having three appointments yesterday: with an ENT, an otoneurologist, and another ENT. All of them agree that he most probably has Sudden Hearing Loss Syndrome—and weirdly enough, none of them seemed to think the infamous Banana Boat incident had anything to do with it. It might (they all agree) be the result of a) a viral infection of the inner ear, b) a small stroke in one of the vessels supplying that ear, or c) a brain tumor, but a) is hugely more probable on the basis of statistics.

Beyond statistics, there’s evidently no way of telling whether someone’s had a stroke in the ear, other than by autopsy [cough], and he’s having an MRI tomorrow morning, just to rule out the brain tumor possibility.

Now, the night before all these appointments, he a) had the noise suddenly stop for ten minutes, spontaneously, and b) noticed that he could hear voicemail on the phone in his left (affected) ear, whereas he hadn’t been able to make out even the prompts for the menu, earlier in the week. So it looks as though he’s begun to improve on his own.

However, the first ENT prescribed oral corticosteroids. The otoneurologist (whom Doug liked a lot; evidently he was fascinated by Doug’s ear peculiarities—among other things, Doug hears stimuli in his left ear a half-tone to a tone-and-a-half higher than he does in his right—no wonder his brain is confused, and making weird noises in response—and spent more than an hour testing him with tuning forks and reflex hammers) approved, but pushed the idea of doing an inter-tympanic injection of steroids (i.e., through the ear-drum). The third ENT was a second opinion on the injection possibility—and was also an ear surgeon, one of these being required actually to do such an injection.

So he wound up having the injection this afternoon. We discover that they punch a small extra hole in the eardrum first, “Like the hole in a beer can,” as the surgeon explained, “so the air can get out.” Doug said it was uncomfortable (I bet! yak), and made him very dizzy for a few minutes, but not terrible, and he was obliged to stay lying down for an hour afterward, to allow the inner ear to marinate. He says the steroidal medicine then drained down his eustachian tubes, and tasted like he was swallowing bits of tinfoil.

Meanwhile, he’d started taking the oral steroids yesterday, and reported today that the tinnitus noise was a lot better—very bearable (and occasionally pleasant; he says all kinds of interesting little noises show up, including a very nice three- or four-note chord and a high-pitched series of noises that he describes as a sort of glittering curtain), save that the hyperacusis is still there, and voices (especially) cause blasts of the less-pleasant noises.

Further meanwhile, we’ve got an iPod shuffle going with a selection of variously-colored noises (his ear didn’t like the pink noise selections, so I’ve just deleted those, but it does like the waterfall noises, the purple noise, and the brown noise. Our eldest daughter, the OR nurse, btw, informs me that brown noise causes people to lose control of their bowels and poop in their pants, but I must say I haven’t noticed that effect. I quite liked the brown noise myself), and the otoneurologist gave him a specially-composed CD of white noise that sounds like one of those rain-sticks, with crickets chirping in the background—he’s been listening to that in his car. (Reminded of the brown noise, I turned that on—the file’s on my computer—just now. It bothered Otis the pug, who’s napping on my feet; he started making little “whuff!” noises in his sleep. Did not, luckily, poop on my feet, but I turned it off, just in case.)

So anyway. [g] Things are much better, both physically and mentally, and—always provided that the MRI doesn’t indicate that he has a brain tumor—all the assorted doctors agree that the prognosis is good.

[And now returning to the present, mid-August]

Things are lots better. Doug still has the tinnitus, but it’s gone down to a livable level. Followups with the various ENT’s, audiologists, etc. indicate that his hearing has recovered to within 6 decibels of normal—which is pretty darn close, if you ask me.

One of the ENT’s told him that tinnitus is a secondary symptom of damage to the inner ear—hearing loss being the primary symptom, of course. He said also that if the hearing loss recovers, the tinnitus usually also subsides—but much more slowly, usually taking several months to go away, following recovery of hearing.

Just hearing that it’s likely to go away eventually is very heartening—and as I say, in the meantime, it seems to be tolerable (of course, I’m not the one tolerating it, so my perception may be inaccurate, but still).

MANY thanks to all of you for the prayers, good thoughts, and helpful advice!

Tagged as: Diana Gabaldon Doug's Ear