Dr. Greene, I’m so frustrated! My son has been sick several times already this winter. It usually starts in the middle of the night (usually a work night!) with screaming. I don’t want to take him to an emergency room in the middle of the night, and I don’t think he needs to go, but sometimes I’m very tempted. Then the next morning I have to take off work and take him to the doctor to find out what is wrong and if he can go to daycare or not. I wish there was some way of knowing what was going on. Especially if there was an ear infection. He’s had four so far, but sometimes when he wakes up in the night, it’s not an ear infection. Any ideas?
Dr. Greene’s Answer:
Today in my office I spoke with a mom who, like you, had been up most of the night with a screaming 11-month-old. All night long she was baffled — was it an ear infection, a cold, teething …? She couldn’t resolve the mystery until morning when she came into my office.
As a physician, I could use a professional otoscope to look into her child’s ear and see if the eardrum was normal, or if it was bright red and bulging, with fluid behind it (acute otitis media). If it turned out to be an ear infection, she could expect to come back to the office in another couple of weeks and once again brave a waiting room full of sick children during the busy winter months, all in order to find out if the ear infection had completely gone away. She would have to rely on someone who was trained to look into ears, and who had expensive medical equipment, to tell her whether her child’s ears were free from fluid.
An exciting new invention is poised to change all this!
Most parents are familiar with ear thermometers. A simple, elegant device is placed in the child’s ear, a button is pushed, and moments later you know what the child’s temperature is — without your having to hold a little glass tube into a body cavity for five minutes (often while the child kicks and screams).
The new EarCheck machine is far more accurate than ear thermometers, but just as easy to use. It slips into the ear, you press a button, the child hears a chirping noise, and within five seconds a tremendous amount of information is given concerning what’s going on inside that ear. This device will revolutionize the treatment of ear infections.
The ear is an amazing thing. Normally sound waves reaching the eardrum cause it to vibrate. The vibrations send a signal to the brain that the brain translates into an incredible range of sounds. EarCheck works by sending sound waves into the child’s ear. It then measures them bouncing back off the eardrum, thereby assessing its mobility. If there is fluid behind the eardrum (always present in otitis media), the eardrum will not be as mobile as it normally is. This lack of mobility is one of the reasons hearing loss occurs during ear infections.
If the EarCheck monitor gives you a “Green, Level 1” light, then you know the eardrum is functioning well. There is a 96.6% chance that there is no fluid in the middle ear, and that your child does not have an ear infection. If the EarCheck monitor gives you a “Red, Level 5” light, the eardrum is not moving well, and there is up to a 92% chance that there is fluid in the middle ear. If the EarCheck monitor gives a red reading, the child’s ear should be looked into by a physician who can determine exactly what is going on. A yellow or red light may or may not represent an infection. Even if it does, it may or may not need antibiotics.
If it turns out that your child has an ear infection, you can track the progress of the infection by using the EarCheck device at home. When the light turns green you can relax and know that the ear infection is resolved and fluid has left your child’s ears. (Even if the light does turn green, don’t stop any medicines that have been prescribed without discussing this with your physician.)
My biggest concern about the EarCheck is that parents may get a yellow or red reading and then call a physician and urge the doctor to prescribe an antibiotic without an office visit. This would be extremely unwise. While keeping kids out of the doctor’s office is a good idea as much as possible, the EarCheck does not give enough information to determine if antibiotics are necessary or not. Often when the light is yellow or red the child will not have an ear infection. Even if there is an infection, it may well be one that can resolve without antibiotics. If a doctor looks into the ears and determines that this is the kind of ear infection that does not benefit from antibiotics, then you can use the EarCheck at home to monitor the progress of the ears. Later, you and your physician can use the information you get from the EarCheck device to decide if the infection is clearing on its own or if medicine should be started.
The EarCheck monitor is available from a limited number of sources. To find out where you can purchase the EarCheck, you can call them at (888) EAR-CHEK (327-2435). For ear-infection-prone children, this wonderful device will quickly pay for itself by saving on unnecessary visits to the doctor. It will also give new information to parents that will equip them to be more active in making sure their child gets the care he or she needs.
In addition, the EarCheck will be an asset to physicians because it will give more information to them about the pattern of ear infections in the children they take care of. Currently, most pediatricians have a follow-up ear re-check appointment about two weeks after the first visit. At that time the doctor can determine if the ear infection is gone or not. If it is gone, the doctor doesn’t know how long it has been gone. Now the parent can check the child’s ears on a daily basis in the comfort of their own home and determine when there is no longer fluid in the ear. This gives the doctor additional information that can be used in future treatment. All in all this should result in a tremendous increase in care.
Using the EarCheck monitor will take the worry and guesswork out of the decision to see a doctor or not. Being able to detect fluid in the ear, using a simple and painless device while in the comfort of your own home, is a tremendous advance that will make the mystery and wondering behind the screaming in the night a thing of the past.
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