Tag Archives: ear

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.

From the desk of Doc Smo: Swimmer’s Ear Prevention 101 (Article)

If you have ever had it, you know Swimmer’s Ear hurts like crazy. However, most people have no idea what Swimmer’s Ear is and what causes it. Well, lets fix that right now. To understand the cause, we need to start by gaining an understanding of the architecture of the ear and how it is different than other places in the body. The ear canal is a dark tunnel lined with skin that is often very damp, especially in warmer weather. Water frequently gets in but gets trapped by the shape of the ear canal. Well, what happens to water anywhere it sits around without movement, especially when it’s at body temperature? You know it, yuk grows in it! This is especially true in your ear canal when you are in and out of water all day. Once the water enables fungus and bacteria to grow in the ear canal, it is easy to see how these microbes can infect the surrounding skin. Swelling occurs to the point that the ear canal can literally be shut, making things much worse. Oh man, that can hurt!
All of this leads to a tender ear, aching down the side of the neck, and a very miserable child. The children most prone to having bouts of Swimmer’s Ear are: those with eczema (lots of cracks in their skin), those who frequently use Q-tips, those who are in and out of water frequently (especially lake or ocean water), and those who go to bed with wet hair (yes, your mother was right on that one).

Once an outer ear infection gets started, it can be very difficult to control; prevention is the only game in town. Here is a simple way to prevent Swimmer’s Ear in your child, especially as they go off to camp and swim in lakes and rivers. First, buy a bottle of rubbing alcohol and pour half of it out. Fill the bottle back up with either white vinegar or apple vinegar. If you can get a bottle with a dropper on it, great. At the end of EVERY summer day, when no more water is going to get into your child’s ear (usually bedtime), put a few drops of the alcohol/vinegar mixture in their ears and rub it around. Dry the excess with a towel. The combination of the alcohol and acidic vinegar make a very hostile place for germs, and they simply don’t grow. Without the bacteria and fungus in abundance, the cracks don’t get infected. Make sure their hair is dry, and put those little puppies to bed. If you are religious about this, most children won’t be suffering from Swimmer’s Ear this summer. Miss a day or two and all bets are off. If they go to camp, figure out how to make this happen there. It is worth the effort.

Understanding Your Child’s Ear Infections Step by Step (Pedcast)

Ear infections, or otitis media, are a painful part of childhood. Understanding the biology behind the development of ear infections can help parents see the warning signs and take preventative measures. Thus, in this pedcast, Doc Smo walks you through the stages of ear infections and provides listeners with ways to help prevent them.



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By some estimates, 40% of visits to pediatricians are for ear infections.

Most children have otitis before the age of 2 years.

I Thought today, we would talk about why children get them, should they be treated, and can they be prevented?

Parents have these questions all the time.

So lets get started with our discussion with a trip down, you know where, science lane.


There are loads of germs in our nose that can cause ear and sinus infections…all the time!  That’s right, sinus and ear infections are usually an overgrowth of germs we already carry.

So why don’t we have ear infections all the time?

To understand the answer to that question, need to know how our noses work.  That’s right, our noses.

Remember the structures that are attached to our noses, our sinuses in every direction around our nose, our ears through the Eustachian tubes, our eyes up through the lacrimal ducts, and our throat pulling up the rear.  

Normally every time we take a breath through our nose, we put fresh air into our sinuses and ears. If our noses are working properly, each breath opens the windows and lets in fresh air into our sinuses and ears and at the same time equalizing the pressure with the ambient pressure around us.

In addition, the cells that line our nose, sinuses and ears secrete a steady trickle of mucous that is kept moving by our cilia, little brooms that constantly sweep the mucous into our throats.  A gentle river of mucous flows through our noses, sinuses, ears and bronchioles all the time cleaning and moving away dirt and germs away from our healthy respiratory system.

The combination of moving mucous and fresh air keeps germs from ganging up on us.


Now think of a child, especially a baby.  A cold means a swollen nasal passage without air moving and loads of extra mucous. Babies don’t blow their noses, remember! This is the recipe for a sinus and ear infection.

Stagnant mucous in airless places.

Here is the sequence of events:

Virus attaches itself to the nasal membrane causing swelling lining cells.  The medical jargon for this is apoptosis or swelling of cells.  We can feel that at the beginning of a cold.

The children’s tiny sinus and ear Ostia become obstructed from airflow causing a VACUUM to form in the ears and sinuses.

Your body doesn’t like a vacuum and fills up these spaces with mucous (when your child’s doctor says, fluid in ear…this stage).

Remember that bacteria in the nose, now it has warm, sugary pockets of stagnant fluid to grow in and BAM, a hot ear infection.

Since bacteria grow so fast, it can be only a matter of hours between fluid in the ear and a raging infection.

The body’s natural defenses, moving mucous and fresh air are not there to keep the germs from taking over.

Children who carry the allergy gene have all the same events occur but the swelling inside their noses is from both dust and pollen allergy and viral infections.  These children are especially prone to ear infections.

So what’s the perfect storm for ear infections?

Under 2 years of age….Promotes…Small nose and no blowing.

Remember this Doc Smo pearl, “Rivers that don’t flow are nasty!”

Being in an environment where infection with respiratory viruses is frequent…..  Being around a lot of other young children.

Remember this Doc Smo pearl…. “Infectious diseases are contagious!”


Being a child with eczema, food allergy, or recurrent wheezing…  having the allergy gene which means lots of swelling in the nose and loaded with mucous.


If your child is prone to ear and sinus infections…practical tips that might help.


1. Avoid crowds of children to play with especially when they are very young and put things in their mouths.  Touch is the method of spread.

2. Be especially careful with group care if your child exhibits signs of allergy.

3. Play with other children outside whenever possible, even when it is cold.  Unlikely to transfer germs outside.

4.Unless your child has clear allergy, Avoid cold medicines with antihistamines, which can make nasal mucous thicker… poor flow means more infections.

5. If your young child has loads of otitis media, try a milk free diet for 2-4 weeks to see if it helps.

6. Hose those little noses with saline a lot… water is a natural cleaner.  Use it!

7. Try and avoid treating ear infections in children older than 2, after your child can talk.  More on this subject listen to “Bugs and Drugs”



That wraps up todays “Pedcast” Thank you for listening.  I hope your understanding of ear infections is better now.

If you enjoyed this talk, try some other DocSmo episodes which you can find at my website, DocSmo.com, at my face book page or on ITunes.

Comments are welcome.


This is Dr. Paul Smolen.

Recording in full digital sound from studio 1E in Charlotte, NC.

Wishing your children noses full of warm breezes and years without sneezes


Until next time
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