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Hi-I Believe I Am Experiencing An Autoimmune Response Specific To

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Posted on Sun, 5 Jan 2020
Question: Hi-I believe I am experiencing an autoimmune response specific to my left ear; symptoms of an inner ear infection (aural fullness, tinnitus). It began to occur ca.1 week after I first started taking Vyvanse (70-140mg). All perception in the lower frequencies (bass) is severly compromised (can`t hear bass, or weird distoritions occur). Last week or so, the fullness can disappear, increasing the dB of the "dial tone" (and vice versa). When I chew, or knock on my head-the "swooshyness" intensifies accordingly. Switched to Adderall since 5 weeks back. Thing is, I dropped my 60mg of Adderall for 1 cap. Vyvanse 70mg last Saturday-so 1 week since last use. Not taking it anymore. Suspecting a connection to my ear after reading the product`s monograph on side-effects -I asked others using the same medication. Nearly all reported back having the same problem (fullness in the ear, tinnitus)-specifically by Vyvanse-but never having made the connection themselves. I consulted my doctor to give me some Prednisone to try out-10mg morning/5 evening for 10 days. On Day 2 now, it maybe feels like its not so intense (?) I am a musician also, so I`d really like your views on this and if I am unto something trying out the corticostereoid treatment. Cheers, XXXXXXX
doctor
Answered by Dr. Prof. Kunal Saha (4 hours later)
Brief Answer:
Suppurative otitis media

Detailed Answer:
Thanks for using the Ask a Doctor service.

I have gone carefully through your query . Going by the presentation it seems that you have suppurative otitis media. Treatment with corticosteroids is not the first thing you should look out for. You need to apply some antibiotic drops to the affected ear. Meanwhile you need to take steam inhalation. This will help in clearing the Eustachian tubes connecting the middle ear with the inner throat on each side. Please let the doctor treat you. I would request you not to intervene in between. Feel free to ask his rationale.

Regards
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Prof. Kunal Saha (12 hours later)
Hello,
Why is your detailed answer, "Thanks for using the Ask a Doctor service." instead of it being your brief answer (which it should be)?

Since I have paid for this service, I`d like someone else to go thru my question and your answer-again.
REASON: while I hope you are correct in your assessment (meaning that the condition may be less complicated & therefore possibly easier to treat), I am not satisfied with it.

A Tympanometry was performed at my ENT`s office and no fluid build-ups were detected in the middle ear. All the readings were inside normal range. Today, for example, the sense of the ear being clogged is 100% gone away. Instead, there is a constant (venous?) hum around 38-40 dB that still goes "bang-bang" every I swallow something.
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Follow up: Dr. Prof. Kunal Saha (4 hours later)
UPDATE, 19.10 Sunday evening:
The one dial-tone (tinnitus) mentioned earlier today, has now split into two tones-one high and one low-approxmately 3 whole notes apart (lowest=DO, highest=MI), with its overall dB level reduced. Both tones seems to have some fluctuations (individual variance) whereas the single one earlier, did not. Also while this is going on, back is a sense of fullness but only slightly.

UPDATE, 19.40: only the high-tone remains, reduced further in dB level; the clogginess is also some reduced. There is an ever-so slight perception of ache in the ear.

•Dr.Saha, I apologize for maybe sounding a bit harsh in my first follow-up. I am not at all questioning your level of competence as a medical professional. It makes no sense to me to have a General & Family Physician attempt to answer my questions since the area addressed belongs to a specialty field, as far as I understand. Have already had a GP and an ENT look at this problem, to no avail.

Best Regards,
doctor
Answered by Dr. Prof. Kunal Saha (8 hours later)
Brief Answer:
Audiometry needed

Detailed Answer:
Thanks for writing back. Could you please upload the audiometry report. If an audiometry has not been done, I would insist you to get one done. I can guide you thereafter.

Your dizziness could either be due to sensorineural or conductive changes, or certain viral infections which can give rise to such presentations. The organ of hearing lies in our inner ear (vestibulocochlear apparatus) and is also associated with the sense of balance. Vestibulocochlear stabilizing agents like cinnarizine or betahistine might be needed. Please discuss with your treating physician whether they would be right for you.

Regards
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Answered by
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Dr. Prof. Kunal Saha

General & Family Physician

Practicing since :1954

Answered : 4467 Questions

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Hi-I Believe I Am Experiencing An Autoimmune Response Specific To

Brief Answer: Suppurative otitis media Detailed Answer: Thanks for using the Ask a Doctor service. I have gone carefully through your query . Going by the presentation it seems that you have suppurative otitis media. Treatment with corticosteroids is not the first thing you should look out for. You need to apply some antibiotic drops to the affected ear. Meanwhile you need to take steam inhalation. This will help in clearing the Eustachian tubes connecting the middle ear with the inner throat on each side. Please let the doctor treat you. I would request you not to intervene in between. Feel free to ask his rationale. Regards