8 ms·

> An audiologist friend told me to go to an ENT physician if not better by 48 hours or the damage could be permanent. Much longer than that and it would be too

> An audiologist friend told me to go to an ENT physician if not better by 48 hours or the damage could be permanent. Much longer than that and it would be too late to try any of the interventions This seems like poor advice. If there is significant, realistic concern about permanent damage, I'd suggest checking immediately, rather than give it extra time...

cian 9y ago
Yes, I always find it amazing how patients can have a sudden sensorineural hearing loss and wait days before presenting. In my opinion patients and the public should treat it as urgently as a sudden sight loss. High dose steroids are regularly prescribed in this sort of scenario in an attempt to minimize damage, and are likely to be more effective the sooner they are given.
- mannykannot 9y ago
  As I am not a doctor, I have always assumed that weird sesorimotor effects might be indicative of a stroke - though in this case, the author had an apparent cause. It puts me in mind of the Cuban embassy thing...
- autokad 9y ago
  After hurting my neck in the shower, Me calling primary care: The earliest we can see you is next Tuesday Me skipping primary care & going to ER instead: After a 2 hour wait, I get condescendingly asked: why didn't you go to your primary care? That's why patients wait days before presenting.
  - asfasgasg 9y ago
    Given the choice between losing my hearing and a slightly unpleasant interaction with a service professional, I would typically choose the latter.
    - nemo1618 9y ago
      That's a bit uncharitable. The choice is rarely as clear as that. It's often hard to know whether an affliction is serious enough to warrant immediate attention. So the person must weigh the risk of delaying immediate treatment against the inconvenience and embarrassment of an unnecessary ER visit. It will be really nice when everyone has access to a medical AI that can assess these things instantly wherever you are.
      - jjoonathan 9y ago
        > inconvenience and embarrassment And cost, now that insurance is playing the "we only cover ER visits that were necessary in hindsight" game. For those of us at the top of the pleb pyramid it's not so bad, but for the average person, a single mistake can be ruinous.
      - w00kie 9y ago
        Japan has a nice system: when you're not sure your issue is bad enough to call 119 (Japanese version of 911), you can call 7119 which will tell you if it's really an emergency and you need an ambulance or if you should just rest and see a doctor in the morning.
        BuildTheRobots 9y ago
        We have similar in the UK (NHS 111) - but because they're rather err on the side of caution, they usually refer you to A&E anyway. They do seem to have some sway over the GPs though - Rather than A&E, they've refereed me to the Doctors instead. When I said it's impossible to get an appointment 111 told me to tell the Doctors they've referred me. At that point the Doctors seem to _have_ to see you the same day.
  - astura 9y ago
    Then you get the $10,000+ bill because your insurance won't cover ER visits for non-emergencies https://www.forbes.com/sites/robertglatter/2017/10/16/anthem-at-odds-with-your-decision-to-visit-the-er-and-refusing-to-pay-in-certain-states/ https://www.forbes.com/sites/robertglatter/2017/10/16/anthem... https://www.vox.com/policy-and-politics/2018/1/29/16906558/anthem-emergency-room-coverage-denials-inappropriate https://www.vox.com/policy-and-politics/2018/1/29/16906558/a...
    - raverbashing 9y ago
      Or you live in a country with no BS medical pricing, take 2 zeros from that value and you get a more realistic pricing estimate for places in Europe (or pretty much elsewhere, probably lower, apart from Japan and Australia, I'd say)
      - charliesome 9y ago
        In Australia presenting at ER is free, for any reason.
        raverbashing 9y ago
        Thanks for the clarification (though if it's a non-emergency your wait might be longer - but that is valid regardless of the country)
    - gcb0 9y ago
      and still don't get care. the us is a joke. went to ER, they took a single xray, 5hours later doctor shows up and say "yeah its broken, we will put a temporary useless immobiliser worse than the one you came in with. here's the phone number of a specialist you can try calling monday". it was $4k for out of pocket btw. my top of the line insurance just said "we can't dispute anything from er visits".
  - jjnoakes 9y ago
    If you have urgent care near you, that is a good situation for it.
  - downandout 9y ago
    Several years ago I was visiting my mom on vacation. I took her to the ER after I was sure she had a stroke. The doctor came in, didn’t listen to anything either she or I had to say, and wrote off her statement that she could only “see half of [the doctor’s] head” as a joke. He told her that she was fine, maybe just a little dehydrated, and that the fact that I brought her to the ER for such a problem represented everything that is wrong with today’s healthcare system. He was essentially calling me an idiot for bringing her. Concerned my mother hadn’t improved and was being discharged, I called my sister, who happened to be a nurse upstairs at the same hospital. She came down and explained to the doctor that my mother was having a “visual disturbance”. As soon as that terminology was used, they took her for an MRI and sure enough, she had indeed had a stroke and was immediately admitted. This was after 4 hours of wasted time and an attempted discharge - simply because the doctor refused to listen and would only go by symptoms. The doctor never apologized for his comments. While I wound up feeling justified in this case, had my sister not intervened, I would likely never have taken her to the ER again unless she was unconscious or bleeding.
    - deleted 9y ago
      [deleted]
    - Tomis02 9y ago
      Did you lodge a complaint against the doctor? Just curious.
      - downandout 9y ago
        I wanted to, but my sister worked at the same hospital and was afraid it might ultimately affect her job or at least her social life there if we did. So I just let it go.
- johnchristopher 9y ago
  I experienced an audio trauma when I was 17. Tinnitus followed. Parents told me "let's wait a week or two and if it isn't gone away then we'll make an appointment". Once the verdict of definitive hear loss and permanent noise was confirmed my dad told me: "don't stay too close to hammers next time". To this day I still wait until I can't move/breath/feel to go to the doctor. edit: unfordable health care and/or bad money education is how people end up putting health to the bottom of the list.
  - Symbiote 9y ago
    Europeans know American adults don't have free healthcare. If you really want to shock a European, tell them that American children don't have free heathcare either. (I remember discovering this when I was about 14, on holiday in the US, when my younger brother caught pneumonia.)
    - johnchristopher 9y ago
      Well, I am European (and living in a country with one of the best coverage).
- ThrowawayP 9y ago
  > Yes, I always find it amazing how patients can have a sudden sensorineural hearing loss and wait days before presenting. Having gone to the physician with complaints many times and be told to wait to see if the issue goes away (most of them didn't) or that there's nothing to be done about it, one is quickly trained not to bother going to a physician for anything short of a major injury. (And this behavior is from a physician who is a Ph.D at a teaching hospital, no less.)
- sizzle 9y ago
  You take healthcare for granted. Not everyone can be seen in 24 hours.
- beenBoutIT 9y ago
  If you're looking for something with a profound anti-inflammatory effect you can get more out of high potency CBD(Cannabidiol) than from high potency steroids. Side effects are generally less with the CBD, although it's exponentially more expensive.
golemotron 9y ago
What are the interventions?
- hh3k0 9y ago
  As Cian pointed out: high-dose steroids.
  - Filligree 9y ago
    Why do they help?
    - meganibla 9y ago
      Prevent Inflammation of course.
    - acjohnson55 9y ago
      I don't know if it's conclusively known, other than inflammation in response to the injury tends to exacerbate the damage to the inner ear. https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0012465/ https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0012465/
      - phkahler 9y ago
        A friends daughter got a brain injury from a car-pedestrian accident. He learned a lot, and told me his take away: If you hit your head and have any concern about it, take Ibuprofen to prevent swelling/inflamation and drive to Ann Arbor (we're in Michigan but that's over an hour away). The first part made sense, the second he said that town and UofM are known for treating that kind of thing. He has them in such high regard that it's worth the drive not even knowing who you're going to see ahead of time!?!?!?
        hh3k0 9y ago
        Hm -- the website of Mayo Clinic says that you should avoid Ibuprofen if you might have a concussion, as they may increase the risk of bleeding. "Avoid other pain relievers such as ibuprofen (Advil, Motrin IB, others) and aspirin, as these medications may increase the risk of bleeding." See: https://www.mayoclinic.org/diseases-conditions/concussion/diagnosis-treatment/drc-20355600 https://www.mayoclinic.org/diseases-conditions/concussion/di...
ryandrake 9y ago
It’s often a cost/risk trade off. A lot of things do fix themselves with time and if you default to going right to the doctor every time you’re injured or feel sick it’s going to cost a fortune, unless you have some kind of gold plated insurance. Some things have to be looked at right away, but for some things it’s unnecessary, and it can pay to wait it out. (of course the above reasoning is pretty specific to the USA— could be different for people in more civilized places)
- astura 9y ago
  It's not even a cost, I have free healthcare through the military and I hesitate to visit doctors. First off, 99% of the time whatever it is fixes itself with time. Going to the doctor requires lots of time and effort, outside urgent care or the ER you're going to have to be going during the workday. Then they might refer you to other doctors and each one wants more and more of your time. I know a guy who goes to the doctor every time he has a viral infection to get antibiotics. Then he has to go back for different antibiotics because he doesn't feel better right away. That seems like a lot of effort when the alternative is doing nothing for the same outcome. The other big issue I have with doctors, I don't know if they are going to prescribe me some bullshit because the real treatment is "you'll get better with time" or the real answer is "there's nothing we can do about that." Or, much worse, something that they believe will help you but is not evidence based. Before you get upset - I once had an MD refer me to a (licensed) physical therapist for craniosacral therapy (complete woo) which billed it to my insurance as something like "physical manipulations." It's also just how I was raised, when I grew up, my parents would say "we'll see if it gets better," and it always did. When I grew up and starting visiting the doctor for things at the advice of others it didn't improve my health outcomes yet significantly increased my annoyance level.
  - eaandkw2 9y ago
    Going to war in Iraq a few times I have heard and experienced a lot of loud sounds. Being about 20m away from the impact of a 105mm canon from an AC-130 was pretty loud. Being right next to a M1 Abrams was probably the worst. A Marine near me actually had a collapsed lung from being in the blast zone. I also RSO’d for a range that shot off 41 SMAW rockets. I had a bad headache for a couple of days after that. Then there was that time that I parked my LAV-25 about 100m from an artillery battery right before they fired a mission where they had to be using a charge 8 or something because a kept losing my train of thought for a minute or so every time they fired a volley. And yes my hearing is pretty bad now. Hopefully I can get hearing aid later on. Edit: changed ear plugs to hearing aid.
jorde 9y ago
Dortor specialized in hearing loss told me to "overdose" on vitamin C as high levels apparently raise blood pressure and thus lead to more blood flow in ears which should help on the recovery of the hairs. There's also pressure tank treatment but I doubt one would get access to one in time. And time is at essence when it comes to hearing loss.

cian 9y ago

Yes, I always find it amazing how patients can have a sudden sensorineural hearing loss and wait days before presenting. In my opinion patients and the public should treat it as urgently as a sudden sight loss. High dose steroids are regularly prescribed in this sort of scenario in an attempt to minimize damage, and are likely to be more effective the sooner they are given.

mannykannot 9y ago
As I am not a doctor, I have always assumed that weird sesorimotor effects might be indicative of a stroke - though in this case, the author had an apparent cause. It puts me in mind of the Cuban embassy thing...
autokad 9y ago
After hurting my neck in the shower, Me calling primary care: The earliest we can see you is next Tuesday Me skipping primary care & going to ER instead: After a 2 hour wait, I get condescendingly asked: why didn't you go to your primary care? That's why patients wait days before presenting.
- asfasgasg 9y ago
  Given the choice between losing my hearing and a slightly unpleasant interaction with a service professional, I would typically choose the latter.
  - nemo1618 9y ago
    That's a bit uncharitable. The choice is rarely as clear as that. It's often hard to know whether an affliction is serious enough to warrant immediate attention. So the person must weigh the risk of delaying immediate treatment against the inconvenience and embarrassment of an unnecessary ER visit. It will be really nice when everyone has access to a medical AI that can assess these things instantly wherever you are.
    - jjoonathan 9y ago
      > inconvenience and embarrassment And cost, now that insurance is playing the "we only cover ER visits that were necessary in hindsight" game. For those of us at the top of the pleb pyramid it's not so bad, but for the average person, a single mistake can be ruinous.
    - w00kie 9y ago
      Japan has a nice system: when you're not sure your issue is bad enough to call 119 (Japanese version of 911), you can call 7119 which will tell you if it's really an emergency and you need an ambulance or if you should just rest and see a doctor in the morning.
      - BuildTheRobots 9y ago
        We have similar in the UK (NHS 111) - but because they're rather err on the side of caution, they usually refer you to A&E anyway. They do seem to have some sway over the GPs though - Rather than A&E, they've refereed me to the Doctors instead. When I said it's impossible to get an appointment 111 told me to tell the Doctors they've referred me. At that point the Doctors seem to _have_ to see you the same day.
- astura 9y ago
  Then you get the $10,000+ bill because your insurance won't cover ER visits for non-emergencies https://www.forbes.com/sites/robertglatter/2017/10/16/anthem-at-odds-with-your-decision-to-visit-the-er-and-refusing-to-pay-in-certain-states/ https://www.forbes.com/sites/robertglatter/2017/10/16/anthem... https://www.vox.com/policy-and-politics/2018/1/29/16906558/anthem-emergency-room-coverage-denials-inappropriate https://www.vox.com/policy-and-politics/2018/1/29/16906558/a...
  - raverbashing 9y ago
    Or you live in a country with no BS medical pricing, take 2 zeros from that value and you get a more realistic pricing estimate for places in Europe (or pretty much elsewhere, probably lower, apart from Japan and Australia, I'd say)
    - charliesome 9y ago
      In Australia presenting at ER is free, for any reason.
      - raverbashing 9y ago
        Thanks for the clarification (though if it's a non-emergency your wait might be longer - but that is valid regardless of the country)
  - gcb0 9y ago
    and still don't get care. the us is a joke. went to ER, they took a single xray, 5hours later doctor shows up and say "yeah its broken, we will put a temporary useless immobiliser worse than the one you came in with. here's the phone number of a specialist you can try calling monday". it was $4k for out of pocket btw. my top of the line insurance just said "we can't dispute anything from er visits".
- jjnoakes 9y ago
  If you have urgent care near you, that is a good situation for it.
- downandout 9y ago
  Several years ago I was visiting my mom on vacation. I took her to the ER after I was sure she had a stroke. The doctor came in, didn’t listen to anything either she or I had to say, and wrote off her statement that she could only “see half of [the doctor’s] head” as a joke. He told her that she was fine, maybe just a little dehydrated, and that the fact that I brought her to the ER for such a problem represented everything that is wrong with today’s healthcare system. He was essentially calling me an idiot for bringing her. Concerned my mother hadn’t improved and was being discharged, I called my sister, who happened to be a nurse upstairs at the same hospital. She came down and explained to the doctor that my mother was having a “visual disturbance”. As soon as that terminology was used, they took her for an MRI and sure enough, she had indeed had a stroke and was immediately admitted. This was after 4 hours of wasted time and an attempted discharge - simply because the doctor refused to listen and would only go by symptoms. The doctor never apologized for his comments. While I wound up feeling justified in this case, had my sister not intervened, I would likely never have taken her to the ER again unless she was unconscious or bleeding.
  - deleted 9y ago
    [deleted]
  - Tomis02 9y ago
    Did you lodge a complaint against the doctor? Just curious.
    - downandout 9y ago
      I wanted to, but my sister worked at the same hospital and was afraid it might ultimately affect her job or at least her social life there if we did. So I just let it go.
johnchristopher 9y ago
I experienced an audio trauma when I was 17. Tinnitus followed. Parents told me "let's wait a week or two and if it isn't gone away then we'll make an appointment". Once the verdict of definitive hear loss and permanent noise was confirmed my dad told me: "don't stay too close to hammers next time". To this day I still wait until I can't move/breath/feel to go to the doctor. edit: unfordable health care and/or bad money education is how people end up putting health to the bottom of the list.
- Symbiote 9y ago
  Europeans know American adults don't have free healthcare. If you really want to shock a European, tell them that American children don't have free heathcare either. (I remember discovering this when I was about 14, on holiday in the US, when my younger brother caught pneumonia.)
  - johnchristopher 9y ago
    Well, I am European (and living in a country with one of the best coverage).
ThrowawayP 9y ago
> Yes, I always find it amazing how patients can have a sudden sensorineural hearing loss and wait days before presenting. Having gone to the physician with complaints many times and be told to wait to see if the issue goes away (most of them didn't) or that there's nothing to be done about it, one is quickly trained not to bother going to a physician for anything short of a major injury. (And this behavior is from a physician who is a Ph.D at a teaching hospital, no less.)
sizzle 9y ago
You take healthcare for granted. Not everyone can be seen in 24 hours.
beenBoutIT 9y ago
If you're looking for something with a profound anti-inflammatory effect you can get more out of high potency CBD(Cannabidiol) than from high potency steroids. Side effects are generally less with the CBD, although it's exponentially more expensive.

golemotron 9y ago

What are the interventions?

hh3k0 9y ago
As Cian pointed out: high-dose steroids.
- Filligree 9y ago
  Why do they help?
  - meganibla 9y ago
    Prevent Inflammation of course.
  - acjohnson55 9y ago
    I don't know if it's conclusively known, other than inflammation in response to the injury tends to exacerbate the damage to the inner ear. https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0012465/ https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0012465/
    - phkahler 9y ago
      A friends daughter got a brain injury from a car-pedestrian accident. He learned a lot, and told me his take away: If you hit your head and have any concern about it, take Ibuprofen to prevent swelling/inflamation and drive to Ann Arbor (we're in Michigan but that's over an hour away). The first part made sense, the second he said that town and UofM are known for treating that kind of thing. He has them in such high regard that it's worth the drive not even knowing who you're going to see ahead of time!?!?!?
      - hh3k0 9y ago
        Hm -- the website of Mayo Clinic says that you should avoid Ibuprofen if you might have a concussion, as they may increase the risk of bleeding. "Avoid other pain relievers such as ibuprofen (Advil, Motrin IB, others) and aspirin, as these medications may increase the risk of bleeding." See: https://www.mayoclinic.org/diseases-conditions/concussion/diagnosis-treatment/drc-20355600 https://www.mayoclinic.org/diseases-conditions/concussion/di...

ryandrake 9y ago

It’s often a cost/risk trade off. A lot of things do fix themselves with time and if you default to going right to the doctor every time you’re injured or feel sick it’s going to cost a fortune, unless you have some kind of gold plated insurance. Some things have to be looked at right away, but for some things it’s unnecessary, and it can pay to wait it out. (of course the above reasoning is pretty specific to the USA— could be different for people in more civilized places)

astura 9y ago
It's not even a cost, I have free healthcare through the military and I hesitate to visit doctors. First off, 99% of the time whatever it is fixes itself with time. Going to the doctor requires lots of time and effort, outside urgent care or the ER you're going to have to be going during the workday. Then they might refer you to other doctors and each one wants more and more of your time. I know a guy who goes to the doctor every time he has a viral infection to get antibiotics. Then he has to go back for different antibiotics because he doesn't feel better right away. That seems like a lot of effort when the alternative is doing nothing for the same outcome. The other big issue I have with doctors, I don't know if they are going to prescribe me some bullshit because the real treatment is "you'll get better with time" or the real answer is "there's nothing we can do about that." Or, much worse, something that they believe will help you but is not evidence based. Before you get upset - I once had an MD refer me to a (licensed) physical therapist for craniosacral therapy (complete woo) which billed it to my insurance as something like "physical manipulations." It's also just how I was raised, when I grew up, my parents would say "we'll see if it gets better," and it always did. When I grew up and starting visiting the doctor for things at the advice of others it didn't improve my health outcomes yet significantly increased my annoyance level.
- eaandkw2 9y ago
  Going to war in Iraq a few times I have heard and experienced a lot of loud sounds. Being about 20m away from the impact of a 105mm canon from an AC-130 was pretty loud. Being right next to a M1 Abrams was probably the worst. A Marine near me actually had a collapsed lung from being in the blast zone. I also RSO’d for a range that shot off 41 SMAW rockets. I had a bad headache for a couple of days after that. Then there was that time that I parked my LAV-25 about 100m from an artillery battery right before they fired a mission where they had to be using a charge 8 or something because a kept losing my train of thought for a minute or so every time they fired a volley. And yes my hearing is pretty bad now. Hopefully I can get hearing aid later on. Edit: changed ear plugs to hearing aid.

jorde 9y ago

Dortor specialized in hearing loss told me to "overdose" on vitamin C as high levels apparently raise blood pressure and thus lead to more blood flow in ears which should help on the recovery of the hairs. There's also pressure tank treatment but I doubt one would get access to one in time. And time is at essence when it comes to hearing loss.