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Dr. SH
Dr. SH, Board Certified Physician
Category: Medical
Satisfied Customers: 8796
Experience:  Doctor of Medicine
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hi there I was feeling unwell for a couple of months. Felt

Resolved Question:

hi there
I was feeling unwell for a couple of months. Felt like I had mild flu all the time and my ear was popping occasionally. I was put on antibiotics followed by a 10 day course of steroids which seemed to help and I felt 80% better.
Last weeks I woke up and my symptoms have returned. My doctor put me on penicillin which seemed to improve my symptoms for a few days but now returned again. My ear popping really badly now when I blow out. I went to see an ENT specialist who said my sinuses clear and no middle ear infection. He felt that it may be my tonsils as they are quite enlarged?? This could be causing blocked inner ear?
He suggested another two week course of steroids as this may help completely rid any infection that lingering??
Submitted: 2 years ago.
Category: Medical
Expert:  Dr. SH replied 2 years ago.
Dr. Shahzad MD :

Hi there. Thank you for your question. I will be helping you out with your queries

Dr. Shahzad MD :

Actually, what I think is happening is

Customer:

hi

Dr. Shahzad MD :

that, as you may also know, there is a tube that connects the ear to the throat which is called as the eustachian tube. This tube usually gets blocked when there is an infection of the throat. Sometimes, even when the infection settles the opening of the tube in the throat is swollen and blocked which is what causes the symptoms that you are having.

Customer:

ok so that may explain when I had the same problem for a week in June it hurt to swallow

Dr. Shahzad MD :

So basically steroids are given not for the infection but to reduce the inflammation to help opening up the tube.

Dr. Shahzad MD :

Yes exactly

Dr. Shahzad MD :

Hurting to swallow is a classical symptom.

Customer:

so hence the steroids made me feel better

Dr. Shahzad MD :

Exactly.

Customer:

I have not had the hard to swallow over last couple of months

Customer:

I felt really ill and spaced out for 8 weeks

Customer:

also my snoring was horrendous

Customer:

and the snoring returned since I feel ill

Customer:

get like hot flushes

Customer:

describe myself as feeling constantly under the weather but not bed bound

Dr. Shahzad MD :

ok

Customer:

so enlarged tonsils can block eustacian tube?

Customer:

even though no sore throat?

Customer:

seemed weird to me??

Dr. Shahzad MD :

But I also think that you should be on some kind of decongestant as well like pseduephedrine or xylometazoline nasal spray as well.

Customer:

been on that for 2 months

Customer:

and steam

Customer:

think it helps a little

Dr. Shahzad MD :

The inflammation associated with enlarged tonsils may not be limited to the tonsils.

Dr. Shahzad MD :

It may be in the back of the throat as well where the tube opens.

Customer:

could be an infection?

Dr. Shahzad MD :

It could be a mild infection, yes,which is causing the blockage of the tube and causing your symptoms.

Customer:

and this can keep recurring and last for weeks?

Customer:

thought I had got rid of it!!

Customer:

Starting to get me down

Dr. Shahzad MD :

There is another thing called as eustachian tube dysfunction, which if diagnosed requires placing a tube in the ear called as the grommet tube.

Dr. Shahzad MD :

In eustachian tube dysfunction these symptoms that you are having are persistent and require placing this small tube in the ear

Dr. Shahzad MD :

Here is an image of the grommet tube

Dr. Shahzad MD :

So if your symptoms persist even after steroid therapy you may require this tube to be placed.

Customer:

ok my consultant seemed to think removing my tonsils was the option

Customer:

but he wanted to do a two week course of steroids to try and blast it as he said

Customer:

then if steroids don't work out with tonsills

Dr. Shahzad MD :

Well, if your tonsil are really very large, which obviously he would know better since he examined you, then removal of tonsils will help yes.

Customer:

find it weird as do not have sore throat

Customer:

he said there whoppers

Dr. Shahzad MD :

oh ok

Dr. Shahzad MD :

then they should be removed.

Dr. Shahzad MD :

Particularly if you do not respond to steroids.

Customer:

would you agree another course of steroids good call before surgery?

Customer:

and why would penicillin not work?

Dr. Shahzad MD :

Yes

Dr. Shahzad MD :

I agree

Dr. Shahzad MD :

Penicillin is an antibiotic.

Dr. Shahzad MD :

There may be inflammation but the infection may not be a very prominent feature.

Customer:

ok

Dr. Shahzad MD :

Additionally, quite often these infections are viral and antibiotics do not work in viral infections.

Customer:

the consultant said I would probably feel better while on the steroids but its how I feel when I am off them will be deciding factor??

Customer:

apparently they not for the long term?

Dr. Shahzad MD :

no

Dr. Shahzad MD :

they are only given for short term only

Customer:

so that is why I felt better after first course but then it returned?

Customer:

he said there a good chance a second course will clear it up?

Dr. Shahzad MD :

Yes

Dr. Shahzad MD :

There is a good chance that it will clear up this time and not come back or at least not come back for a good period of time.

Customer:

ok he felt that a 10 day course may have been a little to short and so this time two weeks

Customer:

final question is the two weeks ok for steroids?

Dr. Shahzad MD :

Yes

Dr. Shahzad MD :

Two weeks is okay for steroids.

Customer:

ok thanks

Dr. Shahzad MD :

You are most welcome
Wish you all the best.
I would appreciate it if you rate me by clicking on one of the smilies below.
Kindest regards

Customer:

will do

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