pediatric housecalls Robert R. Jarrett M.D. M.B.A. FAAP

Child Diseases Parents Should All Know About – Part 2

July 21, 2014

This is part 2 in the series about Child Diseases parents should all know about which came from an idea suggested by viewing another site that had a good idea but which plastered so many scam advertisements on the pages that I wouldn’t dream of recommending it.

That is, of course, the kind of danger you get into when you try and push, stretch and mold scientific data into something that fits your own belief system in order to sell a product you are trying to promote!

More Child Diseases To Know About

Ear Infections and Glue Ears

Frankly, the photos in their article were nice but the information was not only dated but many times of such uninformed thinking that it was not only incorrect but potentially dangerous as well. We can do a WHOLE LOT BETTER by continuing with the child diseases most commonly common to a pediatrician’s office – ears!

Ear infection

Ear, showing the middle ear drained by the Eustachian tubeI’m sorry, but even though I really am trying to keep this series concise I would be remiss if I didn’t warn you straight out that “googling” Ear Infections on the internet is mostly dangerous to your health and pocketbook.

There are few other topics where there is more asinine clap-trap, inaccuracies, out-and-out lies, vested interests and cons. “Ten holistic cures,” “healing ear infections without antibiotics,” “doctors don’t want you to know” – pure bull$*##!

Whew! I’m better now. But the mere thought that someone could even believe “essential oils” or “massages” would cure ear infections; or, that they don’t occasionally require antibiotics is completely beyond belief and the mark of a fool!

Even though infant and children’s heads are proportionately large for their bodies, the actual dimensions of nearly every structure is smaller than the size of most “globs” of mucous. That means they get clogged and blocked very, very easily – no matter what. Doing your absolute best to keep passageways as clear as humanly possible is about all one can do.

When the Eustachian tube – drainage tube between the middle ear and the back of the nose – becomes blocked you not only CAN’T “pop your ears”; but, that very dark, moist place doesn’t drain either… which is never good. “Bugs” grow in dark, moist places.

Girl crying with an ear infectionSo, even though what seems like a near constant runny nose is being CAUSED by a virus, allergen or pollutant, the ACTUAL ear infection, known as “otitis media,” sometimes is being caused by a bacteria growing in those dark recesses. The only way to be certain which is which is by needle aspiration and testing of fluid; which, I don’t know about you, but I wouldn’t find too pleasant on that many kids every day.

Doctors have here-to-fore opted to use their diagnostic skills (and sometimes intuition), along with intimate knowledge of the family and history, to arbitrarily use antibiotics when there was a concern, instead of doing a needle aspiration. [UNFORTUNATELY, that seems to have translated into “just use them on everyone” as an entire generation of generalists, practioners and “computer experts” have begun attending to much of the nation’s children’s illnesses. And now we have gotten into trouble by over-using antibiotics.]

Good doctors are much more judicious with antibiotics these days and responsible ones don’t knee-jerk out the prescription pad for every ear infection. It still takes more time and more skill to diagnose and treat a patient right than some physicians want to give; but, if you feel like your doctor is acting more like a computer than examining and knowing your child (should I say it?) just find another doctor – not start a blog, decrying antibiotics and selling essential oils and herbal cures!

Because they are so common in children in some locales, parents become quite skilled at telling when a “cold” or “allergy” has gone into an ear infection and needs to see a doctor. Symptoms include fever, fussiness and ear-pulling.

Even though most ear infections are due to viruses and should go away on their own, anyone who has worked in a “bush” health clinic, and therefore seen loads of children who didn’t/couldn’t get medical attention, knows intimately that: NOT ALL OF THEM DO.

We also have some childhood vaccinations which help prevent infections from certain types of bacteria that can cause ear infections.

Glue ear

This is the point where too many ear infections, both treated and untreated, end up: a Glue Ear.

Ear Drum with PE Tube (grommet) to treat “Glue Ear”When the Eustachian tube just can’t clear the mucus, cast off skin and infectious waste out of the middle ear, it sort of “gelatinizes” over time and then can’t drain on its own.

There usually isn’t any pain, unless it’s in an acute infection phase, but there definitely is some impairment of hearing, both in acuity and volume. In a child, that doesn’t bode well for language development.

Doctors call the condition “chronic otitis media with effusion” and it often occurs after multiple acute ear infections that have not resolved completely.

A good doctor will always ask to see a child back for follow-up after an acute “otitis media” infection. Doing so is to make darn sure that the fluid has all drained out from the middle ear and there is none left to diminish hearing.

When the fluid persists after an infection it is known as: “otitis media with effusion” and, as we have learned, should clear on its own, eventually, in time – unless another infection, smoking or allergies intervenes.

When it doesn’t resolve on its own within an acceptable amount of time, that is when it’s called “glue ear,” largely because when you aspirate it out it resembles glue. As it remains in the middle ear, it not only diminishes hearing but sets up a reaction of its own on the tissues and hearing bones in that cavity.

Treatment is FIRST, to remove the “glue”; and SECOND, to prevent it from re-forming by treating allergies, infections and environmental pollutants (i.e. parental smoking). Usually that also means placing a polyethylene tube (PE Tube or “grommet”) through the ear-drum, temporarily while the Eustachian tube grows and heals so it then can do its job.

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We’re not done listing the common diseases parents should know about yet. It’ll take probably a “couple few” parts to list them all; so, I’ll talk to you again in part 3.