Earwax issues just keep building up
Q: My doctor said I make more earwax than most people and added that using cotton swabs just pushes the wax farther back in the ear canal. However, cleaning my ears with the over-the-counter eardrops and a squeeze bulb is difficult. Is there another solution or brand of ear cleaner that would work better? It’s important to me because my hearing aids get gummed up with earwax.
A: Impacted earwax can interfere with hearing and may need removal by a physician. People who wear hearing aids or even use ear buds frequently may be especially susceptible to this problem.
To make earwax removal easier, a group of German doctors compared pretreatment with three different solutions. The surprising winner of this “competition” was a common laxative, docusate sodium ( Journal of Primary Care & Community Health, January-December 2020). A few drops of the solution were put in the ear 20 minutes before the doctor used a soft-bulb ear syringe with 500 ml of water at body temperature.
A systematic review of 10 studies found no difference between solutions designed to dissolve earwax and plain water, however (Cochrane Database of Systematic Reviews, July 25, 2018). The authors lament that most of the studies are old and several were not very well designed. They conclude that “the answer remains uncertain.”
Another reader has tried a different approach: “I started putting castor oil in my ear canal because I was diagnosed with dermatitis in my ear. The skin cells combine with earwax and block the canal. The ENT doctor would suction out the debris every few months and, at times, would have to surgically remove it.
“This has been going on for at least 10 years. Since I began using the castor oil, though, my doctor found no accumulation!”
Any of these approaches is appropriate only for people with intact eardrums. If the eardrum has been ruptured or punctured, it could be dangerous to put solutions in the ear (StatPearls, Sept. 28, 2021).
Q: I’ve been taking duloxetine for about 10 years for chronic neck pain. No one told me how to stop taking it, and I have had terrible symptoms since I quit. Even though I tapered for two weeks, I’ve been suffering with stomach issues, brain zaps, sweating, crying, you name it. It’s made me feel like I’m going through menopause again but worse! Isn’t there a better way to get off this pill?
A: Yes! The withdrawal — or as the Food and Drug Administration likes to call it, “discontinuation syndrome” — can be overwhelming. According to the official prescribing information for Cymbalta (duloxetine), even “tapered discontinuation” can lead to: “dizziness, headache, nausea, diarrhea, paresthesia (nerve tingling), irritability, vomiting, insomnia, anxiety, hyperhidrosis (sweating), and fatigue.”
The manufacturer recommends “gradual reduction in the dose” but does not offer practical details. Neither does the FDA.
Although duloxetine is an antidepressant, doctors often prescribe it for pain. Many readers have shared similar reactions to stopping this and many other antidepressants. Some have come up with novel approaches to minimize withdrawal symptoms. This can take several months or longer.
You can learn more about withdrawal symptoms and strategies others have used for stopping such drugs in our eGuide to Dealing with Depression. This online resource may be found under the Health eGuides tab at PeoplesPharmacy.com.