posted
My sis in law is very worried and confused over what to do with her 4.5 year old son. He has recurring severe ear infections, and right now the ENT she's been seeing wants to put in ear tubes for the 5th time.
He's already had his adenoids removed, to no effect. All the other tubes fell out after a few months and then the ear infections would recur.
She has also been taking him to a chiropractor, who says that she doesn't need the surgery or the antibiotics but that by manipulating the child's face, he can get the fluid to drain.
I immediately wanted to reach through the phone and shake her and say "Never take your baby near that quack again!" but I figured a more rational approach was probably needed.
My advice was to take the child to a pediatric ENT specialist for a second opinion and to make certain that the new doc wasn't in any way affiliated with the old one so she can be sure she gets a fresh set of eyes on the child.
What I'd like to know is what are the risks associated with multiple ear tube surgeries? Does anybody know if there are alternatives? I saw something about laser surgery, but it doesn't seem to be indicated for a case like this and it might not even be available in this area anyway.
Also, are there any reputable studies that show whether or not chiropractic has any effect on ear infections? By reputable I mean reputable - I found one online, but it was a study consisting of 43 patients, all of them were treated by the same chiropractor and he reported himself that when he saw them the next time they looked better. I'm looking for a peer-reviewed study that actually has merit, not something like that.
Not treating the fluid isn't an option, either - the child has significant speech delays believed to be related to poor hearing from the constant fluid in his ears. They have to do something. Plus it's not just an issue of fluid, but of infection, he has a high fever and has been waking in the night vomiting the last few days, and she's about at the end of her rope. She says it seems like he's on antibiotics constantly. She doesn't know what to do and she's scared.
Any help would be appreciated.
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posted
Well, I don't know a lot about ears but I really think you're on the right track about getting a second opinion. Two heads are better than one.
Posts: 2064 | Registered: Dec 2003
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posted
No luck on the quacks...I mean the Chiropractors.....
DOn't get me wrong, they have a lot of good things to say about all sorts of back injuries and whatnot...but some of them make all sorts of claims, like being about to "cure" liver and kidney disease by spinal manipulation and pressure points.
I don' think that they do any harm, when used IN CONJUNCTION with modern medical pratices, but the problem is that a lot of these idiots (the ones pushing peoples spines around, not the idiots believing their stories) try to prevent their patient from seeking actual medical help.
I wouldn't EVER trust ANY of them with a childs health, not with something like this.
posted
There is some evidence to suggest that misalignment of the spine can cause all kinds of health problems. I've never heard of a chiropractor manipulating the face though. I also wouldn't quit going to a regular doctor if I did go to the chiropractor. So...
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posted
The reasoning behind the above is that if the spine is misaligned it can press on the nerves in the spinal column. Skilled chiropractors can work on children if they have been trained but you would want to make sure that they have been trained to treat children. It's different than working on an adult, obviously.
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Does your nephew also have frequent colds or allergies? My son had frequent bouts with ear infections until I hit on the idea of preventing the fluid build-up instead of treating the resultant infection.
3 years ago, I started a regime of aggressively treating any sniffle/cough before an infection appears. He has only had 2 ear infections in the last 3 years and had perfect attendance at school. My pediatrician approves. I've used the same regime on my asthmatic older son. He has only had one non-allergy related asthma attack in the last 3 years (he still needs his albuterol when exposed to cats or cigarette smoke).
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posted
My point it that while there is some evidence...hotly contested evidence, mostly done by the very peole I don't trust in these matters....they can't sure diseases that way, although it doesn't stop them from claiming they can.
I have heard some pretty stupid cliams from some of thes people, and the Chiropractor I went to with a back injury years ago didn't believe most of it eaitehr.
I am not saying it can't do some good in some instances, but it should NEVER replace actual medical treatments, IMO.
(Yes, I know they can be Dr's...it isn't the same at all, though. )
Posts: 15082 | Registered: Jul 2001
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posted
Was your sister-in-law ever told the underlying cause of the recurring ear infections? (For instance, I have funny-shaped sinuses-- it's genetic. I still get them as an adult, although mine were never severe enough that I had tubes put in.)
Misshapenness of the ear canals? Allergies? Chronic sinus problems? Or have they just been treating symptomatically? I think it's definitely time to get a new doctor if this one keeps trying the same thing over and over with no result, and isn't looking for a way to prevent the problem, if that makes any sense.
Posts: 21182 | Registered: Sep 2004
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I too would encourage a physician that will help you elucidate the cause of the infections, try to prevent them, and treat them effectively when they occur. I don't want to speak for CT as well, but she and I had a few posts about the altering of cranial plates to relieve headaches etc... and she was gravely concerned and cautioned anyone to refrain from this practice, because it has no medical merit. I agree with her, and the story I relayed involved a medical doctor friend of mine in med school (osteopathic medical school) where he was the victim that the instructor demonstrated his head-bone altering abilities. Jay quietly approached the man after the hands-on lab and insisted that he try to "undo" what he had done because it gave him a splitting headache. Still, there are patients out there that will insist that this is all that helps them...
Because the cause of ear infections is not listed specifically, I would hope that this can be answered if it has not been found already.
quote: Was your sister-in-law ever told the underlying cause of the recurring ear infections? (For instance, I have funny-shaped sinuses-- it's genetic. I still get them as an adult, although mine were never severe enough that I had tubes put in.)
Misshapenness of the ear canals? Allergies? Chronic sinus problems? Or have they just been treating symptomatically? I think it's definitely time to get a new doctor if this one keeps trying the same thing over and over with no result, and isn't looking for a way to prevent the problem, if that makes any sense.
I quote KQ again because these are the places to look in finding the cause of the ear infections. One such example is children with mild food allergies to things we take for granted like corn or wheat. This mild allergy can hamper the immune system over time, with one of the more prominent symptoms being chronic, severe ear infections. This means that a good series of allergy tests may need to be run. But these types of possibilites and scenarios need to be addressed by a good lead physician that knows where to send your child for answers that they themselves cannot provide.
Posts: 1870 | Registered: Mar 2003
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posted
Wow - Belle, I hope this gets taken care of and I'll be praying for the little guy.
Sounds like the ENT has already done everything I have ever heard about being done for something like that, so maybe a new ENT would have new ideas. I don't see how it can hurt to have a second opinion.
A co-worker's daughter (age 2 or 3) had to have her tonsils/adenoids removed and tubes and all to get all the fluid out, and now she is like a new child -- talks so much better, more alert and responsive, can HEAR, etc.
posted
Belle, the only problems with getting recurrent tubes are that each tube puts a new scar in the eardrum. More scar tissue on the eardrum may mean slightly less perfect hearing later on. Also if he is getting each set of tubes put in in the OR while asleep then there are minor risks associated with anesthesia each time. I got my second set of tubes while awake in the doctor's office, but I was seven.
But, these are very small risks. Better than the alternative of not hearing much right now. And he's young enough that the scars/scar tissue are probably minimal.
Second opinion sounds excellent. She could consider doing the second opinion in a larger city or at the nearest medical school hospital, some place where the best of the best are practicing. Also, find a pediatric allergist to follow along also.
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Thanks everyone else too, Alucard, I appreciate hearing that about the facial manipulation.
My aversion to chirorpactic doesn't make me very popular in my family (outside my immediate family, everyone else swears by them and says they're the best things that ever happened to them) but I stand by it. None of the research I've looked at shows me that they can conclusively prove any of their claims, they can't even prove subluxations exist. Some chiopractors say they're visible on x-rays, others say the aren't, and you can't get the chiropractic profession to even agree on the subjects.
My sis in law said that she was going to call her pediatrician on Monday, and talk to him further and ask whether or not he thinks she should go somewhere else. Not exactly my recommendation, because the doctor is the same one that already referred her to the ENT she is seeing now - I was all for going to a completely different set of doctors - but she trusts her ped and wants to talk things over with him first.
And I don't mean to suggest that the ENT she's seeing now is incompetent, it may well be he is doing exactly what he should be doing. It's just that I think she needs more than "oh, well, let's just put in a 5th set of tubes" which is what she's getting now from him.
He does have many colds, seems like he's always sick. I think at one time asthma was suspected and he was put on a breathing treatment regimen. Allergy testing has been done, but no major findings there.
I had a friend whose child was a lot like this who eventually took him to a UAB geneticist who diagnosed an immune deficiency. I wonder if she should consider checking something like that out?
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posted
Allergy doctors, particularly pediatric ones, can test and even treat immune deficiencies. As well as treating your basic allergies. That is part of the reason I suggested he see one, actually.
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Yes -- a new peds ENT (by the way, anyone this specialized in the area will probably know all the others at his/her level, but that's really probably okay), peds allergist, and trying to minimize/get aggressive about early management. If I see a good resource, I'll recommend it, too.
quote:He does have many colds, seems like he's always sick. I think at one time asthma was suspected and he was put on a breathing treatment regimen. Allergy testing has been done, but no major findings there.
I just want to add here one tidbit from personal experience. I have three children. None of them drink milk and their doctors and allergists are in agreement that they shouldn't drink milk. One is violently allergic, tests allergic, and is a classic case of milk allergy. A second gets terrible diarrhea and migranes if he has milk but tests *negative* for milk allergies. A third has no obvious milk related symptoms and tests negative for milk allergies... BUT he had chronic ear infections as a little guy with constant congestion and mucousy drip. He was always on antibiotics. We took milk out of his diet and he has had ONE ear infection in six YEARS!
It is important to note that most allergy tests only test for IgE allergic reactions (the type that cause classical allergic response including anaphalaxis). Many doctors believe that food intolerance, possibly related to IgG can cause problems but there aren't reliable tests for this. (there ARE tests but most mainstream doctors I know do not believe they give reliable results)
I can't say for sure that it will help but I know many people for whom cutting out dairy had a huge impact in reducing ear infections in their children. It's worth a try.
Edit: Just to clarify, when my son DOES drink milk , his congestion, post nasal drip, etc DO come back. My doctor and I concur that he didn't just "outgrow" his problems.
Posts: 251 | Registered: Apr 2005
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posted
Miriya, thanks for the suggestion. Unfortunately, a milk allergy was considered but refraining from drinking milk had no effect on his symptoms.
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