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Crazy Stories From the ER

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Dr. Mark Syms

Dr. Mark Syms is a Neurotologist/Otologist and the Founder of the Arizona Hearing Center. He is one of the first physicians in the country to be board-certified in neurotology and is currently a national leader in hearing technology. After nearly two decades of experience treating ear problems, Dr. Syms has helped thousands of people improve their quality of life.

Dr. Syms graduated with honors from Boston College before earning his medical degree from Jefferson Medical College. He completed his fellowship training at the House Ear Clinic in Los Angeles, one of the world’s premier surgery organizations. Today, Dr. Syms frequently gives lectures on neurotology both nationally and internationally. He is also an extensively published author, a member of numerous professional organizations, and the host of his own podcast, ListenUp!

Here’s a glimpse of what you’ll learn: 

  • Dr. Mark Syms shares a crazy story from the ER—a key fob lodged in the ear—and how he helped the patient
  • The various items Dr. Syms has found in ears: cotton from 10 Q-tips, glue, and more
  • Dr. Syms talks about extreme wax removal
  • What is a cholesteatoma, how does Dr. Syms treat it, and how does it impact hearing loss?
  • Asymmetric hearing loss and its connection to tumors
  • Why Q-tips are almost always the culprit of ear infections 
  • What to do if you have a bug in your ear—and the types of bugs Dr. Syms has removed from patients’ ears

In this episode…

Being an otologist/neurotologist means that you get to see patients with a variety of ear problems. While many of these issues include ear infections, a build up of wax, or hearing loss, sometimes a patient comes in with something truly crazy.

Throughout his many years of treating patients with ear problems, Dr. Mark Syms has had his fair share of crazy emergency room stories. Some of his craziest cases include cockroaches and beetles, key fobs and toys, and even a bone-dissolving skin growth. So, how has he treated these patients, and what is his advice for avoiding these ear emergencies? 

In this episode of ListenUp!, host Dr. Mark Syms is interviewed by Dr. Jeremy Weisz, the Co-founder of Rise25, about some of the craziest stories he has handled in the emergency room. Dr. Syms talks about removing a key fob, bugs, and cotton from patients’ ears, the benefits of ear wax, and how cholesteatomas affect hearing. He also reveals the main culprit of ear infections: Q-tips. Stay tuned.

Resources Mentioned in this episode

Sponsor for this episode…

This episode is brought to you by the Arizona Hearing Center.

The Arizona Hearing Center is a cutting-edge hearing care facility providing comprehensive, family-focused care. Approximately 36 million Americans suffer from some sort of hearing loss, more than half of whom are younger than the age of 65. That’s why the team at the Arizona Hearing Center is focused on providing the highest-quality care using innovative technologies and inclusive treatment plans. 

As the Founder of the Arizona Hearing Center, Dr. Mark Syms is passionate about helping patients effectively treat their hearing loss so that they can stay connected with their family and friends and remain independent. He knows first-hand how hearing loss can impact social connection and effective communication. By relying on three core values—empathy, education, and excellence—Dr. Syms and his team of hearing loss experts are transforming the lives of patients. 

So what are you waiting for? Stop missing out on the conversation and start improving your quality of life today!    

To learn more about the Arizona Hearing Center, visit https://www.azhear.com/ or call us at 602-307-9919. We don’t sell hearing aids—we treat your hearing loss. 

Episode Transcript

Intro  0:04  

Welcome to the ListenUp! podcast where we explore hearing loss communication, connections and health.

Dr. Mark Syms  0:15  

Dr. Mark Syms here, I’m the host of ListenUp! podcast where I feature top leaders in healthcare. I have Jeremy Weisz here from Rise25, who has done hundreds of thousands, not just thousands of interviews with top healthcare experts. And today we’re flipping the script because he’s going to interview me about unusual cases. 

Jeremy Weisz  0:35  

Thanks Dr. Syms. Sometimes it feels like hundreds of thousands. But I’m excited about this episode, in particular, because we’re going to talk about crazy cases. And I always, this is like when you’re sitting around with your family, and you’re like, guess what happened today. That’s what this episode is gonna be about. Before I do, this episode is brought to you by the Arizona Hearing Center. And I know you help patients to effectively treat their hearing loss so they can connect better with their families, I’m not getting your hearing, as much as it is connecting with your family and your friends and remaining independent that’s, that’s the most important piece and, and the reason you’re so passionate, there’s another episode, we would go in depth about this. But you’re so passionate about helping patients because you lost your brother Robbie twice. And you can hear that story in the podcast. And you know you are people asking you what you do, you are the ears and ENT, you’ve performed over 10,000 year surgeries over the past 20 years. So check out the Arizona Hearing Center what they’re doing. He’s also the author of Listen Up, go to listenuphearing.com. So to check out more, you can go to azhear.com. To learn more. Let’s start with the first crazy story. You were telling me a little bit before we hit record. And I couldn’t even believe that’s possible.

Dr. Mark Syms  1:51  

Yeah. You know, I take emergency rooms and emergency calls. And so frankly I didn’t believe the call either. So I got a call from an outlying hospital, that a patient had a car key with the key fob lodged in his ear. And you know, I kind of thought they were kidding, right? Not easy to do. No, it’s not. And so, you know, but actually, if you think about it, if you put the key fob here, and you punch somebody, actually this part of your ear behind here is what we call numa ties, you know, so it’s a honeycomb type structure. So the reality is he had been stabbed in his ear with a key fob. So you know, unfortunate right? You know, unfortunately, I will tell you, you know, obviously the police were involved and all that. But just from a medical point of view, it’s kind of interesting when you go down to see your patient for the first time. And he’s got the little box part with the buttons sticking out of his head behind his ear. So that was definitely interesting.

Jeremy Weisz  2:52  

So what did he do to get that?

Dr. Mark Syms  2:56  

Well, most of the stories What does it always involve? A girl or a woman right? Though he was a guest inappropriately. And unfortunately, a very Another common denominator is alcohol. So he was in a bar hassling some other guy’s girlfriend. The thing I don’t know is how the guy put the key in his head at home because his key was in this guy’s head. For one. I mean. 

Jeremy Weisz  3:23  

Think about the ultimate revenge, right? The person hits on your girlfriend, he ends up taking the girlfriend and your car and going and leaving. Now he’s got the key to this guy’s car. 

Dr. Mark Syms  3:33  

Okay, yeah, well, it didn’t work out that way for him because he ended up in the emergency room with somebody else.

Jeremy Weisz  3:38  

Yeah, yeah, not a good outcome. But that is a good question how that guy got home because he had no key to his car.

Dr. Mark Syms  3:44  

Well, I actually think the police took him to a different place rather than

Jeremy Weisz  3:47  

Ah, that’s a good point.

Jeremy Weisz  3:50  

So I don’t think he got home that night. He got a ride home from a police officer in the back vehicle of a car. Um, so that’s definitely unusual. What do you do in that case?

Dr. Mark Syms  4:01  

Do you have to numb it up and like surgically or we issue it with that was the biggest concern is is there some great vessels the vessel that drains most of the blood from your brain down into your neck back to your heart you right around there, the top of the jugular vein so the big concern was worrying about bleeding so you know interest you know, we set up we were ready to control any bleeding we had all the instruments open. The guy went to sleep. I turned them around. I had it all prepped, you know, so if I needed to open it up and everything I pulled the key out there was no bleeding. I handed the key to the nurse and we cleaned him up more. It was like you know one of those proverbial,

Jeremy Weisz  4:39  

it could have been bad like probably we’re talking millimeters sometimes with the situation right?

Dr. Mark Syms  4:43  

It was actually so because the tip of the key was a button to that vein. So it was very difficult to tell if it had gone up next to it or had it actually punctured it so you know, where I make light of it now, but that was actually the best possible It’s scary. Yeah. Well, it’s a new

Jeremy Weisz  5:02  

imaging like do you do an X ray

Dr. Mark Syms  5:04  

of the area to see CAT scan? a CAT scan? Yeah. You’ve got to take it out.

Jeremy Weisz  5:12  

Yeah, exactly.

Dr. Mark Syms  5:13  

walking around with the key in your head. And you know, if you do that you’re not going to get more you’re not going to be successful in the bar the next time if you have a key in effect here know

Jeremy Weisz  5:21  

what any other crazy ER stories

Dr. Mark Syms  5:24  

like that it’s probably, you know, I mean, people put crazy, you know, kids put crazy stuff in their ears. I had one guy who I’ve never taken as many out this was actually recently he had 10 Qtips in one ear. And so, you know, the

Jeremy Weisz  5:43  

over how long of a period Do you think that? I don’t

Dr. Mark Syms  5:45  

know. So the one thing you

Jeremy Weisz  5:46  

think so they were

Dr. Mark Syms  5:48  

all matted down, right. And so, ya know, the one of the things I always tell people is, I always say Qtips are the tools of the devil right now. So, you know, if you look on the back of a Qtip box, one of the directions says do not stick in your ear. So obviously, he didn’t follow 

Jeremy Weisz  6:03  

What do people do with Qtips? If they don’t stick it in their ear, though?

Dr. Mark Syms  6:07  

That’s a question. Well, first off, I would say that’s a question for the manufacturer, not for me, right? Like, you know, if you go to

Jeremy Weisz  6:13  

like, you get an orange juice, do not drink, like, What am I supposed to do with orange juice now,

Dr. Mark Syms  6:17  

but interestingly, if you go to Qtip.com they’ve got all this other stuff, you know, makeup application and removal of stuff, cleaning stuff like silver, all of this stuff, like everything, put the obvious, right? It’s, you know, like the paraphernalia shops in the old days. were like, you know, we’ll What are you using this bottle for? tobacco?

Jeremy Weisz  6:37  

Yes. You know, we’re talking denial like people are indenial, they’re hearing loss, but at what point for the Qtips like it Qtip four that fella in his ear, 5, 6, 7?

Dr. Mark Syms  6:51  

What do they tell you? I do know where it happens. I asked this person a while ago, Can I ask you a question and go, Why did you get the Q tips at the dollar store? And they inevitably say yes. And so what I mean is, is that the little cotton to the dollar store ones are plastic. They’re like mini straws, rather than the cardboard of the Johnson and Johnson cubes. And they’re just not it. He’s well to that they come off. But you’re right. Like, you wonder like, did he look at the Q tip when he took it off and said, Well, that’s a there’s no cotton on the I don’t know, but I mean, it was it was like having the, you know, in the circus where they’ve got the VW bug and the clowns just keep on coming out. That’s what his ear canal was like, I was like, Oh my God. I mean, I’ve taken two out. I’ve never taken it like eight or nine in one year. And you know, at the end, he’s like, wow, that feels really much better. Like, I would think so.

Jeremy Weisz  7:40  

So Wow. So what else people what appears to be a lodge in their ears? 

Dr. Mark Syms  7:45  

Kids, you know, oftentimes, they’ll put erasers beads. There’s oftentimes so in the summer, I always see sand because people go body surfing in Southern California. sand in their ears. What else have I seen? You know, people with kids love putting little parts of little toys, you know, they’re all these little plastic pieces. You know, I’ve had kids put glue in their ear, you know, they put the oh god here. And as you know in other people, sometimes their part of their hearing aid comes off and then they put a new one on and pack it in. And so I’ve seen people where they’ve got three of the parts of the hearing aid kind of lined up like a train in their ear canal. So there’s crazy stuff in there.

Jeremy Weisz  8:30  

What about Do you have any really extreme wax removal? stories? I am weird. I’m one of those weird people. I will watch wax removal videos on YouTube.

Dr. Mark Syms  8:43  

I tell people I’m so you know, the technical name for a wax is Cerumen. So I tell them I’m a Cerumen-ologist. Right. You know, it’s my specialty I haven’t figured out yet. It sounds more efficient for a future podcast. I want to weigh how much wax I take out in a week and then extrapolate that out to 52 weeks and then to my whole career and try to figure out like how many pounds of wax I’ve removed in like,

Jeremy Weisz  9:07  

just in a week, put it in a big ball and like show it to people. It’s probably not allowed.

Dr. Mark Syms  9:13  

Well, you could if it was just frankly it would be extremely gross.

Jeremy Weisz  9:17  

Exactly. That’s why

Dr. Mark Syms  9:19  

Yeah, I know there are these videos. I watch those videos like I live those videos if that makes sense. 

Jeremy Weisz  9:24  

So we should start getting approval of some people to start filming the wax removal. I would watch those. You would Yeah, I 100% I’ve watched them.

Dr. Mark Syms  9:39  

Interesting. Yeah, you know it’s a it’s kind of like you know, people love watching like remember pimple popper? Yeah, but like you know, the one one type of show I don’t like watching are medical shows, right? Because it’s like I watch it all. I do it all day. But I understand what you’re saying. there is a fascination with it. So extreme wax removal.

Jeremy Weisz  9:57  

Tell me about some.

Dr. Mark Syms  9:59  

Well, you know, I’ve had people where, you know, it’s literally again, it’s like, you know, they basically have packed their whole ear canal from top to bottom with wax. And then there are other people who have had surgical alterations of their ear where they accumulate even more wax. And so you know, you can get a piece of wax out, like, you know, the size of, you know, half of my pinky out of people’s ears and stuff.

Jeremy Weisz  10:20  

What is it just a genetic thing, they produce more Wow, nada hygiene thing, what

Dr. Mark Syms  10:25  

is this big it has to do with if you alter their ear canal surgically, that wax doesn’t travel out the ear canal is normal, and it kind of gets in a jetty and accumulates on it so it becomes a little bit like a snowball where it goes onto itself. So there’s another process that I take care of called cholesteatoma, which is where skin builds up on itself. And it’s kind of like a snowball, and it dissolves bone. I mean, I’ve seen them where they, you know, are so big, they go into people’s brain and, you know, did an operation today where it had destroyed, unfortunately destroyed a guy’s hearing and gone into his balance organ. And you know, they What was it? What is cholesteatoma it’s called, it’s basically asista skin. So if you have your Eustachian tube between your ears, your nose doesn’t work, a vacuum forms and part of your eardrum gets sucked in and diverted. And the outer part of your eardrum is skin. So skin everywhere in your body chip. So what happens is you get this ball of dead skin, and it gets bigger and bigger and bigger, like when you build a snowman, a small snowball, and it gets bigger and bigger and bigger. And so as it gets bigger, it dissolves bone. So it’ll go into people’s hearing Oregon, it’ll go into people’s balance canals. I mean, we have what we call, you know, micro surgical technique where I operate under a microscope to deal with that. Interestingly, 100 years ago, this killed people, it was the number one killer of people between the ages of 20 and 25 100 years ago, and now it’s like almost in the United States never heard of in the third world, it does happen occasionally. But just this is like a disease where modern medical technique is totally eradicated. But our associate, I did. Let me see I did one today and two on two. So I saw three patients where I did cholesteatoma surgeries in a week. So it still exists, how do you get it out?

Jeremy Weisz  12:15  

Because I figure it’s big, it’s building from the inside? Why can’t you pull it out?

Dr. Mark Syms  12:19  

No, you know, you have to go through the mastoid, which is the bone behind the ear and go through the ear canal and work through the ear and remove it. And then you it oftentimes involves the bones of hearing. So you have to replace the bones of hearing with an artificial bone and then you have to rebuild the eardrum. So it’s a multiple port, there are multiple steps in the procedure, but it’s one of the more common operations I do.

Jeremy Weisz  12:41  

Is it a sign of this hearing loss? Is that like,

Dr. Mark Syms  12:46  

Yes, yeah, hearing loss. The other thing is, recurrent infections. So people will have an infection, then the ear will go quiet. And then they’ll get another infection. And that’ll happen like, a couple times a year, every year on a continual basis, they will think it’s an ear infection or something, you know, right. So what happens is that dead ball, that skin that says the dead skin gets infected. And so when it gets infected, you get past it drains out all the dead skin. When that goes away, it starts building up the dead skin again. And so it’s quiet while it’s building up the dead skin. six, eight, you get some water in the ear, bacteria. So you have these breaks, but repeat infections.

Jeremy Weisz  13:28  

Wow. And so one other us, you know the side effects that they have. So it can affect their balance, like hearing loss and loss balance,

Dr. Mark Syms  13:39  

chronic discharge, those are usually things that usually people who had infections as a child, and you know, kind of some of them it’ll catch up in their childhood or early teens, some of them in their 30s and 40s. And they’re actually people who present for the first time in their 60s and 70s Hmm,

Jeremy Weisz  13:57  

um, talk about, you know, tumors. What’s an example of someone who presents because I imagine a lot of these may just look normal, like normal hearing loss. But then when you go and you discover something, what are

Dr. Mark Syms  14:13  

so one of the most common things that I see and work up is what is called asymmetric hearing loss. And that’s where one ear doesn’t hear the same as the other. And people sometimes think about that. But that’s not normal. People should, you know, I always tell people your ears should hear equally good or equally bad. So if you’re hearing losses from aging, let’s say, you know, if you look at my head of hair, it’s not like the right side is going to get gray and the left side is going to stay dark. I mean, the only person that that happens for is Cruella DeVille. Right. And she’s a kind of a cartoon character. But anyway, so you wouldn’t expect both sides to age equally. So if one side hears differently than the other, that can on occasion, be the presentation of a benign tumor that grows on the Between the ear and the brain, and that’s called an acoustic neuroma. So when you look at people who have this asymmetric hearing loss, they all should get a medical workup. In other words, they need to go see a physician to go and make sure that they don’t have this process. And so that’s, you know, one of the great things about what we do at Arizona Hearing Centers is like, you get that soup to nuts. Like, we have a medical team, and we have a hearing technology team. So you know, the hearing technology team does hearing technology that would be cochlear implants, hearing aids and stuff like that. But if you have medical stuff where you have an infection wax, like I said, I’m a criminologist. Or you know, you need a medical workup to make sure that you don’t have a tumor, or you need a surgery to improve your hearing. I mean, I saw a guy yesterday, he just signed up for him. He’s had a progressive hearing loss for 25 years. And he gets the point where his hearing aids don’t work anymore. He comes to me, I’m the first Physician He sees. And he’s like, blown away by the fact that he can have surgery and his hearing can be restored to almost normal. And those are actually funny stories. So when you talk about funny things, you know, when people have such bad hearing loss, they haven’t heard anything. I love asking them. Well, what did you hear for the first time? or What did you realize and one of the common one for men is, you know, when they urinate, they hear that they haven’t heard the pitter patter of the water in the toilet for them. That’s the first thing that I forgot to do. Or they’ll report that they went all over their house because they heard a noise or a buzzing and it was just like the condenser on their refrigerator. And they just never could hear before and haven’t heard that stuff. Or they’ll just go wow, I forgot that birds made noise. I mean, it’s pretty amazing. There’s all this stuff that you and I hear all the time that we take for granted that people just are like, I haven’t heard it for forever. And that’s actually a really fun part of my job. When people hear things that they hadn’t heard for a long time. I mean, that’s one of the most satisfying things to do.

Jeremy Weisz  17:00  

Um, what about the category of infections? What do you see? 

Dr. Mark Syms  17:06  

So, you know, we talked about cholesteatoma as the result of a long term infection. But you know, I also see what are called acute or sudden infections, you know, people will rupture their eardrum and get discharged from their ear, probably the most common infection I see is outer ear infections, which are similar to swimmer’s ear, or the outer ear canal gets affected. And that actually brings me back to the old culprit, because the number one culprit, the cause of that is using a few tips. So the Q tips cause the outer ear infection. So if you look at the incidence of outer ear infections in my practice, greater than 75% of them are on the right side. Reason is most people are right handed, which also means people go to town with the cue tip on the right here. And then when they go over to the left here, they’re much more careful. So they know, they don’t traumatize the ear canal as much. So it’s amazing because what they’ll say is my ears itch. And I always say your ears itch, because you tip your ears are infected, because you use tips and say, Well, I use the Q-tips because my ears are affected. And ah, it’s like, it is a chicken or egg.

Jeremy Weisz  18:06  

How can you stop people from using q tips? I mean, I have seen people, my family, I won’t name names. And I’m like, you shouldn’t be using that. And I cannot convince them to stop.

Dr. Mark Syms  18:17  

I have a sibling who has a container of Q tips this big in their bathroom at their house. Exactly. He or she hates me for saying this, but I always say my wife, I’m married to somebody and I can’t get her to stop using cute tips. So you know, it is what it is. Yeah, I have another relative who used it twice. But when I take the cute tip out, it’s always yellow. It’s like, right, they make him stark white. So when you bring them out, they’re soiled so you think your ears dirty? The question becomes is wax bad. And wax is not bad. It’s healthy and good, right? So it has multiple functions. One it’s a mechanical barrier, meaning it’s like a tar covering your ear canal so it has a pH or an acidity that kills off bacteria. So when you take it off, you want to take the tar off and to remove the acidity and then the third which is not as Apple anymore, it’s sticky so it prevents bugs from going in your ear and things like that actually, not from my practice but if you look across the world the number one foreign body in somebody’s ear is a bug

Jeremy Weisz  19:20  

huh really interesting.

Dr. Mark Syms  19:22  

Well that is another great one because I’ve had them where you know it really drives people crazy when the bug goes in. And it’s hitting the eardrum. 

Jeremy Weisz  19:30  

Oh gosh. Have you there any interesting stories with bugs in yours?

Dr. Mark Syms  19:34  

So here’s the key: you want to fill the ear canal with oil. What the oil will do is it’ll suffocate the bug and kill it.

Jeremy Weisz  19:47  

I mean, I think I would just coming to you right now as opposed

Dr. Mark Syms  19:51  

well, the point is you want to kill it so it’s not beating on your eardrum. Oh, I

Jeremy Weisz  19:55  

gotcha. Right. So

Dr. Mark Syms  19:56  

you put oil in your ear. The thing is if you put water in your air, it can it and then the body starts swelling and it becomes harder to pull out what kind of oil? Just whatever maybe, you know, olive oil, crude Crisco, baby oil.

Jeremy Weisz  20:13  

Avocado oil,

Dr. Mark Syms  20:14  

avocado oil, you know grapeseed oil something peanut oil,

Jeremy Weisz  20:19  

So I want to get a bottle of Dr. Syms’ oil, special oil, a blend of all of them. 

Dr. Mark Syms  20:25  

That’s correct and kills the bug. I’ll be like Colonel Sanders, a bug killing my secret formula.

Jeremy Weisz  20:33  

Have you seen people who have deadly bugs? I like scorpions are no

Dr. Mark Syms  20:38  

no, they don’t tend to go down there. 

Jeremy Weisz  20:41  

Okay, so just like

Dr. Mark Syms  20:43  

right in the middle of bugs, cockroaches those types of beetles. Wow.

Jeremy Weisz  20:48  

It’s great. This is a I like to see videos of that too. I do. I would like to after this. I’m going to convince you to start taking videos of this wax removal and in bug removal for sure. 100% Yeah. So everyone should check out azhear.com, check out Listenuphearing.com for the book, and more episodes of the podcast. Dr. Syms, it’s always a pleasure.

Dr. Mark Syms  21:17  

Thanks, Jeremy. Appreciate it.

Outro  21:22  Thanks for tuning in to the ListenUp! Podcast. We’ll see you again next time and be sure to click subscribe to get updates on future episodes.

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