I need an ENT.
April 22, 2015 9:56 AM Subscribe
Difficulty level within...
I'm 37 and have had trouble with ear infections my whole life (I had tubes as a kid) - I still get up to 4 every year, and am in the middle of a particularly painful one.
My doctor says I need to see an ENT.
Difficulty: I have no money, and I have no insurance (Medicare won't cover it and I can't qualify for Medicaid).
Do I have ANY options at all?
I'm 37 and have had trouble with ear infections my whole life (I had tubes as a kid) - I still get up to 4 every year, and am in the middle of a particularly painful one.
My doctor says I need to see an ENT.
Difficulty: I have no money, and I have no insurance (Medicare won't cover it and I can't qualify for Medicaid).
Do I have ANY options at all?
You might also want to post your location, in case someone knows of a sliding-scale/pay-what-you-can ENT clinic in your area.
posted by ThePinkSuperhero at 10:07 AM on April 22, 2015
posted by ThePinkSuperhero at 10:07 AM on April 22, 2015
See your primary care physician, get the antibiotic. At the end of this round get a high grade probiotic, let your Primary Care doc prescribe. Take this as you end the antibiotics, and afterwards, suck to clear your sinuses, stop blowing, (I paid good money for this medical advice.) Make a routine of 1/2 strength peroxide in your ears once a week. Are those tubes still in there? Make sure to gargle with water each night, so you don't have sugars in your mouth to feed bacteria. Use live apple cider vinegar in your salad dressings to help with bacterial balance.
Be sure to rinse your ears last thing after showering to get alkaline soaps and rinses out, try rinsing plain yogurt into your ears, last thing after showering to create a better balance in that area.
All this folk stuff is actually high tech and cheap. you just have to get the right ph and bacterial balance in that area. I thought Medicare covers specialists whom your primary care doc recommends. I think you can see an ENT if you have such frequent infections. I don't even think you have to have a referral. Call an ENT office and see if they take Medicare, call several until you find one that does.
posted by Oyéah at 10:20 AM on April 22, 2015 [2 favorites]
Be sure to rinse your ears last thing after showering to get alkaline soaps and rinses out, try rinsing plain yogurt into your ears, last thing after showering to create a better balance in that area.
All this folk stuff is actually high tech and cheap. you just have to get the right ph and bacterial balance in that area. I thought Medicare covers specialists whom your primary care doc recommends. I think you can see an ENT if you have such frequent infections. I don't even think you have to have a referral. Call an ENT office and see if they take Medicare, call several until you find one that does.
posted by Oyéah at 10:20 AM on April 22, 2015 [2 favorites]
Just to clarify, do you have Medicare (you mention medicare won't cover it)?
If so, you can sometimes appeal (generally you physician has to write a letter why he's recommending you see a specialist). Not that that is a quick fix, more for future problems or prevention. (I too thought medicare usually covered ENTs with referrals).
Otherwise try calling around to different local clinics and ENT departments in hospitals (they may have more support staff for this kind of thing who could direct you to services that could also help out) and ask if they have sliding scale fees or payment plans.
posted by ghost phoneme at 10:32 AM on April 22, 2015
If so, you can sometimes appeal (generally you physician has to write a letter why he's recommending you see a specialist). Not that that is a quick fix, more for future problems or prevention. (I too thought medicare usually covered ENTs with referrals).
Otherwise try calling around to different local clinics and ENT departments in hospitals (they may have more support staff for this kind of thing who could direct you to services that could also help out) and ask if they have sliding scale fees or payment plans.
posted by ghost phoneme at 10:32 AM on April 22, 2015
Are you in NC? Here's a list of free clinics, maybe the one in your area can arrange for you to see an ENT.
A child I know went to her doc recently with an earache and he prescribed some kind of ginger tincture. Cleared it right up. A quick google yields numerous recipes for ginger ear treatments.
posted by mareli at 10:58 AM on April 22, 2015
A child I know went to her doc recently with an earache and he prescribed some kind of ginger tincture. Cleared it right up. A quick google yields numerous recipes for ginger ear treatments.
posted by mareli at 10:58 AM on April 22, 2015
See your primary care physician, get the antibiotic. At the end of this round get a high grade probiotic, let your Primary Care doc prescribe. Take this as you end the antibiotics, and afterwards, suck to clear your sinuses, stop blowing, (I paid good money for this medical advice.) Make a routine of 1/2 strength peroxide in your ears once a week. Are those tubes still in there? Make sure to gargle with water each night, so you don't have sugars in your mouth to feed bacteria. Use live apple cider vinegar in your salad dressings to help with bacterial balance.
Be sure to rinse your ears last thing after showering to get alkaline soaps and rinses out, try rinsing plain yogurt into your ears, last thing after showering to create a better balance in that area.
All this folk stuff is actually high tech and cheap.
IANAD, but to my untrained ear it sounds like you have years of chronic issues, with a possible acute condition superimposed on what sounds like abnormal function. Introducing foreign liquids/objects into your ear and playing around with what sounds like possible fistula/tube insertions is dangerous at best, and what happens if your conditions worsen? Then you're even farther up shit creek than you were to begin with.
I implore you to explore insurance exchanges, using your PCP to connect you with a sympathetic ENT specialist, or even calling your local free clinics to see if they have ENT recommendations. The ear is not something I would want to experiment with under the best of conditions, and with what sounds like a lot of chronic issues, you need a specialist who you can hold liable over spurious internet medical claims.
posted by kurosawa's pal at 11:21 AM on April 22, 2015 [9 favorites]
Be sure to rinse your ears last thing after showering to get alkaline soaps and rinses out, try rinsing plain yogurt into your ears, last thing after showering to create a better balance in that area.
All this folk stuff is actually high tech and cheap.
IANAD, but to my untrained ear it sounds like you have years of chronic issues, with a possible acute condition superimposed on what sounds like abnormal function. Introducing foreign liquids/objects into your ear and playing around with what sounds like possible fistula/tube insertions is dangerous at best, and what happens if your conditions worsen? Then you're even farther up shit creek than you were to begin with.
I implore you to explore insurance exchanges, using your PCP to connect you with a sympathetic ENT specialist, or even calling your local free clinics to see if they have ENT recommendations. The ear is not something I would want to experiment with under the best of conditions, and with what sounds like a lot of chronic issues, you need a specialist who you can hold liable over spurious internet medical claims.
posted by kurosawa's pal at 11:21 AM on April 22, 2015 [9 favorites]
Yeah I'm going to second "please don't put anything in your ears not explicitly recommended by a doctor." I would be very wary of that kind of thing in general, but with your kind of chronic infections, I would absolutely not do this. I also would not just go in and demand to be prescribed antibiotics by your PCP. Maybe an ENT will prescribe them but that should be their call.
I think it would be helpful if you could update us about the Medicare situation. Do you have some kind of health insurance through Medicare? If the issue is them not wanting to cover you seeing an ENT, can you get a referral and/or do an appeal with the help of your PCP?
If you don't have any insurance, then definitely look into the state exchanges. If you're willing to tell us your location (even just your state) someone might be able to chime in with a location specific recommendation.
posted by litera scripta manet at 11:34 AM on April 22, 2015 [1 favorite]
I think it would be helpful if you could update us about the Medicare situation. Do you have some kind of health insurance through Medicare? If the issue is them not wanting to cover you seeing an ENT, can you get a referral and/or do an appeal with the help of your PCP?
If you don't have any insurance, then definitely look into the state exchanges. If you're willing to tell us your location (even just your state) someone might be able to chime in with a location specific recommendation.
posted by litera scripta manet at 11:34 AM on April 22, 2015 [1 favorite]
Do you have US Medicare? It certainly should cover an ENT visit. How much out of pocket you'll pay will depend on whether you have regular fee for service Medicare or a Medicare HMO. You may need a referral from your PCP if you're in an HMO.
posted by The Elusive Architeuthis at 11:50 AM on April 22, 2015
posted by The Elusive Architeuthis at 11:50 AM on April 22, 2015
Response by poster: thanks, y'all!
i'm in nc now, but moving to rva in 2 weeks.
i have medicare, but *only* part A. i've been waiting for them to grant my part B for what seems like a million years (this is a long, complicated story involving tricare, divorce, medicare, and ssdi). so basically the only thing covered is a very few emergency services.
i have checked the insurance exchanges and unfortunately not only do i not make enough to cover the regular monthly cost, but the deductibles here are so outrageous as to make the plans completely worthless. (at least, the last time i checked)
i don't have tubes anymore - they fell out when i was around 9 or so.
posted by megan_magnolia at 12:15 PM on April 22, 2015
i'm in nc now, but moving to rva in 2 weeks.
i have medicare, but *only* part A. i've been waiting for them to grant my part B for what seems like a million years (this is a long, complicated story involving tricare, divorce, medicare, and ssdi). so basically the only thing covered is a very few emergency services.
i have checked the insurance exchanges and unfortunately not only do i not make enough to cover the regular monthly cost, but the deductibles here are so outrageous as to make the plans completely worthless. (at least, the last time i checked)
i don't have tubes anymore - they fell out when i was around 9 or so.
posted by megan_magnolia at 12:15 PM on April 22, 2015
IANYD. I would take anything you read (i.e. on the internets) here with a large grain of salt, and I encourage you to figure out your insurance coverage so you can go see an ENT ASAP. It sounds like you have chronic ear infections and ENT docs are the ones who are best at managing these issues.
I would see if there is a medical school/hospital with an ENT residency program. Many of these places have a resident clinic staffed by the faculty that may allow you to be evaluated in a timely fashion without breaking the bank. (I would call and check to see what insurance coverage is needed to be seen.)
posted by scalespace at 12:43 PM on April 22, 2015
I would see if there is a medical school/hospital with an ENT residency program. Many of these places have a resident clinic staffed by the faculty that may allow you to be evaluated in a timely fashion without breaking the bank. (I would call and check to see what insurance coverage is needed to be seen.)
posted by scalespace at 12:43 PM on April 22, 2015
Best answer: Hi, I'm an audiologist, not yours, this isn't audiological advice.
Please don't put anything in your ears. Ear infections are in the middle ear, so pouring things in your ear canals will at best do absolutely nothing, and at worst cause you additional problems.
Ear infections are almost always the result of Eustachian tube disfunction (kids get them so much because their Eustachian tubes are basically horizontal, and fluid is not able to drain down the tube into the throat properly - with adults it's usually more of an issue with the muscle of the tube itself).
Four a year is a lot, and is beyond what antibiotics are going to be able to do for you. The likely course of action is permanent PE tubes, which many adults have. But you do need to see an ENT. There's no way around that.
The risk with not getting help is that ear infections can spiral out of control. I've seen some serious issues where an untreated ear infection has led to a cholesteotoma, which can infect the mastoid or temporal bone and at that point you usually have to have part of the bone removed, and possibly replacement of your ear drum and middle ear bones.
This is not to scare you; it's only to say that this chronic of an issue is beyond the home remedy realm. Call ENTs and see if one has a sliding scale. Often a university will offer something like this, so you may try calling UNC or similar.
posted by Lutoslawski at 12:53 PM on April 22, 2015 [7 favorites]
Please don't put anything in your ears. Ear infections are in the middle ear, so pouring things in your ear canals will at best do absolutely nothing, and at worst cause you additional problems.
Ear infections are almost always the result of Eustachian tube disfunction (kids get them so much because their Eustachian tubes are basically horizontal, and fluid is not able to drain down the tube into the throat properly - with adults it's usually more of an issue with the muscle of the tube itself).
Four a year is a lot, and is beyond what antibiotics are going to be able to do for you. The likely course of action is permanent PE tubes, which many adults have. But you do need to see an ENT. There's no way around that.
The risk with not getting help is that ear infections can spiral out of control. I've seen some serious issues where an untreated ear infection has led to a cholesteotoma, which can infect the mastoid or temporal bone and at that point you usually have to have part of the bone removed, and possibly replacement of your ear drum and middle ear bones.
This is not to scare you; it's only to say that this chronic of an issue is beyond the home remedy realm. Call ENTs and see if one has a sliding scale. Often a university will offer something like this, so you may try calling UNC or similar.
posted by Lutoslawski at 12:53 PM on April 22, 2015 [7 favorites]
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posted by ThePinkSuperhero at 10:02 AM on April 22, 2015 [1 favorite]