Dear Dr. Roach: I am a healthy 76 year old female and over the years have had a tendency to accumulate earwax and have it removed periodically. The doctor used a small vacuum cleaner and the noise was very loud. Immediately afterwards he gave me a hearing test and I have hearing loss in my right ear.
Since this incident, about two months ago, I have had tinnitus which is debilitating me and affecting my quality of life. The otolaryngologist suggested an MRI, which I decided not to do. I know it’s not curable, and I know there are methods to manage it. My question is, do you think the decibel level of the vacuum exacerbated the tinnitus? The doctor said that because one of my ears was 100% affected, I notice tinnitus more now. – THAT
Answer: I think your doctor is probably right, that you notice tinnitus more now.
Tinnitus is most often due to hearing loss, whatever the cause. You are unlikely to suffer lasting hearing damage from loud noise of short duration. A vacuum device, held right next to your eardrum, is very loud, up to 103 decibels. Hearing damage due to acute noise exposure is likely to occur when noise is above 120 dB. If the doctor had checked your hearing before cleaning your ear, I suspect it would have been worse than with the wax removed, but of course I can’t be sure.
Using an over-the-counter earwax remover before vacuuming makes the procedure much easier (and sometimes makes vacuuming unnecessary).
Tinnitus that beats in time with your heartbeat should always be further evaluated because it may be caused by an abnormal blood vessel in the brain, such as an aneurysm or fistula (abnormal connection of an artery to a vein).
Dear Dr. Roach: My wife keeps all the prescribed medications. Some are over 10 years old. Can they deteriorate into something deadly, or do they just lose power? I couldn’t convince her to throw them away. I hope you can! —DR
Answer: There is at least one drug, tetracycline, which over time can break down into a substance that can damage the kidneys. However, there are few or no other reports of dangerous expired drugs.
Some drugs break down quite quickly over time. Insulin, nitroglycerin and liquid antibiotics should be used before their expiry date.
Most other drugs remain fairly stable over time. The expiration date is when the manufacturer guarantees it will be safe and effective. However, a study done by the Food and Drug Administration for the military showed that 90% of drugs were almost completely unchanged (and therefore safe to use) for 15 years after they expired. Some drugs have been shown to be stable for decades, even a century or more, if kept in a cool, dark place.
My main concern is whether she is taking these medications appropriately. Many people save antibiotics. Don’t do that; finish your antibiotics. And don’t treat yourself for what you think is an infection. Prescription drugs are powerful and have risks, and your doctor needs to know when you are taking them or not.
Dr Roach regrets that he cannot respond to individual letters, but will incorporate them into the column whenever possible. Readers can email questions to [email protected] or send mail to 628 Virginia Dr., Orlando, FL 32803.