Q:
I am a 50-year-old woman who suffers from chronic fatigue syndrome (12 years now). In May of this year, I contracted an acute case of otitis media in my right ear. I had a very high fever for two days (103.5) and have never had such an earache in my life. I saw my GP, he gave me a shot of antibiotics and a prescription for Levaquin 500 mg once daily. After four days, there was absolutely no relief -- in fact, the pressure was much worse and extended to the top of my head, behind my ear, and across my cheek to the right side of my nose. At this point in time, I visited an ENT. He "punched seven or eight holes" in a visible pus pocket in front of the ear drum. He stated he cleaned out "a lot of gook" and that, hopefully, the rest of the infection would drain. He did not, however, lance the ear drum itself to allow some drainage of the fluid buildup behind it. After several weeks, he suggested that we place a tube in this ear. After much discussion, I asked to give it a little more time since I had never had any problems at all with my ears. He said that would be OK, but to relieve some of the fullness in this ear I should hold my nose and force air into the eustachian tube and that would help it to drain.
I did that periodically throughout the day for 6 - 8 weeks. At first, the sound and feel of this exercise was much like that of sticking a straw in liquid and blowing bubbles. I felt this sensation and could hear bubbling sounds when I did this. After about two months, it was gone. Then...........
About four weeks ago, I started to experience pain once again in this same ear. I also felt a drainage down the back of my throat. Back to the ENT I went. He checked the ear saying that he did not see any problems at all with it. He said he felt this was probably an infection of the lymph node directly under the ear and prescribed Ceftin 250 mg twice a day. He said that should take care of the problem and that it should be better in a couple of days. I took this medication for a full week with no beneficial response. I then went to another GP who quickly said my eardrum in the right ear was totally retracted and partially in my left ear. She felt for lumps, bumps, swelling, etc., but found none. She indicated I was suffering from chronic sinusitis and prescribed Levaquin 500mg daily, Profen II bid, and a daily usage of Nasonex spray. She predicted that these medications would cause my nose to run constantly and help rid the sinuses of the culprit-- mucus.
Note from Dr. Hoffman:
Ouch!
Click here for information on your buddy, mucus.
And here's even more information on mucus.
However, I have now been on this medication for nine days and have found absolutely no relief. I have a deep-seated pain which is not exactly in the back right-hand side of my throat (but close) and seems to extend underneath my jaw, into my ear and slightly behind and above the ear.
At this point in time, I am becoming worried. Could this be a cancerous lesion somewhere? A viral infection that is not responding to medication? A tumor somewhere in the makeup of my ear/nasal passages/pharynx? I don't know what to do and am becoming totally exasperated!!! Could you please recommend suggestions to take back to my doctor? Do I need any particular type of test to be run? X-rays/MRI/Cat Scan? Or can this entire episode be attributed to chronic fatigue syndrome? God knows we have some mighty strange stuff!!
Thank you for your time. Any assistance/recommendations/ suggestions you can give me would be most appreciated.
A: If your GP is correct, and the right ear
drum is very retracted, this could be (indirectly) a source
of ear pain. See this article on Eustachian tube
dysfunction.
What if the pain is NOT from the ear -- then where could it be coming from? The pain could be referred. "Referred pain" is pain that arises from some bit of anatomy OTHER THAN the part that actually hurts. One good example is left shoulder pain as a symptom of heart attack.
Many problems can lead to referred ear pain. Here is a list, undoubtedly incomplete, but here's the best I can do at 10:30 PM:
Temporomandibular joint arthritis (TMJ pain)
Parotid gland tumor, inflammation or abscess
Dental problems
Infection or tumor of any of the following structures: virtually any structure in the nasopharynx (roof of the throat), oral cavity, oropharynx, hypopharynx, larynx; infection or tumor of the esophagus, thyroid gland, and upper trachea
The only way to investigate this problem is by having the doctor take a complete history and conduct a THOROUGH HEAD AND NECK EXAMINATION. This would involve a binocular microscopic examination of your ears and a fiberoptic examination of your throat.
Good luck!