Lend Me Your Ear
Mr. D. had grown increasingly irritable and, after extensive work ups by a family doctor, a psychiatrist and a neurologist, his
This was the story they told me. The family doctor had been concerned with the possibility of depression having noted Mr. D.’s feelings of anger, irritability, apathy and “isolation”. Antidepressant medication made no apparent difference and, thus stymied, the family doc wisely referred to a psychiatrist. The psychiatrist did another assessment, confirmed the diagnosis of depression, tried a different anti-depressant medication ($2 per pill) and began psychotherapy ($150 per session). After 4 sessions, the patient, feeling increasingly “cut off ” and “isolated”, quit therapy and returned to the family doctor.
This time, the family doc, concerned about the possibility of Alzheimer’s disease, referred Mr. D. to a neurologist for a second opinion. The neurologist ($250 for the office visit) doubted Alzheimer’s but suggested a MRI test ($185) to rule out frontal lobe tumor. Doctors are trained to suspect this cause when a patient demonstrates a change in behavior which included disinhibition, aggressiveness and unpredictability. Mrs. D had reported that her husband had acted increasingly paranoid, confused, irritable and apathetic over the past two months. Indeed, the neurologist confirmed this himself during their meeting because Mr. D. was growing increasingly impatient with doctors and was less and less shy about expressing his dissatisfaction. Also his voice was growing increasingly loud and he tended to interrupt people constantly. The MRI was negative. No tumor. No explanation. No recommendation. No help. Total expense at this point: more than $1000.
When I met Mr. D. for the initial assessment, he appeared grumpy, gave a good-hearted effort towards cooperation but ended up feeling discouraged and frustrated. His raspy monotone voice tipped me off. Since he reported no recent colds or sore throats and his wife reported that this was not his typical voice, I confidently had the diagnosis: bilateral impacted cerumen. In common speech, his ears were plugged with wax. Treatment: three days of wax softener followed by ear lavage in my office. After dislodging two large and dense plugs of wax from each ear, the patient beamed: “I feel terrific! This is fantastic!”. No more confusion, apathy, irritability and anger (can’t hear others). No more loud voice (can’t hear self) and no more feelings of isolation (from sensory deprivation). Cost $2.00 for the Murine ear drops and $120 for the two hour consultation and treatment. (In addition, Mr. D. was able to keep the wax plugs both of which were half again as thick and long as a typical pencil eraser. He tells me that he keeps them on his coffee table in a glass container as a conversation piece…).
The human ear is commonly understood to have two important functions: hearing with the cochlea (a snail-shaped canal within the inner ear) and balance with the vestibule (a central cavity of the labyrinth that makes up the inner ear). Recent research, however, has suggested that it also has a “cortical charging” or “energizing” function as well. One researcher demonstrated that the embryologic ear “builds and nourishes the brain”. He showed this by destroying the cochlea of fetal sheep and noting that the brain failed to develop normally. So much neurological stimulation enters via the ear that the old principle “use it or lose it” applies to brain processes also. Other important research confirms the critical role of the ear in stimulating the brain.
Without the functioning ear, the fetus (and an adult like Mr. D.) become unwilling participants in a “sensory deprivation experiment” whereby normal neurological functioning is compromised. In addition, the feelings of isolation are explained in terms of his being gradually cut off from his greatest sensory data gatherer: the ear. Studies have shown that elderly people with compromised hearing become paranoid and aggressive due to losing their ability to monitor the presence of potential threats in the world around them. Alternatively, if not paranoid, they become isolated and reclusive.
What is the purpose of ear wax? This troublesome substance is actually a wonderfully evolved device for cleaning the ears of foreign particles. Wax functions as a transport mechanism for dust, bacteria, toxins and the occasional earwig that gets caught in the ear canal. Only when we are low in essential fatty acids does the wax malfunction by being too stiff and not fluid enough to act as a conveyor belt for these trespassers.
Nutritionally speaking, a deficiency of essential fatty acids can result in excessive ear wax. (Essential fatty acids are foods which we need but can’t make ourselves so, in order to get them, we need to include them in our diet. The most famous examples are cod liver or castor oils! ) In my opinion, a better tasting and more complete alternative to those oils of old is a tablespoon three times a day of pure, cold-pressed, organic flax seed oil. This is an excellent source of all three families of essential fatty acids: the so called “omega 3”, “omega 6” and “omega 9” essential fatty acids. (Flax seed oil is also a wonderful nutritive remedy for cardiovascular diseases and most skin problems).
What else causes too much wax? (Interesting how too little oil can cause too much wax as per above, eh?) Scientists speculate that excessive noise can lead to excessive ear wax. Some of my patients who are construction workers or rock musicians have excessive ear wax. I saw one interesting kid who blared rock music into his ears from walkman earphones. He had impacted ear wax also. I wonder whether the wax builds up in these cases in an adaptive mechanism to protect the delicate ear from damaging noise. NOTE: all you guys getting your wood cut for the winter would do yourselves a BIG favor by finally getting serious about using those ear protectors your wife gave you for Christmas three years ago. Hearing loss, especially high-frequency hearing loss can be very debilitating.
Most doctors agree that regular cleaning with Q-tips is not appropriate because the ear responds to the local irritation by increasing the production of ear wax. Better to keep the ear wax soft by eating enough essential fatty acids and allow it to act as a conveyor belt. That, and the occasional ear wax softeners (Murine is my favorite), as well as ear protectors, will help keep the wax out.
Well, we have dwelt on how bad excessive ear wax is but I am reminded of how grateful Ulysses was in having enough to plug his crew members’ ears when they sailed past the Sirens. If you recall in Homer’s epic poem The Odyssey, Odysseus (also known as Ulysses) spent ten glorious years trying to find to his island home. (It only took me eight years to get to mine. How about you?) At one point, he needed to navigate past the deadly Sirens whose song was so enticing that all boats within their range would mutiny against their captains and land on the Siren island. There they would become enchanted and meet a horrible fate. Ulysses instructed his crew to plug their ears with wax and lash him to the mast with his ears wide open. (That part I never understood except in terms of masochism…) Thus they successfully sailed past the Island home of the Sirens. But for some ear wax to help his crew resist the siren song, Ulysses’ boat would never have passed the Sirens, Ulysses would never have reached his island home Ithaca and world literature would be so much the poorer. Even worse than plugged ears, we can all agree that a paucity of great writing (especially on such islands as Ithaca or ours) is a profound tragedy. So grab a great book for the rainy days ahead and, like your mother always said, “Keep your ears clean”.
To your Health!
(c) BSW April 1998