Medications and the Effects on YOU

Dale Johnson: More healthy conversation about the health of your hearing today on The Conversation Starts Here with Dr. Sandra Miller of Complete Hearing in Lincoln. You can find helpful information, too, at complete-hearing.com. All that said, I want to congratulate you, first of all, for being recognized in the Lincoln Choice Awards as the number one choice for audiology and hearing center. Congratulations.

Dr. Sandra Miller Au.D.: Well, thank you so much. We did a big happy dance when we found out what the results were. We were sad that they didn’t get to have the banquet, and we got to go get our award, but we are so grateful to be recognized. We work very hard, and we just love the fact that our people and our patients and our fans voted us that way. We thank the listeners, and we thank those people who voted for us.

Dale Johnson: Our hats off to everyone at Complete Hearing. Before we launch into today’s healthy hearing subject, bring listeners up to date on your practice style, these days, at Complete Hearing, 4200 Pioneer Woods Drive.

Dr. Sandra Miller Au.D.: Absolutely. Yeah, we’re really excited that we’re going to use this word kind of, we’re open, but we’re “clopen”. That just simply means we have decided to keep our lobby closed, but we are seeing patients that are scheduled. And so we have opened our schedules back up. We are seeing patients inside the office. If you’re simply just still coming for supplies, need a repair, need a cleaning, we are still doing curbside service, and drop off and pick up.

Dr. Sandra Miller Au.D.: And that simply means our staff is inside working really, really hard, but we’re limiting the traffic into the office. When you do come for an appointment, you are going to see no other patients in the lobby. We’re staggering our patients as they come in. We’re taking tons of precautions. We posted a video, coming up on our webpage just to say, “Hey, this is what it looks like now at Complete Hearing. And that just means we’re going to take your temperature. We’re going to ask you to wear a mask. We’re using some plexiglass screens in a lot of different places. Just taking lots and lots of extra precautions to keep the patients safe and to keep our staff safe.
 
Dr. Sandra Miller Au.D.: But, boy, I’ll tell you, it’s been a week of gratefulness that we have patients just back into the office and getting to reengage with them again. It’s been wonderful. So providing full service, but just in a different way.

Dale Johnson: All right. Our subject today, because the ear is very sensitive to changes in overall health, prescribed medications for body ailments can have an impact on a person’s hearing. Dr. Miller has linked us up today with another expert, Seward pharmacist, Mike Murray, for Murray Drug for The Conversation Starts Here.
 
Mike Murray: Thank you for having me.

Dr. Sandra Miller Au.D.: I guess, today, Mike, what I’d love for the listeners to know today is just who you are, a little bit about your background. And then I’d love to get into some conversations about just medications. At Complete Hearing, we do a full intake, and that just means when we see the patient, we are looking at a full meds list and taking a look at what they take, maybe potential interactions. And then, of course, we’re always looking at effects, whether it be tinnitus or balance, or is this toxic to the ear? And so those are things we look at, for sure, when the patient comes in. I thought it’d be really valuable just to talk about, again, who you are, but then some of the most common medications you might see some interactions and why they happen. I thought that’d be a great place to clock today.

Mike Murray:
Okay, well, we’ve been insured 41 years. I’ve had Murray Drug for 41 years. My wife and I have four kids that we have raised through, and kicked out of the house, and sent on their way. As far as medications, aspirin is probably the one that we see the most, where because it’s unregulated, it’s over the counter, so you really can’t control how people take it. Some people think the more, the better. And so you can have some problems with that. Most of the time, it’s a temporary hearing loss or tinnitus, ringing of the ear, that they experience. But sometimes it can be permanent.

Dr. Sandra Miller Au.D.: I love that answer that you gave today, because we have a lot of patients who come in and they say, “Well, I take a daily aspirin.” And I say, “That’s great. How many milligrams are you taking?” Because, who knows? Right? I love the fact that you said, “This is not regulated.” So, “What are you currently taking?” If we have patients who come in that are taking aspirin, or we can even talk about anti-inflammatory like ibuprofen, Motrin, Advil. “What are you taking? So I can understand, is this a risk factor that you might have?” Do you find that people take aspirins and anti-inflammatories for pain? Is it tend to be more for the fact of, “My doctor told me to do this for my heart.” What do you typically see for that?

Mike Murray: Well, most of the aspirin that we see anymore is, and I’ll use the word “prescribed” because the doctor tells them to take it. They don’t use it as a prescription, but it’s the 81 milligram, and they’re using it for their heart. We still do have some older people who take the 325 milligram aspirin, just because that’s all there used to be. And that’s what they took, and that was their pain pill. And again, like I say, sometimes the more, the better, and that’s where they kind of got into trouble that way. The ibuprofens and the Naproxens, the anti-inflammatory medications that are over the counter are kind of the same way. People take them. They don’t necessarily follow the directions on the bottle. They just take them, and they can run into some real problems. Problems besides just ear problems. But we do see quite a bit of that.

Dale Johnson: Dr. Miller, help me understand what’s going on inside the ear to cause a problem when I take aspirin or ibuprofen.

Dr. Sandra Miller Au.D.: Typically, what we see in the ear when people take too much aspirin, or say they take ibuprofen on a very consistent basis, is it has an effect in the inner ear on something called the stria vascularis. To make things more simply termed, you have this area where the stria vascularis is kind of where the housing of the inner hair cells are. And so when that becomes inflamed or there’s a blood flow issue or anything that happens along that line, it’s going to cause potentially, it could be temporary hearing loss. Just like Mr. Murray talked about, when you take these medications in high doses, once you stop doing it, does the hearing come back? And so we see a different amounts of things that might be that it’s temporary, but depending on how long they took it, other medications they might be taking, how their body is filtering through their medications, we do have the potential that it could be permanent. And so they’ve done studies, even in terms of people taking high doses of say, Motrin or Advil daily, on a daily basis all day long, they’re at higher risk for having potential hearing loss. It’s just important to know that everything you put into your body has an effect.

Dale Johnson: What are other types of more common drugs, then, that still are on the shelves that may cause hearing issues?

Mike Murray: There’s a lot of the antibiotics, the aminoglycosides and the quinolones, which are really common, cephalexin, Keflex, Levaquin, those medications. The good thing about most of those are, is they’re all short-term medications that the doctor will prescribe them for 10 days or seven days. And so there shouldn’t be as big of an issue with them unless, as Dr. Miller said, they’re taking with a high dose of aspirin or a high dose of ibuprofen that you really don’t even know that they’re taking, then you can have some problems with those antibiotics, also. Also some loop diuretics, Lasix, which are very, very commonly used medications that can cause some problems, also.

Dr. Sandra Miller Au.D.: I think it’s really interesting, Mike. Maybe address one of the things that I notice is when my patients come in, I’m always looking up their meds list. And when the meds list is short, I get kind of excited, because I think, “Man, they’re not taking much, they’re healthy. There’s not a lot of interaction going on.” As a pharmacist, when you see new prescriptions coming in for a patient, can you kind of go through the protocol of what your thought process is when you see that? What you’re going through in terms of, “Okay, this prescription is now here.” Is it your job to look at what they’re currently taking and then look for the interaction? Tell us a little bit about that.

Mike Murray: Well, one of the first things that I always do is when I have a new patient come in, a transfer in, move to town, or whatever, and we get a list of their medications and it’s a short list, the flags go up. Because a short list, a lot of times means that everything’s not on that list. And you kind of have to say to them then, “Well, okay, this is good. You’re taking this and this, but what are you taking this non-prescription?” “Oh, well I have this and this. I take five or six things over the counter.” And then you can kind of broaden your thought process on how you’re going to deal with the situation, the new prescription that they have, if there’s a potential of an interaction. Obviously, even if it’s a regular patient of mine and there’s an antibiotic that comes in or a new prescription that comes in, I will be sure and warn them and say, “Don’t take this with something over the counter, because there’s a bad interaction between it or they’re synergistic, and you shouldn’t be doing that.”

Dr. Sandra Miller Au.D.: I love that, because I don’t think that always happens, maybe. That’s definitely such a wonderful thing when you think about working with a pharmacist is that they understand how each piece is going to interact with something else. You may not think that a drug that you’re taking that’s prescription, and then you take something over the counter, that they may have an interaction. I don’t know that people even think about that.

Mike Murray: Well, and the other thing, unfortunately, that happens a lot, especially in this day and age of urgent cares and those type situations, is people use more than one physician. I’ve been around long enough, it used to be you went to one doctor, he delivered your kids, and you went to him until you were old. Now, with the online doctors, you can go, and so you might have four or five doctors on a person’s profile, four or five different doctors. And, you know, I mean, as much as they try, they aren’t interacting, and they’re not a 100% sure what that patient is taking.

Dr. Sandra Miller Au.D.: That’s a really good point. There’s a lot of times, too, I think, as we see patients as another provider outside the loop is, of course, we’re trained in pharmacology, but we aren’t experts in, by any stretch of the imagination. Sometimes when my patients are displaying symptoms or they’re coming to me with certain things that might be ear related or balance related, I always talk about making sure your side effects of your medication, and then having an open conversation with your doctor or with your pharmacist, because I think it’s so important.

Dale Johnson: Mike, would you agree to continue this conversation for another program?

Mike Murray: Yes, I would. Thank you.

Dale Johnson: All right. All right. We’re going to continue next week with Mike Murray from Murray Drug in Seward. Dr. Miller, how can someone reach out to you?

Dr. Sandra Miller Au.D.: A great way to reach us is simply give us a call 402-489-4418. Check out our website, complete-hearing.com. Even though our lobby is closed during the day, you’re more than welcome to drive up to the front door and give us a call. We’ll let you right in. We’re at 4200 Pioneer Woods Drive, which is just about at 72nd and Pioneers.

Dale Johnson: And we’re here every Saturday morning for The Conversation Starts Here.

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