Then I was a three-year-old girl. As usual, my parents took me to kindergarten every day. I don't remember being sick often. Well, at least I didn't hear my parents complain to others. My sister, who was more than a year older than me, got sick more often. I remember some miraculous doctor that my dad always mentioned - whenever one of us got sick, they always called her and somehow we would recover.
One morning, my sister woke up with a swollen cheek. It turns out, an infection got into her tooth and it abscessed. At least that's how my parents explained it. Now, being a pediatrician myself, I know exactly what it was, but back then it seemed to me that her tooth enlarged, barely fitting into her mouth, and that's why her cheek swelled up. How I envied her that she wouldn't have to go to kindergarten... How I wished to get sick then. While my sister was sick, every night I would pinch one of my teeth - maybe it's growing? Maybe it will abscess like hers and I won't have to go to kindergarten?
And one night it happened. I woke up to the worst pain in my face. I was glad my little tooth got sick too, but at the same time I was scared - it really hurt. I ran to my parents and proudly announced that I got sick too, and I wouldn't have to go to kindergarten. Looking back now, I felt happy and proud inside, feeling just like my sister. But then my temperature started rising and the pain didn't subside. And the tooth kept throbbing. So my parents decided that the problem wasn't the tooth.
They separated me from my sister (at that time we were living in the same room) and I was privileged - I was put in my parents' bed, surrounded by glasses of water, medicines, and I had to lie down. When the doctor arrived, she confirmed the ear infection, prescribed treatment, and ordered me to stay in bed. After a few days, the ear pain suddenly disappeared because my eardrum burst and pus appeared from my ear. I didn't go to kindergarten for a long time - the illness lasted.
It seems like not much time has passed. But in fact, it's been more than forty years. I had to take aspirin, which is now banned for children, and antibiotics were administered to me by my parents intramuscularly. It's not the most pleasant procedure, as injecting penicillin into the buttock is really painful. A glass syringe, a metal blunt needle - now you can only see them in medical museums. After each use, the instruments had to be boiled - sterilized.
I still can't believe how much medicine, the approach to diseases, and treatment have changed and improved. Nowadays children are vaccinated against bacteria, which most often cause such purulent middle ear infections - Streptococcus pneumoniae, Moraxella catarrhalis, Haemophilus influenzae. I can only suspect that one of these bacteria, most likely pneumococcus (Streptococcus pneumoniae), caused my ear infection, as children were not vaccinated against this bacterium at that time. Unfortunately, in recent years, many parents refuse to vaccinate their children, and due to irrational use of antibiotics, bacteria have spread that are not only resistant to most antibiotics but have also changed so much that even the immune system of vaccinated children no longer recognizes them. Therefore, diseases that we rarely saw without vaccines are coming back.
Treatment has also changed. Antibacterial treatment is not rushed as soon as you notice that the eardrum has ruptured and the ear hurts. After all, more often than not, it's viral, not bacterial, infections. It's enough for the mucous membrane of the nose or adenoids to swell slightly, and the channel connecting the middle ear and the nasopharynx closes. Then negative pressure is created in the ear, the eardrum swells, and if there is even a slight inflammation there, severe ear pain occurs. The same thing happens during a flight when the plane descends. I think many of us have experienced not only ear congestion but also really severe pain. After landing, it's enough to swallow saliva or drink some water and the ears unblock. So, even when sick, reducing mucous membrane swelling, with inflammation decreasing, the pressure between the nose and the middle ear evens out and the pain disappears.
Besides viral or bacterial infection, other common causes of ear infections are allergies (allergic rhinitis, hay fever), swollen adenoids, pacifier use (unfortunately, yes, children who use it are more likely to get ear infections), and passive smoking. Usually, if there is inflammation, nasal or oral disorders increase the risk that the disorder will spread to the middle ear.
And how to treat it? First of all, don't panic when your child has an earache. I know that ear infections still scare parents almost as much as pneumonia. First aid for ear infection and pain is to prescribe drugs to reduce inflammation and fever - ibuprofen or paracetamol. It's prescribed according to a schedule - for 3 days, 3 times a day. Usually, during this time, the inflammation goes away on its own without any additional treatment. Of course, the treatment should be prescribed by a doctor who evaluates the child's overall condition and whether there are any obvious signs of bacterial infection, which would be confirmed by blood tests.
If the ear infection doesn't go away on its own within 3 days or is acute, antibiotic treatment will probably be inevitable. In this case, it's necessary to take the entire course as prescribed by the doctor, even if it seems that the child's condition has improved after a few days of antibiotic use. In addition to treating the infection itself, warm compresses are applied to the ear, the doctor may also prescribe pain relievers (such as ibuprofen mentioned above), measures to reduce mucosal swelling, such as nasal lavage, inhalations, and drugs, such as antihistamines or intranasal corticosteroids. Well, and if ear infections tend to recur, it's necessary to look at the problem more closely, find the cause and eliminate it. Continuous antibiotic treatment doesn't solve the problem, it only postpones it for a while.
And do you really need to rush to an ENT doctor? Every pediatrician or family doctor should know how to diagnose and treat common ear infections. Only if the prescribed treatment doesn't give the desired result or if complications are suspected, then it's necessary to consult an ENT specialist. But it all comes down to trusting the doctor, doesn't it?