Ear Issues [Show Notes]

Episode 92 – Ear Issues

PSA:  Please don’t stick things in your ear any larger than your elbow…and that includes your finger.

Outer ear = the part that you can touch
Middle ear = the area being the ear drum
Inner ear = the cochlea and area responsible for your balance

3 common ear issues
– Ear infections (otitis media)
– Vertigo (and motion sickness)
– Tinnitus (ringing in your ear)
*Ear wax?  <– Go here

The area behind your ear drum has air in it and that pressure is equalized through the eustachian tube.  If that area gets fluid in it, that fluid can grow bacteria and that leads to infection.  The natural motion of opening and closing your jaw helps massage the eustachian tubes and moves air in and out (like when you fly or drive in the mountains and you chew gum or yawn).

Cold and allergies can be the source of the fluid build up that leads to ear infection.  You may have decreased hearing, pain, decreased balance – infection can require antibiotics.

Vertigo = the sensation of spinning, dizziness, being off balance
The semi-circular canals are responsible for your balance.  If it get sloshed too much, or doesn’t level out exactly right, then the signals sent to the brain may translate to being off balance even though your body is upright.  The signal confusion is what can lead to nausea (it’s not actually happening in your stomach – at least not until you vomit!)
The fluid moving around in these canals are why kids can induce dizziness when they spin around in circles (think about the clothes in your washer during the spin cycle – they get pushed to the outside).
Medications  for vertigo are the same as some medications for nausea – plus they have drowsy side effects, so maybe you just sleep it off.
There are many suspected causes, but nothing definite or proven.

Tinnitus = ringing, buzzing, roaring, whooshing sound when nothing is actually making that noise.
Causes: hearing loss (either due to aging or exposure to loud noises); high blood pressure (pulsating); medications
One theory: the hairs in the cochlea are damaged so those frequencies of sound (usually high pitched sounds) can’t be picked up anymore; the brain fills in the gaps with “made up sound”.  This is NOT PROVEN!
High blood pressure can cause you to hear the blood pulsing through the blood vessels in your ears.
Medications that causing ringing in the ears
– Aspirin (acute over-use)
– Aminoglycosides (i.e. Gentamicin = antibiotic) – it has a small therapeutic window, too much can lead to ear damage, it stopped in time, permanent ear damage can be avoided
– Quinine = usually asked for to help leg cramps, also medically prescribed to prevent malaria.  Can only be readily consumed by drinking tonic water.

Flavonoids are put in vitamins and advertised to help tinnitus.  Flavonoids are phytonutrients (nutrients you get from plants).  These nutrients can’t grow the hairs back in the cochlea.  Most of the vitamins and nutrients in the flavonoid vitamins have anti-oxidative properties, but I doubt that tinnitus is a major oxidation problem.

Can being slapped over time cause ringing in the ears?
– being bopped in the face and head can probably cause permanent damage to the structures on the inside and outside of your head.  Being hit in the side of the head can cause pressure build-up in the ear where the air causes the ear drum to rupture.
– Slaps to the face (like “you jerk!” kind of slaps) don’t affect the ears, but punches or slaps to the side of the head near or on the ears can possibly cause damage.

Be nice to your ears!

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Ear Anatomy [Show Notes]

Episode 91 – Ear Anatomy

The Auricle = the part of the ear you can see; made of cartilage (flexible tissue that doesn’t have a large blood supply)
Everything else requires a tool for the doctor to see inside.  And the doctor can only see to about the ear drum.  The stuff behind the ear isn’t visible because of the membrane that blocks it.  The middle and inner ear are surrounded by your head bones.

Science of sound
Sound is created when the air around us is compressed and then expands.  They move away from the source in circles (think radar or sonar or throwing a pebble in a pond.

The ear canal directs the sound waves towards the ear drum.

The ear drum (tympanic membrane) vibrates according to the intensity of the sound and trigger the Hammer-Anvil-Stirrup cascade.
– The ear drum vibrates the handle of the Hammer (Malus bone – yes, it’s a real bone).
– The Hammer bangs on the Anvil (Incus bone).  The Anvil has a tail that is connected to the Stirrup (Stapes bone).
– The Stirrup looks like the spurs on the back of boots.  It it connected to a membrane on the Cochlea and works like a plunger.
– All of these bones are surrounded by air and the pressure is controlled by the Eustachian tube.  This is the access point for ear infections or congestion due to allergies or a cold.

The Cochlea is a bone full of fluid and lined with hairs and shaped like a spiraled sea shell.  The hairs pick up different frequencies of sound (sound wave frequency determines pitch).  If certain levels of hairs get damaged, then you will not be able to hear pitches in that range anymore.  If you unrolled the cochlea, it would be laid out low pitch to high pitch like a piano.  And these hairs are connected to the auditory nerves and turn sound signals into electrical signal to send it to your brain.

Sound gets translated in 2 main ways
1. Identify the sound
2. Identify if the sound has meaning

Semicircular canals of the cochlea are little bone chambers full of fluid and they control balance.  This works like a leveling bubble to help you stay upright.  If it becomes dysfunctional, then it may trigger vertigo.

The middle ear (the area behind the ear drum) is where most of the trouble happens – whether allergies causing stopped up ears, or colds leading to ear infections.

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Allergy Testing Experience [Show Notes]

Episode 90 – Allergy Testing Experience

Anaphylaxis = an out of control allergic reaction that can be life-threatening if medical treatment is not sought immediately
EpiPens are a first-step self-treatment in the case of a major allergic reaction or anaphylaxis.

I got 33 injections!!

It started with a serum test as a baseline – just to see how strongly my histamine reaction was.

The injections are sub-dermal (under the dermis layer of the skin).  It’s the same level if injection that a TB skin test is done (to see if you’ve been exposed to tuberculosis).

The next step was a prick-test or scratch test – these plastic claw things that poke down in my forearms.  This test required me to sit completely still for 20 minutes.  COMPLETE TORTURE!

Numbers 1-20 are plants (trees, grasses, flowers).  C = cat. D = dog (Good news – I’m not allergic to dogs!) M = skin mites (don’t think about this one too hard). CL = cockroaches.  The other letters are household and common molds.

The skin pricks on my forearm was a preliminary test to determine how much serum she was going to inject of each in my upper arms. The mites injection hurt the worse of all of them, but i had minimal reaction.

Slowest tattoo EVAR!

One of my higher reactions was to Fescue (this is the type of grass that Ken grows on the farm as hay to feed the cows!)
The one the nurse was most concerned about was Cocklebur

They didn’t want me to wash the mold markings off until I go in for a delayed reading a few days later.

The next step that they prefer you do is allergy shots – 2 years of weekly injections of what you’re allergic to in hopes to desensitize you to those triggers.  NOPE!  Not doing it!

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Eye Conditions 4 [Show Notes]

Episode 88 – Eye Conditions 4

Dry eye: 48% of Americans over age 18 complain of dry eyes.  Caused by environment, genetics, health conditions, eye procedures, medications.
There are 2 reasons for dry eye:
1. Inflammation blocks the free flow of fluid through the eye.
2. Tear duct insufficiency – the ducts and glands don’t produce adequate moisture for the eye (can be solved by a tear duct stent)
If a medication dries up another part of your body, then it has the potential to dry out your eyes (antihistamines, medications for overactive bladder) – these medications can also lead to constipation.
Many of the common diseases that many Americans deal with can cause dry eye – hypertension (high blood pressure), diabetes, obesity.
They light from electronic devices tricks your eyes into not blinking as often, therefore your eyes can dry out more easily (blinking is your eyes’ remoisturizing process).  The solution is to give your eyes long breaks from electronic light , especially late at night before sleeping.
Callback: Sleep
Air conditions in hotels can make your eyes feel dry because they work to remove excess humidity from the air.
Hormones – whether in pregnancy, menopause, or during the use of prescription birth control products, can cause changes in the moisture content of your eyes.
The Solution: eye drops (either OTC or Rx)

Presbyopia = old or elderly vision
Presby = elders
Presbyterian church = the church’s decision-maker was a group of people called Elders
This seems to happen somewhere around age 40.  The lens of your eye loses some of its flexibility.  The lens has to be really curved to see up close, and then flattens out a bit to see far away.  So, if the flexibility decreases, it means it can’t curve up enough to clearly see things up close.
The solution: wear reading glasses.

Stye = infected oil duct or hair follicle.  Looks like a zit
**DO NOT TRY TO POP A STYE LIKE A ZIT!!**
They will usually clear out on their own in 6-7 days.  Not too troublesome other than being sore, swollen, and not pleasant to look at.
The Solution: warm compress for 15-20 min, then take a shower or wash your face, then leave it alone!  Can use drops or an ointment to help lubricate the eye.  Worst cases will require antibiotic drops or ointment from the doctor.

Corneal dystrophy = a genetic condition that causes the accumulation of protein material build up in the layers of the cornea (recap: cornea = the very front layer of your eye that starts to focus the light into the eye).  If this fluid gets cloudy with junk, then your vision gets blurry. No other symptoms really except worsening vision.  A surgical procedure can be used to clear out the cloudy liquid, but no cure.
This can lead to corneal erosion (where the layers of the cornea begin to separate = painful). Corneal erosion has to be corrected by surgery.  Erosion can also be a result of eye injury – either instant trauma or more gradual like an unhealed corneal abrasion (which can lead to ulceration and eventually erosion).

Take care of your eyes and treat them nicely!

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Eye Conditions 3 [Show Notes]

Episode 87 – Eye Conditions 3

If something happens to your eyes that makes you want to ask the pharmacist if you should go to the doctor, the answer will most likely be “yes, go see a doctor.”  Even at emergency rooms, they will treat you and make you comfortable but always tell you to follow up with your eye doctor.

Photopsias = seeing things that aren’t really there, the visual cortex translates other sensations as “sight”
Floaters – “shadows” that float around in your field of vision.  They *can* be a sign of a detaching retina, but that is usually not the case.  They are normal for most people.
Inside your eyeball is a gel, called vitreous gel.  Throughout your life, that gel begins to liquify.  As it turns to liquid, it may have other bits of gel still floating in that liquid.  And you see “shadows” because they block light from reaching your retina.  Floaters may worsen with dehydration or exhaustion.  If you try to focus on them, they “float” away.
Flashes – “seeing stars” – when the vitreous gel/liquid combo gets shook up and sloshed around (i.e. head trauma).  You can also get “flashes” with Digitalis toxicity (Digoxin is a medication derived from the Foxglove plant and developed for arrhythmias.)  This is a medication that the doctor will test your levels for to make sure toxicity doesn’t happen.
Waves = looks like radiating heat; caused by spasms of the blood vessels in your eyes.  This may be one explanation of the “aura” that comes before a migraine.  If it happens and no headache follows, it’s caused an “ocular migraine”.

Glaucoma = 2nd leading cause of blindness in the US and around the world; increased pressure in your eyes.  The fluid around the eyes typically have adequate drainage so nutrients can flow in and waste can flow out.  If that drainage becomes inadequate, the pressure builds up and it can put pressure on the optic nerve (the nerve that connects from the retina to the brain).  It starts with decreasing peripheral vision, and can become “tunnel vision” where a person can only see right in the middle of their field of vision.  Medications are eye drops that control pressure and help open up drainage pathways as much as possible.
(Macular Degeneration is the #1 cause of blindness in the US, Cataract is the #1 cause of blindness worldwide).  It doesn’t hurt, and it takes a while for the decreased peripheral vision to be noticeable.  It’s not reversible, but it can be slowed with medication.
Eye doctors have a way to check the pressure in your eyes each time you get your eyes checked.

Nystagmus (Nigh-stag-mus) = involuntary rapid eye movement side to side.  Caused by a neurological issue – either related to the eye muscles and nerves or the inner ear (one cause a vertigo).  The shaking seems to be worse when a person looks straight at something or someone.  For someone dealing with nystagmus, they usually discover they can tilt or turn their head to make their eyes slightly off center where the shaking wills stop – this is called a “null point”.  Strengthening eye muscles can help the shaking, but it still worsens with exhaustion or stress.
This can be a result of a stroke, multiple sclerosis (autoimmune).  Dilantin is a medication for seizures, and is another medication that has to be regularly measured because too much can cause temporary nystagmus.

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Eye Conditions 2 [Show Notes]

Episode 86 – Eye Conditions 2

Color blindness = blind to color
But it doesn’t mean that someone sees the world in black and white.
It’s technically labeled as Red-Green color blindness, which means the world is seen in shades of yellow.
The cones in your eyes (a certain shaped cells in your retina) are built to pick up different wavelengths of  light (think ROYGBV).  So the cones that would pick up reds and greens are absent or broken.
Found to be a Y-chromosome trait, so it is more prevalent in males.
Rarely Blue-yellow color blindness is a thing.

conjunctivitis = pink eye = inflammation of the conjunctiva
conjunctiva = the layer that covers your whole eye
3 types:
– Viral – , itching, watering, burning, light sensitivity, very contagious, lasts ~ 7 days
– Bacterial – green/brown discharge (aka “goo”), foreign-body sensation, contagious, can cause damage if untreated, requires antibiotic drop
-Allergic – triggered by allergens, histamine reaction, can accompany a larger, more general allergy reaction, anti-histamine eye drops can help

Corneal abrasion = scratched or injured cornea
Symptoms: redness, watering, light sensitivity, foreign-body sensation
Can be dramatic or traumatic like being hit in the face or eye by something, or something as simple as rubbing an itchy eye or getting something out of their eye.
* If you end up with something in your eye, the best option is to flush it out with water or saline
Bacteria on your hands or the thing that scratched your eye can lead to a deeper infection, but most of the time, if you use caution, it will heal itself rather quickly.

**Solution for light sensitivity:  wear sunglasses at night

Detached retina = when the retina detaches from the back of the eye
*Sounds awful but it doesn’t hurt
Retina – a web of nerves in the back of your eye that sends signals to the brain
Closing curtain sensation = part of the view of vision will become shadowed as the retina detaches gradually from one side to the other.  Floaters also show up if this is happening. (All floaters ARE NOT related to the retina.)
Sudden detachment can be caused by head injuries or sudden intra-ocular pressure drops (the fluid pressure inside your eyeball).  This sudden detachment is experienced as a flash of light and then sudden darkness.
Sudden or gradual detachment requires immediate medical attention and can be repaired with surgery and medical intervention.
Diabetic retinopathy do to chronic damage can lead to retina detachment.
*The risk of retina detachment occurring after an eye procedure (lasik surgery or cataracts surgery) is skewed for people with severe nearsightedness, possibly due to a genetic disposition of having a shorter retina.

Question:  Safe to use allergy eye drops long-term?
Answer:  Sure!  The only problem is that chronic use can lead to your body not responding to the same med over and over as well.  So, to avoid this, swap between drops and allergy tabs – based on if you’re experiencing “eye only” allergies or a wider allergy response that involves the sinuses too.

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