October 27, 2010

Natural Care for Painful Ears

It's cold and flu season again, and that means it's ear infection season too.  3/4 of the patients I've seen this week have had a sore ear, some for the first time, and some as an ongoing complaint.  Treating a painful ear at home is often simple and effective - it's just a matter of knowing why the ear is sore, and when it's safe to self-treat.  Since about two thirds of acute ear infections resolve without any treatment, this is often!

Most adults and older children will recognize when they have a middle ear infection.  The ear feels full and painful.  With a younger child or nonverbal adult, you'll generally see signs such as a red ear, crying or screaming, fever, tugging at the ear or digging in the canal, or non-wax discharge from the ear.  Acute middle ear infections usually come on with a cold or follow closely afterward.

The first thing to do when someone has a painful ear is to look inside to see what is going on.  Sometimes the infection is actually in the canal (otitis externa), rather than behind the eardrum (otitis media).  (This article doesn't cover therapies for otitis externa.)  Sometimes in an intense infection, the eardrum will rupture.  Unfortunately, it so often happens that the pain comes on in the evening or in the middle of the night.  In this situation, it's important not to put any medications INTO the ear canal until someone can take a look inside.  If you feel comfortable using a home otoscope, you can look in there yourself, otherwise call your favorite ND.  Laughing

Parents often wonder if their baby or toddler is just teething.  In my experience, if tugging or poking at the ear is the only sign, there is no fever, no screaming, no discharge, and no red ear, and there's a lot of drooling or biting, then teething is the more likely culprit.  If any of the other ear signs are present, though, it's important to check for an infection.

If you haven't looked in the ear, there are still things you can do to ease pain and support the immune response, including homeopathy and hydrotherapy

Homeopathy is very effective for ear infections.  Two to three doses of a 30c potency (available at your local health foods store) will usually do the trick, when you get the right remedy.  Several common remedies for earaches include the following:

  • For a child or adult with a terribly painful ear that starts around 9 or 10pm, who won't let you even think about touching the ear (except maybe with a warm cloth), and wants to be carried or held even though they are irritable and demanding, think Chamomilla, especially if one cheek is red and the other is pale.
  • If the earache comes on at night, there's an associated sore throat, drooling and sick-smelling sweat, think Mercurius, especially with yellow-green discharge from the ear.
  • The most frequent remedy for ear infections, both acute and chronic, is Pulsatilla.  The person needing this remedy is weepy and wants to be held tenderly and given lots of affection.  It's often the left ear that is most affected, with a painful full or bursting feeling.  It is worse with heat and better in the open/cool air.
  • In a person with a very high fever, red, hot face, cold hands and feet, and an unbearably painful ear (especially the right side), think of Belladonna.  The pains throb, tend to come on around 3pm or after midnight, and are worse with being bumped.  This person may be delirious with fever.

A good book for homeopathic self-treatment is Homeopathic Self-Care: The Quick & Easy Guide for the Whole Family.  If the remedy isn't having any effect after three doses, stop.  If you are having difficulty finding the right remedy, call your ND or homeopath for help.

Two simple hydrotherapy treatments for an ear infection are the onion poultice and warming socks.

  • To make an onion poultice, thinly slice an onion and sauté in a small amount of distilled or filtered water until the onions are transparent (clear).  If all you have is tap water, that's okay.  Place the sautéed onion into a cotton cloth (a flat-fold diaper works well) and gather the loose fabric.  This is where you will hold it.  Make sure the poultice is not burning hot before you apply it over the entire outer ear.  Leave it on until it cools and then gently dry the area and go to bed.  For a stronger treatment, make two poultices and do the second as soon as the first cools.  This treatment helps the pain and is antimicrobial.
  • The warming sock treatment is useful in any cold, ear infection or sore throat.  It increases the circulation of blood and stimulates immune activity.  The most important part is to be WARM before you start.  Take a warm bath first if there is no significant fever.  Next, take a pair of thin cotton socks and soak them.  Wring them out as much as possible and then apply them to warm feet.  Cover each entire sock with a wool or fleece sock and go to bed.  Kids will often want to take them off at first, but a few minutes of distraction usually gets them to the more comfortable part.  In the morning, the socks will be dry and the feet will be warm.  ***It is very important NOT to do this treatment in a person with impaired sensation or circulation in the feet, such as a diabetic.***   Here is a fun instructional video made by an NCNM student.

Once it has been found that there is no rupture of the eardrum, in a person without tympanostomy tubes, it is also possible and helpful to use ear oil drops.  There are many herbal formulations - one of the most common is garlic and mullein in olive oil.  You can find this oil at the health foods store, or make it yourself (ahead of time).  Warm the oil to body temperature before applying 2-3 drops in the painful ear.  You can put a cotton ball in afterward to help keep the oil in, if needed.  The warm oil is soothing and the garlic helps fight the infection.

I often get asked about ear candling for ear infections.  I do not recommend ear candling, as I find no evidence that it is helpful or even does what it's intended to do.  There is also a risk of burns from the hot wax, as well as getting wax into the ear canal.  As you've already read, there are many simple, effective ways to treat ear infections.  Why use an ineffective, possibly harmful, and costly therapy instead?

The best way to treat an ear infection, of course, is to prevent it altogether.  Prevention includes maintaining a strong immune system, drinking plenty of water, and eliminating reactive foods.  Prolonged exclusive breastfeeding is also protective against ear infections in children.  Your naturopathic doctor is well-equipped to give you support with all of these.

One last note, there are other times to seek out medical help (not an exhaustive list):

  • Any fever in a baby under 4 months.
  • A fever higher than 104°F, especially if the cause is unknown.
  • Redness is not confined to the ear, but extends behind the ear.
  • There is swelling behind the ear.
  • An infant or child is listless, unresponsive, dehydrated, or your instinct tells you something is not right.
  • Home remedies have not helped.
I wish you a happy, healthy fall and winter, but if you or someone you love does get sick, now you have a home toolkit for feeling better faster.

October 21, 2009

So, What About All That Halloween Candy?!

I have three kids and they have been looking forward to Halloween for over a month.  My eight year-old has actually been counting down and regularly announces how many days are left.  I am secretly pleased that they're more excited about what to be for Halloween than about how much candy they'll be getting, but I can't stop thinking about all that candy.

Every year I fret about the sugar, artificial colors and flavors, preservatives, and food allergens we'll have to try to avoid.  I wonder whether I should just let them stuff themselves for one day and then throw the rest out, or dole it out piece by piece until it's gone.  I wonder if it's too late to introduce the "Halloween Fairy" or the "Sugar Sprite", who will come to my house to magically transform all the candy into fairy dust and presents.

I remember how much fun Halloween was when I was a kid.  My mom would help us create whatever bizarre costume we got it in our heads that we had to have.  My sister and I were witches and gypsies, princesses and doctors.  One year I was actually the Ace of Hearts.  And the candy!  We would go out and spend HOURS walking through our neighborhood trick-or-treating.  There was the weird guy who gave rolls of pennies and the dentist's wife who always gave out toothbrushes, but mostly there was candy!

So this year I've been thinking about how to change our Halloween tradition for the better, because I want my kids to have great memories too, and I'm not convinced that wallowing in junk has to play such a big part.  Here is some of what I've come up with:

What To Give Out

After searching a bunch of websites for ideas, I found three that I thought had the most to offer.  (Thank you to Suzi Milovanovic on, Jayne Pupek on, and Emily's blog, PaperSeed.)  Here is a list of "treats" that you don't eat:

  • Art supplies: activity pads, coloring books, crayons, chalk, notepads, pencils, pencil toppers, erasers, play-doh, stampers, stickers, paint sets, child-safe scissors, modeling clay, markers, glitter, colored pencils, origami paper and instructions
  • Toys and activities: balls, bubbles, glow sticks, maps, mini globes, books, mini magnifying glasses, matchbox cars, toy dinosaurs or animals, whistles, yo-yos, marbles, dominoes, decks of playing cards, small dolls, coins
  • Dress-up: false teeth, temporary tattoos, bracelets, necklaces, key chains or clips, sunglasses, hair clips, ribbons, scarves, eye patches

Some of these are more expensive than others, but you can make some of them, or find many of them at a dollar store or thrift shop.  You may want a separate stash of child-safe goodies for the 3 and under crowd.

Halloween Traditions

I know that there can be much more to the fun of Halloween than just walking around the neighborhood getting candy.  Here are some of my thoughts:

  • In Fort Collins we have a fun Old Town tradition for younger children, Tiny Tot Halloween, a morning-time trick-or-treat parade around Old Town Square.  This one does involve candy, but it's always so much fun to see all the kids in their costumes, and they don't have to be out after dark.
  • Also, the Gardens on Spring Creek have a Halloween Enchanted Garden, complete with a garden tour, pumpkin painting, magic show, and stories.  Kids 2-8 are encouraged to get dressed up and come  have fun.
  • There are many other events in our area for both kids and adults.  The Coloradoan has a list here.
  • When my oldest was little, a group of friends arranged our own "trick-or-treat street" at our school.  We set up "houses" using sheets and the kids would go from "door" to "door", getting treats that we all felt comfortable with them having.  All the fun of the "real" thing, at least for the toddler and preschool bunch, without the stuff mom and dad don't like.
  • For each holiday, we try to share with our kids where the holiday came from, its place in the cycle of the seasons, and different cultural ideas and celebrations.  Samhain, All Saints Day, and Dia de los Muertos are just a few that happen this time of year.
  • One tradition that I would like to be more consistent with is taking a picture of each of my kids in their costume each year.  It is so fun to look back and remember the creativity and silliness from Halloweens past.

So, What About All That Candy!?

Now we're left with what happens when your little monsters (and ghosts and stockbrokers) DO go trick-or-treating and come home with all that sugary loot.

  • Some families have started their own "Halloween Fairy" tradition, along the lines of Santa or the Tooth Fairy.  The kids leave their candy out, and in the morning the Halloween Fairy (or Sugar Sprite or Great Pumpkin...) has left them a little present.  I personally think this is a great idea, but I have a feeling my eight year-old wouldn't buy it at this point. 
  • Which leads me to the next idea - candy bartering.  Although it misses out on the "magic" of the Halloween Fairy, it gives kids the chance to pick their own gift.  Essentially, kids trade in their bag of candy for something else - a toy, tickets to a movie...whatever you and they can come up with together.
  • Next is what I like to call the "Gorge and Purge" method.  It's an all-you-can-eat buffet of junk food - for one night only.  The benefits are that the kids get that liberating feeling of being able to eat as much candy as they want, and then they get the lesson of why that maybe isn't such a good idea. 
  • Or there's the "Trickle-Down" method.  A few pieces on Halloween, and then one a day until it runs out.  (Or whatever mom and dad decide.)  The benefit of this is that the junk is sandwiched between all the healthy food.  The biggest downside we've found in our family is that the candy lasts until the next Halloween.
  • And then there's the one that my parents instituted:  mom and dad's candy tax.  When we got home and started counting out our treasure, 10% was swiped right off the top.  Laughing  
  • Or you can mix-and-match one or more of these.

I'm going to try some new things at Halloween this year.  My hope is that Halloween can be a fun family celebration with a lot less of the junk.  We can do it!  And if any of you have great ideas for reducing the Halloween candy load, or if you would like to share your family's traditions, I would love to hear from you!

Happy Halloween!

September 25, 2008

Vaccination - What's A Parent To Do?

Pretty much every parent in my practice asks about immunizations at some point.  What do I think about vaccinations?  Am I pro or con?  Do vaccines cause autism?  Do I vaccinate my kids?

Generally, I love talking about my kids.  And I love talking about my parenting ideals and giving suggestions based on my experience.  But when it comes to my personal choices about immunization, I try to hold my tongue.  (And my patients know how hard this is for me!)  Laughing

Here's why.

Immunization isn't just a parenting issue, it's also a medical issue.  When a child receives a vaccine, a foreign substance is introduced into his or her body by way of an injection, a nasal spray or oral drops.  Because of the potential risk of harm, immunization requires informed consent by the parent or legal guardian.  Informed consent means that the patient is told the reason the procedure or treatment is recommended, any alternatives, and the possible risks or side effects and the patient gives permission.

Under my Oregon license, I am legally able to administer vaccines (if I practiced in Oregon).  I am trained in proper administration as well as the potential benefits and risks.  If I were giving vaccines I would be obligated to receive informed consent from patients and/or parents.

While I currently am not involved in the "consent" part of immunization, I consider it my duty to help my patients be informed.  My dearest wish is that every parent be as fully educated as they can be before deciding whether or not to immunize their child.  If a child later suffers because of a vaccine side effect, or catches a vaccine-preventable illness, I want parents to feel like they made the best decision they could at the time, rather than say, "If I had only known."

This means, first, that I let parents know that they have a choice.  Under Colorado law, parents can refuse to immunize their child for three reasons:  medical, religious or philosophical.  Schools may require an exemption form and may send a child home during an outbreak, but they can not force a parent to immunize their child.

Second, I let them know that the CDC immunization schedule is a simply a recommendation designed to immunize as many children as possible as fully as possible.  Parents can choose to delay vaccines, space them out, or choose which vaccines to get and which to refuse.  Vaccines can also be given singly (with certain exceptions).

Third, I encourage parents to read a lot of information for themselves.  There are several books that I recommend, with varying points of view to allow parents to decide for themselves.  (See my book list at the end of this post.)

Fourth, I tell parents that I will support them in whatever decision they feel is right for their child.  Whether they choose to immunize or not, we talk about other ways to stay healthy, including breastfeeding, good nutrition, hygiene, homeopathy, herbal medicines and more.  If they do vaccinate, we discuss ways to minimize or alleviate side effects and support immune health.

So I almost never spill the beans about what my husband and I have decided for our kids.  I don't want someone to base their decision on mine because, while I may have a lot of knowledge, our beliefs may be very different.  Rather than give advice about what choice to make, the best I can do is to help parents make an educated decision for themselves.

Here is my recommended reading list:

  • The Vaccine Guide, by Randall Neustaedter, OMD
  • Vaccinations - A Thoughtful Parent's Guide, By Aviva Jill Romm
  • Childhood Vaccinations - Answers To Your Questions, by Katia Bailetti, ND
  • The Vaccine Book - Making the Right Decision For Your Child, by Robert Sears, MD
  • What Your Doctor May Not Tell You About Children's Vaccinations, by Stephanie Cave, MD
  • Saying No To Vaccines - A Resource Guide For All Ages, by Sherri Tenpenny, DO