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Update: Dangerous abscesses, and hearing loss

February 9, 2013

A bit of an update, starting out with an unsurprising message: Don’t fool around with a tooth abscess. Especially if you are diabetic or have other things messing with your immune system, because it makes us more prone to infections and various dental problems in the first place, and also makes it harder to fight them off and heal. I’m not always so good at following my own advice, but seriously. You will be sorry if you think you may have an abscess, and don’t deal with it ASAP.

He declared that Ludwig’s angina was an emergency, adding that by the time the condition developed in an individual, such may have hearing and understanding difficulty and find himself in serious distress. “This is a condition caused by dental infection. The patient had been careless over his dental care for a while, he had been tolerating a lot of pains and this had resulted in the infection spreading to the floor of the mouth, where the tongue was.”#

Mine didn’t spread in that specific way, but yeah, that sounds way too familiar overall if you substitute “really freaking terrified” for “careless”. (Like “lazy”, I suspect that in the vast majority of cases, “careless” is not a useful characterization anyway.*)  By Thursday, I had gotten concerned enough about how sick I was getting, complete with very painful hugely swollen lymph nodes under my arm on that side and some heart palpitations, probably from a combo of spreading infection and pain, that I figured I’d end up in Urgent Care or maybe the hospital over the weekend if I didn’t go ahead and get some help. When you’re ticking pretty much all the boxes for “seek medical care urgently!”, it’s probably time to do that; the infection got bad enough that I was honestly afraid it might kill me, and I have a little too much experience toughing infections out by now. I was also keeping thinking about taking pliers or the Dremel to it, to relieve some of the pressure. (Hey, sometimes they drill holes professionally to let things drain!😐 Still a horrible DIY project, which I wasn’t really about to try even besides the concern about getting overwhelmed by the released bacterial yuck!)

So, I finally had to ask Mr. U to take the next day off, and he went with me to the dentist and then to pick up antibiotics and more (thankfully available without a prescription) fairly weak pain relief yesterday. Thankfully, his work is much better than average about that kind of thing, and he had plenty of vacation days left. I still felt kinda bad about needing to put him out. I was actually too wrung out to get much in the way of anxiety going, but needed the moral support and help with interpreting and making sure I’d heard any instructions right. They were nice again about working me in within about ten minutes, and didn’t even try to browbeat me over not having been able to get the tooth taken care of yet; shame that’s so refreshingly unusual. Apparently the dentist agreed with my assessment of how sick I was, without my saying much about the details because I was just too sick to talk much and afraid of ending up in the hospital–because this time I got twice as long a course of erythromycin and metronidazole, with the dose doubled for the first few days. So, yeah, once again not making a huge deal out of nothing. Once again, they didn’t give me any pain relief, but hopefully that will improve again with a few days on antibiotics. (Another reason not to let them do a root canal there.) She also questioned whether this might have been going on long enough that they might not be able to save the tooth; little does she know!

At this point, I just want Horrible Volcanic Tooth gone so it can never cause problems again. Especially since root canals sometimes fail, so that the tooth needs to be extracted anyway after all that expense and suffering. Worst case, I’ll need a single-tooth bridge to fill in the gap and prevent some further potential problems, since it does have one molar behind it. I’m also hoping that the jawbone itself is not in too bad a shape, after probably at least 20 years with this problem simmering, and with some of the symptoms from this flare. But, no use worrying about that right now. I may go ahead and get them to extract the tooth once the infection is knocked back some, even with no reasonable expectation of properly working local anesthetic, because I’m not sure I have the spoons available to even get signed up with the anesthetic clinic right now. From experience, that should hurt a lot less than what I’m dealing with ATM. For further less immediately pressing work that no doubt needs done, I will need the sedation, though.

But, the main thing I wanted to write about today is more directly related to my last post on CAPD. I’m running out of steam, so will just paste in something I shared with Mr. U again, maybe adding some more links. In short, a lot of the worsening problems that I’ve been attributing to auditory processing are probably coming from actual hearing loss. (Which probably helped my brain not learn to do some auditory processing tasks very well, to begin with.)

Ear Disorders * Singled Sided Hearing Loss In Children  »

Pretty good one. I’d been aware that I’ve continued to lose hearing in Wonky Ear, from the ongoing damage and probably more infections. Keep a blocked Eustachian tube with fluid buildup, it’s gonna breed bacteria and maybe pop and scar your eardrum again. I’m sure it’s infected now, actually, between the blockage and the handy pool of nearby bacteria.

But, this latest episode of “temporary further hearing loss from blockage/infection renders me barely functional” has helped me figure out that it probably hasn’t been the auditory processing going screwier, but the same effects coming from getting harder of hearing on the one side. (Also giving less info to process.) A lot of it looks the same, with unilateral hearing loss. Also, I’m getting a better idea of just how much baseline hearing has probably been gradually lost. But, it hasn’t even been tested since I was 14 or 15, at “only mild to moderate loss, no worries!” then.

They really didn’t do so well when we were younger at treating chronic ear problems, or taking the resulting hearing loss seriously. They didn’t even know how it can screw up processing development. At least now they do know, and are also aware that a lot of adults don’t just grow out of any of it. Besides assuming that I couldn’t even still have the same chronic Eustachian tube problems in my teens, they kept assuming the hearing loss was temporary, too. With an isolated incident of a blocked-up ear, it usually is. But, yeah, at least you’re hopefully less likely to get told you just need a psychologist now, going in with ear/hearing problems you “shouldn’t” have. (At least that gaslighting made my mom very angry at the time — but I never saw about the ear at all after that, not even for an obvious draining infection.)

In the end, it doesn’t make that much difference whether the decline is in auditory processing or actual hearing, but maybe there are more ways of dealing with it as the big day-to-day obstacle that it is. Actually being physically hard of hearing is also more likely to get taken seriously, unfortunately including by myself to some extent.

______

S0me basics on Eustachian tube dysfunction. A few interesting bits there:

Highest prevalence amongst Native Americans, Inuits, Australian Aborigines, Hispanics, Africans… [I didn’t know that]

Cycle of dysfunction: Structural or functional obstruction of the ET compromises 3 functions of this system:

  • Negative pressure develops in middle ear.
  • Serous exudate is drawn from the middle ear mucosa by negative pressure or refluxed into the middle ear if the ET opens momentarily.
  • Infection of static fluid causes edema and release of inflammatory mediators, which exacerbates cycle of inflammation and obstruction…

In adults, paradoxical closing with swallowing has been noted in a majority of patients (1)… [I didn’t know that either, though I do get that.]

Commonly Associated Conditions

  • Hearing loss [as the first item on the list]

But, indeed, even if it does improve with age in the majority of cases, that doesn’t mean the problem doesn’t continue indefinitely for a lot of people. Especially among us snotty and wheezy folks. I’m glad they’re at least recognizing this now, instead of just tending to brush off symptoms in people they think are too old. (Same with asthma, eczema, etc., which all tend to cluster together!) For some reason, I have never been offered tubes, though several of my similarly snotty cousins had them repeatedly as kids. Not that this always prevents scarring and hearing loss, no. I have been tempted to try to get one as an adult, during particularly bad periods, but am still not sure how much resistance I would run into with even getting an ENT referral through the NHS. (And that obviously involves seeing a GP, in the first place.)

I haven’t had the energy yet to try to figure out much about how figuring out that I probably do have significant hearing loss may change how I handle things, beyond eventually getting my hearing tested again. I was interested to find out, though, that a lot of people have found low-gain hearing aids with directional microphones useful for their CAPD, to help with the background noise problem. That is also apparently often helpful with the kind of conductive hearing loss I seem to have. I’d probably need to go private, and it would be expensive, but that may be worth a try eventually. Even though they focus on the middle ranges, where human voices tend to be, I am still wary of sticking anything that might make noises in that ear with the often painful higher-frequency hyperacusis. (Some frequencies are like an icepick straight into my brain, seriously. And that sensitivity apparently often goes along with losing hearing in the middle ranges, so hopefully it’s not a problem with devices aimed at that!) In spite of having done self-taught lipreading most of my life, this has been causing some major problems day-to-day, and making me avoid getting out some. As mentioned in the last post, especially living in an urban area where it’s impossible to get away from lots of background noise.

But, yeah, developing a better idea of what’s really going on there opens up more options for dealing with it so that I can hopefully improve my quality of life.

Also, I wasn’t sure how to work this in, but one depressingly spot-on quote from an article about CAPD:

The brain seems to operate lawfully and reasonably predictably across disorders, so that hearing acts the same whether the reduced cell count was caused by a stroke or lack of oxygen (allowing for age and recency of the problem in the testing). We are just beginning to confirm by brain wave studies, PET scans, autopsies and other research, that learning disabilities and central auditory processing problems play by the same set of rules as the better researched disorders. This is why you will hear the term “controversial” used for many assessments of learning disabilities, including the audiologic ones.

Until we know the answers, professionals and parents must deal with the learning problems as best suits their own philosophy. One common point of view is that even if a child has CAPD-like hearing problems and fails central auditory tests, it is not 100% proven that he actually has an organic problem of this type, and it causes needless worry and can even interfere with parent-child bonding to propose that a child’s brain might be imperfect in any way. The other view holds that it is better to offer help on the theory that there may be a true CAPD, since the help is not intrinsically harmful and can be stopped it if proves ineffective, and that much harm is done by allowing parents to think that they, the school or the child might be the cause of the problem.

“[C]an even interfere with parent-child bonding to propose that a child’s brain might be imperfect in any way” It’s a shame that this is even a consideration, in so many areas. Because these ideal, “perfect” children (or adults) just do not exist, and are a totally unreasonable expectation. This causes an awful lot of harm, with so many “imperfections”. And it makes me angry, again, that some people prefer not providing any practical help because admitting the need might be stigmatizing. (And, yeah, they are probably right, in way too many cases.)

_____________

* One of the best quotes I have run across in a while:

I have consistently found that the people quickest to accuse others of laziness are the lazy themselves. These people have complicated issues going on in their heads – basically, they know they are responsible for their own problems and are absolutely useless and contributing nothing to society that society actually wants, but it’s more comfortable to project that onto others. If you project that onto the wealthy, you’re expected to back up your accusations with some proof, or at least logic, so it’s easier to project that onto the poor. #

Or onto anybody with relatively less power, of course.

2 Comments leave one →
  1. urocyon permalink*
    May 18, 2013 11:53 am

    I don’t see any way of doing that here, unfortunately.😦 The comment notification e-mails should have a way of unsubscribing at the bottom.

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  1. Diabetes and Hearing Problems -The Health and Wellbeing Magazine

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