Among the things I’ve learnt on this crazy adventure is that I, and I alone, am truly responsible for my health and care. I can assemble a wonderful team, but I am responsible for following up, asking questions, and making choices.
Much of my thinking on this crystallised when I read Jerome Groopman’s wonderfully thought-provoking How Doctors Think last year. It is no over-statement to say it changed the way I understood how doctors think.
General Practitioners see many patients with the same symptoms and illnesses day in and out. For apparently ‘routine’ illnesses, doctors cannot assume that each instance is more sinister than it appears. “When you hear hoof beats,” they learn, “think horses, not zebras.”
Which is all fine… until you are the zebra… or at least a horse of a different colour…
This is a bit of a long and rather icky story.
Back in late April, I had my first outer ear infection in my left ear.
I’ve had my fair share of middle and inner ear infections. Perhaps more than my fair share? Ear infections, like throat aches, have always seemed to be just the calling card of the common cold for me. But never an infection in the outer ear.
My GP*, Dr O, said the outer ear was so inflamed that she couldn’t see down past it. Had I been in a pool recently? Yes, but not under water. Could it, being in my left ear, be related to my jaw surgery? She thought it nothing irregular. I was on my way with a prescription for the antibiotic ear drops that all GPs order first (Sofradex) and a few days later I was fine.
Then it happened again. Two months later, in late June, it was back. Only this time, I lost the hearing in my left ear and it started to, um, discharge. Delightful experience, of course. Especially when you are in an aeroplane holding a tissue to your ear because lift off and descent make the rivers run. (How lucky that I have no dignity left to worry about on this blog.)
After two GP visits, a new type of ear drops (Ciproxin), an ear ‘flushing’, and two rounds of oral antibiotics (Augmentin Duo Forte) later, Dr G decided it was time to send me off to an ear, nose and throat specialist and take a swab from my left ear to send off for analysis. He even was so lovely as to make an urgent booking for me with Dr F, a specialist in otology. Otology, as it turns out, is the study of the anatomy and physiology of the ear and the diagnosis and treatment of ear diseases.
And that’s how, in mid July, I found myself in Dr F’s surgery with a positive swab result for Aspergillus, a nasty little fungus, and confirmation of my fears. It’s little wonder the GPs couldn’t see down my ear canal, Dr F noted as he examined my ear canal. Your regulation ear canal is 9mm wide. My ear canal? A mere 2mm. The scar tissue from my jaw surgeries, Dr F believes, has contracted around my ear canal and narrowed it.
An ear canal this narrow means that any tiny thing can get itself wedged in there and become infected. Dr F also could not see the ear drum and could barely get his sucking equipment: another delightful and downright painful experience. In my case, the antibiotics to date had killed off both the bad and good bacteria and left me open to fungal infections like Aspergillus.
Unfortunately, he continued, I could well be looking more surgery. This news must have been a bit too sobering. I burst into tears.
It’s hard to explain. In a way, I’m quite used to this old surgery lark and I will handle it just fine when it happens, if it happens. And yet. And yet, surgery and recovery sucks. It’s not just the physical pain; it’s the dragging consumption of time, days, months, in recovery. There’s nothing fun about surgery. It’s both a marvellous thing and a terrible thing.
After that first visit, Dr F sent me away with my third batch of eardrops (Lococorten Vioform). This is, one might say, the mother of all ear drops. It took a bit to massage the drops down my diametrically challenged ear canal, but then it felt like acid burning through my middle or inner ear and then down my throat. A point I mentioned on my second visit, to which dear Dr F replied that this indicated I had a hole in my ear drum and he was taking me off the drops immediately.
The good news is that the mother drops cleared out much of the infection and a hearing test showed that the only continuing loss is at the upper and lower registers. To me now, three weeks after my second visit, it seems the hearing is almost back to normal, although I still find I hold the phone on my right ear when I used to hold it on my left ear. After a month of ‘wait and see’, I’m due back in a week or so for Dr F to determine where we go from here.
* Alannah and I go between three GPs at our clinic: Dr O, Dr G and Dr J. We spread the love but then we are there often, indeed weekly at the moment.