Sam the Pharmacist

I saw the other neurotologist this afternoon, another one with whom I’m very impressed, and told her the long saga of my ear. She listened, she asked questions, and at several points she correctly guessed what was coming next. The whole case–what my doctor had done, what should have happened, and what unfortunately happened instead–seemed to make perfect sense to her, which put me at ease. I explained that this was just supposed to be a check-in to make sure that the anti-fungal treatment had been successful, to see how much, if any, damage had been done to the previously healed tissue by the fungal infection, and to decide what I should do while I was away for the next couple of weeks. She asked where I was going, and then took a few minutes to tell me about her, her sister’s, and their families’ first visit to Provincetown, from which she’d just returned. She really loved it there, which laid to rest any lingering questions I might have had about her.

She looked into my ear and confirmed that the anti-fungal treatment had been successful and that no damage had been done to the previously healed tissue. I seem to be back where I was three or four weeks ago, with that same twenty-five percent of the tissue still to finish growing in correctly. As for what to do for the next couple of weeks, she’s suggesting a new approach. She stressed that up until this point, she would have proceeded exactly as my doctor had, but that having reached this point, she would try a powder that’s only made by a single pharmacist, named Sam, in California. It includes an antibiotic agent, an anti-fungal agent, and one other agent that I can’t recall, all of which will prevent any sort of infection, along with a steroid to speed the healing of the tissue. This is likely to be more effective in dark moist places, like an ear canal beset with eczema, because it’s dry. It certainly sounded like the right approach, and I wondered why it’s not normally the first course of treatment. Her office faxed the prescription to Sam, with my cell phone number and instructions to have the powder and associated paraphernalia delivered to the inn where we’ll be staying on Thursday.

A couple of hours later, back in my office, my cell phone rang from a number I didn’t recognize, but I decided to answer anyway: “Hi, this is Sam. Did you order the powder?” My doctor’s office prescribed it for me, yes. “Do you know why she prescribed it?” I think so. “It’s because you have what’s called a weeping ear, right?” Yes, apparently so. “And you’ve been taking drops, and it hasn’t gotten better.” Well, somewhat better, b… “You’re so lucky that you have a doctor that even knows about this treatment. There a so few doctors that do. This will fix everything.”

I couldn’t tell if I was speaking to Tony Robbins, Matthew Lesko, or Charles Manson, but he was telling me what I wanted to hear. I’ve never had a conversation with a pharmacist that’s gone beyond confirming my address and insurance information and assuring them that yes, they are eye drops, but my doctor really does mean for me to put them in my ear. I wasn’t sure I was comfortable with the enthusiasm, and I was starting to get an inkling of why maybe this isn’t normally the first course of treatment. He confirmed the shipping address and took my credit card information, and told me to call them at their toll free number when I receive the powder. I’m to ask for Sam, Rose, or Steve, who will explain to me how to “puff” the powder into my ear twice a day for a month. I looked back at the original prescription, which the doctor’s assistant had given to me after faxing it to Sam, and it does indeed read “puff as BID.”