Ellen’s Ear
Posted on Monday, June 8th, 2009 at 7:13 amEllen’s Ear
Ellen’s ear still has the perforation. We went to see Dr. Holson for a physical as part of enrolling in Glenridge. Ellen’s ear had been bothering her off and on with what she called “seeping” or “still moisture there.” Dr. Holson took a look…couldn’t see a perforation, but said the surface looked “abnormal.” I asked her for an ENT recommendation. She recommended Dr. Saffran.
Went to see Dr. Saffran. He examined both ears…couldn’t see a perforation in the left, but did see what he described as some of the “inner ear material” – spongy like – on the surface. Couldn’t really explain it at the time. Recommended 10-day antibiotic (to take care of any infection/fluid that could be behind the drum) and topical drops for inflammation. Ellen also had a hearing test, which did show loss of hearing in the left ear.
Ellen went through the treatment fine. And afterward, said she noticed she heard better/differently in band and chorus.
Last Friday (June 5) we went in for a re-check. Dr. Saffron asked how she was doing. Ellen told him that she did have a slight burning sensation once (went swimming at Mattie’s grandma’s house) when a little water got in her ear. She also told him that she seemed to be hearing better.
Dr. Saffron took a look in the left hear and immediately said, “I can see the perforation.”
The way I understand it is that with the treatment of the antibiotic and the topical drops, the inflammation of the inner ear material subsided to expose the perforation. It explained why the other doctors didn’t see the perforation and why Ellen still felt the moisture. I looked in and saw the perforation, too. Dr. Saffron said that it is nice and clean now and pink “healthy” looking in all other respects.
With the ear clean and clear now, it may have a chance to heal. We have a recheck appointment in a month to see if there is any change. If not, then surgery is the option to graft the hole. The surgery lasts an hour and a half and is performed under general anesthesia. It is not a difficult procedure, but with the perforation toward the front of the drum it is challenging, as Dr. Saffron would have to go in from behind her ear to reach the spot effectively.
Surgery plans, if necessary, will be made with you, too.
Regarding swimming at Circle F: I told Dr. Saffron Ellen was getting ready to go to camp. He said as long as she keeps the ear dry, it shouldn’t be an issue. She has plenty of ear wax/plugs and we changed one activity from Water Sports which would have had her sliding into the lake from a giant slide and possibly getting thrown in from the “banana/inner tube” ride to Canoeing/Sailing. Ellen seemed fine with the switch. She also knows to wear the ear wax/plug with all water activity and not to go under water, which she said she didn’t like to do in the lake anyway.
Here’s Dr. Saffron’s number if you want to give him a call to speak with him directly and get any questions answered that you may have:
Alan J. Saffran, MD.
7251 University Blvd (at Forsyth)
Winter Park
407.677.0099
Hi David: I missed all these comments. Admission: I do not check email at home regularly, if at all. I do check the comments posted on the Dashboard regularly. In either case I missed these…but glad to find them. I was just coming here to post this update: Ellen and I are going to see Dr. Saffron next Tuesday (June 30), prior to our trip so her ear can be checked. I’m glad he called you back…thanks for posting your conversation with him. We will get EarPlane and ask about the recommended Afrin. Will post about our visit with Dr. Saffron on Tuesday night. Jen
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Jen: Dr. Saffron just called. When I told him the story of Ellen’s previous two visits to an ear doctor, he did not dispute the possibility that there had been an earlier rupture, that it had healed, or that what he found was new and unrelated to any earlier rupture, with the exception that an earlier rupture might have weakened the drum and increased the likelihood of the current rupture.
He confirmed that the EarPlane does work for many fliers. He also recommended Afrin before and/or during flight to reduce congestive swelling at the opening of the eustachian tube in the throat. David
JT: This morning one thing on my mind is Ellen’s Ear. Before calling Dr. Saffron’s office, I Googled the question on my mind “How long does it take for an ear drum to heal?” The answer – normally, a few weeks. One of the more authoritative sites can be found at the following address: http://www.med.umich.edu/1libr/aha/aha_rupteard_crs.htm. The implications are clear – 1) if Ellen’s ear drum was ruptured early 2008, it had healed by the time she went to Aunt Deb’s in August, 2) the rupture Dr. Baylor saw in late August occurred shortly before he saw Ellen, and probably during or immediately after Ellen’s vist to Aunt Deb’s, and 3) the rupture Dr. Saffron saw occurred in 2009, and not long before Ellen saw him. Ellen has a problem with recurring ear infection, and/or recurring fluid build up in the inner ear. Didn’t Brooke have an ear problem? So, I have called Dr. Saffron’s office and left this question for his nurse “How does Ellen avoid recurring rupture?” David
Hi David: Yes, Ellen flew to Aunt Deb’s in August. I will visit the websites you posted tonight. JT
Jen: Today I spoke with Jackie, a nurse at Doctor Baylor’s office. Dr. Baylor originally saw Ellen’s ear August 28th, and did a follow-up October 24th.
Jackie told me that fluid build-up in the inner ear can perforate the ear drum, and cause drainage. She told me that sometimes fluid build-up is medically relieved by perforating the ear drum. She said that the inner ear might be visible if the ear drum was perforated.
Our Quicken records show a parking fee at the Sanford airport on August 20th (a week before L’s doctor visit), and an Allegiant Air Ticket purchase on August 13th. Was it August that Ellen flew to your aunt’s? And Deb sent her home to face “DAD” with a hair cut?
Google “eardrum” and “flying” and you will see that flying can, but rarely, cause rupture of the eardrum in the absence of infection or swelling – http://www.aolhealth.com/conditions/barotrauma. You’ll find that some people have histories of ear drum rupture. You might also find mention of an “earplane” recommended for noise and pressure changes – http://bb.visitaruba.com/f2/how-effective-earplane-earplugs-4119/. In fact, some of the symptoms described in these articles fit those that prevented me from spinning Ellen ’round when she was tiny. Hmmm.
David: I do recall all of the original doctor visits. I did not go back to the original doctor as I sought a second opinion because her ear was still bothering her after the original doctor had said all was well.
Ellen does like Dr. Saffron “better.” He is attentive and gentle, speaks directly to Ellen, and on our first visit was upset by the fact that he did not have an exact answer. He also progresses step by step (did not suggest we rush into surgery).
Avoiding further injury, of course is best. Could it have become re-infected? That sounds like a possibility to me.
I’m sorry I wasn’t clear with “from behind.” An incision “behind” her outer ear is correct.
Necessity of the surgery will depend on if there is any change (healing) over this next month or not.
I am concerned about general anesthesia. I don’t know what it means to live with a perforated ear drum that does not heal or the ideal environment for a graft to take (success rate of the surgery)…these will be good questions, too.
Please ask Dr. Saffron to walk you through our 2 visits. Also ask about avoiding further injury. Flying. Name of the procedure, and, where the graft comes from. If it is an outpatient procedure. You may want to make an office visit appointment so you can meet him in person.
The surgery (if needed) would be performed at Arnold Palmer Hospital, which is one of the best children’s hospital in the nation. Regarding trust. I trust that we will make the right decision.
Let me know what you find out.
Jen: Whatever I can do, whatever you would like me to do, to ensure Ellen gets the best care, I will do.
Did you speak with or meet with the doctors who first saw Ellen in 2008?
How did they explain the change in Ellen’s condition?
When Ellen was first seen, the doctor told us the ear drum was ruptured but healthy. We were told it had begun healing itself. The doctor recommended we wait to see if it would completely heal and return to the office to check. We were told if it did not heal itself it would require surgery. We waited and returned. At our second visit we were seen by the original doctor and a second man. We were told the ear was healed and healthy.
It is possible, Jen, that the ear was traumatized in some new way after seeing the doctor. Swimming might have been enough to do that. Swimming could certainly have infected it.
If a second trauma reinjured her ear – if the ear was easily reinjured – what complications might this present a surgeon?
Is it possible the eardrum could heal itself, again, and remain healed by avoiding pressure changes like swimming or flying?
You’re planning to fly before the summer ends. That should give you pause.
I would think the opinion of another specialist would be a good idea. The concerns would be: 1) the necessity of surgery; and, 2) the risk surgery would do additional injury.
Is there a name for the procedure?
I will do what you’ve recommended and contact the doctor’s office to see how I can arrange to talk to the doctor.
Have you shared all your concerns?
Is there any thing more you would like me to ask the doctor?
Grafted from where?
You say the surgeon goes in “from behind”. What does that mean? Through her thoat and eustrachian tube into her inner ear? Or, through an incission “behind” her outer ear?
Don’t you and I have surgical experience?! Can we really trust anyone else?