Ear wax removal

mal4mac

About five years ago my ears became blocked and my GP surgery removed the wax using ear irrigation, after 'just using drops' hadn't worked. Last week, the nurse seeing me said they no longer remove it and if drops alone didn't work I'd have to go private. I asked for a recommendation and she wouldn't give it, probably not allowed, she just said 'look at the internet'.

The nurse was actually angrier than me, "I don't know why we don't do it any more," she said. I had to console her by saying the NHS is under funded, I can afford to pay, etc... She shook her head, probably thinking about the patients who can't afford to pay, and everyone being put at risk of cowboys.

After a few days using drops I found a private audiologist who cleared them for £65 using micro-suction. It only took him a few minutes, but he gave me a full half hour, showing me the interior of my ear canals, before and after, and a fascinating mini-lecture.

We also had a nice chat and I had the impression he was finding it difficult finding customers. He complained about high street chemists/opticians who give their under-qualified staff 1 days training and then let them loose on fragile ears; then the poor patients have to go back to their GPs with bigger problems, and the GPs have to bring in a real expert (i.e., him!)

Could GP surgeries not employ a chap like this for an hour or so a week? He could probably do ten people an hour if he just performs the suction and doesn't bother with the lecture & visuals. And the patients wouldn't have problems due to under-trained chimps vacuuming their ears.

giraffe69

You can buy a simple machine from Amazon price around £20-£25 which will do the job (painlessly) at home.

mal4mac

giraffe69 wrote: »

You can buy a simple machine from Amazon price around £20-£25 which will do the job (painlessly) at home.

So that would be an untrained chimp (me!) performing a tricky medical procedure... I think I'll pass on that.

Undervalued

Some branches of Specsavers (presumably only the ones that also do hearing aids) do micro suction and charge £35 per ear. The chap I saw was excellent.

In your opening post you say.....

After a few days using drops I found a private audiologist who cleared them for £65 using micro-suction. It only took him a few minutes, but he gave me a full half hour, showing me the interior of my ear canals, before and after, and a fascinating mini-lecture.

We also had a nice chat and I had the impression he was finding it difficult finding customers. He complained about high street chemists/opticians who give their under-qualified staff 1 days training and then let them loose on fragile ears; then the poor patients have to go back to their GPs with bigger problems, and the GPs have to bring in a real expert (i.e., him!)

Which may well be true but I am not sure if there is actually such a thing as a legally regulated and qualified "audiologist". That was the job title used by Specsavers too and I certain had no complaints but it would be interesting to know for future reference.

mal4mac

The guy who treated me was registered with the HCPC, a member of BSHAA, and had a long CV indicating much experience. His name and CV were up there on the web, and backed by 70 five star Google testimonials. No doubt many of the guys working at specsavers, and the like, are very good. But, if unlucky, you might get the clutziest guy who was trained yesterday. Can you check who will be treating you before going in? Of course it should be our GPs recommending the audiologist, and the service should be free. But we are far from living in a reasonable world.

Undervalued

mal4mac wrote: »

The guy who treated me was registered with the HCPC, a member of BSHAA, and had a long CV indicating much experience. His name and CV were up there on the web, and backed by 70 five star Google testimonials. No doubt many of the guys working at specsavers, and the like, are very good. But, if unlucky, you might get the clutziest guy who was trained yesterday. Can you check who will be treating you before going in? Of course it should be our GPs recommending the audiologist, and the service should be free. But we are far from living in a reasonable world.

I am sure he was very good.

However this is the anomaly, as far as I know (I may be wrong) audiologist in not a legally regulated profession so there is nothing to prevent you, I or anybody else buying the equipment and setting up in business. That is different to Optometrists (to continue the Specsavers comparison) where the law requires that they are qualified and registered.

Councillors and Psychologists are another good example. There are two large rival professional bodies (plus several smaller ones) and although they may have qualification requirements for membership and disciplinary procedures, they ultimately have no statutory powers and cannot stop anybody from practising.

My own professional body did some research some years ago. It is quite surprising how many similar situations exist and how misleading some impressive sounding qualifications or distinctions can be. One might involve 3 years post graduate study whereas another may involve little more than filling in a form! Unless you understand the field well you wouldn't know the difference!

Fire_Fox

From the National Health Service article on Earwax build-up

"When it's blocking your ears, a pharmacist can help.

Earwax usually falls out on its own. If it does not and blocks your ear, put 2 to 3 drops of olive or almond oil in your ear twice a day for a few days. Over two weeks lumps of earwax should fall out of your ear, especially at night when you're lying down.

[snip]

Speak to a pharmacist about earwax build-up. They can give advice and suggest treatments. They might recommend chemical drops to dissolve the earwax. The earwax should fall out on its own or dissolve after about a week.

Not all GP practices remove earwax. Some can ....

Preventing earwax build-up ... you can keep using eardrops to soften the wax. This will help it fall out on its own and should prevent blocked ears."

Fire_Fox

From a National Institute for Health and Care Excellence news article, 2017

"Remove earwax if a build-up is causing hearing loss problems, NICE tells primary care

GP surgeries or community clinics should offer to remove earwax if a build-up is contributing to someone’s hearing loss. This means patients do not need to be referred to a specialist ear, nose and throat (ENT) service for the same procedure, new draft guidance from NICE says.

Earwax can be removed using an electronic machine that pumps water into the ear at a controlled pressure, known as ear irrigation. Patients should be given ear drops to soften the wax before irrigation, the draft guidance says.

Other methods of removing earwax include microsuction and manual removal. Microsuction can only be used if the correct training and equipment is in place, NICE says. Ear syringing, where a manual syringe pumps water into the ear, is potentially harmful and should not be used.

Katherine Harrop-Griffiths, consultant in audiovestibular medicine and chair of the guideline committee, said: “Earwax build-up which is causing hearing problems should be managed in primary or community care. Ear irrigation is an effective method of removing earwax. Ear drops should be used to soften the wax before irrigation, either immediately before or for up to five days before the procedure."

No mention of audiologists.

suki1964

I got a syringe from amazon along with a bottle of olive oil and a dropper and have done my own

The syringe has an end on it that forces the water backwards . So the oil softens the wax and all the syringe does is flush it out

mal4mac

Don't get a syringe from amazon! Don't stick anything in your ears! That's what all the medical sites say. If your car breaks down do you take a stick and start poking blindly up the exhaust pipe to fix it?

I had an ear wax blockage five years ago and followed the "try olive oil for two weeks" and it was still blocked... so the nurse irrigated my ears.

This time the nurse said to try the olive oil drops for a week, but added I'd probably need it to be extracted by a private audiologist, and I should look on the internet to find one.

Given that the last removal provided such instant relief, I went early to the audiologist.

What if there is still a blockage after the olive oil drops, do the NHS say what to do on their web site? Not that I can see. They probably don't want to advertise that their actual "solution" is "seek out a private audiologist".

Firefox is right. Follow NHS Direct web site advice as far as you can. Give the olive oil drops two weeks, chat to the pharmacist.That's what I'll do next time, even though the audiologist was a great instant solution. I'll also have a longer chat with my GP about how to choose a wax extractor, and how can I trust that he has qualifications to mess with my ears equal to that of a GP or someone (like the practice nurse) acting under direct orders of the GP.

NICE say, "GP surgeries or community clinics should offer to remove earwax if a build-up is contributing to someone’s hearing loss." Should doesn't mean must.

GPs are not bound by NICE, find GP's professional magazine (Pulse) online and you will see NICE comes in for a lot of slagging from GPs, many resolutely ignoring their advice.

So what do you do if your GP practice does not remove ear wax? Find another practice? Is there another practice? Insist that your GP refer you to an ENT? What if he resolutely refuses? Go to a private GP (and pay even bigger money!)? Complain to my MP?

suki1964

mal4mac wrote: »

Don't get a syringe from amazon! Don't stick anything in your ears! That's what all the medical sites say. If your car breaks down do you take a stick and start poking blindly up the exhaust pipe to fix it?

I had an ear wax blockage five years ago and followed the "try olive oil for two weeks" and it was still blocked... so the nurse irrigated my ears.

This time the nurse said to try the olive oil drops for a week, but added I'd probably need it to be extracted by a private audiologist, and I should look on the internet to find one.

Given that the last removal provided such instant relief, I went early to the audiologist.

What if there is still a blockage after the olive oil drops, do the NHS say what to do on their web site? Not that I can see. They probably don't want to advertise that their actual "solution" is "seek out a private audiologist".

Firefox is right. Follow NHS Direct web site advice as far as you can. Give the olive oil drops two weeks, chat to the pharmacist.That's what I'll do next time, even though the audiologist was a great instant solution. I'll also have a longer chat with my GP about how to choose a wax extractor, and how can I trust that he has qualifications to mess with my ears equal to that of a GP or someone (like the practice nurse) acting under direct orders of the GP.

NICE say, "GP surgeries or community clinics should offer to remove earwax if a build-up is contributing to someone’s hearing loss." Should doesn't mean must.

GPs are not bound by NICE, find GP's professional magazine (Pulse) online and you will see NICE comes in for a lot of slagging from GPs, many resolutely ignoring their advice.

So what do you do if your GP practice does not remove ear wax? Find another practice? Is there another practice? Insist that your GP refer you to an ENT? What if he resolutely refuses? Go to a private GP (and pay even bigger money!)? Complain to my MP?

You obviously didn't read my post

There is no way the syringe can harm the ear. The end is designed with a bung on it that shoots water backwards, not forwards, and it way to fat to be pushed so far in to do any damage whatsoever

Im not a person who uses cotton buds or fingers in their ears. I have Seb derm which needs flushing out else my ears get sore and itchy