ear infection – A Mama's Blog

Three weeks ago, Ryan had a cold. Just a runny nose and a cough. A few days later, he was complaining of ear pain. After his awful experiences with ear infections and a ruptured ear drum last year, the morning he said he had ear pain I called our doctor. We haven’t been to the doctor at all this year, and were told he was out for the day. It was a Friday, and I did not want Ryan to be suffering from an ear infection over the weekend without being on antibiotics.

With our regular doctor out, we had the privilege of our first urgent care visit for the year. The doctor looked in Ryan’s ears and said he had raging infection in one of them. I had to tell her that he is allergic to almost all antibiotics and told her the name of the drug that he can take. I had called my pharmacy that morning to get the name and the spelling of the drug. The doctor told me she had never heard of that drug. She said she would have to go look it up in “The Drug Book.” (this really isn’t the name of the book, but evidently it is that book that tells the medical community everything about drugs.)

So Ryan, Cole and I waited. I tried to keep Cole from climbing up on the sink, to turn on the water. (He is obsessed with sinks and water lately). The doctor finally came back and asked me for the spelling of the drug again. She had “The Drug Book” with her, and showed me there was no drug listed in it by the name I gave her. I asked her if she could call the pharmacy and ask them. She said she would, and we were once again waiting.

This time Cole declared he was hungry and just wanted to go eat. It was lunchtime, and there is nothing worse than waiting at the doctor with sick and hungry kids. About half an hour later, the doctor came back and told me she had called the prescription in- the drug was spelled with a ‘C’ not an ‘S’ as I had told her. I had read the spelling back to the pharmacy, but obviously something got lost in translation. After paying the urgent care center double what we usually pay our doctor, we were off to the pharmacy to get Ryan his medicine.

The pharmacy has a drive-through and I was telling Cole we would get Ryan’s medicine and be home in fifteen minutes. It took ten minutes for the pharmacist to even come to the window, and another fifteen minutes for her to check and then finally tell me they didn’t have enough of this medicine to fulfill the prescription. She also informed me that the strength the doctor had written the prescription for didn’t come in generic- it only came in the name brand-expensive form. She asked me what I wanted to do.

I wanted to ask her why she was asking me- isn’t she the pharmacist that paid a ton of money to go to pharmacy school to learn about drugs? I wanted to ask her if she would let me rewrite the doctor’s prescription for the generic dose? I wanted to ask her doesn’t she get paid to make these types of decisions? Instead I told her, I didn’t know- I just wanted the medicine for my son- what did she recommend? She told me she had enough to get us through the weekend, but then I’d have to come back on Monday to get more. Brilliant! I am so glad we spent time having the conversation that she didn’t have the drug in the first place.

Most people would rip the dang bottle of medicine from the pharmacist’s hands, and peel out of there as fast as she could. But my son hates the way this medicine tastes. I tasted it last year and it was a little better tasting than glue and chalk powder mixed together. So I threw the pharmacy into a frenzy- I asked if they could add flavoring to the medicine. The pharmacist looked liked I asked her to walk to Denver to get the medicine.

She asked me what flavor. Ryan yelled from the back, “Grape.” The pharmacist told me to hold on- she had to go consult “The Drug Book.” I wondered if the people who make “The Drug Book” are laughing their a**es off somewhere. Seriously- doctors and pharmacists spend hundreds of thousands of dollars to go to school to learn all this, and at the end of the day their answers are in a $29.99 book. It has to be the greatest scam of all time.

Fifteen minutes later, which must be the mandated time to look up a drug in “The Drug Book,” the pharmacist told me she could add cherry flavoring no problem, but not grape. She would have to get an approval for the grape flavoring. I told her to just add the cherry. Then she told me it would be at least five hours before they could do it, but since I had to wait that long, they could go ahead and get the approval from the drug manufacturer and add the grape flavoring after all.

At this point I was exhausted and needed a nap as badly as Cole, who had now fallen asleep in his car seat. While I was trying to wake him up (so he’d take his real nap) the pharmacist told me that I could come back after five, get the one bottle of medicine, but they would have to mix the flavoring in it, after I got here. Then I would come back on Monday, and get the rest.

Thirty-five minutes later, two very hungry and half-asleep boys (not to mention their mother), drove away with NO medicine. But Ryan was going to have grape flavor in the medicine after all of that- you had better believe it!

A few hours later, I packed all of us back in the car to go get this Holy Grail of grape medicine. I pulled up and this time it was a pharmacy tech. She spent ten minutes looking for the prescription and then told me grape flavoring was not allowed. I asked her if I could speak to the pharmacist. A few minutes later a new pharmacist, who was way to young to have any of his own children, came to the window and I started in with our case. I shouldn’t have been surprised when he said, “Well, let me go look this up in The Drug Book,” but I was. And they wonder why we have “mommy brain?”

Twenty minutes later, I had Ryan’s GRAPE flavored medicine but a headache thinking I was going to have to go through this all over again on Monday. The pharmacy tech asked me if there was anything else they could do for me and I asked them to order me “The Drug Book.” She looked at me like I had truly gone off the deep end- and I can’t blame her. I can’t believe getting one prescription in 2009 for an ear infection involves consulting “The Drug Book” four times. I should be glad everyone is so careful and conscientious- and I am- but really, it is a bit much.

I wish I could say that was it-end of story, but tonight Ryan said his ear was hurting again, “just like last time.” Our doctor is out this week on vacation, and I know tomorrow, I will spend at least two hours waiting while “The Drug Book” is consulted once again. Yes, somewhere in the book publishing business, the publishers of “The Drug Book” are laughing their a**es off.

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.