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?