audiology | a bonobo humanity?

Posts Tagged ‘audiology’

exploring my condition: bronchiectasis with a side of otitis media

grommets galore

Seventeen days from now I will be talking to an audiologist (at last), because my hearing problem (my voice echoing in my left ear, with general hearing via that ear greatly diminished), which was, it now seems temporarily, fixed via an operation some fifteen months ago, has come back. My right eardrum has a sizeable hole in it, so my left ear has long been my ‘good ear’.

The operation, in February-March of 2023, was to place a grommet in my tympanum, to drain fluid from the middle ear region. It’s a relatively common procedure, performed under general anaesthetic, called a myringotomy. The condition is generally called glue ear (due to the viscous nature of the fluid), and usually occurs in childhood, as a result of the middle ear infections (otitis media) common during that period.

For me, the operation was successful, with normal hearing (for me at least) restored more or less immediately. But after coming down with a cold about six weeks ago, which has left me with a persistent cough and a constant need to clear my throat, the left ear problem has returned, with a vengeance. This has made simple conversation difficult to hear, and has had an isolating effect. My chronic condition, bronchiectasis, which is incurable, and which was diagnosed back in 2011, from memory, has added to my woes. A course of antibiotics has had no effect, nor has the regular taking of Bisolvon chesty forte tablets:

For use as a mucolytic to break down mucus and help clear the chest in conditions accompanied by excessive mucus secretions, such as in the common cold, …

– that’s according to HealthDirect, a government website.

I’ve been sucking on Strepsils, claimed to relieve coughs and to soothe sore throats. Surprisingly, my throat isn’t particularly sore in spite of incessant throat clearing, and my voice ‘catching in my throat’ often when I try to speak. I find that I have occasional prolonged coughing fits at night (in bed). I also suck regularly on Eclipse mints, as I assume my breath must be foul.

The ear, the nose and throat are clearly seen as connected, which is why we have ENT specialists, but I feel the need to learn more about the connections in my case. One of my major symptoms is autophony, my voice being loud inside my head, though according to others I’m speaking more softly, if anything. However I don’t particularly hear my breathing, or arterial noises (that would be scary). I do suffer from tinnitus occasionally.

And then there’s the bronchiectasis. I’ve written about this before, but here’s the basic low-down:

It is a lung disease with enlarged airways that are thickened and/or scarred. This can cause mucus to build up in the lungs. Excessive mucus build-up in the airways may lead to repeated infections causing more lung damage.

This is my worry, that the condition has worsened. I was diagnosed in 2011, from memory, and felt at the time that this might shorten my life, but was assured that the condition was manageable and far from fatal. And for a long time after the diagnosis I suffered no particularly serious symptoms.

Last year’s surgery seems to have gone well, and I was led to believe that the grommet would work itself out over time. HealthDirect has a useful video on grommet insertion, and I’ve found a range of grommet pictures online. They range from black presumably rubber rings, which look like tiny car tyres, to your top-of-the-range solid gold versions (bling, but not showy). The video is accompanied by this commentary:

Your surgeon will make a small hole in the eardrum. They will then remove any fluid by suction. This is called a myringotomy. After the suction, your surgeon will place a plastic or metal grommet in the hole. The choice of material depends on how long the grommet will stay in place. Your surgeon will discuss these options with you before your procedure.

This is interesting. My surgeon didn’t discuss any options with me, but if he had, I would’ve opted for the car tyre, because I think we both assumed that this was a one-off problem, but this outcome has changed my mind. I’m assuming that the more solid grommets would stay in place for longer, perhaps even permanently. So….

Last year’s operation wasn’t cheap for this impoverished pensioner, and another such operation would be at least as much, with extra for the bling, but if it fixes that problem permanently, I’ll definitely go for it.

So there’s only the throat problem to solve….

There are different types of bronchiectasis (this is news to me):

Healthcare providers categorize bronchiectasis based on what the damage to your airways looks like — cylindrical (or tubular), varicose or cystic. Cylindrical bronchiectasis is the most common and least serious form of bronchiectasis. Cystic bronchiectasis is the most severe form. Providers also categorize bronchiectasis as focal (in one area) or diffuse (in many areas throughout your lungs). Traction bronchiectasis happens when scarring in your lungs pulls your airways out of shape.

So now I have to find out my type of bronchiectasis, and all I have to go on is an x-ray which seems to show blockage in the upper left lung region, suggesting it is (or was) focal rather than diffuse. My throat-clearing and coughing is now worse than it has ever been, so the condition may be spreading, and another X-ray may be required.