Ear tubes for a 10 month old girl?

[Jeffrey]

Our 10 month old girl started daycare in mid-March which has caused her multiple colds. About three weeks ago, her cold lead to her first ear infection and her doctor gave her two rounds (10 days, then 7 more days) of the same antibiotic (Augmentin). Our girl's cold/ear infection symptoms improved during the treatment but have since reappeared. We were referred to an ENT who recommended ear tubes to decrease the reoccurence and protect against hearing loss.

Is it prudent to operate on a 10 month old who has only had an ear infection for 3 weeks? Should a different type of antibiotic be used before resorting to surgery on a baby? Are ear tubes the only alternative?

I'm sure you can tell from my questions, I do not like this idea at all! What would you do?

[Indoor66]

Our 10 month old girl started daycare in mid-March which has caused her multiple colds. About three weeks ago, her cold lead to her first ear infection and her doctor gave her two rounds (10 days, then 7 more days) of the same antibiotic (Augmentin). Our girl's cold/ear infection symptoms improved during the treatment but have since reappeared. We were referred to an ENT who recommended ear tubes to decrease the reoccurence and protect against hearing loss.

Is it prudent to operate on a 10 month old who has only had an ear infection for 3 weeks? Should a different type of antibiotic be used before resorting to surgery on a baby? Are ear tubes the only alternative?

I'm sure you can tell from my questions, I do not like this idea at all! What would you do?

I would not hesitate to do the tubes if the ENT specialist treating her recommends. I have been there and done that back when the procedure was new and recommended for my son. Doing it was the best decision and worked out for all. He no longer had the recurring ear problems - to this day. He was about 7 months when he had the procedure.

[OZZIE4DUKE]

Our 10 month old girl started daycare in mid-March which has caused her multiple colds. About three weeks ago, her cold lead to her first ear infection and her doctor gave her two rounds (10 days, then 7 more days) of the same antibiotic (Augmentin). Our girl's cold/ear infection symptoms improved during the treatment but have since reappeared. We were referred to an ENT who recommended ear tubes to decrease the reoccurence and protect against hearing loss.

Is it prudent to operate on a 10 month old who has only had an ear infection for 3 weeks? Should a different type of antibiotic be used before resorting to surgery on a baby? Are ear tubes the only alternative?

I'm sure you can tell from my questions, I do not like this idea at all! What would you do?
I'm not a doctor and I didn't stay in a Holiday Inn Express last night, but I did ask some one who is familiar with pediatrics what they thought.

Have you talked with your pediatrician about the ENT's recommendation, and have you asked him/her if there were other antibiotics you could try? That would be a prudent first step. Perhaps a second opinion from another ENT is in order too.

Also, do either you or your wife (or child's caretaker) smoke? Children who live in a smoker's environment are more prone to ear infections.

[Jeffrey]

I would not hesitate to do the tubes if the ENT specialist treating her recommends. I have been there and done that back when the procedure was new and recommended for my son. Doing it was the best decision and worked out for all. He no longer had the recurring ear problems - to this day. He was about 7 months when he had the procedure.

Thank you for the help and advice!

[Tommac]

My son, who is 17 now, had ear tubes put in when he was 14 months old. This was after months of colds and ear infections and multiple rounds of antibiotics. The tubes did work for him but not without some problems. First you have to be diligent in using ear plugs or putty when giving a bath or when playing in pools. One of my son's tubes came out when he was 6-7. The other one remained in until he was about 13 when we had it (minor) surgically removed, based on the doctors recommendation. about 6-12 months later, the doctor discovered that the eardrum still had a hole in it. We had to have a graft procedure performed to close the hole. It appeared to work at first, but a couple of years later the hole was back. Just two months ago my son had another graft procedure to close the hole. It is the same eardrum that kept the tube for about 10-11 years. We're not sure if the tube and the subsequent holes are directly related, but he has never had any problems with the ear that the tube voluntarily fell out when 6-7 years old.

I would advise giving it a little more time, then make a decision. If this is the first ear infection, your daugher may not have any more. Out son was in daycare and seemed to catch every thing that came along. I hope I haven't confused you.

[Jeffrey]

I did ask some one who is familiar with pediatrics what they thought.

Thank you for going out of your way and doing that for us. It's most appreciated!


Have you talked with your pediatrician about the ENT's recommendation, and have you asked him/her if there were other antibiotics you could try? That would be a prudent first step. Perhaps a second opinion from another ENT is in order too.

Thanks, that's our exact plan. It'll probably take a third opinion before I accept the idea of ear tubes for a 10 month girl.


Also, do either you or your wife (or child's caretaker) smoke? Children who live in a smoker's environment are more prone to ear infections.

No smokers here. The only high risk factor, we've identified, is the daycare (large facility). My wife is still breastfeeding which is considered prudent.

[Jeffrey]

My son, who is 17 now, had ear tubes put in when he was 14 months old. This was after months of colds and ear infections and multiple rounds of antibiotics. The tubes did work for him but not without some problems. First you have to be diligent in using ear plugs or putty when giving a bath or when playing in pools. One of my son's tubes came out when he was 6-7. The other one remained in until he was about 13 when we had it (minor) surgically removed, based on the doctors recommendation. about 6-12 months later, the doctor discovered that the eardrum still had a hole in it. We had to have a graft procedure performed to close the hole. It appeared to work at first, but a couple of years later the hole was back. Just two months ago my son had another graft procedure to close the hole. It is the same eardrum that kept the tube for about 10-11 years. We're not sure if the tube and the subsequent holes are directly related, but he has never had any problems with the ear that the tube voluntarily fell out when 6-7 years old.

I would advise giving it a little more time, then make a decision. If this is the first ear infection, your daugher may not have any more. Out son was in daycare and seemed to catch every thing that came along. I hope I haven't confused you.

Tom, thank you very much! Your detailed account is very, very helpful and easy to follow.

I'm very sorry you'll have had to experience this! Unfortunately, your experiences illustrate my fears and reasons for concern. I really appreciate you making me aware of your experiences and your advice.

[devil84]

I have no problems with tubes in the ears; they were quite helpful for both of my children (now 18 and 20). My daughter got them when she was 3 or so, and hers were quite uneventful and very helpful. My son got them at age 2 or so. Similar to Tommac's son, he had one fall out and get put back in, then it left a hole. We patched the hole at age 6 or 7, and we found another hole at age 15, which then was patched over the summer before his junior year in high school (meaning he couldn't go swimming/jet skiing most of that summer -- bummer).

Tommac also has a good point about the fact that tubes require earplugs during any and all water activity. That includes nightly baths! It's a bother, but worth it for recurring infections! We did several months of recurring infections before we went for surgery.

The hindsight part is that when the child is in school, patching the eardrum isn't the best thing that can happen for his/her grades. The ear requires packing for 4-6 weeks, which means the child doesn't hear well. Not optimum for classroom learning in elementary school. Completely tragic in high school when the child is a drummer in the marching band and needs stereo hearing (and listening in AP classes, too!). We scheduled his second patch surgery at the beginning of the summer, which ruined his summer, but was the lesser of the evils.

None of this was insurmountable, and it is NOT meant to scare anyone away from tubes! The tubes helped both immensely. But given what happened with my son, I'd make good and sure you've got recurring infections before proceeding with tubes.

[Jeffrey]

But given what happened with my son, I'd make good and sure you've got recurring infections before proceeding with tubes.

Thank you very much for the detailed account! I'm very sorry to hear about your son's experiences. This is our daughter's first ear infection and I sincerely appreciate your advice. Your son's experiences justify our hesitation.

[-jk]

On the flip side: hearing loss sucks. When she was one or two, my brother-in-law's niece lost hearing in both ears from an infection and fever the parents weren't respecting enough. She's now in middle school and has implants in both ears.

By all means do get a second opinion - and even a third - but make sure you know the symptoms to look out for.

-jk

[Jeffrey]

On the flip side: hearing loss sucks. When she was one or two, my brother-in-law's niece lost hearing in both ears from an infection and fever the parents weren't respecting enough. She's now in middle school and has implants in both ears.

By all means do get a second opinion - and even a third - but make sure you know the symptoms to look out for.

-jk

Thank you for the great advice! I'm very sorry to hear about your brother-in-law's niece's lost hearing.

For us, this is a very hard decision! Ear tubes appear to be very controversial.

[Devil in the Blue Dress]

Don't know what sort of research you've had an opportunity to do on the subject of ear tubes.

I've found the Mayo Clinic's web page to be helpful on a variety of topics. Here's a link for the topic Ear Tubes. http://mayoclinic.com/health/ear-tubes/MY00601

The Duke Medical Center's Health Library may also provide some helpful information. http://www.dukehealth.org/Search?search_string=ear+tubes&search_category=library

[allenmurray]

Thank you for the great advice! I'm very sorry to hear about your brother-in-law's niece's lost hearing.

For us, this is a very hard decision! Ear tubes appear to be very controversial.

You may also want to get your second opinion from someone who did their training at a differnet time/facility/etc. There are probably a couple of different schools of thought on this within the ENT community (my own son had tonsils removed after multiple bouts of strep throat and we found that different ENTs think differently). If your second opinion comes from an ENT who did his training at the same place/time/under the same folks as the first ENT it may not really be a "second opinon" at all as they were both trained by the same group.

[Highlander]

Son was in daycare, and had chronic ear infections. It seemed like he'd get something every other week and get sent home. Augmentin or Amoxicillin both seemed to work OK for him, although Augmentin didn't require a fight for him to take. I am not a doctor, but below is my understanding.

I know that tubes are basically for very young kids. As you get older, your ear canal begins to slope towards your sinuses, allowing your ears to drain that way. For young kids this canal is essentially flat, so any fluid buildup is more likely to result in an infection. A tube allows that liquid to drain through the ear canal, preventing buildup and most infections. Left untreated, ear infections can cause deafness, and ear tubes have been credited for drastically reducing the occurance of infant hearing loss over the past 20-30 years.

The proceedure is very safe and takes less than 5-10 minutes to complete. Our son cried a good bit once he came out, slept all the way home, and was wide awake by the time we got home and showed no ill effects. He also was not required to wear ear plugs for bath or pool time; our Doctor said it was unlikely for sterilized water (or soapy water) to result in infection. He recommended plugs when he went swimming in the ocean or in freshwater.

By the time he was 3-4, both tubes had naturally worked themselves out. His cousin has had to have 3 sets of tubes; she is six and a half now.

Bottom line - don't be scared of the procedure, as it has become very common for kids under 1yr. If antibiotics won't clear up an ear infection, this is your next best alternative, unless you're willing to take him/her out of daycare. Our #2 just turned two and has had less than 3 ear infections total, but unlike our oldest he doesn't attend daycare.

[Jeffrey]

Don't know what sort of research you've had an opportunity to do on the subject of ear tubes.


Thank you very much for the assistance and links. I plan on doing as much research as possible (sick baby and career willing) during the next few days. My early findings show ear tubes are highly controversial.

[Jeffrey]

You may also want to get your second opinion from someone who did their training at a differnet time/facility/etc. There are probably a couple of different schools of thought on this within the ENT community (my own son had tonsils removed after multiple bouts of strep throat and we found that different ENTs think differently). If your second opinion comes from an ENT who did his training at the same place/time/under the same folks as the first ENT it may not really be a "second opinon" at all as they were both trained by the same group.

Very good point! Thank you very much.

[Jeffrey]

The proceedure is very safe and takes less than 5-10 minutes to complete. Our son cried a good bit once he came out, slept all the way home, and was wide awake by the time we got home and showed no ill effects.

By the time he was 3-4, both tubes had naturally worked themselves out. His cousin has had to have 3 sets of tubes; she is six and a half now.

Bottom line - don't be scared of the procedure, as it has become very common for kids under 1yr. If antibiotics won't clear up an ear infection, this is your next best alternative, unless you're willing to take him/her out of daycare. Our #2 just turned two and has had less than 3 ear infections total, but unlike our oldest he doesn't attend daycare.

Thank you very much for the detailed account of your experiences! I'm very glad to hear about your positive experiences and the speed of the procedure.

I'm more than willing to take our baby girl out of daycare. Getting my wife to stay home is another matter.

[Devil in the Blue Dress]

Thank you very much for the assistance and links. I plan on doing as much research as possible (sick baby and career willing) during the next few days. My early findings show ear tubes are highly controversial.

I may have missed this point in what you've had to say so far.... It may be helpful in making a decision to ask the ENT specialist why he/she recommended ear tubes at this time.

Ear infections can be so painful for anyone, but especially for very young children and their parents. As thorough as you are, Jeffrey, I am confident that when you and your wife make a decision on this matter, it will be what's best your little daughter.

[Lid]

We didn't have to have ear tubes for either of our kids, but my understanding is that they're not terribly controversial at this point -- if they're truly indicated. It does seem odd to recommend them so quickly, after a single infection. I have several friends/relatives who found that tubes were the only way to prevent the multiple ear infections they were struggling with. One good friend's son was about 2 when he had them, and his slight language delay was erased in the matter of a few weeks. It was startling to realize (later) how much the infections were affecting his hearing, and therefore his language development.

That said, my youngest did have several ear infections, just never one on top of another. We considered tubes, but it never got quite to that point. (I should note that my husband is a pediatrician, if that matters.) Both of my kids were in daycare from a young age, but my oldest had perhaps one ear infection ever. It's really hard to predict, and highly dependent on individual anatomy.

Definitely, the second opinion (or third) sounds warranted, and there's no reason to rush out for tubes, if antibiotics work to beat the infection.

If you feel that daycare is the problem, perhaps your wife and you could work together to stay home? Is there some reason it would be solely up to her (don't mean to pry, and feel free to ignore it, but your statement seemed a bit extreme and surprised me)?

[Jeffrey]

I may have missed this point in what you've had to say so far.... It may be helpful in making a decision to ask the ENT specialist why he/she recommended ear tubes at this time.

Ear infections can be so painful for anyone, but especially for very young children and their parents.

The ENT recommended ear tubes to get rid of the current infection (which two rounds of antibiotics have not done) and protect against hearing loss. I assume it was also to decrease the reoccurence of ear infections.


As thorough as you are, Jeffrey, I am confident that when you and your wife make a decision on this matter, it will be what's best your little daughter.

Thank you very much! Our decision is only about what's best for our baby girl. There is nothing I would not do, or give, for her!

[Jeffrey]

We didn't have to have ear tubes for either of our kids, but my understanding is that they're not terribly controversial at this point -- if they're truly indicated. It does seem odd to recommend them so quickly, after a single infection. I have several friends/relatives who found that tubes were the only way to prevent the multiple ear infections they were struggling with. One good friend's son was about 2 when he had them, and his slight language delay was erased in the matter of a few weeks. It was startling to realize (later) how much the infections were affecting his hearing, and therefore his language development.

There seems to be controversy over whether tubes should be used in regards to language development:

http://content.nejm.org/cgi/content/full/356/3/248

I haven't paid much attention to this issue since it's not our current concern. My quick review (of this and other studies) lead me to the conclusion the need for tubes (under certain conditions) is controversial.


That said, my youngest did have several ear infections, just never one on top of another. We considered tubes, but it never got quite to that point. (I should note that my husband is a pediatrician, if that matters.)

The fact your husband is a pediatrician matters to me. At what point would have your husband been in favor of tubes for your youngest? What do you think your husband would do if he were in our situation?


Definitely, the second opinion (or third) sounds warranted, and there's no reason to rush out for tubes, if antibiotics work to beat the infection.

The immediate problem is the original antibiotics did not beat the infection.


If you feel that daycare is the problem, perhaps your wife and you could work together to stay home? Is there some reason it would be solely up to her (don't mean to pry, and feel free to ignore it, but your statement seemed a bit extreme and surprised me)?

My comment was strictly based on economics. My wife's income is her fun money. My income pays all of our bills and creates financial security for all of us.
I would LOVE to stay home with our baby girl! The cost to our family would be significant.

[Lid]

There seems to be controversy over whether tubes should be used in regards to language development:

http://content.nejm.org/cgi/content/full/356/3/248

That makes sense -- I remember seeing that study, but I hear what you're saying, that language development isn't your immediate concern. I think this link (http://aappolicy.aappublications.org/cgi/content/full/pediatrics;113/5/1412) might help you, if you haven't seen it yet. It's the AAP policy statement on ear infections, basically (from 2004). It's long and detailed (but I think you'll enjoy diving in!) -- sections 4 and 9 are probably the most relevant to you, but I didn't look closely to see which parts apply to children under age 2.


The fact your husband is a pediatrician matters to me. At what point would have your husband been in favor of tubes for your youngest?

If I remember correctly (and I may not -- the glorious fact that eventually, most things pass), if he'd had 4 ear infections within 6 months, we were going to seriously consider it. He ended up tapering off with the infections soon after, and we got lucky.



The immediate problem is the original antibiotics did not beat the infection.

I'm so sorry, I read too quickly before and missed that. My husband has practiced in three different places, and one of the main regional differences (even though all are in the South) seems to be the antibiotics of choice for ear infections. There are a variety of options, and it's a bit unusual, I think, to do two rounds of the same antibiotic instead of trying another one. I'd ask about that, definitely, before you go much further. There may be a reason, but it's not been a common approach in any of the places we've lived.


My comment was strictly based on economics. My wife's income is her fun money. My income pays all of our bills and creates financial security for all of us.
I would LOVE to stay home with our baby girl! The cost to our family would be significant.
Ah, gotcha. That does complicate the matter, and I can relate. Someday we hope to be able to do dual part-time jobs and manage that way...

Good luck with this.

[greybeard]

One option that I highly recommend is noninvasive and has great efficacy--take your daughter to a Dr. of Osteopathy who specializes in cranial sacral work. The angle of the ear canals can be sufficiently altered by this work to solve the drainage issue and surgery avoided. My son had similar issues albeit less severe and at an older age than your daughter and Harold made it "all better" in a few visits. Cranial sacral treatments are completely delightful for the patient, and many people take their newborns to their osteopaths immediately after birth and regularly thereafter.

[Jeffrey]

I think this link (http://aappolicy.aappublications.org/cgi/content/full/pediatrics;113/5/1412) might help you, if you haven't seen it yet. It's the AAP policy statement on ear infections, basically (from 2004). It's long and detailed (but I think you'll enjoy diving in!) -- sections 4 and 9 are probably the most relevant to you, but I didn't look closely to see which parts apply to children under age 2.

Thank you very much! I'll definitely look over the policy statement, when time avails.


If I remember correctly (and I may not -- the glorious fact that eventually, most things pass), if he'd had 4 ear infections within 6 months, we were going to seriously consider it.

That seems much more logical to me than the first ear infection.


My husband has practiced in three different places, and one of the main regional differences (even though all are in the South) seems to be the antibiotics of choice for ear infections. There are a variety of options, and it's a bit unusual, I think, to do two rounds of the same antibiotic instead of trying another one. I'd ask about that, definitely, before you go much further. There may be a reason, but it's not been a common approach in any of the places we've lived.

Thank you very much for the antibiotics information. It's in harmony with my suspicion and supports what I've already done.

It seemed logical to me (not that I know anything about medicine) that different types of antibiotics would have different success rates with a specific bacteria. After the first round, I requested a different type but our doctor wanted to use Augmentin a second time because she felt it had made some progress during the first round. Today, I strongly requested (while staying polite) a different type of antibiotic and we were prescribed Vantin. I/we want to give Vantin a chance before moving forward with any other alternative.

[Jeffrey]

One option that I highly recommend is noninvasive and has great efficacy--take your daughter to a Dr. of Osteopathy who specializes in cranial sacral work. The angle of the ear canals can be sufficiently altered by this work to solve the drainage issue and surgery avoided. My son had similar issues albeit less severe and at an older age than your daughter and Harold made it "all better" in a few visits. Cranial sacral treatments are completely delightful for the patient, and many people take their newborns to their osteopaths immediately after birth and regularly thereafter.

Thank you very much for an alternative approach! That's a concept I would definitely entertain and my wife would definitely not.

I have a ruptured disc in my lower back and surgery was recommended. Instead, I've utilized the McKenzie method with sufficient success. OTOH, my brother has had back surgery twice with minimal hesitation. My brother now plays golf. I wouldn't even consider doing such.

[bjornolf]

My wife was a little older when she got a tube in one ear. It was removed many years ago, but her hearing is MUCH worse in the ear that had the tube. Like, if I'm listening to the TV and she has her good ear up, she can't fall asleep. If she turns the other ear up, a freight train could go through and she'd snore right through it. She's not DEAF in that ear, but her hearing definitely isn't good on that side.

I had ear infections for years, but despite the doctor's advice, my mother had read some horrible reports about them and refused them. Turned out I was eating foods I was allergic too, which was cause me to get toncilitis, which cause swelling in my ear canals. When we figured that out and I stopped eating those foods, my infections stopped. Maybe you should get your daughter tested for food allergies?

Also, is it possible that someone in the daycare is smoking? Even smoke on clothing can have adverse affects like this.

I'd look into alternative treatment and maybe get a second opinion from another ENT before taking the rather drastic step of getting tubes put in.

[greybeard]

Thank you very much for an alternative approach! That's a concept I would definitely entertain and my wife would definitely not.

I have a ruptured disc in my lower back and surgery was recommended. Instead, I've utilized the McKenzie method with sufficient success. OTOH, my brother has had back surgery twice with minimal hesitation. My brother now plays golf. I wouldn't even consider doing such.

Not either or, and changing the declination of the ear canals in an infant is a piece of cake for a skilled practitioner. You have a lifetime to load your kid up with antibiotics. If ear aches become a problem, a visit to an osteopath might change that. Less ear aches, less antibiotics. Your wife is against this. Must be related to mine.

Never heard of the McKenzie method; I'm a Feldenkrais man myself. If you are interested in discovering how to learn to use your body differently to avoid difficulties that the ruptured disc might present, my guy Moshe and his body of work are nothing to sneeze at, and the lessons the work comprises are fun and interesting. Learning to become aware of what we do that is habitual is a developed skill, and then developing options, real choice about such matters, is actually quite rewarding in my experience.

You might keep in mind the following: the muscles of the belly, which flex your torso, work easiest, most effectively and comfortably, when the muscles of the back, which are erector muscles, are most devoid of constriction, that is, when they are relaxed. Most concepts around protecting the back involve straightening the spine and holding firm with the erector muscles and constricting your rib cage. Doing that makes movement, getting up or turning, imponderably more difficult, and creates overload in the erector muscles to boot, which will end up aching at the end of the day due to such overwork. Learning how to reduce the residual tension in your back muscles (no not by stretching), to soften your ribs and allow your sternum to sink, will improve the ease on your back in getting in and out of chairs and up from lying down. It will also help free up your pelvis which will permit you to ambulate, either walking or crawling after your kid, with much greater ease and strain on your back.

Yeah I know, not what your orthopod told you. What do they know about how the body moves most effectively? Do they study that? Where?

[arydolphin]

Jeffrey,
I finished my pediatric residency last June, and am now working in a Pediatric ER. You've already gotten a bunch of good information from others in this thread. I'll just add a few quick things, and if you have other questions, just PM me and we can go from there. In short, a surgery for ear tubes is one of the most common surgeries that an ENT doctor can do, and one of the shortest as well. However, in my experience, that type of surgery is done on kids with recurrent ear infections, not one persistent infection. Also, while Augmentin is a pretty good drug for ear infections, my first choice if a kid was not responding to Augmentin would be to switch antibiotics after a full course of the antibiotic, not just add on more days of the same antibiotic. For what it's worth, my first-line choice for ear infections in Amoxicillin, and Augmentin is a combination medication that contains Amoxicillin; if a kid doesn't respond to Amox, I usually step up to Augmentin. The particular organism that was causing the infection may have not responded well to Augmentin for some reason.

One other thing: did your child start to have fevers again after completing the course of Augmentin? A child of that age will have some fluid behind their tympanic membranes whenever they have a cold (aka upper respiratory infection, or URI), but that fluid doesn't necessarily mean that they have an ear infection. The fluid can build up due to nasal congestion that is part of a URI, which can lead to an ear infection after the URI starts. Of course, it's hard to specifically talk about your child when I can't see her, but I ask about the fever to try to figure out whether it's a new infection, or whether she has continued to have nasal congestion from the previous infection.

Anyways, there's no problem in going back to your pediatrician and saying that the ENT recommended surgery, but that you're not comfortable with that. You could also ask about another ENT group to see your daughter as well. Feel free to PM me with other questions if you have them, and have a great night.

[Jeffrey]

Maybe you should get your daughter tested for food allergies?

Also, is it possible that someone in the daycare is smoking? Even smoke on clothing can have adverse affects like this.

I'd look into alternative treatment and maybe get a second opinion from another ENT before taking the rather drastic step of getting tubes put in.

Thank you very much! I appreciate your insight and advice. We will not be making a rushed decision, since we have the benefit of time. I will definitely give more thought to the food allergy and daycare smoking possibilities you kindly mentioned.

[Jeffrey]

Not either or, and changing the declination of the ear canals in an infant is a piece of cake for a skilled practitioner. You have a lifetime to load your kid up with antibiotics. If ear aches become a problem, a visit to an osteopath might change that. Less ear aches, less antibiotics. Your wife is against this. Must be related to mine.

Yes, she is, and they could be.


Never heard of the McKenzie method; I'm a Feldenkrais man myself. If you are interested in discovering how to learn to use your body differently to avoid difficulties that the ruptured disc might present, my guy Moshe and his body of work are nothing to sneeze at, and the lessons the work comprises are fun and interesting. Learning to become aware of what we do that is habitual is a developed skill, and then developing options, real choice about such matters, is actually quite rewarding in my experience.


Thank you very much for an alternative approach. After resolving my more important concern (my girl's ear infection issue), I'd love to discuss this further with you. We could start another thread (hopefully next week) or exchange PM's (whichever you'd prefer).

Until then, here's a McKenzie link:

http://www.mckenziemdt.org/robin.cfm

[Jeffrey]

Jeffrey,
I finished my pediatric residency last June, and am now working in a Pediatric ER.

Mere thanks cannot fully display how much I appreciate your help and assistance with our precious little one! Nevertheless, thank you very much!


I'll just add a few quick things, and if you have other questions, just PM me and we can go from there.

Thank you very much for the very kind offer! I will gratefully send you a PM or proceed with this thread (your choice).


However, in my experience, that type of surgery is done on kids with recurrent ear infections, not one persistent infection. Also, while Augmentin is a pretty good drug for ear infections, my first choice if a kid was not responding to Augmentin would be to switch antibiotics after a full course of the antibiotic, not just add on more days of the same antibiotic.

Thank you for confirming both of my suspicions. Neither (ear tubes for first infection and not changing antibiotics after the first round was unsuccessful) seemed logical to me, but I'm ignorant on the subject.


For what it's worth, my first-line choice for ear infections in Amoxicillin, and Augmentin is a combination medication that contains Amoxicillin; if a kid doesn't respond to Amox, I usually step up to Augmentin. The particular organism that was causing the infection may have not responded well to Augmentin for some reason.

We started Vantin last night. What are your views on Vantin for this purpose?


One other thing: did your child start to have fevers again after completing the course of Augmentin? A child of that age will have some fluid behind their tympanic membranes whenever they have a cold (aka upper respiratory infection, or URI), but that fluid doesn't necessarily mean that they have an ear infection. The fluid can build up due to nasal congestion that is part of a URI, which can lead to an ear infection after the URI starts. Of course, it's hard to specifically talk about your child when I can't see her, but I ask about the fever to try to figure out whether it's a new infection, or whether she has continued to have nasal congestion from the previous infection.

I'll call my wife and get her recall on this, since all of the doctor visits are starting to blend together in my mind. I want to make sure my recall is correct.


Feel free to PM me with other questions if you have them, and have a great night.

Thanks again for your kindness and generosity! All the best to you & yours!

[allenmurray]

I have a ruptured disc in my lower back and surgery was recommended. Instead, I've utilized the McKenzie method with sufficient success. OTOH, my brother has had back surgery twice with minimal hesitation. My brother now plays golf. I wouldn't even consider doing such.

After struggling with my back for a number of years, my GP referred me to a orthopedist. Because of her conservative approach (which I appreciate) she sent me to a back doctor who is not a surgeon and who specializes in non-surgical approaches to back problems. He looked at my MRI, did a thorough exam, took me through some exercises and posture positions in his office, and then said, (I'm not sure it will make it through the filters) "I can dick around with this if you want, but if you want it fixed you'll need surgery." Having the surgery reccomended by someone who specializes in non-surgical approaches made me feel far better about the surgery. As I was coming out of the anethsesia I could tell it was "fixed". Two months later (after working hard with my PT) I could barely remember the pain I had lived with for six years.

Don't discount surgery. But having it reccomended by someone who tries to avoid surgery will make you feel a lot better about going into it.

[Jeffrey]

One other thing: did your child start to have fevers again after completing the course of Augmentin? A child of that age will have some fluid behind their tympanic membranes whenever they have a cold (aka upper respiratory infection, or URI), but that fluid doesn't necessarily mean that they have an ear infection. The fluid can build up due to nasal congestion that is part of a URI, which can lead to an ear infection after the URI starts. Of course, it's hard to specifically talk about your child when I can't see her, but I ask about the fever to try to figure out whether it's a new infection, or whether she has continued to have nasal congestion from the previous infection.

My wife's recall is the same as mine. The second round of Augmentin ended on May 1st. On the evening of May 5th, our baby started running a slight fever (around 101 degrees) and we took her back to her doctor on the morning of May 6th. Our pediatrician said her ears looked the same as they had during the two previous visits and thus sent us to an ENT. It was at this visit (May 6th) when I questioned whether her ears looked the same as they had during the two previous visits (during the second office visit, our pediatrician said one side had improved which was her justification for prescribing the same antibiotic a second time). Our pediatrician said, "I think I made a mistake before when I said one side had improved. I think they've looked the same each time and I just got the two sides confused before". That's when I strongly requested a different antibiotic.

Thanks again for the help.... we need it! :)

[Jeffrey]

After struggling with my back for a number of years, my GP referred me to a orthopedist. Because of her conservative approach (which I appreciate) she sent me to a back doctor who is not a surgeon and who specializes in non-surgical approaches to back problems. He looked at my MRI, did a thorough exam, took me through some exercises and posture positions in his office, and then said, (I'm not sure it will make it through the filters) "I can dick around with this if you want, but if you want it fixed you'll need surgery." Having the surgery reccomended by someone who specializes in non-surgical approaches made me feel far better about the surgery. As I was coming out of the anethsesia I could tell it was "fixed". Two months later (after working hard with my PT) I could barely remember the pain I had lived with for six years.

Don't discount surgery. But having it reccomended by someone who tries to avoid surgery will make you feel a lot better about going into it.

Thank you very much for the detailed account of your experiences! I'll heed your appreciated advice.

[moonpie23]

After struggling with my back for a number of years, my GP referred me to a orthopedist. Because of her conservative approach (which I appreciate) she sent me to a back doctor who is not a surgeon and who specializes in non-surgical approaches to back problems. He looked at my MRI, did a thorough exam, took me through some exercises and posture positions in his office, and then said, (I'm not sure it will make it through the filters) "I can dick around with this if you want, but if you want it fixed you'll need surgery." Having the surgery reccomended by someone who specializes in non-surgical approaches made me feel far better about the surgery. As I was coming out of the anethsesia I could tell it was "fixed". Two months later (after working hard with my PT) I could barely remember the pain I had lived with for six years.

Don't discount surgery. But having it reccomended by someone who tries to avoid surgery will make you feel a lot better about going into it.

that being said, don't ever NOT get a second or 3rd opinion before you DO elect to have surgery (either on yourself or your child)

i too had back pain that progressed over a period of a couple of months. When i was finally convinced it was just that i had "thrown my back out", I went to an orthopedic clinic. The doctor i saw took x rays and came in to tell me i had blah-de-blah, and that he was going to TRY some steroids, but if that didn't help, it was going to require surgery.

I got the script for the steroids two days before christmas 2007. By christmas day, i could not stand straight up, and spent christmas and the week following in a chair due to excruciating pain.

on my return to raleigh, i called the doctor to inquire how long i should expect the steroids to kick in and bring me some relief. he said, "come on back in and we'll get you set up for surgery".......

when i went in, i was left waiting in the waiting room in pain so bad, other patients were saying i could go AHEAD OF THEM.....i was called into the exam room and made to wait ANOTHER 30 min before a NURSE PRACTITIONER came in to see me. I was so angry, i told them to give me my x-rays and that i was going somewhere else. (which they did)

a friend of mine suggested that i see a chiropractor. I was in so much pain, i agreed to anything. I called to get an appt (at a duke approved chiro) and was told i could come in that afternoon...

I went in, he said, "well, you've got blah de blah" and we can get you started on your treatment today.....They gave me the hot towel on the back while getting the little electro-muscle stimulator thing on the base of my spine and then i went in for my "adjustment"

long story short......he fixed it....i mean he FIXED it that day....i stood up, i walked out under my own power.....it still hurt, but NOTHING like when i had walked in...

three weeks later, i was pain-free and on a 4-6 week adjustment schedule.

I'm not sayin...........i'm just sayin....:eek:

[bjornolf]

Chiropracters are awesome. The problem is finding one that's good. Many of them are quacks and/or hacks. We had a guy out in California that was UNBELIEVABLE. He was this little japanese guy, but he was REALLY aggressive in his treatment, and he could turn you into a pretzel in seconds, but when he was done, you felt GREAT. He was amazing. My parents used to fly out to California, one of the main reasons of their trip being to see him.

[cspan37421]

http://www.chirobase.org/12Hx/mencken.html

[Cavlaw]

I was a perfect candidate for tubes when I was a kid, as I had a TON of inner ear infections (more than a dozen before I was 10).

My parents, a dentist and an ER nurse, were resistant to having them put in, and I'm glad for it. The thought just creeps me out. It was a near thing, though, and they now say a few more and they would have done it. Fortunately, they were very diligent in getting me in to the doc straightaway every time I got one, so it was treated and I never suffered any noticable hearing loss. My iPod has been far worse for that.

They did have the advantage, though, of the ear infections not starting until I was old enough to express that I had pain in my ear. It would have been more difficult for them to be appropriately diligent about it had I been only 10 months and limited to crying without explanation.

[unexpected]

I had ear tubes placed in my ears when i was about 7 years old. I still remember going to the hospital and getting them put in. In 1991, you still had to go under fully- it was not an outpatient procedure like it is now.

I loved them- they fully stopped my ear infections until I had them taken out when I was 13. I was allowed to shower without earplugs, but I always went swimming with ear plugs. I actually rather enjoyed that actually. I hate the feeling of water in my ears, and as I was on a swim team, it helped me focus.

When I got them removed at 13, I started having ear infections again. From the ages of 13-23, I had SEVENTEEN ear infections. Anytime I got sick, a cold, minor congestion, anything, I would get an ear infection. The doctor recommended to my parents that they put the ear tubes back in, but my parents decided not to. By this point, I had gotten so good at self-diagnosing my ear infections, that I only had discomfort for 1-2 days, so it wasn't a big deal.

When I got them removed, I also had the same problem with the perforation in my ear drum for a little while. The pain for that was HORRIBLE.

[OZZIE4DUKE]

I had ear tubes placed in my ears when i was about 7 years old. I still remember going to the hospital and getting them put in. In 1991, you still had to go under fully- it was not an outpatient procedure like it is now.

I loved them- they fully stopped my ear infections until I had them taken out when I was 13. I was allowed to shower without earplugs, but I always went swimming with ear plugs. I actually rather enjoyed that actually. I hate the feeling of water in my ears, and as I was on a swim team, it helped me focus.

When I got them removed at 13, I started having ear infections again. From the ages of 13-23, I had SEVENTEEN ear infections. Anytime I got sick, a cold, minor congestion, anything, I would get an ear infection. The doctor recommended to my parents that they put the ear tubes back in, but my parents decided not to. By this point, I had gotten so good at self-diagnosing my ear infections, that I only had discomfort for 1-2 days, so it wasn't a big deal.

When I got them removed, I also had the same problem with the perforation in my ear drum for a little while. The pain for that was HORRIBLE.
I suggest you read greybeard's post, #23, above and perhaps look into it if you are still having problems with ear infections.

[diablesseblu]

I suffered mightily for years from very painful ear infections. This was in the days before tubes so that wasn't a treatment option.

After three different bouts of my having an eardrum lanced to relieve pressure (once with no anesthesia), my parents were at wits end. However, my pediatrician and ENT doc were not on the same page about how to proceed.

Thankfully, the ENT surgeon prevailed. He insisted on removing my adenoids and I never had another infection.

I have wondered for years if the increase in repeat ear infections is partially because that the once common "T&A surgery" is rarely done now. I know....most people reading that term today would think of other body parts.
:)

[bjornolf]

I had food allergies, and for some reason, every time I ate one of the foods I was allergic to, I got tonsilitis and sometimes an ear infection. By the time they figured out it was my food allergies and I stopped eating those foods, my tonsils were such a mess that I still got tonsillitis more often than I should have. When they finally took out my tonsils a couple years later, I stopped having problems with my food allergies, and I stopped getting ear infections. It was great! Of course, that doesn't always work that way.

[greybeard]

A word about your daughter's standing and walking. She's done a pretty fabulous job figuring lots of movement things out on her own through now. My man Moshe would say do not be intrusive now. That would mean if you support her in standing, do so in as neutral, soft a way as you can, letting her loose and regain her balance within the safety of keeping her up, on those occasions when letting her fall would not work. Definitely do not interfere with her walking experiences. Absolute worst, is to hold her by the hands with arms extended over her head and encourage a walk by moving one arm forward. Who walks like that? Nobody that's who? Her ability to figure things out just got terribly more complicated and somewhat stultified.

If you watch your daughter through her acquisition of physical skills, how things pop up out of time playing in space, you have some inkling into a major theme in the body of work that the Feldenkrais Method comprises.

[Ima Facultiwyfe]

How is the baby today? Did the second antibiotic do the trick? I sure hope she was happy and perky for Mothers' Day and that you don't have to resort to the tubes.
Love, Ima

[Jeffrey]

My parents, a dentist and an ER nurse, were resistant to having them put in, and I'm glad for it.

They did have the advantage, though, of the ear infections not starting until I was old enough to express that I had pain in my ear. It would have been more difficult for them to be appropriately diligent about it had I been only 10 months and limited to crying without explanation.

Thanks for joining the thread.

We're also resistant but you mention our biggest obstacle... our 10 month old baby appears miserable and cannot express why in words.

[Jeffrey]

A word about your daughter's standing and walking. She's done a pretty fabulous job figuring lots of movement things out on her own through now. My man Moshe would say do not be intrusive now. That would mean if you support her in standing, do so in as neutral, soft a way as you can, letting her loose and regain her balance within the safety of keeping her up, on those occasions when letting her fall would not work. Definitely do not interfere with her walking experiences. Absolute worst, is to hold her by the hands with arms extended over her head and encourage a walk by moving one arm forward. Who walks like that? Nobody that's who? Her ability to figure things out just got terribly more complicated and somewhat stultified.

If you watch your daughter through her acquisition of physical skills, how things pop up out of time playing in space, you have some inkling into a major theme in the body of work that the Feldenkrais Method comprises.

A friend of mine recently inquired about my favorite age. I said now, mainly because of our baby. Living life again, through her & her actions, is amazing.

Observation has become my primary hobby. Everything I've noticed fully supports all of your statements. I would love to hear more about the Feldenkrais Method.

[Jeffrey]

How is the baby today? Did the second antibiotic do the trick? I sure hope she was happy and perky for Mothers' Day and that you don't have to resort to the tubes.
Love, Ima

Thank you very much for asking! Our baby girl does not seem to be significantly improving and the second antibiotic appears to be more of a relief than cure. She still has substantial congestion.

How's your baby girl? I think about her often and loved her kind card.

[Ima Facultiwyfe]

She's a school teacher, in fact. Truth is we've had another setback as of last night. More fever, more cultures, more drains. But, she's able to keep food down now, so she's stronger for the fight.

I certainly have empathy for your little one and her ears. We've gone that route in our family for a couple of generations. Never went as far as the drains. Our conservative pediatrician tried everything he could first and it never became a necessity. There were times when we really gave it very serious consideration, though. It's so hard making decisions for others.....especially if they ARE our own little ones we love so very much.

I'm thinking of you and yours. You sound like such a loving person, I 'm confident you'll make the right decision after digesting all the facts.
Love, Ima

[Jeffrey]

She's a school teacher, in fact. Truth is we've had another setback as of last night. More fever, more cultures, more drains. But, she's able to keep food down now, so she's stronger for the fight.

I certainly have empathy for your little one and her ears. We've gone that route in our family for a couple of generations. Never went as far as the drains. Our conservative pediatrician tried everything he could first and it never became a necessity. There were times when we really gave it very serious consideration, though. It's so hard making decisions for others.....especially if they ARE our own little ones we love so very much.

I'm thinking of you and yours. You sound like such a loving person, I 'm confident you'll make the right decision after digesting all the facts.
Love, Ima

I predict my 10 month old will be considered my baby girl forever, just like I suspect you consider your girl. Interestingly, my wife was a school teacher and now is a school administrator.

I'm so sorry all of you'll are going through this horrible experience. I think about you'll often and eagerly await the, extremely ovedue, good news. I only wish there was something I could do to help.

Thank you, very much, for all the kind words and thoughts! They're greatly appreciated.

[Indoor66]

Jeffrey, I think you are a very nice man.

[Jeffrey]

Jeffrey, I think you are a very nice man.

Thank you, very much, for the kind words. They're most appreciated.

I also hold you in very high regard!

[Indoor66]

Thank you, very much, for the kind words. They're most appreciated.

I also hold you in very high regard!

Thank you.

[Jeffrey]

Thanks to everyone who participated on this thread. Your assistance has been very helpful.

Just got back from the pediatrician and I'm thrilled to report that our baby girl's ear infection is gone. It seems that she was battling allergies and an ear infection which is why she's still congested. I cannot put into words our level of relief and happiness.

Hope all of you have as good of a day as we are.

[DukieInKansas]

Thanks to everyone who participated on this thread. Your assistance has been very helpful.

Just got back from the pediatrician and I'm thrilled to report that our baby girl's ear infection is gone. It seems that she was battling allergies and an ear infection which is why she's still congested. I cannot put into words our level of relief and happiness.

Hope all of you have as good of a day as we are.

YEAH! I hope the allergies disappear quickly.

[Reisen]

Any more ear infections?

We're about to have our first, and I'm reading up on baby threads :-)

[Jeffrey]

Any more ear infections?

We're about to have our first, and I'm reading up on baby threads :-)

I suspect she will have ear infections as long as she is in daycare.

However, the ear tubes are great and have enabled her ears to drain. She can now beat an ear infection without antibiotics.

Congrats on the soon to arrive! Greatest experience of my life!

[Reisen]

Yeah, I'm a little worried about the daycare thing. I've heard mixed reviews. One thing I did hear, though, was that your kid will get sick basically every other week for the first year, maybe 18 months, but will then develop "super-immunity". One coworker was saying that after 18 months of daycare, her kid didn't get sick for 3 years straight!

[summerwind03]

She's a cutie.

Yeah, I think the studies show that kids in day care get sick a lot when they're young, but then don't get sick much once they start school. Kids who aren't in day care, don't get sick as much when they're young, but are sick a lot once they start school. Pick your poison.

[DukieInKansas]

Reisen - congratulations on the impending arrival of your first child.

Jeffrey - I'm glad the tubes worked. She is a cutie!

[Clipsfan]

Jeffrey - that is a very cute girl!

My 11 month old had her first ear infection 11 days ago and just finished her course of Amoxycillin yesterday, and while I haven't been back to the doctor to confirm yet, she seems to be better. She had started day care about a month ago and has been sick since the very beginning. I'd been warned about such and so wasn't surprised but it's still rough, especially as she's been sharing her illnesses. I found this thread very informative and will make sure to keep a close eye on my little girl's ear. Thanks to everyone who posted all the useful information.

[Indoor66]

You have a beautiful daughter, Jeffry. Cherish every moment - the time will fly by.

[OZZIE4DUKE]

I suspect she will have ear infections as long as she is in daycare.

However, the ear tubes are great and have enabled her ears to drain. She can now beat an ear infection without antibiotics.

Congrats on the soon to arrive! Greatest experience of my life!
She's a cutie for sure! Red hair and pouty lips - as the father of a former beautiful child (now a beautiful woman with her own 2-week old cutie :D), you're in for a wonderful, if sometimes frightening, adventure! Get your shotgun ready, and read the 8 rules for dating my daughter email :eek: - it was posted here years ago and I think repeated last year (?).

[Clipsfan]

She's a cutie for sure! Red hair and pouty lips - as the father of a former beautiful child (now a beautiful woman with her own 2-week old cutie :D), you're in for a wonderful, if sometimes frightening, adventure! Get your shotgun ready, and read the 8 rules for dating my daughter email :eek: - it was posted here years ago and I think repeated last year (?).

Congratulations Ozzie on the new grandchild. I'm going to look up that rules of dating my daughter now...

[Jeffrey]

Thanks, to all, for the kind words about our bundle of joy!

[Jeffrey]

....read the 8 rules for dating my daughter email :eek: - it was posted here years ago and I think repeated last year (?).

Thanks for the advice. Does anyone have a link?

Congrats, again, on your new bundle of joy. Must be really great to be a grandfather. You can spoil your grandchildren and when they start to act up, you can give them back to their parents. :D

[DukieInKansas]

Thanks for the advice. Does anyone have a link?

Congrats, again, on your new bundle of joy. Must be really great to be a grandfather. You can spoil your grandchildren and when they start to act up, you can give them back to their parents. :D

This is also a ploy available to aunts & uncles.

[DukieInKansas]

Found on wikipedia: http://en.wikipedia.org/wiki/8_Simple_Rules
from W. Bruce Cameron's book 8 Simple Rules for Dating My Teenage Daughter.

The rules are:

Use your hands on my daughter and you'll lose them after.
You make her cry, I make you cry.
Safe sex is a myth. Anything you try will be hazardous to your health.
Bring her home late, there's no next date.
If you pull into my driveway and honk, you better be dropping off a package because you're sure not picking anything up.
No complaining while you're waiting for her. If you're bored, change my oil.
If your pants hang off your hips, I'll gladly secure them with my staple gun.
Dates must be in crowded public places. You want romance? Read a book.


And here are another set: http://www.davesdaily.com/funpages/10_rules_for_dating_my_daughter.htm This one adds 2 rules and expands on the above 8.

[Jeffrey]

This is also a ploy available to aunts & uncles.

Thanks for the warning! :D

[Jeffrey]

Found on wikipedia: http://en.wikipedia.org/wiki/8_Simple_Rules
from W. Bruce Cameron's book 8 Simple Rules for Dating My Teenage Daughter.

The rules are:

Use your hands on my daughter and you'll lose them after.
You make her cry, I make you cry.
Safe sex is a myth. Anything you try will be hazardous to your health.
Bring her home late, there's no next date.
If you pull into my driveway and honk, you better be dropping off a package because you're sure not picking anything up.
No complaining while you're waiting for her. If you're bored, change my oil.
If your pants hang off your hips, I'll gladly secure them with my staple gun.
Dates must be in crowded public places. You want romance? Read a book.


And here are another set: http://www.davesdaily.com/funpages/10_rules_for_dating_my_daughter.htm This one adds 2 rules and expands on the above 8.

Thanks...... I'm going to post these on our front door when my daughter turns 13!

[OZZIE4DUKE]

Thanks...... I'm going to post these on our front door when my daughter turns 13!
13? Thar'll be WAY to late. Try when she is 9. :eek:

[Jeffrey]

13? Thar'll be WAY to late. Try when she is 9. :eek:


Thanks for helping us make a very hard decision. It's official..... she'll be homeschooled.

[greybeard]

You might want to consult an osteopathic physician (yes they have medical licenses, DO instead of MD but the same hard science background) who is highly skilled in cranial-sacral osteopathy.

The bones of the skull move, especially in infants, and the angle of ear canals can be improved with such subtle manipulations. If you are in the DC area, Harold Goodman in Silver Spring, Md is your man. Good luck.