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Thread: My Daughter's TM Ruptured! (Venting post and seeking advice)

  1. #1
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    Default My Daughter's TM Ruptured! (Venting post and seeking advice)

    Sometimes there are disadvantages to being a (former) medical professional. My 5 y.o. daughter had a pretty severe ear infection 2 weeks ago and was treated with antibiotics. She's been complaining of muffled hearing in that ear since then. I've checked her ear a few times over the last week, but until today, there has always been too much wax to actually visualize her tympanic membrane. This morning, she awoke with a bunch of wax on her pillowcase, so I took a look at her ear tonight before her bath, and sure enough, there's a gaping hole in her tympanic membrane! Thankfully, I used a silicone ear plug in her ear for her swimming lesson Monday night, but I'm thinking now I'll just withdraw her from the class because with the hole being as large as it is - 1/3 of her TM - I don't want to risk further infection and/or permanent hearing loss.

    I'm wondering if anyone on this forum can give me a rough idea how long it takes for a TM to heal? As a former Nurse Practitioner, I was able to diagnose ear infections and TM perforations, as well as treat ear infections. But once a perforation was seen, I was mandated to refer to an ENT, so I usually didn't see patients after their diagnosis and thus, don't have a clear idea of how long they take to heal or what follow up is required. Various websites suggest it takes 2-10 (or more) weeks for perforations to heal, if they are going to heal. In the interim, I plan to use waterproof ear plugs on her when she's in the shower, bath, etc. and have her refrain from swimming or getting her head wet. I'm going to try to get her in to see her pediatrician this week and request a referral to an ENT only because repeated TM ruptures as a toddler/preschooler are what began my hearing loss journey.

    I had my daughter's hearing tested before she started preschool, when she was 4, in order to obtain a baseline because my neurotologist said there is speculation that enlarged vestibular aqueducts (which is what I have in my right ear only), may be hereditary. Her hearing was well within normal limits then. I'm wondering how long after the TM heals (if it heals!) I should get her hearing re-checked? If anyone can shed some light on this, I would be very grateful.

    Kerry
    November, 2016

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  2. #2
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    As a pediatrician, I would definitely want any significant perf to be followed by an ENT, preferably a pediatric specialist. You're right, if it doesn't heal properly there can be all sorts of complications. Push hard to get that referral ASAP. Meanwhile, keep it dry. And no drops of any kind, especially the ones for ear ache or OTC swimmer's ear.
    I would recheck her hearing as soon as it is healed. The ENT may even want to follow hearing tests sooner if it is taking a while to heal.
    Good luck. Let us know (or PM me) how things turn out.
    Last edited by DianaS; 04-06-2016 at 08:13 PM.
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  3. #3
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    Thank you for your quick response, Diana! Good to know I'm on the right track. I will be phoning the Pediatrician first thing tomorrow morning requesting an appointment asap. Our Pediatrician is REALLY difficult to get in to see, as in, a wait list of months, but hopefully the nurse will understand the urgency. I'm not above grovelling if need be.

    I may also give the Pediatric audiologist a call tomorrow, too. She indicated at our initial visit that she is very amenable to fitting children in urgently. Perhaps if hearing loss is documented, in light of a normal hearing test a year ago, that will expedite an ENT referral.

    Kerry
    November, 2016

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  4. Default

    swimming would probably be the worst thing to do at this moment.
    Last edited by doubledown; 05-14-2016 at 11:46 PM.

  5. #5

    Default

    I agree the ENT referral is important. Keep the ear dry and just in case you have holiday plans - also avoid any plane trips while it is healing until the ENT clears her.
    Carol

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  6. #6
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    Thanks everyone. I appreciate each of your quick responses. Thankfully, my medical background has saved me from making any stupid decisions like sending her to swimming lessons without her ear canal fully sealed off with a waterproof plug. (She actually didn't submerge her head at all in her lesson this week because I asked the instructor not to, but I cancelled her lessons this morning anyway because the hole's not likely going to be healed well enough for her to not miss most of the classes.)

    I spoke with the pediatrician's nurse today. My daughter is going to be seen for follow up tomorrow as her pediatrician had an overfull slate today. I trust her pediatrician implicitly, and their office also trusts my judgment as so far, I've diagnosed my kids' ailments accurately and in a timely manner prior to presenting to their office They now know that I won't ask for an appointment unless something's really wrong.

    DD, I already had the pharmacist extend her prescription of amoxil, which is the first-line treatment for acute OM in Canada. The pediatrician gave a 7-day prescription, and I extended it to 10 days after discussing my concerns of excess ear wax, ongoing pain and fever with the pharmacist. (She was also given an adult dose initially, not because of her size, but because of the significant bulging and redness to her ear drum. I'm not at all surprised it ruptured.) In cases like this, it's really helpful to have a medical background because I'm sure I've been given a lot more leeway than most others would get.

    I am, quite literally, praying this heals quickly. We have a 2.5 hour flight to the west coast in mid-June for my Dad's surprise 75th birthday. He's not well, so to not attend, or attend without the kids, would be a sad option as I'm not sure how many more chances we'll have for visits with him. In theory, her TM could heal up completely by then if we're careful and she doesn't get another infection in the interim. Time will tell, I guess.

    Thank you again, everyone!!!

    Kerry
    November, 2016

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  7. #7
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    Quote Originally Posted by KerBear View Post
    Sometimes there are disadvantages to being a (former) medical professional. My 5 y.o. daughter had a pretty severe ear infection 2 weeks ago and was treated with antibiotics. She's been complaining of muffled hearing in that ear since then. I've checked her ear a few times over the last week, but until today, there has always been too much wax to actually visualize her tympanic membrane. This morning, she awoke with a bunch of wax on her pillowcase, so I took a look at her ear tonight before her bath, and sure enough, there's a gaping hole in her tympanic membrane! Thankfully, I used a silicone ear plug in her ear for her swimming lesson Monday night, but I'm thinking now I'll just withdraw her from the class because with the hole being as large as it is - 1/3 of her TM - I don't want to risk further infection and/or permanent hearing loss.

    I'm wondering if anyone on this forum can give me a rough idea how long it takes for a TM to heal? As a former Nurse Practitioner, I was able to diagnose ear infections and TM perforations, as well as treat ear infections. But once a perforation was seen, I was mandated to refer to an ENT, so I usually didn't see patients after their diagnosis and thus, don't have a clear idea of how long they take to heal or what follow up is required. Various websites suggest it takes 2-10 (or more) weeks for perforations to heal, if they are going to heal. In the interim, I plan to use waterproof ear plugs on her when she's in the shower, bath, etc. and have her refrain from swimming or getting her head wet. I'm going to try to get her in to see her pediatrician this week and request a referral to an ENT only because repeated TM ruptures as a toddler/preschooler are what began my hearing loss journey.

    I had my daughter's hearing tested before she started preschool, when she was 4, in order to obtain a baseline because my neurotologist said there is speculation that enlarged vestibular aqueducts (which is what I have in my right ear only), may be hereditary. Her hearing was well within normal limits then. I'm wondering how long after the TM heals (if it heals!) I should get her hearing re-checked? If anyone can shed some light on this, I would be very grateful.

    Kerry
    Everything I've read says it takes 6-8 weeks for most to heal, but larger perforations can take 3 months or more and some never heal and need surgical intervention, which is obviously the worst case scenario. I also called a friend who had a perforated eardrum a year ago and he said his took about 2 months to heal over.
    Last edited by seb; 04-07-2016 at 12:50 PM.
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  8. #8
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    Kerry, How is she doing?
    4/26/16 Pretty much unchanged from last year

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    2011: Phonak Audeo Smart Vs (trial), then Starkey Wi 110s
    July 2016 Bernafon Juno 9 trial, then Oticon Opns

  9. #9
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    Quote Originally Posted by DianaS View Post
    Kerry, How is she doing?
    Thank you for asking! I've been meaning to update this thread for awhile but haven't quite gotten around to it as we're about to move houses and life has gotten insanely busy.

    My pediatrician's husband, who is a GP, followed up with my daughter the Monday after I last posted. He agreed that it looked like a small tear in her TM, but both of us thought it looked weird. He then squeezed some air into her affected ear, and since there was no give in the area that we thought was torn, he got his wife (my kids' pediatrician) in to see it. Between the two of them, they decided that she doesn't actually have a hole in her TM, but that she does have "some sort of shadow" on it. They're going to follow up with her in 6 weeks, and if the shadow is still there, they will refer her on to an ENT. They also did a basic tuning fork test with her and found all frequencies to be mildly impaired in her right ear only, so they will also be following up with that in 6 weeks' time as well. This seems reasonable to me. I'll be looking at her ear once a week or so until she's next seen, so I'm pretty confident that if anything goes awry, I should have some idea because I know what the weird "shadow" looks like; if it changes, I'll know to have her seen.

    From my daughter's perspective, her hearing in the affected ear is no longer muffled, and from my perspective, she's back to being able to hear a pin drop from another room - literally! - so the hearing loss seems to have resolved. I also spoke with the pediatric audiologist who did the baseline screening for my daughter, and she said that if I'm at all concerned, I could bring her in for a hearing test the same day I bring my son in for his 4-year-old baseline screening in September. She booked extra time for his appointment so that she can have the flexibility to fit my daughter in that day if need be. Overall, I'm very satisfied with the care she has received from both the pediatrician (and her husband) and the audiologist. They've gone above and beyond in my opinion.

    I'm sure I'm just overly anxious about ear infections in my kids because I had so many when I was their age, and my right TM ruptured so many times, that I did have a "slight LF" loss in my right ear from childhood on. Add to that the fact that we know I have EVA in my right ear, I'm definitely inclined to be cautious. If either child ends up with EVA, I may want to be cautious about which activities I let them participate in. Then again, maybe I won't. That will be a difficult decision to make if we ever have to. I'll cross that bridge then...

    Kerry
    November, 2016

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  10. #10
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    Glad she's doing well. Hearing and vision are two things you don't want to take a chance with.
    Good luck with the move.
    4/26/16 Pretty much unchanged from last year

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    R 25 25 35 40 40 55 55 35 35
    L 25 25 40 30 35 40 50 30 75

    Word Recognition: Right 80% @ 60dB; Left 100% @ 60 dB

    2011: Phonak Audeo Smart Vs (trial), then Starkey Wi 110s
    July 2016 Bernafon Juno 9 trial, then Oticon Opns

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