From: judyd@pendragon.CNA.TEK.COM (Judy E. Drake)
Newsgroups: misc.kids
Subject: Re: FAQL on ear infections and ear tubes (LONG)
Date: 10 Apr 92 22:47:17 GMT
Organization: Tektronix, Inc., Redmond,  OR.


I've had sort of atypical experiences with ear infections 
and ear tubes with my son, but being extreme, could help 
point out some additional aspects of this topic.  My pediatrician
informed me once that my son has the "practice record" for
the absolute worst case of chronic ear infections in over
100 years of his group's combined practice!  I didn't know
whether to be honored or dismayed!

>Ear infections are bacterial, and are thus treated with antibiotics.
>Also, in the first 24 hours before the antibiotic really starts working,
>the child can have Tylenol to help with the pain.  Also, keep the
>child more upright to allow for the eustacian tubes to drain.

I was told that ear infections run about 50% bacterial infections
and 50% viral infections.  They are always treated with antibiotics
because that way there's a 50% chance they'll be cured by the drugs.
Doctors like to treat ear infections fairly aggressively to avoid
the hearing loss that can develop from an untreated infection.
On the other hand, if you don't give the kid the antibiotics, 
there's a 50% chance the infection is viral and will clear up on
its own.

>2A. WHAT DIFFERENT ANTIBIOTICS ARE USED?
> 
>Amoxicillin...
>
>Augmentin...
>
>Septra...
>
>Other antibiotics include Ceclor and Suprax...

After oral antibiotics stopped working for my son, he was treated
with injections of a Ceclor-based antibiotic.  Every time he got
an infection, we'd have to bring him in to the doctor's office
every other day for six days (three shots).  

Some kids might develop intolerances to certain antibiotics.
For example, Augmentin made my son throw up.  The injections 
eventually gave him a horrible case of hives (both internal and
external and a very high temperature.  This was diagnosed as
a Ceclor reaction.

After we had to take our son off all antibiotics, he was prescribed
Tobrex ear drops.  We had to give these to him every day for several
months as a prophylactic measure against infection.

>2B. WHAT OTHER TREATMENTS MIGHT HELP?
>
>Milk products increase mucous production, so decreasing the child's 
>intake of them may help.

My pediatrician also suggested that if the child is a baby, to make
sure his head is tilted up at an angle when nursing, as opposed to
flat on his back.  There are some who believe that nursing while lying
down can cause fluid to back up into the eustacian tubes.

He also reminded me to do this when my daughter was born, before she
had had any ear infections.  Apparently the tendency to get ear infections
can be hereditary.

>3C.  WHAT IS THE OPERATION LIKE?
>
>Before the operation, a child is usally required to give a blood
>sample and a urine sample for analysis and testing.  This can be done
>any time before the day of the operation. 
>
>Because of the general anaesthetic, your child is not allowed to eat
>or drink from midnight the night before the operation until the operation
>is completed.  Usually, these operations are scheduled early in the 
>morning, and a set of children are done youngest first.

This is where my experience diverged dramatically from the testimonials
given in the FAQ.  With Jordan, we were offered the choice of general
or local anesthesia, and we chose the local.  He was strapped to a
papoose board and given a shot to numb each ear, and the ENT inserted
the tubes right there in his office.  No general anesthesia risks, 
no blood tests, no fasting, no recovery room, no vomiting, etc., etc.

To me this is by far preferable to getting a general, but it doesn't
seem like anyone else here was offered the choice.  Sure, the kid
screams through the procedure (Jordan was 6 months old when he got
his), but it's over in a matter of minutes, and he was fine.  We kept
him on Tylenol for the rest of the day, but I'm not sure that mattered.

>3D.  WHAT DOES THE OPERATION COST?
>
>For the surgeon and anesthesiologist, people reported the total cost to
>be about $1200-$1500 (in 1991).

For us, since the operation was done in the ENT's office with no
anesthesiologist, it cost between $300 and $400, I think.  This was
in 1989, though.

>3E.  DOES THE OPERATION HELP?
>
>Most people report that their children had no ear infections for at
>least the first nine months after the surgery.  In all cases, the ear
>infections were never as acute or lonng-lasting as the ones the child
>had before the ear tubes were put in.  With the tubes in, the ear
>infections were much easier to spot, and were therefore caught
>earlier.

With Jordan, he had an ear infection two weeks after the tubes were
put in, and just about every two weeks after that.  In other words,
the tubes had absolutely no effect on the frequency of ear infections.
However, the big difference was that since the fluid could drain out
the ear tube, pressure did not build up behind the eardrum and it
didn't hurt him nearly as much.  He could sleep through the night
better with an infection, and was generally happier.  Plus, it 
provided a sure way for me to tell when his ears were infected,
because I could see the fluid draining out.

>3H.  WHEN AND HOW DO EAR TUBES FALL OUT?
>
>The ear tubes are trumpet shaped, and will work their way out eventually
>(usually about 9 months to a year).  They are designed not to fall in.
>Growth seems to be a factor in how soon they fall out -- as the ear
>develops it pushes the tubes out.

We were told that the ear tubes would last from 6 months to a year;
however, 18 months after he got them (at his 2-year checkkup), they 
were still in.


Based on our very traumatic experiences with ear infections in a very 
young baby, I have developed some (uncorroborated, of course, with
a sample size of 1) theories about infections.  

I was told by our pediatrician that it takes the ear up to two 
months to completely heal from an infection.  I personally believe 
that during that time the ear is more susceptible to becoming 
reinfected.  If the child is in an environment where he is exposed 
to the respiratory infections that lead to ear infections, his next 
cold is more likely to cause an ear infection.

With us, we finally came to our senses and took Jordan out of 
daycare when he was about 9 or 10 months old.  He was very,
very sick at the time from his Ceclor reaction, but fortunately
his ears were uninfected.  We just took him out one day because
of his illness and then decided to never sent him back, and it 
was the best thing we ever did as far as his ear infections went.  
He never got another one.  Being at home, his ears got a chance 
to heal completely.  The next cold he got was about six months 
later, and it was the first one that was NOT followed by an ear 
infection.  He is now almost three and has not had an ear infection 
since we took him out of daycare.

Our pediatrician later admitted to me that they learned something
with Jordan.  He said that the pediatricians in his clinic now 
suggest to parents of kids with extremely chronic ear infections to 
consider taking them out of daycare if possible.  

Despite his early problems, Jordan seems to have suffered no 
lasting adverse effects or hearing loss.

That's about it.  Hope it helps someone out there.

Judy Drake
Newsgroups: misc.kids