it's a wild time

I hope none of you ever experience it!! But if you ever wake up one day with a clogged ear, a decrease in hearing/muffled hearing and/or ringing - especially if it's only in one ear: Go to the emergency department. Not a GP or family doctor, and most definitely don't try home remedies of dripping olive oil into your ear. Please just go straight to emergency. Immediately. Right away. Without delay.

Even if the doctors find its just earwax, in which case - you can breathe easy - do insist for a comprehensive audiogram to be done (that is, one that goes higher than the usual 8k frequency). This is very, very important to rule out SSHL, because if it is indeed SSHL, treatment is most effective when started within 24 hours of symptom onset. Treatment effectiveness decreases with each passing day, and after 3 weeks, treatment may no longer have any discernible impact.

I'm starting on it very close to this 3 week mark, so I'm crossing my fingers that things will work out fine. it took me four doctors to finally get a proper course of treatment, because the first two did not realize it might have been SSHL since I didn't show the typical signs of a significant loss in hearing. The third did though, after a simple audiogram didn't show very good results (I had a big drop at the 6-8k range but they didn't have the facilities to test any higher). He warned me to seek a specialist immediately. That was when I found out that my range of loss was in the 8-10k frequency range. Prior to me starting treatment, it has thankfully improved from a moderately severe loss to a mild loss now, but it still isn't back to normal yet. Extrapolating from my first audiogram, the doctor shared that I likely did actually have a big drop in that area all those days ago, which would have warranted an SSHL diagnosis.

It's 20 days after my symptom onset, and Day 2 of medication, and the side effects are horrid to say the least. As long as it helps... I guess I have to try to just bear with it for now.

Which reminds me - speak to your doctor on the potential side effects and how to prepare against it, because it would help to brace yourself for a tough few weeks! Much better than being caught off guard.

Then see me silly

see me writhe round willy nilly

see me bite and kick a toy

No one tells them their bowels are going to lose strength and coordination, so it gets more and more difficult to have bowel movements. No one warns them about obstipation, much less bowel obstructions. I have a saying I repeat often in clinic: “Proper pooping prevents problems!” I say it because it makes people chuckle, because it destigmatizes needing to poop. Everyone poops. And it turns out pooping requires both a complex network of nerves to create peristalsis, and stools soft enough to move through the bowels, and I have watched more than one elderly patient die because their bowels stopped working right.

No one talks about hemorrhoids, so I have patients coming in terrified by blood in their stools–and listen, blood in your poop is definitely a good reason to see a doctor; if you’re over 50 and you haven’t had a colonoscopy, get one. It’s the best health screening we have evidence for, in my opinion. Colon cancer is a bitch. But more commonly, people have bloody stools because they have either hemorrhoids that are bleeding or because they have an anal fissure after straining on a hard bowel movement. Do you know what a hemorrhoid is? I didn’t, until I was well into medical school. Everyone has them. They’re venous columns that surround the rectum and anus. Internal ones can bleed; external ones can itch. Most people will get them eventually. Be kind about them.

Everyone is going to have trouble peeing if they live long enough. Men can’t start, women can’t stop. Because people with prostates will often have benign enlargement of the prostate–it’s not cancer, but it gets bigger–and the urethra, the tube that lets urine leave the bladder, goes through the prostate. Bigger prostate = compressed tube, less flow. Meanwhile, people with uteruses have much shorter urethras, which means that when we lose that beautiful collagen and elastic, we also lose it in the two sphincters that help us keep from leaking urine, and so we leak urine. Especially when something triggers an increase in intra-abdominal pressure, like a sneeze or a cough or a laugh.

All these things people are taught to be ashamed of and embarrassed about–they are so common. They’re normal parts of having a human body and doing the things one does with a human body. Poop trouble? Welcome to the club! People have been writing about their cures for constipation for as long as written language has existed. Listen, you are not alone. You are not alone. You are not alone. And that means that when someone else has a gross problem, you must be kind to them, because that is going to be you. There will be a day when you have diarrhea, because viral gastroenteritis spreads like wildfire every winter. There will be a day when you cough a huge glob of mucus comes out, because mucus is a natural defense mechanism and kind of miraculous but also nasty. Every gross thing a body can do, yours is likely to do, if not now then later.

Rick Hobson