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This is not a trick question. "Ototoxic" means exactly what it sounds like---toxic to the ear. Eardrop means exactly what it says--a drop you put in your ear. Yes, I will admit that there are several compartments to the ear. There is the outer ear. There is the middle ear. There is the inner ear. "Ototoxic" medication damages the tiny hairlike organs of the inner ear that are responsible for our sensations of sound and position. Between the outer ear and the middle ear there is a thin membrane we call the tympanic membrane, also sometimes called the eardrum. Eardrops are placed in the outer ear, and if the eardrum is in one piece, those ear drops do not make their way to the inner ear and do not touch any of those delicate fibers.

If the tympanic membrane is in one piece.

My tympanic membrane(TM) was not in one piece. That was why I went to the minor emergency center. I accidentally poked a hole in my TM while cleaning my ear and it hurt. I was given pain meds and drops. I used them. A week later, I woke up so dizzy that I had to stay home. My ear started ringing as if someone had just fired a handgun beside my head. My hearing on the left side became muffled. Over the next five days it got worse.

Just how long did it take for a tiny hole in the eardrum to get better? I decided to google it. And there, I read that certain antibiotic drops should not be used if the TM was perforated because they were "ototoxic." They could get through the middle ear and into the inner ear and damage those little hairlike fibers making you dizzy, giving you ringing and hearing loss.

I stopped the drops immediately. A month later, I still feel as if someone has just fired a hand gun right beside my left ear. My migraines, which were in perfect control before this happened are back with me everyday.

And I keep asking myself, with so many alternatives on the market---antibiotic ear drops that do not damage the inner ear---why does the FDA allow the sale of ototoxic ear drops in this country? Would we tolerate "gastrotoxic Kool-aid" for our children? "Dermatoxic skin cream"? "Oculatoxic eye drops?"

No fair saying "It's up to the doctor to use them correctly." I'm a doctor. I didn't know those particular drops had the ability to chew up my inner ear until I looked it up. The manufacturer of Accutane has made damn sure that every doctor knows that no one should ever take their product and get pregnant. Ever. Why don't the manufacturers of ototoxic drops make sure that no doctor ever gives them to anyone who may have a perforated TM or a tube in their ear or a bad middle ear infection with a hole that the doctor can not see or a bad swimmers ear with a hole that the doctor can not see? And if there are too many situations in which a doctor can not be absolutely sure that a patient who could benefit from antibiotic ear drops does not have a hole in their TM, why does not the FDA say "Maybe we should rethink the whole idea of 'ototoxic ear drops' and stick with the ones that don't damage the ear"?

Don't rely upon the malpractice system to keep you safe. This is a rare complication. If the handful of people to whom this happens sue and settle and sign a gag clause, no one will ever hear about it.

And that is why my personal problem is important for all of us. How do we keep ourselves healthy and safe in a world where Big Pharm is determined to sell us more drugs? We can not rely on the court system to do it--not when most verdicts are sealed. We can not rely on the FDA to do it, not when we have a revolving door between the government and industry. We have to google every single prescription we get from every single doctor, no matter how innocuous it seems. I let one slip by me and look what happened to me?  

Originally posted to McCamy Taylor on Mon Apr 07, 2014 at 02:40 PM PDT.

Also republished by Community Spotlight and KosAbility.

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Comment Preferences

  •  Tip Jar (135+ / 0-)
    Recommended by:
    bobswern, OregonWetDog, allergywoman, swampyankee, PinHole, belinda ridgewood, Louisiana 1976, commonmass, alwaysquestion, jk2003, cosette, elfling, oldpotsmuggler, edsbrooklyn, Senor Unoball, Naniboujou, wader, Bluesee, BMScott, lunachickie, viral, rbird, Bob Love, chimene, elziax, Chaddiwicker, rapala, fToRrEeEsSt, ladybug53, rk2, novapsyche, myboo, Calvino Partigiani, karmsy, Ottoe, knitwithpurpose, 42, Catskill Julie, mommyof3, Regina in a Sears Kit House, serendipityisabitch, ModerateJosh, Jollie Ollie Orange, my2petpeeves, sfbob, cotterperson, lexalou, nuclear winter solstice, Fixed Point Theorem, third Party please, weck, peregrine kate, leeleedee, CharlieHipHop, atana, kurious, wilderness voice, Vetwife, Anne was here, jm214, thanatokephaloides, SoCalSal, nailbender, judy99, Clive all hat no horse Rodeo, Cassandra Waites, worldlotus, Bonsai66, oakroyd, joe pittsburgh, texasmom, NYmom, maregug, IndieGuy, on the cusp, notrouble, linkage, beverlywoods, Agathena, Lorikeet, anyname, Dem Beans, Matilda, Josiah Bartlett, xaxnar, buddabelly, churchylafemme, deltadoc, Chinton, prfb, revsue, 1BQ, reflectionsv37, fixxit, astrogeology girl, northsylvania, NonnyO, Crabby Abbey, Amor Y Risa, riverlover, caul, Tinfoil Hat, Ahianne, asym, Rogneid, chira2, melo, kurt, getlost, Creosote, Dood Abides, waterstreet2013, MissyH, catwho, rb137, Cedwyn, spiritplumber, RiveroftheWest, Angie in WA State, johanus, stringer bell, jorogo, peptabysmal, Damnit Janet, Mickquinas, Powered Grace, mslat27, rmx2630, Santa Susanna Kid, Observerinvancouver, suzq, splashy, Hayate Yagami, FarWestGirl, antirove

    "A dog starved at his master's gate/Predicts the ruin of the state" Blake

    by McCamy Taylor on Mon Apr 07, 2014 at 02:40:07 PM PDT

  •  Ugh (46+ / 0-)

    Thanks for the heads-up and very sorry that happened to you.  Since almost ANY ear infection MIGHT involve a perforated membrane, it does seem crazy to use an antibiotic safe only for intact ear drums.

    "The extinction of the human race will come from its inability to EMOTIONALLY comprehend the exponential function." -- Edward Teller

    by lgmcp on Mon Apr 07, 2014 at 02:44:44 PM PDT

  •  Pardon my saying so, but this spells: (23+ / 0-)

    L.A.W.S.U.I.T.

    Yes, unfortunately we each must become an expert in our own disease.  Also, I tell my clients (in almost seriousness) take your lawyer with you to the hospital.  

    •  lawsuit (6+ / 0-)
      Pardon my saying so, but this spells:

      L.A.W.S.U.I.T.

      Yes, unfortunately we each must become an expert in our own disease.  Also, I tell my clients (in almost seriousness) take your lawyer with you to the hospital.  

      And make it abundantly clear to all parties that any settlement must NOT involve a gag order!

      "It's high time (and then some) that we put an end to the exceptionalistic nonsense floating around in our culture and face the fact that either the economy works for all, or it doesn't work AT all." -- Sean McCullough (DailyKos user thanatokephaloides)

      by thanatokephaloides on Mon Apr 07, 2014 at 05:36:56 PM PDT

      [ Parent ]

      •  Good comment, esp. about gag orders. (0+ / 0-)

        I remember from a New Yorker article years ago a variation on that (which probably included a gag order but I can't recall).  In a very early asbestos suit, the trial lawyers for the plaintiff(s) reached a settlement which included a provision that the trial lawyers would never act in another asbestos suit, thus pissing down the drain all the expertise they'd gained.  Maybe the lawyers were trying to do the best for their clients and/or maybe they had no idea how big the scope for these claims would get.  But it stank.  IMHO.  

        We must, indeed, all hang together, or assuredly we shall all hang separately. B. Franklin

        by Observerinvancouver on Tue Apr 08, 2014 at 12:25:14 PM PDT

        [ Parent ]

    •  pardon my saying so (0+ / 0-)

      but you're not a plaintiff's tort lawyer, are you?

  •  General subject which is near and dear to me... (30+ / 0-)

    ...since I had a life-threatening experience due to a drug interaction (one drug prescribed by my allergist and another drug prescribed by a dermatologist--both were aware that I was taking these drugs in combination). The problem was the it was not yet widely-publicized, even in the medical profession, that there was a problem when taking the two drugs at the same time.

    Additionally, I've dealt with multiple minor punctures (3X) to the same eardrum, due to a buildup of sinus fluids in the Eustachian tube as a byproduct of my allergies. Eventually, the scarring in the eardrum (after healing three times), creates a loss of hearing. (I only have about 1/2 the hearing in my bad ear as I do in my "good" one, as a result!)

    ALWAYS, ALWAYS, if it's at all possible, double-check for yourself (in whatever way possible; online, etc.) when taking more than one drug with another. For that matter, even if you're drinking GRAPEFRUIT JUICE (or, certain other food products) and also taking med's, check into any possible interactions with ANYTHING you're taking.

    DO NOT ASSUME anything when taking prescription drugs, in general, is the best rule of all.

     

    "I always thought if you worked hard enough and tried hard enough, things would work out. I was wrong." --Katharine Graham

    by bobswern on Mon Apr 07, 2014 at 02:54:52 PM PDT

    •  which drugs? (2+ / 0-)
      Recommended by:
      thanatokephaloides, bobswern

      would be helpful for people to know

      •  which drugs? (7+ / 0-)

        wilderness voice asked:

        which drugs? would be helpful for people to know
        ANY drugs. ALL drugs. Including vitamins and herbals.

        Almost all of your food, too.

        Or, as bobswern said:

        ALWAYS, ALWAYS, if it's at all possible, double-check for yourself (in whatever way possible; online, etc.) when taking more than one drug with another. For that matter, even if you're drinking GRAPEFRUIT JUICE (or, certain other food products) and also taking med's, check into any possible interactions with ANYTHING you're taking.

        DO NOT ASSUME anything when taking prescription drugs, in general, is the best rule of all.

        Actually, the "best rule of all" here, like everywhere else in life, is:
        "Always assume THE WORST and deal with it first!"
        In other words, assume that if it can go wrong, it will -- and act accordingly. Especially with human medicine in these United-For-Corporate-Profit States of America.

        "It's high time (and then some) that we put an end to the exceptionalistic nonsense floating around in our culture and face the fact that either the economy works for all, or it doesn't work AT all." -- Sean McCullough (DailyKos user thanatokephaloides)

        by thanatokephaloides on Mon Apr 07, 2014 at 05:47:24 PM PDT

        [ Parent ]

      •  In my case... (7+ / 0-)

        ...it was a combination of the allergy drug Seldane and the antibiotic Erythromycin. The combination induces heart attacks and, occasionally, death. I collapsed once, in public, and ended up under supervision of a cardiologist for a few months. This happened in the late 80's. It's a well-known problem now, and I believe Seldane is not prescribed much, nowadays, if at all. (That's why I didn't mention the brands/drugs.)

        "I always thought if you worked hard enough and tried hard enough, things would work out. I was wrong." --Katharine Graham

        by bobswern on Mon Apr 07, 2014 at 08:16:45 PM PDT

        [ Parent ]

        •  Here's a link from a 1992 LA Times' article... (1+ / 0-)
          Recommended by:
          wilderness voice

          "I always thought if you worked hard enough and tried hard enough, things would work out. I was wrong." --Katharine Graham

          by bobswern on Mon Apr 07, 2014 at 08:21:59 PM PDT

          [ Parent ]

        •  SELDANE was recalled in 1997. (3+ / 0-)

          Terfenadine (Seldane):

          Approved in 1985, Seldane was a great breakthrough in the allergy arena, in that it treated the symptoms of allergic rhinitis, but without the drowsiness and fatigue of other antihistamines.

          And it earned its weight in gold. Drug maker Hoechst Marion Roussel (now Aventis) sold $440 million worth of it worldwide the year before the recall. In fact, in the first 11 months of 1996, 4.3 million prescriptions for Seldane and 2.3 million for a variation, Seldane-D, were filled.

          However, it soon turned out that Seldane, particularly when taken together with antibiotics or antifungal drugs, could cause heart rhythm abnormalities.

          Throughout its years on the market, the FDA received about 40 reports of the abnormalities, linked to 8 deaths.

          But because it was the only antihistamine available without the side effect of drowsiness, the FDA deemed that the benefits outweighed the risks of the drug.

          However, in 1996 the FDA approved another Hoechst Marion Roussel antihistamine, Allegra (fexofenadine), which had the same active compound as Seldane, but didn't cause abnormal heart rhythms.

          That was enough to put Seldane out of the category of 'benefits outweighing risks.'

          The FDA asked the company to withdraw the drug from the market because of its negative effects.

          Dr. Robert J. Temple, an official of the FDA, said the recall was not because people were dying in massive numbers. Rather, he said, ''We are saying that there is a potentially lethal but infrequent risk that you can safely avoid, and that is not acceptable anymore."

          Ultimately the FDA banned Seldane in Jaunary 1997, leading to a recall.

          Only eight deaths documented..........  No idea how many not documented.

          FDA cowardice on display. Pharma bludgeon-wielding also on display.

          "Stealing kids' lunch money makes them strong and independent." -- Rand Ryan-Paul von Koch

          by waterstreet2013 on Tue Apr 08, 2014 at 05:58:59 AM PDT

          [ Parent ]

      •  During my extensive hospital stays I was given (2+ / 0-)
        Recommended by:
        bobswern, wilderness voice

        a lot of Tylenol (to pre-empt pain).  It turned out I had a rare reaction that produced pyroglutamic acidosis and acute kidney failure.   A bit of info here:

        http://www.ncbi.nlm.nih.gov/...

        My husband told me later that someone medical told him (I was still in la la land) they'd never seen anyone receiving dialysis in an emergency department before.  Dunno if that's really the case.  :)

        We must, indeed, all hang together, or assuredly we shall all hang separately. B. Franklin

        by Observerinvancouver on Tue Apr 08, 2014 at 12:42:49 PM PDT

        [ Parent ]

    •  Especially grapefruit juice or pomegranate juice (7+ / 0-)

      I know one class of medications they interfere with: anti-rejection drugs for transplants. I can't have either and I love both fruits.

      What they do is make the drugs more, not less effective, which can have toxic results on your kidneys. Your medical team keeps these at a fine balance.

    •  If you deal with only one pharmacist... (11+ / 0-)

      ... as I do, ask if they can run a check for drug interactions.

      Between my daily high blood pressure meds, heart med, gout med, prescribed vitamins, I make sure my pharmacist knows exactly what I'm taking and when - ditto the dr. office.

      I know the medical professionals are not necessarily knowledgeable about some meds, so I always ask my pharmacist or his assistant (who is also a licensed pharmacist) to run drug interaction checks for me.

      I also have food & ingredient allergies, so the pharmacist special-orders pills without red dyes whenever possible, or suggests substitutes.

      A good pharmacist is a wonderful person to know!!!

      I'm sick of attempts to steer this nation from principles evolved in The Age of Reason to hallucinations derived from illiterate herdsmen. ~ Crashing Vor

      by NonnyO on Tue Apr 08, 2014 at 12:11:02 AM PDT

      [ Parent ]

      •  VA's OpenVistA system does this automatically. (4+ / 0-)

        100% of the time.

        So of course hospitals and managed care combined practices fight like badgers to avoid using this software.

        Yeah, it could be put online for anybody to use.

        That might cost $250,000 a year for a 1,000-hits-a-second public web site with the intersection tables in memory.

        Multiply by "pi"-squared for actual budget impact. Accurate to three decimal places.

        "Stealing kids' lunch money makes them strong and independent." -- Rand Ryan-Paul von Koch

        by waterstreet2013 on Tue Apr 08, 2014 at 06:04:41 AM PDT

        [ Parent ]

        •  That's what all pharmacists should do... (3+ / 0-)
          Recommended by:
          jorogo, bobswern, waterstreet2013

          ... all of the time.

          When I first started asking about drug interactions a few years ago, I got the impression my pharmacist was already doing that, so it's quite possible they do it automatically without telling me, altho I have asked them at various times to run checks.  If all pharmacists are not doing so automatically, they should.

          Potential conflicts will only arise if people do not tell the pharmacist everything they take, I suspect, whether prescription or OTC.  

          Because of my stupid allergies it turns out I have to be a fanatic label-reader whether I want to or not (and I'd rather be able to trust buying food without MSG, sage, or without tons of sodium, etc..., but, I can't trust food producers to use their f'n common sense).  Ergo, I have to be something I'm not by inclination.  It has saved me a ton of money, however, since now I don't have to come home, open something up, and discover too late I didn't read the label and just toss something in the garbage because I can't have it.

          There's a genetic component to all of my allergies.  Both of my parents were allergic to various things.  My brother is allergic.  One of his sons had a reaction to a yellowjacket sting and had to have an epipen with him or at the school nurse's thereafter.  Assorted other cousins are allergic to different things.  Sometimes we have the same pollens and such that we're allergic to, other times it's different things and food ingredients.

          Makes life "interesting" when one could wish for boredom in the area of allergies....

          I'm sick of attempts to steer this nation from principles evolved in The Age of Reason to hallucinations derived from illiterate herdsmen. ~ Crashing Vor

          by NonnyO on Tue Apr 08, 2014 at 09:46:16 AM PDT

          [ Parent ]

          •  From another fanatic label-reader, (3+ / 0-)
            Recommended by:
            bobswern, waterstreet2013, NonnyO

            doncha just love those "peel here" lablels that are showing up on a lot of on-the-shelf medications? If a clerk sees you peeling labels they're likely to ask what the heck you're doing. But if you want to see the "other" ingredients, you have no choice.

            And please tell me about sage.

            "All war is stupid" - JFK

            by jorogo on Tue Apr 08, 2014 at 10:19:12 AM PDT

            [ Parent ]

            •  Tell the clerk to give you the ingredient (3+ / 0-)
              Recommended by:
              waterstreet2013, NonnyO, jorogo

              documentation.  If they don't have a pharmacist with that info, they should have it handy for customers.  If they don't have it, then they have their explanation why you're peeling back the label.

            •  I haven't encountered the 'peel back'... (1+ / 0-)
              Recommended by:
              jorogo

              ... labels yet.  Or, if I did, I probably ignored it and put it back on the shelf unread.

              Sage, as a pollen or a spice.  As a spice, I included it in food once (meatloaf).  My reaction was an instantaneous three-day migraine punctured by projectile vomiting and dry heaves when there was nothing in my stomach to vomit up.

              What hurt worse was that this was after I'd had the allergy tests so I knew I was allergic to sage as a pollen.  Whatever prompted me to stupidly buy it as a spice is still beyond my ability to comprehend.  Needless to say, I tossed it in the garbage as soon as I was well enough to get out of bed without adverse reactions.

              I've had other ingredients that have produced bad migraines, but the only other ones so serious I was wishing for death were MSG & three teeny-tiny sips of tequila (sunrise/sunset? - total amount was not over a teaspoon since I didn't like the taste) that also produced nasty three-day migraines so bad I literally could not move without retching.

              The odd allergy reaction is to the smell of former neighbors in another place cooking stuffed green peppers.  I know I have an adverse reaction to the smell of onions; have had since I was a child and they are not allowed in my home as an adult.  Green peppers and red peppers were not part of foodstuffs when I was young so I never had to think about it..., but this one neighbor where I used to live cooked these things all the time and I was the one who got the three day migraine from only the smell of this garbage!  Ugh!!!!!  Within the last couple of years one of my neighbors has cooked something that smells like what the former neighbor cooked, and I start to get a retching feeling and migraine just from the smell coming through the heat vents.  OMG, it's horrible!!!  Worse than the shit smell of onions, I can only imagine it's as bad as the smell of rotting corpses.  And people eat this...???  Why???

              I'm sick of attempts to steer this nation from principles evolved in The Age of Reason to hallucinations derived from illiterate herdsmen. ~ Crashing Vor

              by NonnyO on Tue Apr 08, 2014 at 05:03:19 PM PDT

              [ Parent ]

              •  We each have our own allergies. (1+ / 0-)
                Recommended by:
                NonnyO

                I'm sorry for your reactions to some of my favorite spices and aromatic veggies. But I've known people who can't eat anything that lives in water - no seafood, fresh or saltwater. That would cause a deep depression for me.

                My only allergies are in 3 wide ranging areas - cats (which I love, so just deal with it) red wine (splitting headaches) which I can easily live without - white is fine, and canker sores in my mouth and throat. That last one took almost 40 years for a doctor to figure out, so I can stop them now.

                I have one idea for you, if you liked the taste of the sage in meatloaf. (I do, but maybe this reaction put you off) I found this quite by accident, as I thought I was picking wild sage around my house, based on the aroma. It was great in meatloaf. Turned out I'd been picking and cooking with spotted mint. (a.k.a. horse mint) So, I just keep picking, drying, and eating it.

                "All war is stupid" - JFK

                by jorogo on Wed Apr 09, 2014 at 05:55:18 AM PDT

                [ Parent ]

                •  I no longer remember what sage tasted like (1+ / 0-)
                  Recommended by:
                  jorogo

                  Just the horrid migraine and projectile vomiting.  It probably wasn't very strong.  I never did like over-flavored anything, esp. meat.

                  Likely the unceasing sneezing fit I had traveling I-90 across WA was sage pollen.  Wouldn't surprise me.  I am allergic to both the sage pollen and sage as a spice.

                  In any case, it doesn't make any difference now because I haven't eaten beef since 1992.  The last three experiences gave me diarrhea about 20 minutes after I ate, then turned into a migraine.  The last two times of eating beef were to make sure I was using absolutely fresh beef from the store, and I bought and cooked it the same day, right along with my usual milk gravy.  Same reaction.  I quit eating beef.

                  Years later when publicity about what is fed cattle in feeder lots led me to suspect the likely culprit is the chemicals fed to cattle in feeder lots is what tainted the meat.  Chicken now tastes bad, as does turkey.  Again, the culprit is most likely more chemicals with the feed on factory farms.  Some pork is still okay, but even fresh pork isn't to my liking.  Bacon is the only thing that tastes the same and I like that.

                  I suspect I could eat all those things if they were from animals on a regular farm that are fed grass, hay, or grain, humanely butchered.  Maybe.

                  I'm sick of attempts to steer this nation from principles evolved in The Age of Reason to hallucinations derived from illiterate herdsmen. ~ Crashing Vor

                  by NonnyO on Wed Apr 09, 2014 at 04:27:38 PM PDT

                  [ Parent ]

                  •  I don't even consider store-bought meat. (1+ / 0-)
                    Recommended by:
                    NonnyO

                    My small percentage of red meat is either local bison or venison. I just had lamb, too, because I know where it came from, as the organic chickens I get. I love fish, but that's a crapshoot - farms are controlled but feed is suspect, and the oceans are wide open for drifting pollutants. If I can catch my own fish from a freshwater lake, that's usually the best. Even so, the world's a dumping ground for polluters, and who knows where even wild animals roam.

                    "All war is stupid" - JFK

                    by jorogo on Thu Apr 10, 2014 at 09:24:06 AM PDT

                    [ Parent ]

          •  Pharmacists do have live systems. (1+ / 0-)
            Recommended by:
            NonnyO

            Thing is, the systems are not as good as VA.

            VA does not limit itself to Big Pharma approved information sources. VA protects patients, everything else be damned.

            "Stealing kids' lunch money makes them strong and independent." -- Rand Ryan-Paul von Koch

            by waterstreet2013 on Tue Apr 08, 2014 at 03:21:05 PM PDT

            [ Parent ]

  •  Ear drops are not the only OTC or (28+ / 0-)

    prescribed medication, that are ototoxic.

    I (we) always, always, always read the fine print which comes with a medication.  

    After I had a viral pneumonia 15 yrs ago, I was prescribed a medicine for my innards to help restore them, after they were gutted by the meds used to fight the viral infection.  Mr Pinhole read the fine print, and immediately called the doc on the fact that it was ototoxic to my remaining hearing.  They were expensive too.  

    Doc prescribed another med - but meanwhile no one covered the cost of the nonreturnable first medicine.  Thanks to his alert, the cost was just monetary.  

    I now have insisted that the pharmacy I usually use, have noted on my account, the hearing loss, and warning about these kinds of drugs.
    *****
    Sometimes a tough decision has to be made of which is the lesser evil.  There is a cancer drug which is supposed to be fairly effective on certain cancers - it is ototoxic.

  •  I'm a veterinarian (31+ / 0-)

    It is drilled into our heads to not pour stuff into an ear unless the drum is intact. Dogs eardrums can be much harder to visualize than peoples drums due to the crazy shape of their ear canals.  Sometimes it requires anesthesia to properly visualize a drum.  Sometimes I have to use oral meds including prednisone for a few days to bring down the swelling inside the canal so I can see it before I'll put anything in that ear.  
    Now, not all ear drops are ototoxic, but some of them are and I always try to know for sure whether or not that drum is a ruptured before I prescribe drops.
    Now, aren't peoples drums pretty easily visualized? Was it checked or was it possibly swollen on exam then ruptured once the meds were started?

    We are raised to honor all the wrong explorers and discoverers - thieves planting flags, murderers carrying crosses. Let us at last praise the colonizers of dreams. - Peter S. Beagle

    by jk2003 on Mon Apr 07, 2014 at 03:11:28 PM PDT

    •  Human ear canals are not straight (9+ / 0-)

      This, only a portion of the drum may be visible. Also, a pinhole perforation isn't easy to see.

      There is a pressure volume test used to assess the middle ear and it can often detect the presence of a perforation.

      Be ashamed to die until you have won some victory for humanity. Horace Mann (and btw, the bike in kayakbiker is a bicycle)

      by Kayakbiker on Mon Apr 07, 2014 at 05:32:06 PM PDT

      [ Parent ]

      •  Thank you (6+ / 0-)

        Yes, we can't always 100 percent know if there is or isn't a tiny hole in the drum.  I try to culture these ears and find out exactly what is growing and what drugs can be used and -hopefully - be able to pick one without ototoxicity.

        We are raised to honor all the wrong explorers and discoverers - thieves planting flags, murderers carrying crosses. Let us at last praise the colonizers of dreams. - Peter S. Beagle

        by jk2003 on Mon Apr 07, 2014 at 07:39:45 PM PDT

        [ Parent ]

    •  can you rec one who practices as you do in Tucson? (2+ / 0-)
      Recommended by:
      Ahianne, jk2003

      I have a fuzzy Fox Terrier who has something going on in her ears...not sure if it's bacterial, fungal or just goop though I do clean them regularly with cocker spaniel ear solution.....

      I find no obvious signs of ear mites though the goo what there is is very dark and it smells kinda yeasty.

      Went away all winter and I though I had her cured...spring rolls in and all of a sudden it's ow ear season....

      Vaya con Dios Don Alejo
      I want to die a slave to principles. Not to men.
      Emiliano Zapata

      by buddabelly on Mon Apr 07, 2014 at 09:11:09 PM PDT

      [ Parent ]

      •  I am nowhere near Tucson and don't know (1+ / 0-)
        Recommended by:
        buddabelly

        Any vets there.  Sorry.
        Brown yeasty ears that are seasonal may be secondary to allergies.  Getting any sensitivities under control may help but if her chronic ear infections are secondary to allergies they will never be cured, just controlled.

        Questions?  Let me know.

        We are raised to honor all the wrong explorers and discoverers - thieves planting flags, murderers carrying crosses. Let us at last praise the colonizers of dreams. - Peter S. Beagle

        by jk2003 on Tue Apr 08, 2014 at 09:10:07 AM PDT

        [ Parent ]

  •  Sorry, forgot to answer the question (21+ / 0-)

    They are on the market because there are infections that only respond to certain antibiotics.  And they may be harmful to the inner ear but theoretically, they should never get there.  

    We are raised to honor all the wrong explorers and discoverers - thieves planting flags, murderers carrying crosses. Let us at last praise the colonizers of dreams. - Peter S. Beagle

    by jk2003 on Mon Apr 07, 2014 at 03:25:10 PM PDT

    •  I use these ear drops fairly often (5+ / 0-)

      I seem to be susceptible to ear infections. I occasionally get them after snorkeling in the ocean. They are the only thing that seems to knock off the infection and it usually takes only a day or 2 and I'm fine again. I keep them on hand at all times.

      That said, I didn't realize they could actually damage my hearing if I had a perferated ear drum. You learn something new on this site every day!

      I'll keep using the drops as needed, but I'll be a little more aware in the future.

  •  What is the drug in question? n/t (11+ / 0-)

    The word "parent" is supposed to be a VERB, people...

    by wesmorgan1 on Mon Apr 07, 2014 at 03:36:25 PM PDT

    •  have never seen this diarist comment (0+ / 0-)

      however, possibly an aminoglycoside antibiotic such as neomycin.  In any case there is no excuse for prescribing ototoxic eardrops except (possibly) as a last resort:
      http://american-hearing.org/...

      As nontoxic ear drops are currently available [for example, Olfaction (ofloxacin) or ciprofloxin containing products], it would seem prudent in the future to use these agents instead of potentially toxic drugs, when there is a perforation.

      Otic Preparations in Common Use

      The following is a list of otic preparations that are in common use. The percentage use information is from Lundy and Graham, (1993)
      Corticosporin otic solution (COS) — contains polymyxin B (10,000 U), neomycin (3.5 mg), hydrocortisone (10 mg) /ml. (94.5% usage)...

      Thomas (2005) reported the case of a patient who developed total hearing loss after using a cream containing triamcinolone, neomycin, gramicidin and nystatin (Tri-Adcortyl cream)....

      Brummett et al. (1976) examined the effects of neomycin and polymyxin B in the guinea pig and found that AC cochlear potential was decreased and hair cell damage was noted following morphological examination.

      this really should be reformulated.
      •  Yeah, but if the diarist won't give details... (0+ / 0-)

        ...I have a difficult time taking the diary at face value.

        He posted another diary yesterday, criticizing the HMO he supposedly chose through the ACA for its lack of PCPs, a high deductible, etc. - but won't specify which plan, even after numerous folks (including me) posted hard data that contradicted his claims.

        Color me skeptical.

        The word "parent" is supposed to be a VERB, people...

        by wesmorgan1 on Tue Apr 08, 2014 at 10:36:45 AM PDT

        [ Parent ]

      •  I have to say, the quoted advice is TERRIBLE (0+ / 0-)

        Ofloxacin and all flouroquinolones (including ciprofloxacin, basically any drug with 'flox' in the name). ARE NOT SAFE.

        A significant minority of patients will develop flouroquinolone poisoning, causing permanent debilitating problems.

        I personally have a very mild case, thanks to ofloxacin otic & a perforated ear drum, and I basically can't walk unless I regularly take a number of supplements. Flouroquinolone poisoning often results in weak tendons/connective tissue: check the warning labels for cipro or that kind of drug sometime: the "spontaneous tendon rupture" threat is NOT  a joke. If anything, it's severely understated because it does not explain the permanent nature of flouroquinolone poisoning.

        Long story short:

        As nontoxic ear drops are currently available [for example, Olfaction (ofloxacin) or ciprofloxin containing products], it would seem prudent in the future to use these agents instead of potentially toxic drugs, when there is a perforation.
        implies that Ofloxacin is not potentially toxic, which is NOT true. It is potentially highly toxic!
        •  fluoroquinolones (0+ / 0-)

          are notorious for causing tendonitis at regular oral doses. The amount of active ingredient that gets into ears from drops is tiny by comparison, and only a small fraction of that might get absorbed into general circulation.  So I am extremely skeptical that ear drops are a danger.  In any case better this than something ototoxic.

          •  Depends on the ailment. (1+ / 0-)
            Recommended by:
            wilderness voice

            In any case, I get stress injuries from walking unless I take magnesium/glucosamine supplements after an ear infection treated with ofloxacin otic & amoxycillin.

            I realize that the dosage of otic is much smaller than oral doses, and the reasons you mention above are why the warning labels are different. My personal theory is that I'm more susceptible to flouroquinolone poisoning than most. Also, I had a bitter taste in the throat after each dose, so I think quite a bit of what I dripped into my ear was effective ingested.

            But frankly, I have the symptoms of mild flouroquinolone poisoning with no other apparent cause, so while I understand your skepticism, ofloxacin otic IS a danger for the same ailments ototoxic drugs would be.

            As noted in another comment, doing nothing is often better than medicating. Which would have been the case for me, and many who are prescribed flouroquinolones for non-serious infections like ear infections, pinkeye, etc.

  •  Hearing instrument (aid) dispenser here. (15+ / 0-)

    My 15 years dispensing tells me you're better off with an ENT.  Primary care docs are not always competent to simply examine the outer ear.  They don't see cerumen when it's there, and tend to minimize it when they do see it.  Course you're not going to see an ENT in the ER - and good luck if you're there.

    I preach the church without Christ, where the lame don't walk, the blind don't see and what's dead stays that way! Hazel Motes in "Wise Blood" (Flannery O'Connor)

    by chalatenango on Mon Apr 07, 2014 at 03:57:17 PM PDT

    •  ENT doc and the ER (11+ / 0-)
      Course you're not going to see an ENT in the ER - and good luck if you're there.
      I've actually got to hand it to the ER doc who served me when I went in because a reaction to an antibiotic caused my entire sense of taste to disappear (see this comment above).

      When he couldn't figure out what the eff was happening, he consulted with his ENT guy before making any decisions.

      The ENT doc said that I was probably dealing with a low-grade fungal infection (because the original antibiotic had destroyed too many allied bacteria along with the bad bacs) and recommended a course of oral antifungals.

      My sense of taste started coming back about a week after I was done with the antifungal course.

      So an ER doc who knows what (s)he doesn't know is worth her weight in gold......

      ;-)

      "It's high time (and then some) that we put an end to the exceptionalistic nonsense floating around in our culture and face the fact that either the economy works for all, or it doesn't work AT all." -- Sean McCullough (DailyKos user thanatokephaloides)

      by thanatokephaloides on Mon Apr 07, 2014 at 06:03:23 PM PDT

      [ Parent ]

      •  Brilliant sentence form: (2+ / 0-)
        So an ___ who knows what (s)he doesn't know is worth her weight in gold......
        Any job from auto mechanic on up fills the bill. It might take a year's work or a whole career to match the literal value of "weight in gold."

        At $1300 an ounce, you get the idea.

        "Stealing kids' lunch money makes them strong and independent." -- Rand Ryan-Paul von Koch

        by waterstreet2013 on Tue Apr 08, 2014 at 06:14:34 AM PDT

        [ Parent ]

    •  Cerumen = ear wax. (3+ / 0-)

      "Stealing kids' lunch money makes them strong and independent." -- Rand Ryan-Paul von Koch

      by waterstreet2013 on Tue Apr 08, 2014 at 06:09:08 AM PDT

      [ Parent ]

  •  I'm sorry you're going through this. (9+ / 0-)

    The cilia are precious & can never be replaced.

    It still amazes me that we have hair in our ears that alert us to sound & ensure our balance.  That makes hair one of the most important structures in the human body.

  •  Cortisporin otic? (12+ / 0-)

    The suspension can be used with a ruptured eardrum, but the solution can't. The reason the solution gets prescribed anyway is that it does not need to be shaken before each use. The suspension does, because the three ingredients in it tend to separate. Without mixing before applying, which many patients are not going to do, each dose of the suspension varies in content so it won't work as well.

    Swimmers ear, which is the usual reason the solution is prescribed, does not cause ruptured eardrum. However, someone could certainly have both swimmers ear and an eardrum ruptured for some other reason. Ear drums are not always easy to see. Ear wax and debris get it the way, or the canal might be swollen.

    It's easy to argue that nothing ototoxic should be put in the ear just in case there is an unexpected break in the TM. But many drugs taken orally and IV are also ototoxic. And an even larger number of drugs are toxic to liver or kidneys.  Over the counter ibuprofen can cause renal failure and should never be taken by anyone at risk for that. But what about the patient who doesn't know they are at risk for that? It's a little more difficult than people realize to stay safe from the harmful affects of all kinds of drugs.

  •  I have had three near-death experiences from (5+ / 0-)

    reactions to drugs.

    Now I own a health food store, and look for my own answers to health issues. Finally, no allergies, no asthma and no pain in my left shoulder because I dug and dug until I found my triggers and eliminated as many of them as I could.

    For the rest, I use herbs and supplements.

    The American Revolution was a beginning, not a consummation. Woodrow Wilson

    by 4Freedom on Mon Apr 07, 2014 at 04:49:53 PM PDT

    •  Please, Dearest 4Freedoms, write a diary. (2+ / 0-)
      Recommended by:
      RiveroftheWest, 4Freedom

      Cover arthritis and triggers. Do a survey of the anatomy & physiology of triggers.

      There's also a big move on to address triggers for cancer. If you do arthritis, maybe we can encourage someone in the field to cover state-of-the-art for cancer.

      Thanks in advance.....

      (And please drop me a message if/when this happens.)

      "Stealing kids' lunch money makes them strong and independent." -- Rand Ryan-Paul von Koch

      by waterstreet2013 on Tue Apr 08, 2014 at 06:21:31 AM PDT

      [ Parent ]

  •  You mention lawsuit, if so it seems like (6+ / 0-)

    it should be directed against the physician, not the drug company.

  •  I was in the hospital three years ago (3+ / 0-)

    and the anasthetic for a bronchoscopy and my hearing has never been normal since... I have allergies over everything and they stop up and once in awhile they unstop but I am sure it was the local anesthetic because I sure never had this fluid build up before.  They say fluid and infection once in awhile like a small kid would get.. Who knows?  I deal with it...The drainage from my sinuses are horrific.

    Thanks for the diary.

    We the People have to make a difference and the Change.....Just do it ! Be part of helping us build a veteran community online. United Veterans of America

    by Vetwife on Mon Apr 07, 2014 at 05:32:25 PM PDT

  •  Uhh (3+ / 0-)

    "We have to google every single prescription we get from every single doctor, no matter how innocuous it seems."

    Do you seriously think it's even possible to create a public policy that enables people to take drugs without first learning about their effects, without any other significant downsides? I don't think you've thought this through.

  •  Not just individual drugs but interactions too (5+ / 0-)

    Years of experience from having a husband on warfarin plus several other prescription drugs led me to automatically Google "warfarin and {whatever}" whenever he changed or got a new prescription or supplement.

  •  What drug was it? (2+ / 0-)
    Recommended by:
    Susan G in MN, wilderness voice

    You don't say.

    We want to build cyber magicians!

    by VelvetElvis on Mon Apr 07, 2014 at 06:29:00 PM PDT

  •  Banning drugs due to uncommon side effects (4+ / 0-)

    is a bad idea.  Maybe drugs with potentially dangerous side effects should be first-line treatments, but they should be around to use when safer drugs fail.

    We want to build cyber magicians!

    by VelvetElvis on Mon Apr 07, 2014 at 06:35:32 PM PDT

  •  Given this diarist's recent history (2+ / 0-)
    Recommended by:
    Susan G in MN, grover

    I would take this with a large grain of salt.

    We want to build cyber magicians!

    by VelvetElvis on Mon Apr 07, 2014 at 07:53:57 PM PDT

  •  Yikes, McCamy! (1+ / 0-)
    Recommended by:
    waterstreet2013

    And thank you, thank you for the warning. I'd better look out for those eardrops the next time I have an ear infection. I had tubes in my ears until I was ten. Have the holes closed completely? How do I know?

  •  VA has a perfectly good software/database (2+ / 0-)
    Recommended by:
    catwho, wilderness voice

    system called VistA -- with an open source version OpenVistA -- that includes doing drug interactions automatically.

    You want a test of pharma oligarchy, look to there being no open public access to this system.

    Providing a public service with OpenVistA might have a base cost at $250,000 a year with the database in memory and doing 1,000 queries a second. There are pharmacy support systems out there, of course. But they're nowhere near as good as VistA and they reflect Big Pharma lies at every option.

    Medscape has up a web page with a "Drug Interaction Checker." One nice feature is that is addresses herbal remedies. But this is not aggressive -- it reflects company reports, not observational data or the "anecdotal" reports that are critical for new drugs.

    That system is incomplete.

    Yeah, you can drive the analysis further with Rule of Thumb operations analysis calculations:

    -- The real cost on a large organization budget goes to "pi"-square times the $250,000. Round up to $2,500,000 a year.

    -- The societal benefit of generalizing VistA protections (upgrading from such as the Medscape system) takes us to CDC. Have a seat, folks:

    Over 770,000 people are injured or die each year in hospitals from adverse drug events (ADEs), which may cost up to $5.6 million each year per hospital depending on hospital size. This estimate does not include ADE caused admissions, malpractice and litigation costs, or the costs of injuries to patients.
    VA does better. Heavy investment in diagnosis is part of it. VistA software controls do most of the rest. Socialism works quite well indeed. Same for TriCare.

    As for capitalism, its vulnerability to criminal acts shows up as strongly in health care as on Wall Street. Their thuggish fight against electronic capture of medical records -- cutting their billing revenues -- is a prime example.

    "Stealing kids' lunch money makes them strong and independent." -- Rand Ryan-Paul von Koch

    by waterstreet2013 on Tue Apr 08, 2014 at 06:47:30 AM PDT

  •  Ahhhh pharmaceuticals.... (1+ / 0-)
    Recommended by:
    wilderness voice

    Some are incredibly useful and absolutely necessary.
    BUT....
    Many are over used and over prescribed.
    I was prescribed a medication (which as it turns out, I was severely allergic to), the doctor claimed there could be no relation between the drug I was prescribed and my specific reactions, I was shunted to another doctor who prescribed a topical drug (which did no good), and then I went back to the original doctor who told me to go to the emergency room.  Seriously, wtf?  I went to yet another doctor who was ruder and more condescending than any professional I've ever been to.  He was the most unhelpful jackass I've ever encountered in any aspect of healthcare.  Not one of these people professed knowledge of the side effects I was suffering with the drug I was taking.  Each one of them poo-pooed me when I said I'd never had anything like the reaction until I took the medication.  It was my imagination.   I went to an allergist who was terrific but told me it wasn't allergies due to any outside influence.  I decided to google the side effects and my reaction was among them, it was rare but it was there.  I took myself off the drug and the reaction went away almost overnight (well, not quite overnight, but it was quickly).
    I finally went to a Chinese herbalist and holistic doctor who was terrific and who I liked very much.

    I think, therefore I am........................... Plus ca change, plus c'est la meme chose....AKA Engine Nighthawk - don't even ask!

    by Lilyvt on Tue Apr 08, 2014 at 06:53:19 AM PDT

    •  doctors are taught the canard (0+ / 0-)

      "when you hear hoofbeats don't look for zebras", i.e., atypical reactions. So they end up totally ill-equipped to deal with these incidents.  

      •  But what's a horse and what's a zebra? (1+ / 0-)
        Recommended by:
        wilderness voice

        My favorite topic, the massive underdiagnosis of obstructive  sleep apnea---currently affects about 10% of the population over 40 and 80% of people with it are still not diagnosed the way it was twenty years ago when only 4% of people over 40 were affected---shows that doctors do not understand the true incidence of many diseases. If they did not see it pointed out to them in their residency training they do not believe that it exists.

        Often, doctors are not taught to recognize a disease until a pharm company or a durable medical goods company finds a way to make a fortune off it. Then, suddenly, everyone has "clinical depression" or everyone needs a pacemaker.

        If Glaxo-Smith-Kline can come up with a $5 a day pill for sleep apnea, the nation's physicians will all become experts.  The pharmaceutical reps will see to that.

        "A dog starved at his master's gate/Predicts the ruin of the state" Blake

        by McCamy Taylor on Tue Apr 08, 2014 at 12:35:25 PM PDT

        [ Parent ]

        •  lotta zebras (0+ / 0-)

          I daresay many patients are harmed by many doctors' refusal to consider the possibility of zebras. From reading patient reports it is evident that typical reactions to medication are commonplace.  Speaking of which, I think it would be helpful if you could share with us the name of the medication that caused your ear injury so we know what to avoid in similar circumstances.

  •  Total sympathies for your ear problems. I (0+ / 0-)

    get positional vertigo transitioning to and from lying down.  It's really quite mild but I hate it.  Your situation sounds many magnitudes worse.  (I'm actually getting a little queasy imagining what it's like.)  Having discussions with CC and FSM about possible improvements in your situation.  

    We must, indeed, all hang together, or assuredly we shall all hang separately. B. Franklin

    by Observerinvancouver on Tue Apr 08, 2014 at 12:53:48 PM PDT

  •  Often the best solution is no medicine. (0+ / 0-)

    And not just in terms of not 'cleaning' the ears (ear wax is incredibly clean, anti-bacterial, etc.)

    There is an antibiotic ear drop that is not "ototoxic" - it's ofloxacin drops. DO NOT EVER RECOMMEND OFLOXACIN.

    I had a perforated ear drum (from an ear infection) not to long ago. I was prescribed amoxycillin (wonder drug) for the main infection & ear drops in case the infection spread to the outer ear.

    Essentially for the outer ear there were three options: take ototoxic ear drops, take ofloxacin ear drops, or do nothing. Ototoxic ear drops would have been a very bad idea (they'd get into the inner ear through the perforated ear drums). Ear infections are scary, though not serious, so I didn't want to do option #3: do nothing. My doctor convinced me to take ofloxacin. BIG MISTAKE.

    Ofloxacin, like all flouroquinolones (think cipro, levaquin, any antibiotic that includes "flox" as part of the name - ciprafloxacin, levafloxacin, ofloxacin, etc.), will poison a significant minority of people who take it.

    Now I have a permanent condition where I have to take supplements (magnesium, glucosamine, etc) to walk safely.

    The correct solution to my ear infection, as in many situations, was to NOT DO ANYTHING (aside from the uber-safe amoxycillin).

    So I guess the response to: why are ototoxic ear drops on the market? is: there are no better options. Some people demand (or genuinely need medication) with serious side effects. And there aren't ear drops without serious side effects.

    You doctor misled you. He should have said "Do nothing, it will get better eventually. And for goodness sake, stop poking things in your ears." Shame on him for not doing so.

    And refuse with extreme prejudice any doctor pushing a flouroquinolone on you unless you're going to die if you don't take it.

    •  I took a quinolone once. Thought I had lupus. (1+ / 0-)
      Recommended by:
      MisterFred

      Woke up with every tendon in my body on fire. Then I remembered "Oh, I took that antibiotic." I can seriously believe those things cause tendon rupture in some people. They went straight to my tendons. Freaky how some drugs act in some people.

      Maybe one day they will do able to do tests of people's biochemistry to determine how drugs will act in their system before they give them to them.

       

      "A dog starved at his master's gate/Predicts the ruin of the state" Blake

      by McCamy Taylor on Tue Apr 08, 2014 at 02:51:00 PM PDT

      [ Parent ]

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