Suggest treatment for fluid behind ear drum - Online Doctor Chats
I read the post. How much and how frequently are you giving tylenol to him?
May I know his current body weight?
Is he running fever?
No fever. No infection upon exam. But fluid remains after 3 weeks
9 years old
OK, let me brief you.
Usually 1 Tylenol 325 mg followed by 1 ibuprofen ( am & pm) not giving q4 hours
Ok I'm listening
In such cases, I suggest my patients to take round the clock analgesics.
Ok Tylenol / ibuprofen or both alternating?
If you are using tylenol in a syrup form, I would suggest you titrate his doses to 400mg which can be taken q 4th hourly.
Ibuprofen may be added twice daily.
He swallows pill
Encourage him to blow balloons.
If he is swallowing pill then you may continue with 325mg. If you are able to find 125mg tablets, you may add to it. Both pills round the clock.
Ibuprofen in the dose of 200mg twice daily is an addition pain relieving options I suggest if round the clock tylenol isn't able to control the pain.
In simple terms my prescription would be
1. Tylenol round the clock in required doses (400 - 500mg) every 4th hourly.
How long until we should get further testing. Tympanogram irrigate fluid etc.. When should it go away
If the pain continue to persist despite continuous tylenol
then Ibuprofen may be added for addition benefits.
There is no serious harm in taking both ibuprofen and tylenol.
But make sure you keep ibuprofen doses below 200mg.
Since its already been 3 weeks
I would not recommend that you wait for more than couple of weeks.
Okay good to know. Ibuprofen 200 mg per day or per dose
Ibuprofen 200mg per dose. You may repeat the dose after 12 hours incase he needs it.
Chronic presence of fluid behind the ear drum will need a therapeutic procedure - a grommet insertion.
Therefore if he continues to be in pain for more than couple of weeks from now
you should take him to an ENT surgeon
What would the likely treatment be for this if persists? Hypothetical ... Steroid? Antibiotics? If so which antibibiotics cover this & if no infection why antibiotic? Preventative ? Curious.
And tympanometry measures pressure/? I'm not sure
In most cases antiinflammatory medicines (pain killers), antihistamines and nasal decongestants are able to take care of this problem.
Rarely when the condition becomes chronic, grommet insertion is indicated.
Heat isn't helping ? Do u recommend or stear away from? I've heard both
Tympanometry is a test that measures mobility of the ear drum.
Presence of fluid or eustachian tube block alters the movements of ear drum
which helps the doctor assess the severity and chronicity of the problem.
Ok. Thank you so much!!! I have a few more questions. Just to be sure.
Doctor will then be able to decide further treatment.
Please proceed with the questions.
So heat/ no heat?
Hot water bottle heating pad?
Avoid giving him cold and refrigerated food products.
If he is able to perform a steam inhalation
that will be an addition treatment option.
it is important that he blows balloon.
if he finds it painful, give him chewing gum.
chewing and swallowing movement has similar benefits like blowing.
That should also help him.
Okay. He's also showing signs of sensitivity to loud noises especially when taken by surprise.from volume Music in car. To just talking to him up close
I think we have less than 5 minutes left; please proceed with your question.
Steam inhalation ?
Yes, increased sensitivity to sound is well explained by presence of sound.
I mean inhaling vapors from hot water.
You can add vicks liquid to the warm water. Stir the water and help him inhale the vapors.
Okay short on time grateful to u . Very helpful. Thank you so much. We will proceed with ent!!
It helps to open the eustachian tube and drain the fluid out of his ear.
Try these measures at home.
What about wax
I prefer using vicks.
Should we try to irrigate
Dewaxing is not going to be of much help.
Okay that was it!! Have a wonderful evening and God Bless You
Wish you the same.
Thanks for consulting me.
Bye for now.
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