Ear infection: please help!

October 15, 2008 8:28 PM

For an outer ear infection, how do I get the medication drops safely past the pus to the infected ear canal?

So 3 days ago I started to feel a tinge of pain between my ear and jaw hinge. I did the wait-and-see for a day and it got worse pretty fast. I have old vicodin that still works that I was taking for the pain (when I needed to sleep and focus on work, ear pain is terribly distracting) So I go to the doctor, he looks in my ear canal and says "yes it looks enflamed" and prescribed me the Neomycin/Polymixin/Hydrocortisone drops. The first couple applications were pretty easy, I could feel them drip down the canal, all was good. After two applications, I thought I could feel some blockage in the ear canal. here is where my stupidity begins.

I get the bright idea to flush my ear out with warm water to try and flush the pus/wax/whatever out so the medicine can coat the entire canal. Well i sort of went crazy. Probably 20 minutes of flushing ensued, with no payoff wax-boulder tumbling out. After I gave up, I used a hair dryer on low to dry my ear off, didn't use a q-tip or anything.

My wife gets home, looks in my ear and says "there's no wax/pus blockage, but your ear canal looks about 1/3 the width of the other one". So I go to bed and in the middle of the night I wake up (probably 4-5 hours after the flushing) and my ear canal is totally blocked. It's swollen shut and sounds like I have one of those -30db earplugs in my ear. Also the pain is way worse, so now I have to take a 2 year old vicodin to function, which does the trick fine but once it wears off i'm in pain city again. The problem I then discovered was that I can't get the drops to go down my ear-canal. I'll sit there with my head tilted for like 5 minutes, then straighten up and out they come.

So i go back to the doctor today (different doc, thanks HMOs) and tell him the story about the flushing and what not. I don't tell him about the vicodin cuz I know it's illegal cuz the prescription is expired and I know not telling him was a mistake. So he takes the ear-looker-inner instrument and plunges it (much like a jilted lover would a dagger into their betrayer's heart) right through my swollen-shut canal (OUCH!) and says "yeah it's infected... you might also have a middle ear infection too but I can't see through the outer canal so lets put you on 10 days of amoxicillin just to be safe".

An hour later (the vicodin was worn off) my ear hurt SO friggin much, i'm not sure how much of it was from the infection or the breaking of my ear-canal-hymen by the good doctor. My wife tried to apply the drops but she said the ear canal was very tight and spackled with yellow pus. So the medicine just sits on the mouth of the canal and doesn't go down. It might have gone down a LITTLE, but after 15 minutes of wiggling my ear , pulling the lobe around trying to let the medicine work it's way down, sitting up still put drops of the medicine onto my shirt collar. The second doctor was positive that my wife could drip the medicine into the canal and work it right down. Maybe the pus really formed after he shoved the instrument down the canal?

Anyhow, maybe most of this was uneccessary to write down. My ultimate question is: I'm on the amoxicillin AND the drops. The drops are blocked by the swollen canal and yellow-pus. How can I get the medicine down in there? They say don't put anything in your ear (and i think flushing with warm water made things worse, maybe i just did it too much) so what do I do?

If a medical professional could give some advice, it would be greatly appreciated. I assume I have to move the pus out of the way, right? I can't think of any other way. What I sort of think you will say is "you have to move the pus out of the way, so let your ear get wet in the shower and apply the medicine immediately"

Ear infections really suck, thank you in advance for your advice.

In retrospect, they probably would have prescribed me pain medication...

posted by high0nfire to health & fitness (10 comments total)

after 15 minutes of wiggling my ear , pulling the lobe around trying to let the medicine work it's way down, sitting up still put drops of the medicine onto my shirt collar.

If I understand what you are saying, that is normal. If I put medication in my totally uninfected ear and don't keep my head tilted, the liquid will drip right out, even after a few minutes.

Don't forget that you can call your doctor's office and get advice, usually from a nurse or assistant, but they will contact the doctor if necessary. That's what I would recommend doing.

Until you talk to your doctor's office, keep using the medication, even if it's just on the outside of the infected area. Don't poke around in there or try to flush it out yourself.
posted by grouse at 8:36 PM on October 15, 2008

When you put in the drops in, don't be impatient. Lay there for a while, fifteen or thirty minutes. Hydrocortisone is anti-imflammatory; it'll make the swelling go down.

But it may take several treatments before it works. It probably won't open up the first time you use the ear drops. It probably won't open up the second time, either. But eventually it will.

Stop being your own doctor. Do what your doctor tells you to, and don't be a hurry. Your ear is a mess and it's going to take a while for it to get better.

Don't "pull the lobe". Don't "wiggle the ear". Don't "flush it in the shower". Stop that crap. It's only going to make things worse.
posted by Class Goat at 8:37 PM on October 15, 2008

Stop. Do not mess with your ear.
You need to get to an ENT. If you cannot get an appt Friday, and you cannot wait until Monday. Go to a local ED, hopefully a academic one where there is an ENT service.
posted by ruwan at 8:38 PM on October 15, 2008

thank you very much for the quick responses! The second doctor did say that if it wasn't feeling better by friday to get an ENT involved. I'll leave my ear well alone and keep on keepin' on with the drops (and the oral amoxicillin pills) and come friday hopefully there will be some hint of relief on the way. Thanks again for the level-headed advice.
posted by high0nfire at 8:55 PM on October 15, 2008

Pulling the lobe - gently! - is acceptable. But don't do it much - just a few tugs after you put the drops in, if at all. Massaging your tragus may also help them go down, but again, if it doesn't help immediately, it won't.
posted by spaceman_spiff at 9:22 PM on October 15, 2008

I had an extremely painful ear infection where my canal was closed completely. The ENT inserted a cotton plug that would keep the canal open and soak up the drops and ensure they made it inside. Definitely the way to go, I'd make an appointment immediately. Before my appointment it was so painful I'd wake up shouting.
posted by skinnydipp at 6:12 AM on October 16, 2008

Yep--see an ENT as soon as you can. I had a wicked, wicked ear infection about two months ago that mostly closed my ear. Drops did nothing--I was in agony, contemplating suicide, and so forth--until I saw an ENT who, as skinnydipp says, inserted a wick. I felt markedly better within hours.
posted by uncleozzy at 6:38 AM on October 16, 2008

Former primary care internist here: There's nothing ENT-specific about an ear wick. Any doctor who takes care of otitis externa (swimmer's ear) can do the same thing. The fact that he didn't may mean he thought it didn't need it at the time. Things change, though, so if it worsens, call him back. Don't go to the ED unless you're (1) miserable and (2) prepared to wait a long time while life-threatening problems get brought in ahead of you.

Also, you can put drops in the ear canal, then use a cotton ear-plug to help hold the drops in contact. Just use a big piece of cotton that's easy to get back out. But Class Goat has it right: lie on your side with your affected ear up for 10 minutes after you put the drops in.
posted by cameradv at 9:45 AM on October 16, 2008

yeah the earwick thing is what you want. i got pseudomonas in my ears when i was about 10 and also on a 3 week boat trip to block island/nantucket. nothing like a raging, pussy, pressure-filled noise-blocking ear infection on a freaking boat. anyway. after waiting like three days for the doctor to arrive on BI, we also found out that given the infection, my previously implanted ear tubes may cause major issues. so he had to flush my ear canals with this giant syringe looking thing "even though it had the potential to rupture my ear drums" and get the tubes out. fun stuff. qtips came out neon green. it was awful. they gave me a set of ear wicks which my dad then had to change himself (since the doctor wasn't full time on the island) which was also really fun. no seriously i think my dad enjoyed it, but he also liked removing our stitches as kids. anyway. this anecdote isn't offered as anything useful. i came away with pretty much fine ars except i have some apparently really funky scars in my ear canals which are very interesting to any new doc who happens to take a look in there -- they usually call around all the nurses and stuff to show them what it looks like. i don't know what it looks like. my ears get clogged with wax easily. otherwise no problems.
posted by Soulbee at 10:38 AM on October 17, 2008

not that it matters but the pseudomonas i had was not the swimmer's ear variety but the icky gnarly deeply penetrating variety. ew. i just HAD to go google what that looks like in ears. ew.
posted by Soulbee at 10:42 AM on October 17, 2008