Dr. Shyam Kalyan N
MBBS (MADRAS MEDICAL COLLEGE)., DLO., CERTIFICATE IN ALLERGIC RHINITIS MANAGEMENT., DNB
Allergy Specialist, Otolaryngology (E.N.T
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Now, let the patient be aware of and follow the instructions below:
1. I think, based on details that the drum is not intact. So, at all costs, the patient should not let water enter the said ear. While bathing they have to keep a cotton plug with a drop of vaseline inside the ear canal. The vaseline will act as a perfect seal for water to not enter. After bathing they should remove the cotton plug which may have got wet. Swimming needs special precautions as well. Plugs may help. If not helping consider not swimming.
2. Now, let the patient complete the course of Levofloxacin. I hope the frequency and dosage of the medicine have been checked by an appropriate doctor. If you have any doubt regarding that write to me and I shall guide you.
3. Esomeprazole helps in removing reflux related symptoms which indirectly worsen ear problems. Esomeprazole 40 mg tablet may be taken once daily in empty stomach, say half an hour before breakfast.
4. In the current scenario, in addition to Levofloxacin and Esomeprazole, the patient needs a good decongestant and antihistaminic. Something like Sudafed (Pseudoephedrine) and Allegra (Fexofenadine). These drugs produce sleep as the side effect and can be taken half a tablet twice daily. If you need something for pain relief, Sinarest LP and Recofast plus have an additional Tylenol (Paracetamol) component in their combination medicines. If you get these drugs where the patient is I can guide regarding the dosage and frequency.
5. An anti-inflammatory medicine like Chymoral forte (combination of Trypsin, Chymotrypsin, Bromelain, Rutopside) will be helpful in accentuating the healing and removal of dead cells and clearing out inflammatory products from the site of the problem. Other alternatives to this drug are Phlogam, Serratiopeptidase, etc.
6. The patient is advised to take rest. Once the condition subsides completely then the patient needs a full evaluation including ear under microscope and audiometry.
7. The antianxiety medicines need to be taken seriously if the doctor has prescribed and taken properly as per instructions.