Insects in the Ear!

When I saw this video, I remembered the countless times I removed different kinds of insect in the ears of a lot of people at the Jose Reyes Medical Center's Emergency Room. These were the cases that we usually attended to especially in the wee hours of the morning, with patients claiming "something" crawled up in their ear while they were sleeping. I have removed cockroaches, wasps, moths and even worms! I remember one case where a mentally challenged individual was brought to us complaining of movements inside his ear, and on otoscopy and endoscopy, we saw several moving "fruit" worms in his middle ear! We had to bring him to the operating room to put him under sedation to be able to remove the worms.

A colleague of mine reported once that he removed several live and feeding ticks in 2 sisters who had a shihtzu sharing their bed. He also had an experience of removing live maggots in the one ear canal which burrowed in the middle ear!

It may be so "gross" to some and unthinkable to many but these cases do happen and here are some tips you might want to know just in case it happens to someone close and there's no doctor around.

1. Remain calm. It is a scary situation but you have to focus on the task at hand.

2. Assess the object to see if it can be easily seen in the ear canal and be removed. Pull the ear upward and backwards to better visualize the canal. Use a flashlight for a better lighting.

3. Insects/objects that can be easily seen can be grasped with tweezers and pulled out gently. Remember to have the person or child stay very still while you remove the object.

4. Gravity can also help dislodge the foreign body so you can tilt the head to one side and gently shake the head until the object falls.

5. Flushing the object out of the ear by using boiled, but cooled down, water may also help to remove the object. Use a bulb syringe to suck up the water, tilt head to the side over a bowl, squeeze the water into the ear canal and let the water flush and drain out from the ear canal. You may have to do this more than one time, and should only be done when object is really small.

6. Just like in the video above, removing insects that may have crawled or flown into the ear can be accomplished by pouring warmed mineral, olive, or baby oil into the ear canal. After the oil is poured into the ear canal, let it stay in the ear for a few minutes and then tilt the head over a bowl, allowing the oil to drain out. This process may need to be repeated until the insect flushes out of the ear or you can do step number 5 to facilitate the insect removal.

Abdominal Epilepsy?

The other day, I encountered an uncommon medical diagnosis, abdominal epilepsy. Maybe I was absent when this was taught in med school or maybe it was mentioned but it just didn't register in my memory bank. Anyway, for those colleagues who haven't heard of this as well, here's what I found out about it, so that next time you are faced with a weird abdominal pain, you will think of abdominal epilepsy as a differential. There are many medical causes of abdominal pain; abdominal epilepsy is one of the rare causes. From a medical perspective, the term epilepsy refers not to a single disease, but to a group of symptoms with numerous causes. The common factor in all forms of epilepsy is an excessive electrical excitability of the brain. The increased excitation is called a seizure and may manifest as a partial or total loss of consciousness and muscle spasms or other involuntary movements. Many conditions can produce epilepsy. For example, a genetic predisposition is

"Ganacity"

If there's one word that I will never forget from my AGSB experience, it's "ganacity"! A word frequently mentioned by our FinMan professor. What does it mean? It's a combination of the tagalog word "gana" (appetite, zest) and the english suffix "city" which converts an adjective word into a noun. 'Ganacity' therefore refers to one's state of desire or interest in something. I am sharing this because I feel that my 'ganacity' for what I am doing now is spiralling down, and it is so difficult to reverse it back up or just to keep it at a maintained level. It is becoming a struggle on a day to day basis. I am hoping that night and day will alternate fast so that this battle will end soon.

The Beauty of Giving

It is heartwarming to read how people are coming together to help and support all those involved in this war against the corona virus 19. Indeed, the blessing in this crisis is the transparency of people and the willingness to help those in need without a second thought. We have proven once again that we can care beyond ourselves. Hopefully though, this selflessness goes beyond the end of this pandemic. Giving sincerely is powerful not only for the heart but also for the mind and soul. It provides an intrinsic reward that’s far more valuable than the gift. It’s ‘finding one’s self by losing it in the service of others. As we nest in the comforts of our home, let us continuously find ways to help others in even small and meaningful ways.

Tooth and ENT Doctor

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