This is one of the weirder things I've read lately. I thought you might find it interesting and possibly useful.
Doctor, There's a Fish in My Ear
Or at Least That's What It Felt Like. In the End, the Truth Was Nearly as Strange
By Heather M. Rothman
Special to The Washington Post
Tuesday, August 6, 2002; Page HE01
I've always been known among my family and friends for having strange medical ailments -- the blueberry allergy, the popcorn-induced nausea, what have you -- so in mid-May when I started feeling like there was a fish in my ear, no one thought twice about it. No one except me. In fact, for four days I could barely think about anything besides the odd "squishing" and constant popping in my left auditory apparatus.
It was Monday night, while playing softball on the Ellipse, that I first became aware my ear felt funny. Not funny ha-ha, but cloudy and kind of like something was living it up in there. I used a cotton swab when I got home, but the strange feeling would not disappear. By the time I woke up the next morning, my hearing was foggy, and I began an ill-humored cataloguing of the possibilities.
Was an ear infection brewing? Had my boyfriend's persistent cough finally caught up with me? Was something going around the Capitol Hill press corps? Was I going deaf? Was I dying? All legitimate questions, I thought.
Meanwhile, my ear was talking every time I sat or stood or put my head to the pillow. I was no longer amused. You try living with an ear pop every second. The cloudier my hearing got, and the more constant the popping sound became, the more determined I became to find out what was wrong.
Doctor Visits One and Two
After sitting through a Senate hearing that I had trouble following because of the pyrotechnics in my ear, I headed to the offices of the Capitol physician. One of the perks of working on the Hill is that you can just walk in as needed. Lawmakers, their staff and reporters like me can stop by with a cough or a headache and come out with a diagnosis and some over-the-counter medicine. A nurse gave me the works and I thought that my fish would be fried. She took my temperature (as normal as can be), checked my throat (as pink as always) and then got to my ears.
Here's where it gets weird.
She told me my left ear looked fine, but that my right ear looked red. That was the wrong ear. Hmmm . . . was my right ear really troubled and the left having sympathy pains? With some acetaminophen in my system, I headed to my regular physician's office for a late-afternoon appointment.
I was becoming anxious. Solving this problem quickly was imperative because I was supposed to fly home to New York in three days. And like all good mothers, mine would be devastated if I was a no-show.
Something else was making me anxious, too. What had begun as an annoyance was now registering as pain. Nothing extreme, but my pain threshold is low. It was sort of like when I had my wisdom teeth pulled and I told the oral surgeon he was hurting me, and he told me what I was feeling couldn't be pain; that was just the "pressure" of his yanking out my teeth.
As expected, the only person I could see at my doctor's office on short notice was the physician's assistant. She's a pleasant enough woman, but also one who's made light of my problems before.
She looked inside both ears, told me that neither was red but that I had small ear canals. She also told me adults rarely get ear infections, despite my insistence that I am prone to them. First a wrong prescription, then an insinuation that I am not even a candidate for ear infections despite my history, and finally a diagnosis that there was nothing wrong with my ear but that I should take Advil and call her again in two days if the pain continued.
I was getting nowhere.
An Earful
When I was young, the only thing I knew about the ear was that when it got "sick," as my mom would say, I would have to take the "pink bubble gum medicine."
But since then I had become an ear aficionada -- and what I know about its complexity and susceptibility to various ills explains why I was now worried.
The outer ear -- the funnel-shaped piece that channels sound through the ear canal to the eardrum, where the sound is processed -- is the part you can hold. As a friend of mine notes, dogs and rabbits can move their outer ears, but most people can't. At least one source of ear pain -- swimmer's ear, or otitis externa -- is caused by an infection that takes root in the outer ear. That couldn't be my problem -- or could it?
The membrane covering the narrow end of the funnel is the tympanic membrane, or the eardrum. Like the top of a snare drum, it is extraordinarily sensitive. Anything pressing against the eardrum will cause abnormal sounds or vibrations and irritate the nerves around it. Another possibility.
The middle ear, the region between the eardrum and the inner ear, which converts sound waves into mechanical energy, can also play host to painful problems. Middle ear infections, or otitis media, occur when the eustachian tube, the pressure equalizer that connects the middle ear to the throat, gets blocked. If the tube doesn't have adequate drainage, bacteria can set up shop. Ouch again.
The inner ear, involved in both hearing and balance, includes the cochlea, which looks like a seashell and contains nerve endings important for hearing. A virus in the inner ear can cause a sensation of falling or disequilibrium, or vertigo.
Even though my problem remained undiagnosed, I was happy to hear two health professionals tell me I shouldn't be losing my balance any time soon. They knew this because when using an otoscope -- an instrument for examining the eardrum and the passage to it from the outer ear -- a professional can tell if there is an infection. An inflammatory response will produce a telltale bulge behind the eardrum. In my case, there was no bulge.
I was relieved to know not just that I could fly but also that I wouldn't have to repeat a bad experience I had a decade ago.
When I was 15, the flu and two inner ear infections made me pass out one night and hit my head on the bathroom vanity, toilet and floor. After my parents got me standing, I told them I could walk fine. Then I walked into a wall and passed out again.
I woke up a few hours later in the hospital without remembering how or why I was there. Not only was I sick, but I had a terrible headache and bruises on my forehead. No, I didn't want that again.
Tuesday night I barely slept. I tried to think of ways to stop the popping in my ears, but after moving my jaw so many times in so many different ways, it too started to hurt. Please let this stop and I'll be good for the rest of the year, I pleaded that night.
Wednesday was just as bad. By the time Wednesday night rolled around, my ear had been squishing and popping for three days. I decided to fall on the mercies of an ear, nose and throat specialist.
Dr. Sandra Woll, My Hero.
Turning Point
An incredibly friendly receptionist gave me a 2 p.m. appointment for that same Thursday. I arrived early to fill out paperwork and was seen by Woll at 2:05 p.m. She walked into the examining room with a mini-computer and a wireless modem and downloaded my medical history. She asked me to tell her about the problem.
I explained about the squishing, and the fish in there eating my brain, and the constant popping that left me feeling like I was stuck on an airplane that just kept taking off, gaining altitude and landing.
Woll listened, then said she thought she knew what was wrong.
Finally. Someone who believes me.
She picked up an otoscope and looked first into my "good" ear. Then she moved on to my left ear, lingering a bit.
Your problem is, she said, with a pause for effect: You have a hair on your eardrum.
A what? I asked. How? At 25, aren't I too young to grow hair in a place like that?
"It's not growing, just sitting on the tympanic membrane," Woll said.
We went into another exam room so Woll could extract the hair. Again, she peered into my ear. What do you know, she said, you actually have two hairs on your eardrum.
My favorite doctor then used a "suction irrigator" -- the rough equivalent of a dentist's "Mr. Thirsty" device -- to suck one one-and-a-half-inch hair off my eardrum. I instantly began to feel better. Yes! The second hair, roughly the same length, was a bit trickier. But armed with a "micro-forceps," Woll extracted it.
The fish was gone! No more squishing. The cloudiness was dissipating and I could hear much better.
But what about the popping? Woll said it was one of two things: It was either temporomandibular joint disorder or a swollen jaw joint that I had inflamed by making funny faces all week in a failing effort to relieve my ear. If ibuprofen for a week did not clear up the jaw situation, I should visit my dentist, she said.
How Did She Know?
So how is it that two other medical professionals examined my ear and missed the two hairs making a home in my ear? Chances are, said Woll, most doctors miss something like this because they look too quickly or are in search of something else: an infection, not debris.
Woll herself encountered the hair-on-the-ear condition by accident after she and a colleague talked with an audiologist about a patient with complaints just like mine. "We found that removing hair from the eardrum helped," she said. Now, whenever a patient uses the word "squishy" to describe an ear problem, she looks for hair.
"By the time people get to us, they have had weeks or months of 'squishing,' " Woll said. "Most just live with it because the medical community doesn't see wax or an infection, so they say nothing is wrong. Eventually the hair either falls out or water gets in the ear and takes it out."
If it doesn't drive patients nuts first. One patient, convinced the pain was caused by a sinus infection, had a sinus CAT scan, a hearing test and an MRI of her jaw before the real culprit was found. The hair was removed and the patient felt better.
Woll said the hair usually gets there during a haircut.
Sure enough, I'd had a haircut the afternoon the fish moved in.
Care in the Chair
As expected, my friends and colleagues have been merciless. Since my return to the Capitol I keep hearing, "No way" or "You were in all that pain because of three inches worth of hair?" or my favorite, "What's the punch line?"
But they all want to know what to do to prevent them from feeling my pain.
It's simple, I say. During your next haircut, wear earplugs.
You better believe I will.
Heather M. Rothman is a Washington area writer.
© 2002 The Washington Post Company |
