Ruptured Eardrum

We have always been pretty healthy.  Until my C-section, I had never been admitted in a hospital.  I thank the powers-that-be-every day that my children are healthy and have no serious medical conditions.

With that being said, ever since September, it seems like we have been sick, especially the children, with one thing after another.  I have blogged about it, and everytime I think we have seen the worst (flu, colds, coughing, stomach viruses, etc.) either Ryan or Cole-or both of them- come down with something new.

The latest- Ryan has a ruptured eardrum and what the doctor calls a “raging” ear infection in his other ear.  This makes two double ear infections less than a month apart.  Until this happened, Ryan has never had an ear infection before.  He is almost four and a half.  What is happening where he is getting double ear infections?  The doctor had just cleared his ears, saying they were both healed, and then a few days later, he said his ear was hurting again.

We went to the doctor a week ago Monday, and he said he had one ear infection, and gave us a prescription for an antibiotic.  Ryan also had a fever lingering around 102.  Tuesday, Wednesday, and Thursday went by with no real change.  If I didn’t give Ryan Children’s Motrin every four hours for the pain and his fever, he was absolutely miserable, crying in pain.  He would have an hour here, an hour there, where he would seem OK, but the fever never broke and he started saying his other ear hurt too.  To top that off, he had no energy, was very lethargic, and didn’t want to eat.  He has lost about 4 pounds last week. 

On Friday, what looked like light yellow snot (sorry if this is too graphic) started draining out of his known ear infection ear.  Then his ear started crusting over. I remembered one of my friends said her son had a ruptured eardrum and she knew this when fluid started coming out of his ear.  I had my suspicions on Friday, but since it was a really thick fluid, I wasn’t sure.

On Saturday morning I called our doctor’s office and got a doctor (if you want to call him that) on call.  Not our regular doctor. When I told him Ryan still had a fever, still had ear pain, new ear pain in his other ear, and fluid draining out of his ear, and told him I suspected he had a ruptured eardrum he said, “Hmmm that is puzzling to me.  I think you just need to wait a few more days and see if the antibiotics start working.” 

At this point I told Dr. On-Call that it had been 6 days already since Ryan had started on antibiotics, and clearly it was not working.  I told him we only had one dose left.  If it wasn’t working by now, I doubt one more dose was going to do the trick.  Dr. On-Call didn’t budge and told me since Ryan was allergic to penicillin he was on the strongest antibiotic they had, and the dosage was correct.  I knew what he was telling me just couldn’t correct.  I hung up on Dr. On-Call, very frustrated. 

Today, after posting the situation on my mom’s board, where one of the members is a pediatric physicians assistant, she told me it sounded like Ryan did have a ruptured eardrum, and if a fever or the other symptoms don’t clear up within three days of starting antibiotics, a stronger antibiotic is needed.  Can she call Dr. On-Call and tell him that?  How could an actual medical doctor NOT know that?

I had an appointment with our regular D.O. doctor, for Monday afternoon.  He confirmed that Ryan did have a ruptured eardrum and the other infection in his ear.  He thought for a moment and then came up within 2 seconds, another, stronger, antibiotic he would prescribe for Ryan.  Could he call Dr. On-Call and tell him there are stronger antibiotics than what he told me Ryan was on?

After having one dose of the stronger one this afternoon, he got some color back in his face, and ate the biggest meal for dinner, that he has eaten in over a week.  I really hope this round of antibiotics cures these ear infections once and for all.

On Sunday night I was reading up on ruptured eardrums, and they sound worse than they are.  Evidently when the fluid pressure gets to great in the middle ear, the eardrum ruptures to release the pressure.  Our doctor said back in the old days, before they had strong antibiotics to treat severe ear infections, they would actually rupture the eardrum on purpose to relieve the pressure.  He said it was the body’s way of taking care of the problem.  He said in his 25 years of practice, he had never seen a child’s ruptured eardrum not heal itself.

Doctor said it can take a month or two, and we need to be careful to make sure no water, ear drops, etc. gets into Ryan’s ear until it is healed.  He said if liquid gets into the rupture, it could damage Ryan’s hearing.  He suggested for baths to put a little piece of a cotton ball, coated with a little vaseline in Ryan’s ear, to seal out any water.  So I hope his ear heals with no incidents. 

The one thing that threw me off a bit in determining if Ryan really had the ruptured eardrum was the discharge.  I thought it had to be a liquid like water.  Dr. On-Call told me ruptured eardrums always produce blood and pus.  Evidently they can, but that isn’t always a symptom.  The drainage can be clear also.  If the child’s pillow has a dried residue on it, this is usually a sign of a rupture ear drum.  I found a good site last night that was very helpful with more information on ruptured eardrums from Medline Plus Encyclopedia. 

I think I’ll have to keep Ryan home from school in the morning- it is supposed to be cold and the class goes outside.  I don’t want cold air blowing in his ears, and his ear is still draining. 

Oh, I mentioned to our Dr. what Dr. On-Call said, and didn’t do.  He told me it can sometimes be hard for a doctor to diagnosis over the phone, without seeing the child.  I know that can be true, but jeez… this seemed pretty obvious to me, with no medical training, and my friend the P.A. nailed it, on-line, without ever seeing Ryan either.  I did let my doctor know that I wasn’t happy at all, with Dr. On-Call. 

It is so hard to see your child in pain, and you are absolutely helpless to make them feel better.  I learned that I have to be more insistent when dealing with the Dr. On-Call’s.  I hope there isn’t a next time, but if there is, I am not going to take “no” for an answer.  I will insist that Dr. On-Call at least look at Ryan, even if it means it disrupts the doctor’s Saturday.