Moderate to severe inner ear pain and nausea after concussion

April 25, 2023 8:18 PM

A day after my last question, I developed pressure in the ears. Telehealth nurse said I should go to the ER again, they told me to just rest. Today spoke to my GP who said the same. Pain in the inner ears is now getting kind of bad. Can’t handle much sound at all. Not sure what to do next, thoughts?

I was told to come back with severe symptoms - visual changes, speaking gibberish, severe headache, etc, and to otherwise just rest. GP said to do absolute rest for one week or maybe two and then see.

Rest by the way is proving impossible. I can’t handle being bored, like at all, have been looking at screens. On top of that I have nowhere to really rest. Partner is unwell and mostly tries to be quiet, has had moments where he couldn’t. So I stupidly came to my dad’s, he is chill but has memory and hearing issues so wants to talk, often. I even had to go grocery shopping, no one could help with this. So I’m not doing anything anymore and will try to get earmuffs at least. Compulsively addicted to screens…. How on earth can anyone not *do* *anything* at all…

That aside I don’t know what to do about my ears. GP said to do brain rest for a week and see. ER will be pointless, they only do CTs for severe symptoms and so far 0/2 doctors have any idea about this ear thing. I think something is wrong - maybe an “inner ear concussion”? - and that at some point a neurologist should get involved. Not sure when that point would be. But yeah no one is bothered currently. Injury was morning of Friday 21st btw.

posted by cotton dress sock to Health & Fitness (9 answers total)

Can you be still and listen to lovely music? I'm thinking Bach or Mozart or even Philip Glass, not loud songs with intense lyrics that require interpretation and concentration. This is an opportunity to stretch your musical vocabulary, and not just to European Classical composers; there's a world of music to discover. That might satisfy the "engagement" part of the screen experience, yet in a more soothing way, while being potentially more rewarding than anything you might see on a screen. This also could engage your dad, who might enjoy beautiful music, as well as the experience of listening with you. Also you might nap a bit. My experience with screens is that they seem to push off rest, replacing it with the constant urge to engage. Concussion care really does require disengaging and resting as much as possible, including resting your eyes.

Unfortunately I have no advice on the pain in the inner ear, but I would at least try to go to a primary care physician if it doesn't improve. You should be following up with someone, such as your PCP, who might ultimately suggest referral to a neurologist. The ER is for immediate situations rather than consistent follow-up. I, a school nurse, have a high school student who had a concussion who is followed by a dedicated post-concussion team at a local children's hospital months after his concussion (which was severe) and still gets pretty bad headaches and nausea occasionally, attributed to his concussion. He is also excused from class at least once a week because reading still causes headaches, and he needs to go the the nurse's office for a lights-out period of absolute rest and quiet.
posted by citygirl at 8:55 PM on April 25, 2023 [1 favorite]

If it were me, for boredom I would try podcasts or audiobooks. Best would be the audiobook of something that you already know and love. The idea is that would be engaging to listen to but less work for your brain since you know what is going to happen, avoids using your vision and less pressure to stay awake. The other option would be podcasts that are mildly interesting - again enough to engage your attention but no loud shouting or complex topics or arousing debates. I think my personal picks would be Oologies by Ali Ward or You Are Dead To Me - scripted show for host and historian plus a comedian representing the average viewer's perspective.
posted by metahawk at 9:36 PM on April 25, 2023 [1 favorite]

Podcasts or audio books sound bad for ear pain. I am pretty concerned that no doctor is concerned! From your last question...they didn't ever do a CT? I know you tried but I think I would be exaggerating my symptoms even in the hopes of getting one. No headache at all? No visual changes?

Anything getting worse after a concussion, even hearing, seems like scan time.
posted by tiny frying pan at 5:55 AM on April 26, 2023 [7 favorites]

The important thing is to do brain rest for you. If being a houseplant stresses you out, then that's not the right thing for you. Brain rest is different for different people.

If you've got to look at screens, figure out what's going to hurt you the least. For me, that was watching simple TV shows while relaxing on the sofa, but staying off my computer and especially staying off my phone.

Painkillers gave me nausea, which I didn't realize for a few days. After I stopped taking them my nausea went away. The headache remained, but the painkillers hadn't done much for them anyway as far as I could tell.
posted by The corpse in the library at 7:19 AM on April 26, 2023 [2 favorites]

I think you should go back and exaggerate your pain number. If you think it’s a 6, tell them it’s a 9. Pain is subjective anyway so the numbers don’t mean much and should be used strategically. Doctors don’t listen to “certain people” (women, fat people, BIPOC people, disabled people, lower income people, etc) and tend to minimize and dismiss their symptoms, so if you’re in any of those demographics, make sure to advocate strongly for yourself. The ear symptom does sound “severe” to me (I’ve had concussions and not had ear pain) and I think you need a head scan.

And seriously try to lay off the screen. Eye movements and thinking are not good for your head!
posted by nouvelle-personne at 7:55 AM on April 26, 2023 [4 favorites]

At no point have you mentioned the nature of the injury that lead to the concussion. Is it possible that the ear symptoms are related to the injury, but not related to the concussion? A jaw injury could certainly manifest as ear pain.
Concussions are brain injuries. Mild or no they must be taken seriously, so if rest is indicated and screens are prohibited you are not doing yourself a favor by trying to figure out how to recover against the recommendations of your doctors.
posted by OHenryPacey at 7:56 AM on April 26, 2023 [1 favorite]

Response by poster: I do have a headache but it’s not severe (though randomly I’ll get more pain in particular areas). A pressured feeling on the top of my head and into the ears. No visual changes, thankfully. Never lost consciousness. Just nausea (but no vomiting), a little vertigo and this ear pain. No hearing loss that I notice but definite hypersensitivity to sound. I took Tylenol for the first couple days but not since then.

I think the doctors are going by the Canadian CT rule: https://www.mdcalc.com/calc/608/canadian-ct-head-injury-trauma-rule
I gather that in the ER, they would only image if they suspected a bleed, which would require emergency surgery. Which makes sense.

My GP thinks my screen use borked things and that I should “reset” from eg today and do near-complete brain rest, after which maybe he would consider a referral? Doubtful tbh…

Have done a bit (just a bit) of reading and it seems that even if the fluid in the inner ear has shifted, that can cause these kinds of symptoms. So can some other mechanisms. I guess there are a few specialists in Toronto that address this… if rest doesn’t help, the hurdle would be getting a referral.
posted by cotton dress sock at 7:59 AM on April 26, 2023

Response by poster: OHenryPacey - I was cleaning under the kitchen sink, was startled by a loud noise, and whacked the top-middle-right of my head hard against the underside of the actual sink. No jaw pain that I’m aware of. I do have transient pain around my crown, middle top of the head, and my right temple throbs when I bend down.
posted by cotton dress sock at 8:02 AM on April 26, 2023

The pain you're feeling might be referred pain. I struck the back of my head but my pain was on the top. For years I had a sore spot there, and to this day if I'm getting one of my headaches that spot is sensitive.

I nervously mentioned this to one or two of the experts I saw -- there's so much stigma around head injuries, I felt self-conscious whenever I described something I thought was odd -- and they confirmed it wasn't unusual. Nerves are weird, brains are weird, doctors don't know as much about concussions as we'd like.

Now get off Metafilter and go take a nap, cotton dress sock!
posted by The corpse in the library at 8:31 AM on April 26, 2023 [3 favorites]