Ear pain solved by Dr. Mom, (Pedcast)

Thank you, Thank you, thank you for joining me today to talk kids.  I hope you are having a good day… I am.   The weather is great in Charlotte and I am energized to bring you another pedcast… a short audio discussions of useful health information in mp3 format.  Read or listen to a cast directly from my website or download an episode and take a DocSmo pedcast for a walk or to the gym.  I’m good company and I guarantee I will teach you something.  I might even make you laugh once in a while. Today I am going to bring you some very practical information about ear pain that might not only help you, but also save you some visits to the doctor.  Save you some hard cash… so sit back and listen.

I was in the office the other day when a 10 year old came in complaining of ear pain.  He is a frequent flyer when it comes to ear infections so it was very reasonable for his mother to bring him in to get checked out. Anyway, this was this child’s third visit since fall for ear pain so the subject of how to do home diagnosis of ear infections came up.  If you have a child with allergies like this child, you may hear the complaint of ear pain frequently so I thought my blog audience might be interested in what I told them so here goes, Doc Smo’s practical advice when it comes to parental diagnosis of ear pain.

Let’s review how our nose and ears work before we get into the nitty gritty details of what I want to teach you today.  You know, a quick detour down to where Science drive intersects Useful Way. When everything is working well in your child’s nose, each nasal breath forces a slight amount of fresh air into their ears and sinuses, freshening everything up so to speak.  It’s like opening the windows to let a little fresh air in. The nose should be full of air as well as the sinuses and… your child’s middle ear. These nasal breaths equalize the pressure between the nose and middle ear and also keep the air fresh inside the middle ear.

So now your child has some condition that makes the inside of their nose swell like a cold, or allergies.  Uh oh, now the Eustachian tubes, the connection between the nose and the middle ear, stop working…  No fresh air is going up to the middle ear with each breath so pressure changes start happening..  A negative pressure, a vacuum starts to develop in the ear that can literally suck mucous into the middle ear along with bacteria from the nose.  If this condition goes on long enough, you know what’s coming next…a full blown crying, screaming, middle of the night ear infection.  Remember this sequence of events:  first cold or allergies, that causes the eustachian tubes to stop working and a vacuum to form in the ear.  If this goes on long enough, fluid gets sucked into the middle ear, and eventually, an ear infection develops.

Now that you understand these events when your child’s nose clogs, you can understand that your child can get pain at the vacuum stage…  or …  at the ear infection stage.  It doesn’t matter whether the eardrum is sucked inward or pushed outward, either hurts like crazy.  You child’s eardrum is as sensitive as their cornea.  Movement of any form is incredibly painful. We all know what getting poked in the eye feels like…bad. Ears feel exactly the same.

Now lets get to the practical advice I gave this family.  Since ear pain can be caused by either a vacuum pressure change only needing home care or a real ear infection, I showed them how to tell the difference at home… should your child have ear pain, have them pinch their nose and gently blow air against the closed, pinched nose.  Try this yourself. This maneuver is called a valsalva. If they hear a click or pop in the ear with gentle outward blowing pressure, most likely your child does not have an ear infection since air can be forced into the middle ear.  Additionally, a very quiet noise like fingers rubbing together 12”-16″ from the ear can usually be heard if there is no ear infection.  The combination of a click and normal hearing means you might want to cancel that visit to the doctor.  Time to decongest the nose with saline and a nasal or oral decongestant. Should the contrary events be present however, no click with decreased hearing in the affected ear, this usually means an ear infection.  Time to review your “wait and see” procedure for ear infections and maybe call your child’s doctor.

It’s that simple.  Once you understand what causes middle ear pain, it’s fairly easy to make the diagnosis yourself as long as your child is old enough to cooperate and tell you what they feel.  I hope that knowledge will help you avoid unnecessary visits to the pediatrician.  Lord knows, you are probably there enough!  We love to see you but we would rather your child spend his or her time out playing at the park.  But, if you have any health question about your child, please call their pediatrician and talk it over with them.  They know your child best.

Thank you for tuning in today.  This is Dr. Paul Smolen, bringing you practical, portable, pediatrics.  Your comments are welcome at www.docsmo.com.  If you like talking all things kid, subscribe at my blog, like us on Facebook, or subscribe on iTunes.  I will try my best to make you glad you did.

This is Doc Smo, hoping that after this pedcast you have no fears about your child’s ears.  Until next time.