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Suggest treatment for middle ear infection

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Posted on Thu, 26 Mar 2015
Question: I had a scratch in my ear about a month or so back and I was diagnosed with a middle ear infection and my first medicine seemed to cause my anxiety so I got on another medicine and I thought it cleared up and in between then and now I've had bad anxiety attacks, lost weight because I've barely ate... Etc... But now I believe I have a sinus infection. I have small pain under my jaw that comes and goes on my left side in same side for a few days before I had this in my throat I had small pain but under the ear. I've had on and off gum pain on that side, on and off nose isn't fully clogged sensations but it's not runny either on that side in my nostril. Very little coughing almost coughing just to clear my throat of congestion. On and off sore throats. Some days I have pressure headaches and one day I had a full blown headache but those lasted only 3 days. I'm just wandering if my medicine from my middle ear infection caused my anxiety and now if I have a sinus infection? It's been a long circle for a month or so... I've also had both my ears popping. And in between all this I've had my period... During everything I've had my chest xrayed and my heart checked out by a cardiologist and they both say everything it's fine. So, could my anxiety have caused a sinus infection or could a sinus infection have caused my anxiety. I have bipolar anxiety and depression and was off meds for 4 almost 5 years but haven't had an anxiety attack since 2010 or earlier... I'm only 22 almost 23 years old and had my fourth child 3 months ago and since like I said a month or so ago I've had all this been happening to me. Haven't been to the Dr to get a set diagnosis on of I have a sinus infection but I'm pretty sure I do because my son has had green snot and all my kids have been coughing except the baby. And now me and my fiance have the same symptoms. But when my son got diagnosed he just had a bad cold they said
doctor
Answered by Dr. Pankaj Borade (1 hour later)
Brief Answer:
sinusitis and anxiety problem needs independent management.

Detailed Answer:
dear,
welcome to HCM
From the given description, the problem of sinusitis gets very apparent. History psychiatric condition needs to be explored.

In my opinion, the sinusitis and anxiety condition appears unrelated to each other and exist independently. Although stress from any medical condition may precipitate and perpetuate anxiety problems, however they both needs to be managed independently.

The symptoms of headache, throat clearing, cough as mentioned by you are highly suggestive if sinusitis. the ear sensations are possibly due to extension inflammation and blocked eustachian tube. The presence of respiratory infection in family further supports it.
Suggestions for sinusitis:
1) A course of antibiotics will be required which can only be obtained on doctors prescription, therefore a consultation to local physican is required.
2) Steam inhalation three times a day will help clearing the congestion.
3) meanwhile, use of over the counter drugs of antihistaminic like cetrizine and NSAIDS like paracetamol can be use to deal with the headache and secretions.
4) A visit to ENT doctor can help to rule out middle ear infection as it can mimic presentation similar to sinusitis.

regarding anxiety problem:
It is important to have a specific diagnosis, know about associated co morbidities. I would need to now
1) do you feel that your heart is racing, all the day or episodic? what are the triggering cases? is it on exposure to specific situation or occurs without reason any time?
2) is it associated with vomiting, dizziness, nausea?
3) how are you keeping your mood lately? low, depressed?
4) any difficulty in sleep? feelings of guilt? persistent worry?
5) kindly provide details of medication prescribed, with duration. Reason for discontinuation?
answer to these will help me to have a clearer clinical picture of your problem.
A psychiatrist consultation can be suggestible considering a need for detailed work up and known history of psychiatric problem. Presence of weight loss is suggestive of co occurring depression.

we shall continue the discussion.
kindly followup with the information.
Regards,
Dr Pankaj Borade
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Pankaj Borade (43 minutes later)
I have trouble sleeping, the heart racing has subsided because I've continuously been trying to make myself better, trying to eat more but I don't view the losing weight as too much of a problem because after I had my 4th baby back to back I've been at the weight of 209 lbs and I can afford to lose weight especially since I'm getting married in August. Most of my other symptoms have subsided since I've lifted myself out of it and I just want to be able to live my life again. The doctor prescribed me Kolonapin .5 mg twice daily as needed which helped but it mostly helped the anxiety not my bipolar disorder and I'm scared of the side affects and the chance of getting addicted. I've never been addicted to anything in my life except cigarettes. I've tried marijuana before but I'm able to put that down easily. I've drank alcohol before but never became an issue. Other than those things I've never tried anything else. I have to see my psychiatrist on the 3rd of March. Mostly it's the fear of choking when I eat but I just try to relax that fear in my mind to make myself eat. Mostly, I've been giving up the pop alot to keep my anxiety at bay and I mostly drink water. The Kolonapin I've only taken once a week since 4 weeks ago when I was prescribed it. I'm just wandering if there is medicines for bipolar disorder that I don't have to make life changes for. I use to take lithium when I was younger and instantly when I took it it made me feel better but I know I have to watch my salt with it and I hated the constant blood draws to make sure it doesn't make my kidneys fail but I've got so much on my hands I can't really manage more apts. Currently I haven't found a family doctor to help me out I've just been going to ER's when I need to and urgent care. Still trying to find a doctor that takes Caresource in Middletown that is accepting new patients
doctor
Answered by Dr. Pankaj Borade (22 hours later)
Brief Answer:
few suggestion in treatment

Detailed Answer:
thank you for the information.
From your description it appears likely a condition of anxiety disorder.
Possibility of a bipolar or mood disorder can not be discounted as there is a history of lithium.
Considering all the information i have now,
1) A psychiatrist meeting on 3 march is important and very must a thing to look forward to.
2) For your anxiety i would suggest you to discuss with your psychiatrist, an addition of small dose of beta blocker like propranolol to your treatment.
3) For your sleep a long acting benzodiazepine can be considered at bed time.
4) Co occurring mood disorder is very likely, a mood stabilising drug can be considered.

welcome for further suggestions.
Regards.
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Pankaj Borade (1 hour later)
I'm just so nervous about all these medicines and I don't want to change my life so the medicines don't make another problem and I mostly want liquid or chewable medicines for my fear of swallowing because it all started when I was a kid and almost choked on my medication but I've never had the fear for eating except when I have an anxiety attack. And I'm also static of side affects since my obgyn gave me this one medicine because I was trying to find some relief and I had my first ever suicidal thought and with Dr permission I instantly stopped not long after I started using that medicine but it's just circles and circles it seems I'm going in. Mostly now without any medicine hardly any medicines I've managed to get myself out of everything. But it kind of is just like exhausting and just wanting my life back. I drink so much water to reduce the thoughts of, "I'm going to die in my sleep." To go to bed at night. Is there any medication like lithium that will subside it all? I almost cheated in my fiance of 6 years and who I had all my kids by. I think it's more my bipolar causing everything so is there any medicine that I can take for my bipolar that I don't have to change my life for?
doctor
Answered by Dr. Pankaj Borade (21 hours later)
Brief Answer:
few drugs can be discuss for

Detailed Answer:
thank you for the reply.
Yes, there are few options that we can think of putting you on, I would want your doctor at think of considering an addition quetiapine to your prescription.
For anxiety, low dose long acting benzodiazepines can be thought of along with beta blocker. Given in divided doses.
Taking medication is must, and you need to understand that if properly and regularly taken it can improve your functioning to normal.

the above suggestions can be discussed with your treating psychiatrist.

welcome for further suggestion,
Regards
Dr Pankaj Borade
Above answer was peer-reviewed by : Dr. Prasad
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Dr. Pankaj Borade

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Suggest treatment for middle ear infection

Brief Answer: sinusitis and anxiety problem needs independent management. Detailed Answer: dear, welcome to HCM From the given description, the problem of sinusitis gets very apparent. History psychiatric condition needs to be explored. In my opinion, the sinusitis and anxiety condition appears unrelated to each other and exist independently. Although stress from any medical condition may precipitate and perpetuate anxiety problems, however they both needs to be managed independently. The symptoms of headache, throat clearing, cough as mentioned by you are highly suggestive if sinusitis. the ear sensations are possibly due to extension inflammation and blocked eustachian tube. The presence of respiratory infection in family further supports it. Suggestions for sinusitis: 1) A course of antibiotics will be required which can only be obtained on doctors prescription, therefore a consultation to local physican is required. 2) Steam inhalation three times a day will help clearing the congestion. 3) meanwhile, use of over the counter drugs of antihistaminic like cetrizine and NSAIDS like paracetamol can be use to deal with the headache and secretions. 4) A visit to ENT doctor can help to rule out middle ear infection as it can mimic presentation similar to sinusitis. regarding anxiety problem: It is important to have a specific diagnosis, know about associated co morbidities. I would need to now 1) do you feel that your heart is racing, all the day or episodic? what are the triggering cases? is it on exposure to specific situation or occurs without reason any time? 2) is it associated with vomiting, dizziness, nausea? 3) how are you keeping your mood lately? low, depressed? 4) any difficulty in sleep? feelings of guilt? persistent worry? 5) kindly provide details of medication prescribed, with duration. Reason for discontinuation? answer to these will help me to have a clearer clinical picture of your problem. A psychiatrist consultation can be suggestible considering a need for detailed work up and known history of psychiatric problem. Presence of weight loss is suggestive of co occurring depression. we shall continue the discussion. kindly followup with the information. Regards, Dr Pankaj Borade