Transcript: Ear, Nose And Throat | Apr 26, 2001

(music plays)

The opening sequence shows a wooden table with a small lit candle.
Fast clips show different sets of hands performing activities on the table such as pulling petals from a daisy, drawing a big red heart, tuning a violin, flipping through the pages of a book, cooking, and pouring a glass of red wine.
In animation, the title appears inside the shape of a house: "More to life."

Then, Maureen Taylor appears in a studio with textured yellow walls and the logo of the show in the background, which reads "More to life."

Maureen is in her late thirties, with wavy brown hair in a bob. She's wearing a blue blazer over a white shirt.

She says "MORE TO LIFE." FOR MANY PARENTS THE END OF WINTER MEANS THE END OF EAR INFECTION SEASON, MIDDLE EAR INFECTIONS ACCOUNT FOR MORE THAN 25 MILLION DOCTOR VISITS A YEAR IN NORTH AMERICA. SOME PARENTS WILL BE TOLD TO LET THE INFECTION RUN ITS COURSE. OTHERS MAY BE GIVEN A PRESCRIPTION FOR ANTIBIOTICS. AND IF THE CHILD HAS RECURRING EAR Infections, THE DOCTOR MIGHT WANT TO PERFORM SURGERY. IN A FEW MINUTES WE'LL TAKE YOUR CALLS FOR OTTO LAIRNGOLOGIST Dr. BENITA BENGLISH BUT FIRST THE STRAIGHT GOODS ON EAR TUBING.

A clip plays in which a toddler stands in a bathtub squealing.

A dark-haired woman picks her up and says COME HERE, DARLING. ALL RIGHT.

(CRYING)

The woman says NO, YOU DIDN'T TELL ME WHAT YOU WANT. YOU WANT THE TUB FULL OF WATER?

Maureen says FOR MARIA IT SEEMED HER TWO-YEAR-OLD DAUGHTER CASSANDRA GOT ONE EAR INFECTION AFTER ANOTHER.

A caption appears on screen. It reads "Maria Rayson."

Maria is in her thirties, with short dark hair.

She says DURING THE TIME SHE HAD THE EAR Infections SHE WAS VERY IRRITABILITY, CRANKY, PULLING ON HER EAR, FEVERISH, DIDN'T WANT TO SLEEP ON HER OWN, DIDN'T SLEEP WELL AT NIGHT, FOUND THAT SHE JUST DIDN'T WANT TO BE CUDDLED, YET SHE WANTED SOMEONE THERE.

A woman in her late forties approaches a toddler in a doctor's office and says HI ASHLEY, WHAT'S HAPPENING HERE?

Maureen says CASSANDRA'S PEDIATRICIAN Dr. DIANE SACHS SEES MANY CHILDREN WITH EAR INFECTIONS.

Diane, with short curly dark hair, sits in a room and says
WE WOULD TRY IF THE CHILD'S NOT TERRIBLY UNCOMFORTABLE OR HAVING A LOT OF FEVER GREATER THAN 38.5 WE WOULD TRY AND SAY LET'S TREAT THE PAIN AND DISCOMFORT AND SEE IF THIS EAR INFECTION WON'T GO AWAY BY ITSELF.

Maureen says ABOUT 81 PERCENT OF EAR INFECTIONS IN CHILDREN DO HEEL WITHOUT ANY TREATMENT BUT DOCTOR NEEDS TO FOLLOW THE CHILD CLOSELY TO MAKE SURE NO COMPLICATIONS DEVELOP.

A caption reads "Doctor Diane Saks. Pediatrician."

As fast clips show her at work, examining a child's ears, Diane says WE EXAMINE THE CHILD, MAKE SURE THERE'S NO OTHER SERIOUS INFECTIONS, AND LOOK IN THE EAR, AND IF WE SEE AN EAR DRUM THAT'S BULGING WITH PUS, THAT'S RED, THAT HAS LACK OF MOVEMENT, MEANING THAT THERE'S SOME FLUID BEHIND THE EAR CANAL, THEN WE WOULD TREAT WITH ANTIBIOTICS. AND THE REASON WE WOULD TREAT, SOMEONE OBVIOUSLY WE ARE IMPRESSED BY THE CHILD'S PAIN AND DISCOMFORT BUT MORE IMPORTANTLY IS THAT WE WERE WORRIED ABOUT COMPLICATIONS OF THESE EAR INFECTIONS AND THE MOST SERIOUS AND STILL EXIST IS THAT THE EAR WILL BECOME PUSY AND THE PUSY WILL AFFECT THE INNER WORKINGS OF THE EAR. AND THEREFORE LONG-TERM SEQUELLA OF NOT HEARING PROPERLY.

A coloured cross-section diagram of a human ear appears on screen.

Maureen says EAR INFECTIONS OFTEN BEGIN WITH A RESPIRATORY INFECTION. MICROBES THEN INVADE THE MIDDLE EAR AND THE IMMUNE SYSTEM REACTS WITH INFLAMMATION AND SECRETION OF FLUIDS.

In animation, blue particles travel up an airway leading into the inner ear and gather there. Then, the are becomes red and fills with a green liquid.

Maureen continues IN A YOUNG CHILD THE EUSTACHIAN TUBES ARE ANDORT NARROW SO FLOOD CAN BECOME TRAPPED IN THE MIDDLE EAST, CAUSING MORE DISCOMFORT AND CREATING AN IDEAL BREEDING GROUND FOR INFECTION. THAT'S WHEN ANTIBIOTICS ARE CALLED FOR. CASSANDRA WAS PRESCRIBED ANTIBIOTICS REPEATEDLY BUT AFTER 15 EAR INFECTIONS IN ONLY 20 MONTHS MARIA WAS CONCERNED ABOUT CASSANDRA'S GROWING TOLERANCE TO THE DRUGS.

In a clip, as Maria bottle-feeds Cassandra, she says CLOSE YOUR EYES.

Maria says ANTIBIOTICS ARE ALWAYS... THERE'S ALWAYS THE RISK THE BODY BECOMES DESENSITIZED TO IT, SO THE ANTIBIOTIC NO LONGER WORKS AS WELL AS IT SHOULD AND THAT DID BECOME THE CASE IN OCTOBER OF '99. THE BIAXIN WHICH WAS A STRONG ANTIBIOTIC JUST DIDN'T WORK ANYMORE SO WE HAD TO GO TO ANOTHER GROUP OF ANTIBIOTICS TO TRY TO CLEAR THE EAR INFECTIONS AND THAT'S WHEN MY CONCERN REALLY HIT THAT OKAY, NOW I DON'T HAVE A GOOD STRONG ANTIBIOTIC FOR ANOTHER INFECTION LATER ON IN LIFE.

Maureen says WITH FLUID BUILD-UP IN HER MIDDLE EAR, CASSANDRA WAS NOT HEARING CLEARLY AND MARIA WORRIED ABOUT HER LANGUAGE DEVELOPMENT.

Maria says AT THIS TIME OF HER LIFE, SPEAKING IS... IT WAS STARTING. SHE WAS GETTING THE WORDS OUT SHE WANTED TO TRY TO SPEAK, AND HAVING THE EAR FULL OF FLUID WAS CAUSING HER NOT TO HEAR US CLEARLY AND THEREFORE SHE WOULD NOT SPEAK OUT THE WORDS CLEARLY. SHE WOULD SAY THE WORD "UV" INSTEAD OF LOVE NICE AND CLEARLY.

Maureen says THAT WAS WHEN MARIA WAS REFERRED TO Dr. HONEY BRGE JETS, AN EAR NOSE AND THROAT SPECIALIST.

A caption reads "Doctor Hany Guirgis. E.N.T. Surgeon."

Hany, in his late forties, clean-shaven and balding, says WE KEEP TREATING THE CHILD WITH ANTIBIOTICS AND THE FLUID IN THE MIDDLE EAR IS STILL NOT GOING AWAY AND YOU LEAVE THE CHILD FOR A LONGER PERIOD OF TIME WITH FLUID IN THE EARS MEANS THAT HE WILL HAVE A HEARING LOSS OF SAY BETWEEN 15 TO 25 DECIBEL WHICH AFFECT THE CHILD'S PERFORMANCE AT SCHOOL.

Fast clips show Hany preparing to perform a surgery.

Maureen says BECAUSE THE ANTIBIOTICS FAILED TO CONTROL CASSANDRA'S EAR Infections SHE WAS AN IDEAL CANDIDATE FOR EAR TUBES. BILATERAL MIRINGOTOMY AS IT'S CALLED IS THE MOST COMMON OPERATION PERFORMED ON CHILDREN IN CANADA.

Diane says WHAT EAR TUBING DOES IS ALLOWS FOR AERATION AND CONTINUED FUNCTION OF THE EUSTACHIAN KANG NAL, MIDDLE EAR AND IT IS VERY USE NFL A CHILD WHO HAS HAD NUMEROUS SERIOUS EAR Infections AND THE NUMBER VARIES, PROBABLY SIX IS A NUMBER THAT MANY OF US HOLD TO A STANDARD, BUT IF YOU HAVE FOUR SERIOUS EAR INFECTIONS, YOU KNOW, EACH CHILD'S AN INDIVIDUAL, I MIGHT ASK AN E.N.T. SPECIALIST FOR HIS OPINION OR HER OPINION. I THINK TUBES ARE VERY WORTH WHILE IN A CHILD WHO'S BEEN ON ANTIBIOTICS CONTINUALLY. A CHILD WHO IS MISSING SCHOOL CONTINUALLY, A CHILD WHO'S HAVING TROUBLE HEARING.

Hany says THE DAMAGE ITSELF THAT CAN BE CAUSED BY THE PRESENCE OF THE FLUID IN THE EAR, AND THIS FLUID CAN TURN INTO A VERY THICK LIQUID WE CALL LIKE A GLUE, AND THE EAR'S BECOMING LIKE WHAT WE CALL A GLUE EAR IN WHICH IT AFFECTS THE LITTLE TINY OSSICLES IN THE EAR OR THE SMALL BONES IN THE EAR THAT AFFECT THE HEARING, AND THE HEARING LOSS IN THIS CASE CAN BECOME PERMANENT.

Maureen says Dr. GUIRGIS EXPLAINS WHAT HAPPENS IN SURGERY.

Fast clips show healthcare professionals holding a respirator against a young boy's face. Hany looks through a microscope. Then, he inserts a fine tube into the child's ear through a small funnel.

Hany says THE CHILD IS BROUGHT TO OPERATING ROOM AND HE WILL BE PUT UNDER GENERAL ANAESTHESIA WITH MASK VENTILATION. THEN ONCE THE EAR DRUM IS VISUALIZED UNDER THE MICROSCOPIC VIEW, WE PLACE AN INCISION OR A CUT IN THE LOWER PART OF THE EAR DRUM. THEN WE USE A SMALL VACUUM SUCTION TUBING IN WHICH WE ASPIRATE THE LIQUID FROM THE MIDDLE EAR SPACE. THEN ONCE WE SEE THAT THE MIDDLE EAR CAVITY IS BECOMING LIKE CLEAR AND FILLED WITH AIR, WE PLACE OUR VENTILATION TUBE, WHICH IS LIKE AN OPEN-ENDED TUBE, AND IT WILL BE SUSPENDED IN THE EAR DRUM ITSELF.

Maureen says BUT EVEN THIS COMMON OPERATION INVOLVES RISKS THAT PARENTS NEED TO CONSIDER.

Diane says I THINK THE BIGGEST RISK PROBABLY STILL IS ANAESTHETIC. IT'S A BIG DRUG. IT'S DONE VERY WELL NOW. WE KNOW A LOT ABOUT ANAESTHESIA, BUT IT IS STILL A DRUG. SO I'M ALWAYS WORRIED WHEN CHILDREN HAVE TO UNDERGO ANAESTHESIA. NO ONE SHOULD TAKE THAT LIGHTLY AND MAKE SURE THAT THEY FEEL COMFORTABLE AND UNDERSTAND WHAT THAT MEANS.

Maureen says THE PROCEDURE ONLY TAKES SEVEN TO TEN MINUTES AND THE CHILD GOES HOME ON THE SAME DAY.

Hany says IT'S ACTUALLY AN IMMEDIATE GOOD RECOVERY. THERE IS NO PAIN INVOLVED IN IT, OR IF THERE IS ANY DISCOMFORT, WITH JUST A REGULAR LIQUID TYLENOL IT WILL WILL CONTROL ANY FEELING OF PAIN. OTHER THAN THAT, THERE IS NO SPECIFIC RECOVERY PERIOD REQUIRED.

In a home bathtub, Maria dries Cassandra's ears as she says OKAY, COME HERE, SWEETIE. LET ME SEE. PUT YOUR EARS IN.

Maria says TO PROTECT HER EARS, THE TUBES ARE SUPPOSED TO STAY IN BETWEEN SIX MONTHS TO TWELVE MONTHS, I WAS TOLD. WHEN SHE GOES INTO THE BATHTUB WE PUT SOME VASELINE ON A COTTON BALL AND PUT THAT INTO HER EAR AND THE VASELINE MAKES THE BARRIER AND COTTON BALL HOLDS IT IN PLACE AND YOU DON'T SOAK IT AND DRENCH IT WITH WATER BUT YOU TRY TO AVOID AS MUCH AS POSSIBLE. WE CAME HOME, BY 10:30 THAT MORNING WE WERE HOME AND SHE HAD A GOOD LONG SLEEP UNTIL ABOUT 2:30 AND THEN SHE WOKE UP, SHE WAS THE HAPPIEST, GIGGLING, LAUGHING, LOVED TO BE CUDDLED, LOVED TO BE HUGGED. BEFORE SHE DIDN'T WANT ANYONE TOUCHING HER. SHE DIDN'T WANT TO BE CUDDLED, YOU KNOW, CRANKY, IRRITABILITY, AND NOW SHE WAS PLAYFUL AND IT WAS COMPLETELY... A PERSONALITY CHANGE AND SHE WAS HAPPIER.

In a clip, a middle-aged blond man pushes a cheerful Cassandra on a swing in a park.

The clips end.

Maureen says WELL, IF YOU HAVE ANY QUESTIONS ABOUT EAR TUBING OR ANYTHING TO DO WITH THE EARS NOSE OR THROAT, MY GUEST THIS AFTERNOON CAN ANSWER THEM. Dr. VINITA BINDLISH IS AN OTOLARYNGOLOGIST WHO PRACTICES IN WINDSOR.

Vinita is in her thirties, with shoulder-length wavy dark hair. She's wearing a red suit and a white blouse.

A caption reads "416-484-2727. 1-888-411-1234."
Then, it changes to "moretolife@tvo.org"

Maureen says HI, NICE TO HAVE YOU HERE.

Venita says THANK YOU VERY MUCH, IT'S MY PLEASURE.

Maureen says NOW A COUPLE OF THINGS THAT THE EAR TUBING PIECE BROUGHT TO MIND, I'VE READ SOMETHING RECENTLY ABOUT THEY'VE STUDIED EAR TUBING AND WHETHER THERE ARE ANY LONG-TERM SORT OF PROBLEMS AFTER HAVING THE TUBES. WHAT DID THEY FIND?

The caption changes to "Doctor Vinita Bindlish. Otolaryngologist."

Venita says IN TERMS OF LONG-TERM PROBLEMS RELATED TO HAVING EAR TUBES PLACED, THEY'RE VERY RARE AND FAIRLY UNCOMMON. THE MOST COMMON IS SCARRING OF THE TYMPANIC MEMBRANE. OF COURSE YOU'VE MADE A CUT IN A PORTION OF THE BODY, AND SECONDLY THERE CAN BE WHAT WE CALL A PERSISTENT PERFORATION WHERE ONCE THE TUBE FALLS OUT OF THE EAR DRUM, THE NICK THAT YOU MADE IN THE EAR DRUM ORIGINALLY TO INSERT THE TUBE DOESN'T HEEL ITSELF AND OF COURSE THE THIRD THING IS THAT THE TUBE ITSELF, WHILE IT'S IN PLACE CAN IRRITATE THE MIDDLE EAR SPACE, CAUSING PERSISTENT TRAINAGE OF THE MIDDLE EAR. AND THEN, OF COURSE, THE... LESS COMMON IS THAT THE TUBE, RATHER THAN FALLING OUT INTO THE EAR CANAL CAN ACTUALLY FALL INTO THE MIDDLE EAR SPACE.

Maureen says OH, DEAR.

Venita says AND WOULD REQUIRE FURTHER SURGERY TO REMOVE.

Maureen says BUT YOU'RE SAYING MOST OF THESE THINGS ARE RARE.

Venita says THEY'RE FAIRLY UNCOMMON.

Maureen says OKAY, AND YOU HAVE TO WEIGH, I GUESS, THOSE RISKS AGAINST THE RISKS THAT WE JUST HEARD ABOUT IN THE EYE ITEM IN NOT DOING ANYTHING ABOUT RECURRENT EAR INFECTIONS.

Venita says CORRECT. CORRECT.

Maureen says OKAY. I'M ALSO READING SOMETHING ABOUT EAR TUBING AND ADENOID REMOVAL. CAN YOU TELL US ABOUT THAT?

Venita says WELL, THERE WAS A RECENT ARTICLE IN THE NEW ENGLAND JOURNAL OF MEDICINE FROM APRIL THE 19th... IN FACT THERE WERE TWO, BUT WE CAN TALK ABOUT THE ONE THAT YOU'VE MENTIONED. WHICH WAS A RETROSPECTIVE STUDY DONE THROUGH THE UNIVERSITY OF TORONTO, WHERE THEY LOOKED AT THEIR RECORDS OF CHILDREN WHO HAD HAD TUBES PLACED IN THEIR EARS, AND THEN IF THEY HAD HAD SUBSEQUENT OR AT THE SAME TIME ADJUVANT PROCEDURES LIKE ADENOIDECTOMY OR ADENOIDS AND TONSILS AND THIS STUDY FOUND PERFORMING AN ADJUVANT ADENOIDECTOMY OR TONSILLECTOMY THAT THE INCIDENTS OF REINSERTION IN TUBES WAS REDUCED.

Maureen says SO WHAT YOU'RE SAYING IS IF THEY DID THOSE OPERATIONS AT THE SAME TIME AS THEY PUT THE TUBES IN THE EARS, THEY DIDN'T HAVE TO GO BACK AND PUT THE TUBES BACK IN...

Venita says A SECOND OR THIRD TIME AS OFTEN. AS WELL AS IT REDUCED THE HOSPITALIZATIONS AND COMPLICATIONS OF PERSISTENT EAR INFECTIONS AS WELL.

Maureen says NOW YOU SEE, THAT'S FUNNY. I HAVE NEPHEW WHO LIVES IN WINDSOR, BY THE WAY, ERIC, WHO'S Mr. EAR INFECTION AND HE HAD TUBES PUT IN AT ELEVEN MONTHS BUT MY SISTER'S SAYING HE'S STILL GETTING ABOUT SIX OR SEVEN EAR INFECTIONS A YEAR. WHAT WOULD EXPLAIN THAT? AND HE'S ABOUT FOUR OR FIVE NOW.

Venita says WELL, PARTLY CHILDREN ARE SET UP TO GET EAR Infections BECAUSE OF THEIR ANATOMY. PART OF THE FIRST PIECE, ALLUDED TO THAT, THAT THEIR EUSTACHIAN TUBES ARE SHORTER, THEY'RE NOT AS LONG AS THEY ARE IN AN ADULT. THEY'RE ALSO AT A MORE HORIZONTAL ANGLE AS OPPOSED TO A MORE VERTICAL... VERTICAL ANGLE SO THEIR ABILITY TO DRAIN THE MIDDLE EAR IS NOT AS GOOD. THE OTHER THING IS CHILDREN ARE EXPOSED TO OTHER CHILDREN.

Maureen says YES.

Venita says AND THEY PICK UP INFECTIONS MORE READILY. THE OTHER THING IS, IS THAT PERSISTENT INFECTIONS IN A YOUNGER AGE CAN LEAD TO EUSTACHIAN TUBE DYSFUNCTION IN A SMALL PERCENTAGE OF PATIENTS WHERE THE U.S. STATION TUBE JUST DOES NOT FUNCTION WELL.

Maureen says WILL THAT GO AWAY, EVENTUALLY?

Venita says UM, IN MOST CHILDREN, YES, IN A SMALL PERCENTAGE THAT MANIFESTS ITSELF AS PERSISTENT EAR PROBLEMS INTO ADULTS AND WE DO SEE IT INTO ADULTS AS WELL, PROBLEMS WITH THE EAR DRUM FUNCTION AND THE IN FACT IT DOESN'T SORT OF SIT PROPERLY. IT'LL SINK INTO THE MIDDLE EAR SPACE INSTEAD OF SORT OF MAINTAINING AN AERATED MIDDLE EAR.

Maureen says I SEE. YOU MENTIONED OTHER KIDS BEING AROUND OTHER KIDS. KIDS PICK UP INFECTIONS EASILY. THIS IS SOMETHING I'VE NEVER UNDERSTOOD. ARE EAR INFECTIONS CONTAGIOUS PER SE?

Venita says NO, AN EAR INFECTION PERCENT SAY IS NOT CONTAGIOUS. IT'S JUST THAT WE DON'T KNOW ALWAYS JUST BY LOOKING AT AN EAR WHETHER AN EAR INFECTION IS RELATED TO A VIRUS OR BACTERIOLOGY INFECTION. AND IT'S THE VIRUS OR BACTERIAL INFECTION THAT HAS CAUSED THIS EAR INFECTION TO OCCUR, WHICH IS CONTAGIOUS.

Maureen says AND LIKE WE SAID, OFTEN IT STARTS WITH A RESPIRATORY INFECTION.

Venita says CORRECT.

Maureen says THAT'S CONTAGIOUS. A COLD OR SOMETHING.

Venita says BASICALLY. AND WE KNOW THAT YOUNG CHILDREN LIKE TO SHARE FOOD, THEY LIKE TO PUT THINGS IN THEIR MOUTH, THEY LIKE TO TOUCH EACH OTHER WITH THEIR FINGERS, AND THAT IS THE COMMON WAY THAT IT'S SPREAD FROM ONE CHILD TO ANOTHER.

Maureen says SO IN YOUR PRACTICE WHAT'S YOUR CUT-OFF FOR RECOMMENDING TO A PARENT PERHAPS THAT EAR TUBING IS THE WAY TO GO? HOW MANY EAR INFECTIONS WOULD YOU HAVE TO SEE IN THAT CHILD?

Venita says WELL, EVERY CHILD IS DIFFERENT AND EVERY PARENT IS DIFFERENT. I HAVE SOME PARENTS WHO WANT TUBES FOR ONE INFECTION AND I HAVE SOME PARENTS WHO DON'T WANT A TUBE AT ALL AND THEIR CHILD HAS HAD MULTIPLE INFECTIONS. MY GENERAL RECOMMENDATION IS SIX TO SEVEN INFECTIONS IN ONE WINTER. FAILURE OF WHY THE PARTICULARS TO CLEAR INFECTIONS. EVIDENCE OF HEARING LOSS OR PERSISTENT MIDDLE EAR EFFUSION AND I ALSO KEEP IN THE BACK OF MY MIND IF A CHILD HAS HAD A COMPLICATED COURSE WITH RESPECT TO HAVING AN EAR INFECTION, SUCH AS A VERY HIGH FEVER CAUSING DEHYDRATION AND HOSPITALIZATION, OR THE CHILD HAD A FEBRILE SEIZURE RELATED TO THE HIGH FEVER OR DEVELOPED A COMPLICATION LIKE MENINGITIS FROM AN EAR INFECTION.

Maureen says THOSE WOULD BE...

Venita says THOSE WOULD BE ALSO INDICATIONS, EVEN IF IT WAS JUST ONE INFECTION.

Maureen says OKAY. BACK TO THE STUDY ABOUT THE ADENOIDS. DO YOU FEEL NOW THAT BASED ON THAT STUDY YOU MIGHT RECOMMEND ADENOID REMOVAL AT THE SAME TIME AS THE CHILD IS GETTING THE TUBES IN?

Venita says IT HAS BEEN MY RECOMMENDATION SO FAR NOT NECESSARILY TO RECOMMEND ADJUVANT PROCEDURES JUST BECAUSE A CHILD IS HAVING AN ANAESTHETIC. I GENERALLY WILL ONLY RECOMMEND THEM IF IT'S THE SECOND OR THIRD TIME A TUBE IS BEING PLACED, I WILL RECOMMEND AN ADENOIDECTOMY AND THEN IF I HAVE A HISTORY OF OTHER PROBLEMS RELATED TO ADENOIDS OR CONSTABLE LIGHT TIS OR CHRONIC OR ACUTE RECURRENT TONSILLITIS AND IN FACT THIS NEW ENGLAND JOURNAL IN THE END IN THE DISCUSSION THE AUTHORS HAVE ALSO SAID WE ARE NOT ROUTINELY RECOMMENDED THESE ADJUVANT PROCEDURES BE DONE ALONG WITH THESE PROCEDURES BUT IT MAY BE A CONSIDERATION FOR PARENTS AND PRACTITIONERS FOR A CHILD WHO HAS PERSISTENT MIDDLE EAR degrees AND REQUIRES TUBES BUT ALSO HAS OTHER PROBLEMS RELATED TO CONSTABLE LIGHT TIS, NASAL OBSTRUCTION, THEY'RE A MOUTH-BREATHER, SNORING, ET CETERA.

Maureen says I'M SURE WE'RE GOING TO GET QUESTIONS FROM PARENTS ABOUT HERE TUBING BUT WE CAN TALK ABOUT THROAT PROBLEMS AND NOSE PROBLEMS LIKE SINUSITIS AS WELL. MY GUEST THIS AFTERNOON IS Dr. VINITA BINDLISH AND SHE'S AN OTOLARYNGOLOGIST.

The phone numbers and email reappear briefly.

Maureen says JANICE IS IN KINGSTON. HI JANICE.

The Caller says HI. MY QUESTION HAS TO DO WITH TONSILS. MY DAUGHTER IS ELEVEN YEARS OLD. THREE YEARS AGO WE HAD HER TO A SPECIALIST BECAUSE SHE WAS COMPLAINING ABOUT HAVING PROBLEMS SWALLOWING AND AT THAT TIME WE WERE TOLD THAT HER TONSILS YES WERE ENLARGED BUT THEY THOUGHT THEY WOULD SHRINK WITH AGE AND IF SHE CONTINUED TO HAVE PROBLEMS TO MAKE ANOTHER APPOINTMENT. ABOUT SIX MONTHS AGO WE HAD HER BACK IN AGAIN. SHE WAS STILL COMPLAINING OF SWALLOWING. SHE IS A MOUTH BREATHER, SHE SNORES AT NIGHT, AND THE SECOND E.N.T. SPECIALIST HAD SAID TO US THAT HE DIDN'T REALLY SEE A PROBLEM WITH IT. SHE'S NOT PRONE TO HAVE A LOT OF STREP THROATS, AT LEAST I WASN'T AWARE OF IT. I AM A LAB TECHNOLOGIST AND I DON'T BELIEVE IN OVER USE OF ANTIBIOTICS SO THAT'S SOMETHING I'VE KIND OF... I ALWAYS HAVE IN THE BACK OF MY MIND. HIS SUGGESTION WAS TO JUST KEEP AN EYE ON HER THROAT, AND I'M STILL NOT SURE WHAT TO DO. SHE'S HAD A COUPLE SOAR THROATS THIS PAST WINTER. WE DID DO A COUPLE SWABS, SHE DID HAVE STREP THROAT, ACTUALLY AFTER A 48 HOUR INCUBATION SO THERE WAS VERY LITTLE THERE BUT ENOUGH FOR THEM TO DETECT IT AND MY FAMILY DOCTOR SAID JUST DO THIS, CONTINUE TO KEEP TRACK, AND I JUST WANTED ANOTHER OPINION AS TO... SHE WOULD LIKE TO HAVE THEM OUT, ACTUALLY. THEY'RE THAT IRRITATING TO HER. BUT I JUST WOULD LIKE ANOTHER OPINION.

Maureen says AND YOU WANT TO TALK IN GENERAL HERE BECAUSE YOU HAVEN'T SEEN THE THROAT.

Venita says CORRECT. IN GENERAL RECURRENT ACUTE TONSILLITIS CAN BE QUITE A BOTHER SOME PROBLEM. IN A CHILD I GENERALLY RECOMMEND TONSILLECTOMY FOR SIX TO SEVEN ACUTE Infections IN ONE WINTER OR THREE TO FOUR INFECTIONS FOR TWO WINTERS IN A ROW. ALTERNATIVELY I ALSO RECOMMEND TONSILLECTOMY WHERE A CHILD IS HAVING TROUBLES SWALLOWING OR EATING RELATED TO THE SIZE OF THE TONSILS OCCUPYING THE SPACE AT THE BACK OF THE THROAT. AND THEN THIS CHILD MAY BE LOSING WEIGHT BECAUSE OF THIS, BECAUSE THEY'RE JUST NOT ABLE TO EAT. THE LAST REASON I THINK I WOULD RECOMMEND TONSILLECTOMY SIMILAR TO THE REASON I RECOMMEND TUBE SAS COMPLICATED COURSE OF ACUTE TONSILLITIS WHERE THERE'S A FEBRILE CEASE YOU'RE OR THE TONSILS SWELL SO MUCH WHEN THE CHILD HAS AN ACUTE INFECTION IT BLOCKS THE AIR PASSAGE.

Maureen says NOW IS TONSILLITIS DIFFERENT FROM STREP THROAT?

Venita says WELL, TONSILLITIS IS A GENERIC TERM FOR INFLAMMATION OF THE TONSILS THEMSELVES. IT CAN BE CAUSED BY A VIRUS, IT CAN BE CAUSED BY BACTERIA, IT CAN BE CAUSED BY OTHER THINGS AS WELL. STREP THROAT IS SPECIFICALLY A STOP THROAT CAUSED BY STREPTOCOCCUS WHICH IS A BACTERIA.

Maureen says SO WHEN A CHILD COMPLAINS OF A SORE THROAT THAT MAY MEAN TONSILLITIS NOT DUE TO STREP.

Venita says CORRECT.

Maureen says AND THAT'S STILL AN INFECTION IN YOUR OPINION AND IF YOU'RE GETTING A NUMBER OF THOSE IN A WINTER IT MAY BE ADVISABLE TO TAKE THE TONSILS OUT.

Venita says PARTICULARLY AS I SAID IF THE CHILD'S VIRAL ILLNESS OR STREP THROAT ILLNESS IS CAUSING OTHER PROBLEMS WHERE THEY GET DEHYDRATED OR THEY'RE MISSING A LOT OF SCHOOL BECAUSE OF IT. UNFORTUNATELY, IF MOST OF THE EPISODES ARE VIRAL THEN REMOVING THE TONSILS DOES NOT PREVENT A CHILD FROM GETTING ANOTHER ORE THROAT THEY JUST WON'T GET TONSILLITIS AND THE COMPLICATIONS AROUND HAVING TONSILLITIS BUT YOU CAN STILL GET A SORE THROAT AND COLD.

Maureen says WHEN WE WERE KIDS EVERYBODY WAS GOING IN TO GET THEIR TONSILS OUT AND EATING ICE-CREAM IN THE HOSPITAL AND I WAS REALLY JEALOUS BECAUSE NOBODY TOOK MINE OUT BUT WE DON'T DO THEM AS OFTEN ANYMORE.

Venita says NO. TWENTY YEARS AGO IT WAS ALMOST ROUTINE TO HAVE TONSILS REMOVED. WELL I SHOULDN'T SAY ROUTINE, THAT'S PROBABLY OVER STATING IT BUT IT WAS MORE COMMON AND OUR INDICATIONS FOR REMOVING THEM WERE NOT AS STRICT AS THEY ARE NOW. WE ALSO RECOGNIZE NOW THE IMPORTANCE OF TONSILS IN IMMUNE FUNCTION IN TERMS OF IT'S A WAY THAT OUR... THAT CHILDREN SAMPLE THEIR ENVIRONMENT. THEY PUT THINGS IN THEIR MOUTH AND THIS IS THE WAY THEIR BODY DEVELOPS IMMUNITY AND MAKES ANTIGENS... RECOGNIZES ANTIGENS AND RECOGNIZES... MAKES ANTIBODIES.

Maureen says SO THEY'RE IMPORTANT...

Venita says WE THINK TO AROUND THE AGE OF TWO, TWO AND A HALF THEY'RE IMPORTANT IN THE IMMUNE FUNCTION AND AS CHILDREN GROW BEYOND THE AGE OF TWO OTHER PARTS OF THE BODY TAKE OVER FOR DEVELOPMENT OF IMMUNITY.

Maureen says THANK YOU JANICE FOR YOUR PHONE CALL. BEEN KNEE IS IN WINGHAM. HI BONNIE.

The Caller says HI.

Maureen says HI, GO AHEAD.

The Caller says MY QUESTION IS WITH REGARDS TO EAR TUBING. MY THREE-YEAR-OLD DAUGHTER HAD IT DONE BACK IN FEBRUARY AND UPON RECENT VISIT TO OUR FAMILY PHYSICIAN IT WAS DISCOVERED THAT ONE OF THE TUBES HAS FALLEN OUT. NOW WE WERE TOLD THAT IT WAS SUPPOSED TO STAY IN FOR A PERIOD OF SIX TO NINE MONTHS AND I WAS JUST WONDERING IF BECAUSE IT'S FALLEN OUT SO SOON, WOULD IT BE REQUIRED TO BE RE-INSERTED OR SHOULD I JUST LEAVE HER AS SHE IS?

Venita says I'LL ANSWER THE SECOND PART OF YOUR QUESTION FIRST. IT'S GENERALLY NOT COMMON FOR THEM TO FALL OUT IMMEDIATELY AFTER SURGERY. SOMETIMES THEY DO. IT'S NOT THE FAULT OF THE PERSON WHO PUT THEM IN SOMETIMES THE EAR DRUM AFTER REPEATED INFECTIONS IS JUST SO PAPER THIN, IT JUST CAN'T SUPPORT THE TUBE. AND... VERY RARELY, OF COURSE IT CAN PUSH THE TUBE OUT IMMEDIATELY. SO THAT MAY JUST BE JUST HER... JUST THIS CHILD'S BODY REACTING TO THE TUBE. I WOULD SAY THAT I WOULD NOT NECESSARILY RECOMMEND REINSERTION AT THIS TIME. I WOULD WAIT AND SEE WHAT HAPPENS, WHETHER THE CHILD DEVELOPS ANOTHER INFECTION OR WHETHER THERE'S ANY HEARING LOSS. I MEAN, I'M NOT SURE WHY THE TUBES WERE ORIGINALLY PLACED BUT CERTAINLY IF THERE WAS FLUID THERE THAT FLUID WOULD HAVE BEEN ASPIRATED AT THE TIME OF INSERTION, SO IF HEARING LOSS WAS THE REASON FOR PLACING THE TUBES, THAT HAS SOMEWHAT BEEN TREATED BY THE ASPIRATION OF THE FLUID AND I WOULD WAIT AND SEE WHAT HAPPENS RATHER THAN RUSHING TO REINSERT THE TUBE.

Maureen says BECAUSE IN GENERAL, YOU WON'T GET EAR Infections AS OFTEN THROUGH THE SUMMER MONTHS, PRESUMABLY, RIGHT?

Venita says THAT'S WHAT WE THINK. THAT IN THE SUMMER MONTHS CHILDREN TEND TO BE MORE WELL AND THERE'S LESS COLDS THAT...

Maureen says GOING AROUND.

Venita says GOING AROUND.

Maureen says THANK YOU BEENY. GOOD LUCK. MARCI IS IN KINGSTON. HELLO, MARCI.

The Caller says HI THERE. MY QUESTION IS RELATED TO MY THREE-YEAR-OLD SON. HE HAS ENLARGED ADENOIDS AND THE X-RAY CAME BACK SAYING IT WAS MODERATE TO SEVERE, AND WE HAVE ALSO NOTICED THAT HE HAS VERY BRIEFLY, MAYBE LIKE A FRACTION OF A SECOND QUIT BREATHING IN THE NIGHT, AND IT'S VERY STARTLING, BUT WE'RE JUST KIND OF WONDERING, BECAUSE THERE'S SUCH A LARGE WAITING LIST, WE WERE WONDERING HOW LONG CAN WE LEAVE THIS TO GET INTO AN E.N.T.?

Maureen says OH, YOU HAVEN'T EVEN SEEN A SPECIALIST YET?

The Caller says WELL, WE SAW OUR G.P., AND HE IS TRYING TO GET US IN AS QUICK AS HE CAN. BUT IN THIS AREA, IT'S JUST A SIX MONTHS TO A YEAR WAITING LIST.

Maureen says OKAY. AND THIS IS OBVIOUSLY AN ADENOID PROBLEM.

Venita says CORRECT.

Maureen says HERE I AM DIAGNOSING... YOU TELL US WHAT IT IS, OBVIOUSLY.

Venita says FOR CHILDREN, PARTICULARLY AT THIS AGE, THEY DO HAVE LARGE ADENOIDS AND FOR SOME CHILDREN THEY CAN BE SO LARGE THAT THEY CAN BLOCK THE BACK OF THE NOSE, OR THE COENA OF THE NOSE. AND SO WHAT HAPPENS IS WHEN THEY SLEEP, THEY'RE ENABLE OR EVEN WHEN THEY'RE IN THE ASLEEP, THEY'RE UNABLE TO BREATHE THROUGH THEIR NOSE. THE TISSUE IS OBSTRUCTING THE BACK OF THEIR NOSE. IF THEY GET A VIRAL ILLNESS THAT TISSUE WILL SWELL AND FURTHER OBSTRUCT THEM. WHAT THIS LADY IS DESCRIBING IS PROBABLY SOMETHING NOT EXACTLY SLEEP APNEA BUT SORT OF OBSTRUCTIVE SLEEP SYMPTOMS RELATED TO THE FACT THAT THE BACK OF THE NOSE IS BLOCKED SO THIS CHILD IS PROBABLY BREATHING THROUGH HIS OR HER MOUTH DURING THE NIGHT TO SLEEP, AND THEN OF COURSE A CHILD THAT AGE ALSO HAS TONSILS AND THEY, TOO, MAY BE LARGER THAN... IN PROPORTION TO THE SIZE THIS CHILD'S MOUTH AND THE BACK OF THE THROAT AND THEY ALSO MAY BE CAUSING A PROBLEM, AND THIS IS WHY SHE MAY BE SEEING SMALL, BRIEF EPISODES WHERE THE CHILD'S APPARENTLY NOT BREATHING WHILE SLEEPING.

Maureen says IT ALMOST SOUNDS LIKE SLEEP APNOEA BUT IS IT AS BIG A CONCERN AS IT WOULD BE IN AN ADULT?

Venita says IN THE LONG-TERM, YES, BECAUSE IT CAN HAVE LONG-TERM SIDE EFFECTS, BUT, BUT IN A YOUNG CHILD EARLY ON, PROBABLY NOT. THE WORST THING ABOUT IT IS IF IT'S LEFT AND GOES ON FOR A LONG TIME, THE CHILDREN THEN DON'T SLEEP WELL, AND NOT SLEEPING WELL, AS WE KNOW AS ADULTS, CAN LEAD TO A LOT OF OTHER PROBLEMS WITH BEHAVIOUR, CRABBINESS, THEY DON'T DO WELL IN SCHOOL, THEY DON'T WANT TO PAY ATTENTION. SO LONG-TERM, OR EVEN SHORT TERM, IT'S NOT... IT'S NOT A GOOD THING FOR A CHILD TO NOT SLEEP WELL AT NIGHT.

Maureen says IS IT SIX MONTHS IT A YEAR WAIT? I MEAN, IS IT DANGEROUS OR IS IT MORE OF A HUGE INCONVENIENCE?

Venita says IT'S PROBABLY MORE OF A HUGE INCONVENIENCE. THE CHANCES OF IT BEING DANGEROUS OR POTENTIALLY LIFE-THREATENING ARE VERY SMALL.

Maureen says I IMAGINE YOU'VE GOT QUITE THE WAITING LIST DOWN IN WINDSOR YOURSELF.

Venita says NOT YET. I'M FAIRLY NEW IN PRACTICE, SO I AM NOT BOOKING THAT FAR AHEAD RIGHT NOW.

Maureen says DO YOU TREAT ADULTS FOR SNORING AS WELL? DO YOU DO ANY OF THAT LASER STUFF?

Venita says I HAVEN'T STARTED DOING LASER SURGERY BUT I DO DO SOME SURGERY IN ADULTS FOR SNORING.

Maureen says AND WHAT ARE YOU DOING RIGHT NOW? HOW DO YOU TREAT SNORING?

Venita says WELL, I SEE MY PATIENTS, I TAKE A HISTORY AND I DECIDE WHETHER THIS IS A SNORING PROBLEM OR AN APNOEA PROBLEM.

Maureen says OH, I SEE.

Venita says IF I THINK IT'S AN APNOEA PROBLEM, I GENERALLY SEND THEM FOR A SLEEP STUDY SO THAT I KNOW FOR SURE WHETHER IT'S APNOEA OR NOT SO THAT WE CAN PREPARE... BE MORE PREPARED FOR THE ANAESTHETIC AND POST-OPERATIVE CARE. THE TYPE OF SURGERIES I'M RECOMMENDING INCLUDE STRAIGHTENING OUT THE SEPTUM OF THE NOSE, REMOVING POLYPS FROM INSIDE THE NOSE, REMOVING TONSILS. SOME ADULTS DO HAVE ADENOIDS, REMOVING ADENOIDS. DOING SOMETHING CALLED A UVULA FARENGAL PLATOPLASTY WHICH IS TAKING THE UVULA, THE THING THAT HANGS AT THE BACK OF THE THROAT, TAKING IT OFF AND IS A STRIP OF THE MUCOSA OF THE PALLET AND MODIFYING THE SHAPE OF THE PALATE A LITTLE BIT AND TAKING AWAY THE TISSUE THAT VIBRATES WHILE YOU'RE BREATHING AND SLEEPING TO TAKE AWAY THE SNORING.

Maureen says ARE THESE SUCCESSFUL THESE PROCEDURES?

Venita says THEY'RE FAIRLY SUCCESSFUL.

Maureen says DO THE WIVES TELL YOU THEY'RE SUCCESSFUL? YOU'D HAVE TO ASK THEM, WOULDN'T YOU?

Venita says WE'D HAVE TO ASK THEM, THAT'S TRUE. GENERALLY SPEAKING FOR SNORING, THEY ARE FAIRLY SUCCESSFUL. FOR SLEEP APNOEA THEY'RE NOT ALWAYS SUCCESSFUL.

Maureen says RIGHT. OKAY. ALL RIGHT, THANKS AGAIN FOR THE CALL. MARCI. DARLENE IS IN St. THOMAS. HELLO, DARLENE.

The Caller says HELLO, HI I JUST WANTED TO ASK THE DOCTOR A QUESTION ABOUT CELLULITIS DUE TO AN EAR ACHE IS IT APT TO REPEAT ITSELF AFTER YOU GET LIKE ANOTHER EAR ACHE?

Maureen says IS IT CELLULITIS OR SINUSITIS?

The Caller says NO I HAD AN EAR ACHE AND IT WASN'T LOOKED AFTER FAST ENOUGH, AND I DEVELOPED CELLULITIS IN THE EAR CANAL AND ALL UP AND DOWN MY FACE. I WAS VERY, VERY ILL. NOW IS THAT APT TO REPEAT ITSELF?

Venita says WHAT THE CALLER IS DESCRIBING SOUNDS TO ME LIKE A COMPLICATED EPISODE OF WHAT IS KNOWN AS OTITIS EXTERNA WHICH IS AN INFECTION OF THE SKIN OF THE EAR CANAL, WHICH IS SIMILAR TO THE SKIN WE HAVE ON OUR FACE. AND IT'S CAUSED BY BACTERIA... WE ALL HAVE BACTERIA IN OUR EAR CANAL, BUT WHAT HAPPENS IS THAT YOU GET A LITTLE WATER IN THERE, THE SKIN OF THE EAR CANAL SOFTENS A LITTLE BIT. THERE'S WAX AND SKIN AND THEN THE BACTERIA HAVE SOMETHING TO EAT AND THEN THEY OVERGROW AND THEY CAUSE AN INFECTION OF THE SKIVELT IT'S A CLOSED SPACE.

Maureen says RIGHT.

Venita says AND THAT CAN SPREAD TO THE SKIN OF THE FACE AS SHE DESCRIBED BECAUSE IT'S THE SAME SKIN. THE WAY TO AVOID THAT REPEATING IS TO BE VERY VIGOROUS ABOUT NOT LETTING ANY WATER GET IN THE EAR AT ALL ON THAT SIDE.

Maureen says AND IS THAT COTTON LIKE WE SAW...

Venita says ANYTHING. EAR PLUG, COTTON, ET CETERA. THE OTHER THING IS, IS THAT I ALWAYS TELL MY PATIENTS DON'T PUT ANYTHING BIGGER THAN YOUR ELBOW IN YOUR EAR.

Maureen says THAT'S AN OLD FAVOURITE OF OTOLARYNGOLOGISTS. MEANING DON'T PUT ANYTHING IN YOUR EAR.

Venita says EXACTLY BECAUSE THE SKIVE THE EAR CANAL IS QUITE THIN AND DOES NOT TOLERATE TRAUMA. AND REPEATED TRAUMA FROM HAIR PINS OR Q-TIPS CAN AFRAID THAT SKIN AND SET UP THIS WHOLE PROCESS TO HAPPEN AGAIN.

Maureen says SO HOW DO YOU CLEAN YOUR EARS THEN?

Venita says WELL YOU'RE NOT SUPPOSED TO CLEAN YOUR EARS. THEY'RE SELF-CLEANING. THEY'RE SELF-CLEANING. THE EARS ARE DESIGNED TO MOVE WAX OUT ON THEIR OWN.

Maureen says OKAY, SO IF YOU SEE A LITTLE FLICK IN YOUR SON'S EAR YOU JUST HAVE TO...

Venita says YOU SHOULD LEAVE IT ALONE.

Maureen says THAT'S HARD TO DO. LIKE PICKS A SCAB WHEN YOU WERE A KID. THANKS VERY MUCH, DARLENE.

She reads from a laptop computer and says
WHEN YOU WERE A... -- ANOTHER QUESTION ABOUT ADENOIDS. "AS A CHILD I SUFFERED FROM A NUMBER OF EAR Infections. EVENTUALLY I SAW AN E.N.T. SPECIALIST AND HE RECOMMENDED I GET TUBES. THIS ESSENTIALLY HAD TO BE REPEATED SEVERAL TIMES AS I CONTINUED TO SUFFER FROM EAR INFECTIONS. THEY THEN SUGGESTED MY ADENOIDS BE REMOVED. ONCE THOSE WERE REMOVED I NO LONGER SUFFERED FROM THE EAR INFECTIONS. MY QUESTION IS WHAT AFFECT DO ADENOIDS HAVE ON EAR Infections?"

Venita says WELL AS I HAD SAID BEFORE, ADENOIDS ARE BASICALLY LYMPHATIC TISSUE THAT LUVE AT THE BACK OF THE NOSE, AND IFED A VOIDS ARE LARGE ENOUGH THEY CAN BLOCK THE EUSTACHIAN TUBE OPENING ALSO AT THE BACK OF THE NOSE. SO THE EUSTACHIAN TUBE CONNECTS THE MIDDLE EAR TO THE NASAL PHARYNX OR THE BACK OF THE NOSE AND IF THEY BLOCK THE EUSTACHIAN TUBES FROM DRAINING THAT CAN CAUSE PERSISTENT TANT EFFUSION. ALSO IT'S THOUGHT IN CHILDREN THAT ADENOIDS ACT AS A SEED FOR BACTERIA TO GO INTO THROUGH THE EUSTACHIAN TUBE OPENING INTO THE MIDDLE EAR SPACE. SO REMOVING THED A VOIDS... ADENOIDS DOES TWO THINGS. IT TAKES AWAY THE PHYSICAL BLOCKAGE, WHICH IS PROBABLY LESS OF A MECHANISM, BUT WE ALSO THINK THAT IT TAKES AWAY A SOURCE OF INFECTION, WHERE SORT OF BACTERIA AND VIRUSES SIT ON THIS PAD OF TISSUE.

Maureen says READY TO START ANOTHER EAR INFECTION.

Venita says CORRECT.

Maureen says ALL RIGHT. WE'RE TALKING ABOUT EARS, NOSES AND THROATS THIS AFTERNOON WITH Dr. VINITA BINDLISH, AN OTOLARYNGOLOGIST IN THE WINDSOR AREA. IF YOU HAVE QUESTIONS FOR HER, GIVE US A CALL HERE AT "MORE TO LIFE."

The phone numbers and email reappear briefly.

Maureen says JOANNE IS IN HUNTSVILLE. HELLO, JOANNE, WELCOME.

The Caller says HI, I'M A WOMAN IN MY LATE 40s AND I'M JUST GOING IN FOR MY NINTH SET OF TUBES. I'M LISTENING TO WHAT YOU'RE SAYING ABOUT THE ADENOIDS. I STILL DO HAVE MY ADENOIDS. THE PROBLEM I HAVE IS MY EUSTACHIAN TUBES KEEP SWELLING SHUT WITHOUT GETTING COLD ALL THE TIME. JUST I CAN WAKE UP ONE MORNING AND THEY'RE SWOLLEN SHUT, THE FLUID BUILDS UP AND I GET TUBES AGAIN. IF IT'S NOT THE ADENOIDS IS THERE A PROCEDURE THAT CAN BE DONE KEEP MY EUSTACHIAN TUBES FROM SWELLING SHUT? BECAUSE THIS IS ONLY IN THE LAST 16 YEARS AND I'M JUST GOING TO GO IN FOR MY NINTH SET OF TUBES.

Maureen says WOW. THAT'S A LOT.

Venita says THAT IS A LOT. I WOULD AGREE. UNFORTUNATELY, ONE OF THE THINGS THAT COULD BE DONE FOR THIS PROBLEM, WHICH IS PROBABLY PERSISTENT EUSTACHIAN TUBE DYSFUNCTION IS RATHER THAN PUTTING A STANDARD MYRINGOTOMY TUBE IN, WHICH IS THE ONE THAT Dr. GUIRGIS DESCRIBED, THE SHORT VENTILATING TUBE THAT'S OPEN-ENED WE CAN SOMETIMES PUT IN SOMETHING CALLED A T-TUBE WHICH IS A LITTLE BIT LONGER AND IT HAS LONGER PHELANGES AND CAN BE DONE THROUGH THE DRUM ITSELF, SIMILAR TO THE WAY A STANDARD VENTILATING TUBE IS PLACED OR CAN BE DONE BY BASICALLY RAISING A FLAP WHICH MEANS LIFTING UP THE EAR DRUM AND PLACING THIS TUBE IN THE MIDDLE EAR SPACE ITSELF. NOW, THE ADVANTAGE OF IT IS THAT IT'S A LONG-STANDING TUBE. IT WILL LAST LONGER SO THAT THIS LADY, OR SOMEONE IN HER SIMILAR POSITION DOESN'T HAVE TO KEEP REPEATEDLY HAVING TUBES PLACED EVERY SINGLE TIME. AND THE HOPE WOULD BE THAT WITH THE TUBE BEING PRESENT FOR A LONG PERIOD OF TIME... I MEAN THESE TUBES LAST A COUPLE OF YEARS THAT IT MAY HELP EQUALIZE THE PRESSURES OF THE MIDDLE EAR AND IMPROVE MIDDLE EAR FUNCTION. PROBABLY IT WOULD BE LESS OF AN ADVANTAGE FOR THIS LADY, BUT AT LEAST SHE MAY NOT HAVE TO KEEP REPEATEDLY HAVING TUBES, SOUNDS LIKE EVERY YEAR, YEAR AND A HALF.

Maureen says ARE THERE SOME PEOPLE WHO ARE JUST GOING TO HAVE THIS PROBLEM THEIR WHOLE LIFE?

Venita says YES, IT'S A VERY SMALL PERCENTAGE WHERE THEY JUST HAVE PERSISTENT EUSTACHIAN TUBE DYSFUNCTION.

Maureen says YOU WOULD THINK NOW, YOU KNOW, WITH THE... WE'VE INVENTED SO MANY DIFFERENT THINGS, YOU'D THINK WE WOULD INVENT A NEW WAY TO REBUILD THAT EUSTACHIAN TUBE SO IT WORKED BETTER.

Venita says WELL, YOU WOULD THINK SO. IT'S... ANATOMICALLY THOUGH IT'S IN A VERY DIFFICULT AREA TO ACCESS SURGICALLY WITHOUT HAVING TO REMOVE A LOT OF OTHER TISSUE, AS WELL AS PUT OTHER STRUCTURES AT A FAIR AMOUNT OF RISK TO GET TO THE EUSTACHIAN TUBE.

Maureen says JUST TOO TRICKY. OKAY, THANK YOU JOANNE. GOOD LUCK. I KNOW THAT YOU TREAT A LOT OF PATIENTS FOR CHRONIC SINUSITIS AS WELL AND YOU'VE DONE SOME RESEARCH INTO ITS RELATIONSHIP TO MOULD OR FUNGUS.

Venita says CORRECT.

Maureen says TELL US A LITTLE BIT ABOUT THAT.

Venita says WELL THERE HAS RECENTLY BEEN... WELL, ABOUT A COUPLE OF YEARS THERE'S BEEN A LOT OF INTEREST IN THE CONCEPT OF FUNGUS OR MOULD AS A CAUSE OF CHRONIC SINUSITIS. THIS WAS BORNE OUT BY A COUPLE OF STUDIES A FEW YEARS AGO, ONE, THE MOST FAMOUS ONE FROM THE MAYO CLINIC IN THAT PEOPLE WITH PEOPLE WITH CHRONIC SINUSITIS THERE IS A HIGHER INCIDENCE OF FUNGUS IN THEIR NOSE. AND WHAT WE THINK... IT'S NOT ACTUALLY THE FUNGUS ITSELF, BECAUSE FUNGUS IS EVERYWHERE IN OUR ENVIRONMENT. IT'S A PARTICULAR PERSON'S BODY REACTION TO THAT FUNGUS, MANIFESTING ITSELF IN THE SINUSES, CAUSING CHRONIC SINUS PROBLEMS.

Maureen says SO THEY'RE SENSITIVE TO IT. MORE SENSITIVE THAN MANY PEOPLE ARE.

Venita says CORRECT. CORRECT, AND THERE'S A GREAT DEAL OF RESEARCH AND STUDY GOING ON RIGHT NOW. ONE TO TRY AND CONTINUE TO PROVE THIS, WHETHER IT TRULY IS A FUNGUS OR AN ALLERGY TO THIS FUNGUS, WHICH IS THE CAUSE, AND THEN THERE ARE SOME RESEARCH TRIALS GOING ON IN THE UNITED STATES AND THE REST OF THE WORLD TO TREAT PATIENTS WITH FUNGAL THERAPY DIRECTED AGAINST THIS. BECAUSE WE DON'T TRADITIONALLY TREAT CHRONIC SINUS degrees WITH ANTIFUNGAL THERAPY.

Maureen says WHAT IS ANTIFUNGAL THERAPY.

Venita says WELL, THE THINGS THAT ARE BEING LOOKED AT RIGHT NOW ARE COMMON MEDICATIONS USED TO TREAT FUNGUS INFECTIONS, WHETHER THEY SHOULD BE USED EITHER ON A TOPICAL BASIS OR SYSTEMIC BASIS TO TREAT CHRONIC SINUSITIS. OR SHOULD WE BE GIVING PATIENTS IMMUNOTHERAPY OR ALLERGY SHOTS AGAINST FUNGUS.

Maureen says SO GIVE THEM A LITTLE BIT OF FUNGUS.

Venita says TO BUILD UP THEIR IMMUNITY TO IT. TRADITIONALLY WE DON'T TREAT PATIENTS WITH ANTIFUNGAL IMMUNOTHERAPY.

Maureen says RIGHT SO SHOULD PEOPLE WHO CAN SEE MOULD AROUND THEIR HOME OR FUNGUS, AND THEY'RE SENSITIVE TO IT SHOULD THEY LEAVE THAT ENVIRONMENT OR IS IT BETTER STAY AND TRY TO BUILD UP AN IMMUNITY TO IT EVENTUALLY?

Venita says WELL, I DON'T WANT TO ENCOURAGE PEOPLE TO ALL OF A SUDDEN...

Maureen says GET UP AND MOVE.

Venita says GTH GET UP AND MOVE. THERE ARE SOME REPORTS WHERE... I WON'T NAME THE CITY, BUT THERE WAS A COURTHOUSE THAT WAS FOUND TO BE FULL OF MOULD.

Maureen says OH, YES. RIGHT.

Venita says AND THERE ARE... PEOPLE WHO WORKED IN THAT COURTHOUSE WHO ARE NOW SUFFERING THE AFFECTS OF THE EXPOSURE TO ALL THAT MOULD FOR SUCH A LONG PERIOD OF TIME.

Maureen says EVEN THOUGH THEY'RE NOT IN THAT ENVIRONMENT ANYMORE?

Venita says EVEN THOUGH THEY'RE NOT IN THAT ENVIRONMENT ANYMORE BUT THAT'S NOT JUST SINUS degrees. THERE ARE OTHER COMPLAINTS AND OTHER MEDICAL PROBLEMS RELATED TO IT. CERTAINLY IF YOU ARE IN AN ENVIRONMENT AND YOU'RE HAVING SYMPTOMS THAT ARE UNEXPLAINED, OR SPECIFICALLY CHRONIC SINUSITIS AND YOU KNOW THAT, FIND OUT THAT THE MOULD IS IN THIS ENVIRONMENT AND IT'S MORE THAN IT SHOULD BE, THEN IT MAY NOT BE A BAD IDEA TO CONSIDER MOVING.

Maureen says OKAY. VIC IN SARNIA. HI RICK.

The Caller says HOW ARE YOU GUYS DOING?

Maureen says GOOD.

The Caller says I JUST HAVE HAD A COMPLETE RINGING IN MY EAR IT HASN'T STOPPED SINCE AUGUST IN MY ONE RIGHT EAR.

Maureen says YOU HAD A COMPLETE WHAT? SORRY?

The Caller says PARDON?

Maureen says CAN YOU REPEAT WHAT YOU HAVE?

The Caller says MY EAR'S BEEN RINGING NON-STOP SINCE AUGUST.

Maureen says OH, AND THIS IS CALLED TINNITUS?

Venita says TINNITUS, ACCENT ON THE WRONG SYLLABLE.

Maureen says IS IT'S COMMON, ISN'T IT?

Venita says IT ACTUALLY IS A COMMON PROBLEM, AFFECTS MILLIONS OF PEOPLE. THE MOST COMMON CAUSE OF TINNITUS OR RINGING IN THE EAR IS HEARING LOSS, SO WE THINK. CERTAINLY ANYONE WHO COMES TO ME WITH THAT COMPLAINT, EVEN IF THEY TELL ME THEY THINK THEIR HEARING IS NORMAL, I WOULD... I WILL RECOMMEND TO THEM THAT WE TEST THEIR HEARING JUST TO MAKE SURE. THAT AGAIN, THAT DOESN'T MEAN THAT FP THEIR HEARING IS NORMAL THEY DON'T LEGITIMATELY HAVE A PROBLEM AND I DO HAVE PATIENTS LIKE THAT, WHERE THE HEARING IS NORMAL BUT THEY'RE STILL HAVING PERSISTENT RINGING OF THE EARS. OCCASIONALLY, VERY RARELY, IT MAY BE RELATED TO OTHER PATHOLOGY WITHIN THE CONNECTION OF THE INNER EAR TO THE BRAIN. IN WHICH CASE I MAY DO ONE OR TWO SUBSEQUENT TESTS. BUT IF THE PATIENT'S HEARING IS NORMAL AND THAT'S THE ONLY SYMPTOM THEY HAVE, MANY TIMES I RECOMMEND DIETARY MODIFICATIONS, WHERE THEY CAN TRY AVOIDING SALT OR CAFFEINE OR ALCOHOL.

Maureen says HOW WOULD THAT HELP?

Venita says WELL THESE ARE ALL SUBSTANCES WHICH EFFECT THE CALIBRE OF BLOOD VESSELS AND THE INNER EAR DOES HAVE BLOOD VESSELS. I DON'T GUARANTEE THAT THIS WORKS TO ANYBODY BUT IT IS SOMETHING I ASK PATIENTS TO TRY IF THEY WISH, TO SEE IF IT HELPS. I ALSO ADVISE THEM NOT TO SIT IN TOTALLY QUIET ENVIRONMENTS, BECAUSE THEN THAT'S WHEN IT'S MORE BOTHERSOME.

Maureen says OKAY.

Venita says SO YOU ALWAYS HAVE A LITTLE BIT OF NOISE IN THE BACKGROUND, AND THAT BASICALLY SORT OF... IT TAKES THEIR MIND OFF IT, ONE, IF THEY'RE BEING BOTHERED BY IT. BUT IT ALSO CAUSES A LITTLE INHIBITION OF THAT NOISE BECAUSE THE EAR IS CONCENTRATING ON SOMETHING ELSE.

Maureen says OKAY. AND IS THERE ANYTHING ELSE?

Venita says WELL, IF THERE'S HEARING LOSS, THEN I RECOMMEND... DEPENDING ON THE DEGREE OF HEARING LOSS, I CAN RECOMMEND HEARING AIDS OR HEARING AMPLIFICATION.

Maureen says AND WILL THAT GET RID OF THE RINGING?

Venita says IT DOESN'T GET RID OF IT NIRLY BUT IT DOES HELP. THERE ARE ALSO DEVICES CALLED MASKERS WHICH CAN BE USED. AND WHAT THEY DO... IT'S BASICALLY LIKE A HEARING AID, IT'S WORN IN THE EAR AND IT... YOU SET IT AT A SPECIFICALLY TONE OR DECIBEL LEVEL AND WHAT HAPPENS IS YOU HAVE IT ON FOR LIKE AN HOUR, AND IT CAUSES WHAT WE... WHAT IS KNOWN AS RESIDUAL INHIB BASE IN THAT IT'S SORT OF NEGATIVE FEEDBACK, TURNS OFF THE TINNITUS. THOSE ARE EXPENSIVE. THEY DON'T WORK ALL THE TIME. AND OF COURSE YOU ARE PUTTING A DEVICE IN YOUR EAR WHICH IS PUTTING NOISE IN YOUR EAR.

Maureen says YEAH, YEAH.

Venita says SO IT'S NOT ALWAYS CONVENIENT OR COMFORTABLE.

Maureen says BUT THE FIRST THING FOR RICK IS TO GET HIS HEARING TESTED.

Venita says CORRECT.

Maureen says OKAY. ALL RIGHT, GOOD LUCK, RICK. THANKS. NOW YOU MENTIONED DIET. HERE'S A QUESTION ABOUT MILK AND DAIRY PRODUCTS AND THEIR RELATIONSHIP TO EAR INFECTIONS.

She reads from the laptop and says
THERE'S A BOOK ABOUT THIS BY Dr. JAMES BALCH. IF A BOTTLE-FED BABY HAS AN EAR INFECTION ELIMINATE MILK AND DAIRY PRODUCTS FROM THE BABY'S DIET FOR 30 DAYS TO SEE IF ANY BENEFITS RESULT. WHAT DO YOU THINK ABOUT THAT? WHAT'S THE RESEARCH THAT YOU'VE READ SAY ABOUT THAT?

Venita says I'VE HAD A LOT OF PATIENTS WHO COME IT ME ASKING ME THIS. THE COMMUNITY THAT I PRACTICE IN, SOME OF THE ALLERGISTS DO FEEL THIS, AND DO RECOMMEND A TRIAL OF 30 OR 60 DAYS OFF MILK AND MILK PRODUCTS. MY PERSONAL FEELING IS THAT I DON'T RECOMMEND IT. UNLESS THERE ARE OTHER REASONS FOR MILK INTOLERANCE, LIKE LACTOSE INTOLERANCE OR DIGESTIVE PROBLEMS, I GENERALLY DON'T RECOMMEND AVOID DANCE IN CHILDREN THAT YOUNG OF SOMETHING THAT IS VERY IMPORTANT FOR THEM.

Maureen says OKAY. I ASSUME THEY'VE STUDIED THIS. YOU MEAN THEY HAVEN'T FOUND A DIRECT CAUSAL RELATIONSHIP?

Venita says I DON'T THINK THE EVIDENCE IS CONCLUSIVE.

Maureen says OKAY. OKAY, JENNIFER IS NEXT IN GOULET RIVER. HI JENNIFER.

The Caller says HI.

Maureen says HI.

The Caller says MY QUESTION IS ABOUT EAR CANDLING. I HAVE A SEVEN-YEAR-OLD DAUGHTER AND SHE HAS... SHE DOES GET A LOT OF WAX IN HER EAR. HER DAD'S THE SAME. AND I'VE HAD HER EARS CANDLED, AND I'VE ALSO USED WARM VINEGAR... OR WARM WATER AND VINEGAR IN HER EAR WITH A SYRINGE AND I WOULD LIKE TO KNOW YOUR OPINION OF EAR CANDLING. AND I HAVE ANOTHER QUESTION THAT'S RELATED TO THIS. BECAUSE SHE HAS SO MUCH WAX IN HER EARS, SHOULD SHE BE WEARING EAR PLUGS WHEN WE GO SWIMMING TO KEEP WATER OUT OF HER EARS AND STOPPING IT FROM GETTING TRAPPED IN BEHIND THE WAX IN HER EARS?

Maureen says OKAY.

Venita says I'LL ANSWER THE SECOND QUESTION FIRST. I DON'T THINK YOU NEED TO WORRY ABOUT HER GETTING WATER IN HER EARS BECAUSE OF THE WAX. YOU DON'T NEED TO PUT EAR PLUGS IN HER EARS WHEN SHE GOES SWIMMING. WITH RESPECT TO EAR CANDLING, I RECOMMEND TO ALL MY PATIENTS THAT IF THEY WOULD LIKE TO TRY AN ALTERNATIVE MEDICINE THAT THEY ARE PERFECTLY AT LIBERTY TO DO SO, AND I ENCOURAGE THEM TO DO SO. MY PERSONAL FEELINGS ABOUT EAR CANDLING ARE IRRELEVANT.

Maureen says WELL I'D LIKE TO HEAR THEM ANYWAY. NO, I MEAN EAR NOSE AND THROAT SPECIALISTS DON'T DO EAR CANDLING.

Venita says NO, WE DON'T DO EAR CANDLING.

Maureen says YOU KNOW, THERE ARE NO STUDIES THAT IT WORKS AND AS YOU JUST SAID EARS ARE SELF-CLEANING. I MEAN, IF YOU DON'T EVEN WANT US TO CLEAN IT OUT WITH A Q TIP YOU PROBABLY DON'T WANT US DRIPPING HOT WAX NEAR IT.

Venita says NO, AND I HAVE ON OCCASION HAD TO REMOVE DRIED WAX FROM PEOPLE'S EARS THAT HAS BEEN LEFT BEHIND BY EAR CANDLING AND HAS CAUSED EAR INFECTIONS. BUT I DON'T THINK IT'S MY PLACE TO TELL PEOPLE...

Maureen says IF THEY ABSOLUTELY WANT TO...

Venita says IF THEY WISH TO TRY AN ALTERNATIVE FORM OF MEDICAL THERAPY THAT THEY SHOULD OR SHOULD NOT.

Maureen says NOW ABOUT EAR PLUGS AND SWIMMING, WHY DO PEOPLE WEAR THEM THEN, IF THERE'S NO REASON TO? OR ARE SOME PEOPLE JUST BOTHERED BY THAT WATER IN THE EAR FEELING?

Venita says WELL, FOR children WHO HAVE TUBES IN THEIR EAR, THEY SHOULD HAVE EAR PLUGS WHEN THEY GO SWIMMING OR SOME SORT OF WATER-TYPE PROTECTION, EAR AN... EITHER AN AQUA BAND OR EAR PLUGS BECAUSE YOU DON'T WANT WATER GOING INTO THE MIDDLE EAR SPACE. ONE, IT MIGHT MAKE THEM DIZZY AND TWO, MIGHT CAUSE AN EAR INFECTION, ESPECIALLY IF THEY'RE SWIMMING IN LAKE WATER. FOR THE REST OF US, IT'S PROBABLY NOT NECESSARILY FOR MOST OF US. SOME PEOPLE JUST GET DRIVEN CRAZY BY THE FACT THAT THERE'S WATER IN THE EAR AND YOU CAN KIND OF FEEL IT SWISHING AROUND. FOR PEOPLE WHO HAVE TROUBLE WITH CHRONIC SKIN INFECTIONS OF THE EXTERNAL CANAL, WHICH WE CAULKED ABOUT, FOR THOSE PEOPLE I DO RECOMMEND THAT THEY TAKE STRICT WATER PRECAUTIONS AND LET NO WATER GET IN THEIR EAR EITHER THE BATH, SHOWER OR SWIMMING AND RECREATIONAL ACTIVITIES. CERTAINLY FOR SOMEONE WHO OFTEN SWIMS IN LAKE WATER, WHICH IS NOT CLEAN, ALL THE TIME, THEY MIGHT WANT TO THINK ABOUT HAVING PLUGS IN THEIR EARS BECAUSE THAT CAN CAUSE AN INTERNAL EAR INFECTION.

Maureen says OKAY. GLENNA IS IN AJAX. WELCOME GLENNA. HI.

The Caller says HI. I'M ACTUALLY CALLING ABOUT A PROBLEM MY MOTHER HAS. IT WAS JUST DIAGNOSED ON SUNDAY... OR SUNDAY SHE WOKE UP AND SHE HAS... SHE WAS VERY, VERY DIZZY. SHE WAS DIAGNOSED ON MONDAY AS HAVING COLISEUM BUILD-UP ON THE SMALL HAIRS IN HER INNER EAR AND SHE WAS TOLD OTHER THAN TAKING A PILL WHEN SHE GETS DIZZY TO STOP THE DIZZINESS THERE'S REALLY NOTHING THEY CAN DO. SHE HAS TO WAIT FOR IT TO GO AWAY ON ITS OWN. IT COULD TAKE UP TO A MONTH TO GO AWAY. IN THE INTERIM OBVIOUSLY SHE CAN'T DRIVE, FINDS IT VERY HARD TO DO SIMPLE THINGS SUCH AS DRESSING HERSELF, BENDING OVER, ET CETERA. ANY OTHER OPTIONS OUT THERE OR...? ANY INPUT?

Maureen says THIS ISN'T VERTIGO, IS IT?

Venita says IT'S A FORM OF VERTIGO.

Maureen says CALCIUM ON THE HAIRS IN THE EAR.

Venita says CORRECT, WE CALL THAT CANALITHIASIS OR CUPULOLITHIASI ON THE BALANCE ORGAN OF THE INNER EAR. I'D BE INTERESTED TO KNOW IF SHE WAS TOLD THAT BY AN E.N.T. PERSON OR BY SOMEONE WHO WAS NOT.

Maureen says WELL LET'S ASK. GLENNA WHO TOLD YOUR MOTHER?

The Caller says JUST HER G.P.

Venita says OKAY. THERE IS ONE OTHER THING THAT COULD BE DONE, DEPENDING UPON THE RESULTS OF PHYSICAL EXAMINATION AND YOU'VE RULED OUT THAT THERE ISN'T A STROKE OR ANY NEUROLOGICAL PROBLEM THAT HAS OCCURRED CAUSE THIS VERTIGO, THERE'S ONE MANOEUVRE THAT CAN BE DONE WHERE YOU TRY AND DISLODGE THIS CALCIUM CRYSTAL OR THIS CANALITH BY... IT'S CALLED AN EPLESE MANOEUVRE IS BASICALLY ROTATING SOMEBODY 360 degrees STARTING FROM ONE SIDE TO THE OTHER SIDE OVER A PERIOD OF ABOUT 15 MINUTES WHERE WE TRY AND DISLODGE THE CRYSTAL ITSELF.

Maureen says DO PHYSIOTHERAPISTS DO THIS?

Venita says NOT TO MY KNOWLEDGE.

Maureen says OH, OKAY. E.N.T. SPECIALISTS DO DO IT?

Venita says YES, WE DO DO THEM.

Maureen says OKAY, SO THEY SHOULD PROBABLY ASK HER G.P. FOR A REFERRAL.

Venita says CORRECT.

Maureen says TO HELP HER OUT. OKAY, THANKS VERY MUCH, GLENNA. I HAVE QUESTION HERE ABOUT STREP THROAT.

She reads from the laptop and says
"IF PENICILLIN DOESN'T WORK WHAT ELSE COULD A FOUR-YEAR-OLD TAKE?"

Venita says AGAIN, IT DEPENDS ON THE COMMUNITY THAT THIS FOUR-YEAR-OLD LIVES IN. EVERY COMMUNITY HAS DIFFERENT RESISTANCE PATTERNS TO ANTIBIOTICS.

Maureen says REALLY? GEOGRAPHIC COMMUNITY?

Venita says CORRECT, DEPENDING UPON THE USE OF ANTIBIOTICS IN THAT COMMUNITY, HOW FREQUENTLY THEY'RE USED, FOR WHAT TYPES OF ORGANISMS. SO THAT PARTLY IT WOULD BE WHAT AREA DOES THIS CHILD LIVE IN THE OTHER THING... FIRST THING IS, TO THINK ABOUT, IF THE ANTIBIOTIC PENICILLIN IS NOT WORKING IS THAT IS THIS A VIRAL INFECTION AND NOT NECESSARILY A BACTERIAL ONE.

Maureen says BUT IF IT'S STREP, IF IT'S...

Venita says OKAY, WE KNOW IT'S STREP.

Maureen says OKAY, LET'S ASSUME THAT SHE'S RIGHT.

Venita says OKAY, THERE ARE OTHER OPTIONS ANTIBIOTICS WHICH HAVE REPORTED LESS RESISTANCE TO STREPTOCOCCUS SO YOU CAN GO INTO SECOND GENERATION CEPHALOSPORINS, BIAXIN CAN ALSO BE USED. SOMETIMES SOMETHING CALLED SEPTRA WHICH IS A COMBINATION OF SULFA AND ANOTHER ANTIBIOTIC. THERE'S ANOTHER ANTIBIOTIC KNOWN AS PEDIAZOLE WHICH CAN ALSO BE USED AS SORT OF A SECOND... SOMETIMES FIRST LINE, SOMETIMES ALSO CAN BE SECOND LINE AND THAT'S RIT MICE SIN WITH SULFA.

Maureen says OH, I'VE HAD ALL THESE BOTTLES IN MY FRIDGE I THINK AT ONE TIME OR ANOTHER. SO IF REGULAR PENICILLIN ISN'T WORKING YOU GO BACK TO THE DOCTOR AND SAY IT'S NOT WORKING.

Venita says CORRECT AND THERE ARE SECOND LINE AGENTS WHICH WOULD BE EFFECTIVE.

Maureen says ALL RIGHT. MARGARET IS IN KINCARDINE HELLO MARGARET.

The Caller says HELLO THERE. I'M CALLING BECAUSE MY 10-YEAR-OLD SON, SINCE HE WAS VERY YOUNG, THREE OR FOUR, TWO OR THREE TIMES A YEAR, HE WOULD GO COMPLETELY DEAF. I WOULD TAKE HIM TO THE FAMILY DOCTOR. MOST OF THE TIMES HE WOULD SAY HIS EARS WERE PLUGGED WITH THE WAX AND IT WAS VERY HARD AND HE WOULD SEND ME TO THE EAR NOSE AND THROAT SPECIALIST TO GET THEM SYRINGED. SO THIS HAS BEEN GOING ON AND LIKE I SAID HE'S NOW TEN. AT AROUND... JUST AFTER CHRISTMAS HE WAS DEAF AGAIN, AND I TOOK HIM TO THE EMERGENCY. THEY SAID THAT THEY HAD TO SYRINGE THEM, SO THEY DID, AND A WEEK LATER HE WAS STILL DEAF, TOOK HIM TO THE FAMILY DOCTOR AND HE PUT HIM ON PENICILLIN. WE WENT BACK ABOUT A WEEK LATER BECAUSE HE STILL COULDN'T HEAR. HE TOOK HIM OFF THE PENICILLIN, PUT HIM ON THIS OTHER MEDICATION WHICH HE SAID WAS A LOT STRONGER AND IF I FOUND LIKE IT WAS CAUSING DIARRHEA AND THAT NOT TO GIVE IT TO HIM. AND IN THE MEANTIME HE WOULD MAKE AN APPOINTMENT WITH THE SPECIALIST. SO WE FINALLY WENT TO THE SPECIALIST A COUPLE WEEKS AGO. HE ASKED ME THE MEDICATIONS HE'D BEEN ON. I TOLD HIM. HE SAID WELL THERE'S NO POINT IN ANYMORE MEDICATION AND HE'S NOW SCHEDULED TO GET TUBES ON JUNE THE 4th. NOW MY QUESTION IS HE'S NEVER HAD EAR Infections LIKE ALL THESE YEARS, IT'S JUST BEEN A CASE OF THEY KEEP GETTING BLOCKED UP. THEY SAID THE WAX WAS LIKE ROCK HARD. BUT AFTER HE HAD THE LAST SYRINGING A FEW WEEKS AGO, THEN THEY SAID NOW THERE'S FLUID BEHIND THERE. NOW I DON'T KNOW IF THE SYRINGING CAUSED THAT AND... YOU KNOW, I'M JUST WONDERING WILL THE TUBES DO ANY GOOD? LIKE I'M REALLY NOT SURE.

Maureen says HMM. OKAY, CAN YOU TALK A LITTLE BIT ABOUT WHETHER TUBES ARE AN OPTION IF IT'S NOT AN EAR INFECTION BUT RATHER THE PROBLEM SHE DESCRIBES?

Venita says WITHOUT GOING INTO THE SPECIFICS, I DON'T BELIEVE THAT THE SYRINGING HAS CAUSED THE PROBLEM, AND I GUESS I'M NOT CLEAR, WHEN YOU WENT TO THE E.N.T. SURGEON, DID THEY TEST HIS HEARING?

The Caller says NO.

Venita says THEY DID NOT. DID HE TELL YOU HE SAW FLUID BEHIND YOUR CHILD'S EAR DRUM?

The Caller says YEAH, HE SAID THERE WAS A BIT OF FLUID BEHIND THERE.

Venita says OKAY, SO THAT'S THE REASON FOR THE TUBES. I THINK THOSE ARE... IT'S KIND OF TWO SEPARATE PROBLEMS THAT ARE KIND OF HAPPENING TOGETHER AND CLOUDING THINGS A LITTLE BIT. I THINK THE WAX IS A SEPARATE ISSUE, AND THE FLUID BEHIND THE EAR DRUM IS PROBABLY WHAT IS REALLY GOING ON, PROBABLY CAUSING A LITTLE BIT OF HEARING AND LOSS THEN THIS CHILD IS GETTING A BIG WAX PLUG, AND IT'S SORT OF PUSHING HIM OVER THE EDGE. SO HE PROBABLY DOESN'T NOTICED WHEN HE'S GOT A LITTLE BIT OF FLUID IN HIS MIDDLE EAR SPACE, IT PROBABLY DOESN'T COMPROMISE HIM TOO MUCH BUT THEN GETTING THIS BIG WAX PLUG, WHICH IS HARD AND PROBABLY SOCKED RIGHT UP AGAINST THE EAR DRUM, IT'S PROBABLY JUST TIPPING HIM OVER THE EDGE AND MAKING HIM COMPLETELY DEAF.

Maureen says NOW THE TUBING WILL HELP THE FLUID.

Venita says CORRECT. IT WON'T...

Maureen says REALLY HELP THE WAX.

Venita says IT WON'T HELP THE WAX PROBLEM, NO.

Maureen says ARE SOME PEOPLE PRONE TO HARD LUMPS OF WAX MORE THAN...

Venita says YES, SOME PEOPLE ARE MORE THAN EARS. OFTEN TIMES IT'S, IT'S CASES WHERE Q TIPS HAVE BEEN USED AND THE Q TIP... WHAT IT HAS DONE IS TAKEN AWAY THE WAX YOU CAN SEE BUT THERE'S MORE EAR CANAL WHERE YOU CAN'T SEE SORT OF AROUND A CORNER AND WHAT HAPPENS IS THAT WAX GETS PUSHED FURTHER BACK AND THEN THAT EAR IS UNABLE TO PUSH IT OUT BECAUSE IT'S IN A SPOT THAT IT'S NOT REALLY SUPPOSED TO BE IN AND THEN IT JUST GETS... IT DRIES OUT AND GETS HARD AND SITS THERE.

Maureen says OKAY, ALL RIGHT. THANKS MARGARET FOR YOUR QUESTION. PROBABLY THE LAST ONE WE'LL BE EIGHTH ABLE TO GET TO, TINA'S IN WINDSOR.

She reads from the laptop and says
AS A CHILD I HAD MANY THROAT INFECTIONS AND WAS ON ANTIBIOTICS. I GOT MY TONSILS OUT AT THE AGE OF 19. BEFORE THAT EVERY TIME THE WEATHER CHANGED I'D GET VERY ILL. MY SINUSES ARE ALWAYS INFLAMED DUE TO ALLERGIES AND I TAKED AVILLE SINUS MEDICINE EVERYDAY. DOES HAVING SINUS PROBLEMS CAUSE TOOTH PAIN EAR PAIN AND HEADACHES?

Venita says WELL EVERYTHING SHE'S JUST DESCRIBED CAN BE RELATED TO HAVING A SINUS PROBLEM. CERTAINLY HEADACHES CAN BE CAUSED BY SINUS INFECTIONS. WE DO HAVE FOREHEAD SINUSES AND IF THEY ARE INFECTED OR INFLAMED THEN IT CAN BE PERCENT RECEIVED AS A HEADACHE ACROSS THE TORONTO OF THE HEAD, OR THE OTHER SINUS, THE SPHENOID SINUS CAN GIVE YOU A HEADACHE AT THE BACK OF YOUR HEAD, IN FACT. THE EAR PAIN CAN ALSO BE CAUSED BY SINUS IT TUS, WHERE THE... SEE, THE LINING OF YOUR SINUSES AND THE LINING OF YOUR EUSTACHIAN TUBE IS THE SAME, IT'S MUCOSA AND IF IT'S INFLAMED IN YOUR SINUSES BECAUSE OF AN INFECTION OR WHETHER IT'S VIRAL OR BACTERIAL, CAN ALSO BE INFLAMED IN YOUR EUSTACHIAN TUBE SO CAUSE YOUR EUSTACHIAN TUBE TO FEEL PLUGGED AND GIVE PEOPLE A SENSATION OF PAIN.

Maureen says AND WHAT ABOUT THE TOOTH?

Venita says YES, BECAUSE WE DO HAVE CHEEK SINUSES, WHICH SIT SORT OF RIGHT HERE, AND IF YOU'VE GOT INFECTION SOAR PUS IN THE SINUS, IT CAN SIT RIGHT ON THE TOOTH ROOTS AND GIVE YOU INFECTION, BECAUSE THE UPPER TEETH, THE ROOTS CAN PROJECT INTO THE SINUS.

Maureen says IS OVER THE COUNTER MEDICINE ENOUGH FOR CHRONIC SINUSITIS OR SHOULD YOU BE ON GOT PARTICULARS FOR THAT?

Venita says WELL, CHRONIC SINUSITIS IS A LITTLE BIT DIFFERENT.

Maureen says OH, AND I HAVEN'T GIVEN YOU NEARLY ENOUGH TIME TO GO INTO THAT SO JUST IN GENERAL CAN YOU TAKE SINUS MEDICINE OVER THE COUNTER FOR THIS?

Venita says I DON'T RECOMMEND THAT PEOPLE DO IT FOR LONG PERIODS OF TIME BECAUSE IT CAN ACTUALLY FURTHER EXACERBATE THEIR SYMPTOMS AND MILWAUKEE THEM FEEL WORSE WITHOUT REALLY ADDRESSING THE...

Maureen says THE UNDERLYING PROBLEM. ALL RIGHT, WE'LL HAVE TO LEAVE IT THERE. THANKS VERY MUCH FOR COMING IN TODAY.

Venita says THANK YOU VERY MUCH.

Maureen says Dr. BENITA BINDLISH IS AN OTOLARYNGOLOGIST IN WINDSOR. THE CANADIAN HEARING SOCIETY HAS OFFICES IN throughout Ontario. THE PEOPLE AT THE FOLLOWING NUMBER WILL DIRECT YOU TO THE OFFICE NEAREST YOU.

A slate reads "Canadian Hearing Society, 416-964-9595, www.chs.ca."

Maureen says And that's our show for today. I'm Maureen Taylor. Thanks for watching, I hope you'll join us again. We're here Monday through Friday at 1 o'clock.

A slate reads "The advice given in the preceding program is of a general nature only. Viewers should consult their own medical professional for medical advice specific to their circumstances."

Watch: Ear, Nose And Throat