Dale Johnson: Dr. Sandra Miller of complete hearing in Lincoln joins me this morning on KFOR for The Conversation Starts Here. Complete-hearing.com is your source for much more information and where you can hear this conversation again and past better hearing conversations with Dr. Miller every Saturday we focus on the health of your hearing. Good morning Dr. Miller.
Dr. Sandra Miller Au.D: Good morning. Nice to be back today.
Dale Johnson: Weather is starting to cooperate. Thank you mother nature…
Dr. Sandra Miller Au.D: Yeah.
Dale Johnson: … showing us some budding trees and some lush green lawns and soon the bees will be back. But so will the allergies and that’s our subject today. Explain how allergies and what they do to an ear impacts our hearing.
Dr. Sandra Miller Au.D: Absolutely. So I just noticed that with all the things that are happening and the change of season and such, people are very prone to allergies, some have subtle symptoms. I was teasing you earlier that I think that I never had allergies till I moved to Nebraska and I think if you’re here long enough your nose just starts to run. I don’t know, maybe randomly. So one thing I want to talk about today is the allergy symptoms that you might be having and how that can really play into your ears becoming plugged. So I think they will talk about when the ears get plugged and allergies, we are going to tie that together. And then other things that really cause your ears to plug and how can we help that? So were going to talk about the anatomy first today. Why do my ears get plugged?
Dr. Sandra Miller Au.D: So there’s something called your eustachian tube. It’s located near the back of your nose and it connects your middle ear to your throat. And it’s purpose is simply to equalize the pressure in your middle ear. So I want you to think about when you fly on an airplane and when you get that really plugged feeling, it’s because of the pressure on the outside and the pressure in your middle ear are not equal. And that’s why you get that plugged feeling. What’s nice about your eustasian tube is it naturally opens and closes when you chew or when you swallow. So naturally it’s opening and closing all day and it’s keeping that middle ear nice and balanced for airspace. What’s interesting is the lining of the eustachian tube is the same as the sinuses and as the nose. And so when allergies and sinus infections start to flare up, you can imagine that that lining swells so that eustachian tube, what will happen is it will become more closed.
Dr. Sandra Miller Au.D: And so naturally the air in the middle ear space is not being ventilated and that’s why your ear feels kind of plugged and so that’s how it’s tied to allergies. It’s just that inflammation of that lining. And so it’s happening in our nose and in our sinuses, but it’s also happening in that tube that ventilates the middle ear. And that’s why it feels plugged up.
Dr. Sandra Miller Au.D: There’s other things that can actually affect those [inaudible 00:02:57]. I want you to think about, we talked about being in an airplane, even when you maybe are driving through the mountains in Colorado and you notice how your ears plug up, same concept minus infection. Those are the things where the ears get plugged because that system where that eustachian tube is not ventilating correctly will cause your ears to feel plugged and if they stay plugged long enough, what will happen is you’ll develop fluid in your middle ear.
Dr. Sandra Miller Au.D: So if you end up developing fluid in the middle ear that’s going to cause some things that maybe your ears will feel even more full. There are a couple of things that cause your ear to feel plugged that might not be tied with that eustachian tube and that can simply be earwax. We’ve talked a lot about earwax before and what happens with that and a final thing that maybe makes your ears feel plugged is a sudden hearing loss. You wake up and you just can’t hear and your ear will feel plugged with that as well. So when you have this plugged feeling, we need to get to the bottom of what might be causing it.
Dale Johnson: You had my attention when you said my ear went all the way behind my nose.
Dr. Sandra Miller Au.D: Yes.
Dale Johnson: Did not realize that.
Dr. Sandra Miller Au.D: Yes, behind your nose, kind of in your upper throat. We call that area the nasopharynx. And that’s where that eustachian tube ties into. I think our body is so uniquely made when you think about when I swallow or yawn or chew that this just opens and closes. And this pressure equalization just happens naturally. But when you start to get these other symptoms and those linings start to swell is when you start to notice, oh my ears are just plugged today. I think it’s so interesting that how our body just dynamically works.
Dale Johnson: Help me understand plugged. Now, ear wax, that’s a substance I can visually see. Yeah, it’s plugged it’s blocking a canal. But elevation for example. And yawning seems to unplug.
Dr. Sandra Miller Au.D: Right.
Dale Johnson: Help me understand what’s going on in there.
Dr. Sandra Miller Au.D: Great. So we’ve talked about how naturally when we chew and when you swallow, what happens, those are kind of the solutions to the ear being plugged. So if you swallow and yawn, what happens is air is going from the eustachian tube and being pushed back into the middle ear space. So when it opens back up, it equalizes the pressure. Well, imagine when that’s not opening and closing as naturally as it should because that lining is swollen and the pressure’s not equalized. You have to end up forcing the air into that middle ear space to make it feel unplugged. I often tell my patients, your eardrum is like a thin piece of paper and what happens when the pressure is not equal from the outside to the inside because that tube on the middle ear is not functioning, is that piece of paper gets kind of sucked in or retracted and it starts to feel kind of like the ear is just plugged. And so when we swallow, we push air into the middle ear or we yawn. That will allow that pressure to equalize.
Dr. Sandra Miller Au.D: So those are two ways to kind of get that to solve. The other way is something we call the Valsalva maneuver and just means you’re going to simply plug your nose and blow with your mouth closed. And what that does is again, it pushes air from the eustachian tube up into that middle ear space. It opens that up and pushes the eardrum back out and it makes it more natural in terms of popping the ear. So people say, well sometimes my ears pop when I swallow and chew and that’s because the air is being pushed up into the middle ear. So when we Valsal we just plug our nose and blow with our mouth closed and that usually does the trick.
Dr. Sandra Miller Au.D: Another one is called the Lowry method where you would plug your nose and swallow, is another way to do this. And there’s other things you can do over the counter. You can buy something called [inaudible 00:00:06:35]. It’s another way to push that air through the nasal cavity and open up that space. And then sometimes your primary care physician or an EMT position may say, Hey, you know what? An oral decongestant would be a good idea for you as well.
Dale Johnson: If we were on Zoom, viewers would have seen me holding my nose and closing my mouth doing exactly what you were instructing people to do.
Dr. Sandra Miller Au.D: Yeah. I think a lot of people always ask me about flying. I’m so concerned when I fly if my ears pop, what can I do for that? And I have the same problem. I know my eardrums don’t move very easily. So when I fly, I always take an oral decongestant before I get on the airplane and I constantly have like a bottle of water with me and I’m yawning and swallowing, just trying to keep my ear from not plugging up cause I’ve been in a situation where I didn’t have the ability to do that. And boy, by the time I landed, my ear was full for an entire day where I just couldn’t get my ear to pop back open. So it’s just something to think about when you have those symptoms and when people start to have these, especially during allergy season. Some of those strategies are just some of the things I’d recommend you do. Swallow, yawn, drink some water, plug your nose and blow.
Dale Johnson: I’m a fortunate one to not be suffering from allergies, but there are plenty of people here at the radio station and around me that do and they associate it with a nose thing. So in this conversation, which deals with hearing and ears, how much of the nose do you as an ear specialist, a hearing specialist, have to know?
Dr. Sandra Miller Au.D: No, it’s not one of our primary focuses in terms of do we focus on the nose in terms of the anatomy and learning about those types of things. I would say my knowledge of nose and things like that are more limited.
Dale Johnson: Mm-hmm (affirmative).
Dr. Sandra Miller Au.D: Just knowing that the lining of the eustachian tube affects the middle ear definitely is the same lining that’s in the sinuses. We know things that correlate to each other. So when people come to me and say, you know Dr. Miller, I have a sinus infection, my ears feel really plugged, well then I definitely know, okay, that’s because of X, so that I know the correlations between the two systems for sure. I don’t have an in depth detailed knowledge of nose and sinus type of things.
Dale Johnson: Mm-hmm (affirmative).
Dale Johnson: For people wearing hearing devices and have allergies. Do adjustments need to be made by a professional rather than me just sitting, watching TV and holding my nose and blowing out. Are there things that you as a professional can adjust to compensate for my allergies?
Dr. Sandra Miller Au.D: That’s a really good question because I tell my patients during this time of the season, they’re wondering if it’s them or if it’s their hearing aid that’s not working. So when they get this full feeling they’re not quite sure which [inaudible 00:09:20] to address. So we always make sure the devices are working well and then we tell them when you’re having this fuller feeling, I want you to use all those strategies we talked about, swallowing, yawning, Valsal, Lowry. But then we also say in the times when it’s plugged up, just turn the volume up. It’s a temporary typical problem. We can use the volume control or we can actually set up a secondary program for them to use during those times when they’re feeling a little more plugged up.
Dale Johnson: You can find out more information by going to complete-hearing.com. You can learn the basics or you can attempt to get in touch with the professionals at Complete Hearing even in the new way in which we are living because Complete Hearing is made some adjustments. Talk about the clinic.
Dr. Sandra Miller Au.D: Yeah, absolutely. I can encourage your listeners to check us out on Facebook or on the website. We are continually monitoring and abiding by state recommendations the governor’s recommending. Maybe we can start seeing patients again or open up our clinic to see patients again on May 4th. So what’s happening on the backside of Complete Hearing we are very much preparing for that to be a very safe environment, for you to come in. We are going to be doing some things that we haven’t done before so we are going to be telling our patients this might look a little different than what you’re used to. Just like everybody’s used to when you’re out and about now. I went to Trader Joe’s this last week and how they’re having you stand in a certain position and the shields are up in terms of the plexiglass shield. While Corona virus is still very active around our state, we want to make sure that we’re diligent and so what you’re going to see when you come back into the clinic is a little bit of a different change and we’ll talk more about that next week.
Dr. Sandra Miller Au.D: We continue to have curbside service drop off and pickup. We’re still answering the phone, sending out supplies at no cost. We’re doing tele-health. We’ll talk more about that next week as well. So there isn’t anything still going on that we’re still connecting with our patients and making sure that they’re taken care of and we’re serving anybody in Nebraska. So if you have a need, Complete Hearing is ready to serve you even though it’s in a different way.
Dale Johnson: And the email, Dr. Miller, [email protected] for immediate hearing needs.
Dr. Sandra Miller Au.D: Yes, give us an email. That is monitored every single day as well as giving us a phone call. Our phones are answered every day as well. Every work day, I should say, Monday through Friday.
Dale Johnson: You may get Kim, Kim picked up the phone at the office when I called to get in touch with Dr. Miller. So you may, you may hear the friendly voice of Kim when you call the clinic. All right, complete-hearing.com hear this conversation again. There is a podcast tab on Complete Hearing’s website. You can hear this conversation and catch up on other interesting hearing conversations too with Dr. Miller because every Saturday morning we’re here. The Conversation Starts Here. Have a good weekend, Dr. Miller.
Dr. Sandra Miller Au.D: You too. Thank you, Dale.
