**‘The better to hear you with...’**

Rx for Readers welcomes queries from readers about medical problems. Experts will answer those we find most interesting.

By RX FOR READERS/JUDY SIEGEL-ITZKOVICH
A mother and her children cover their ears at a Formula 1 race (illustrative). (photo credit: REUTERS)
A mother and her children cover their ears at a Formula 1 race (illustrative).
(photo credit: REUTERS)
At a recent Shabbat dinner, my sister asked my 5-year-old daughter a question across the table. My daughter looked at her and didn’t answer; my sister thought she was just being bashful.
My mother then asked my daughter the same question, and she answered her.
My sister was hurt and asked her: “Why don’t you answer me?” But she didn’t respond.
We decided to take her for a hearing check. The ear, nose and throat expert diagnosed water in her ears, and she is slated to have surgery for the insertion of “buttons” (drainage tubes on her eardrums). Can you explain where this water comes from, and why it wasn’t noticed before now?
T.L., Ma’aleh Adumim
Avital Trau-Margalit, a clinical communications expert at Ariel University’s communications department, replies:
This is a common problem in children from birth up to the age of six. It can cause not only hearing damage, but also difficulties in the development of social and life skills, and should be diagnosed early.
When a child gets a cold, the tiny Eustachian tube that connects the middle ear with the back of the throat can become clogged due to an excess of mucus and the thickening of tissue in the adenoid region. These liquids cause the air inside the ear to be absorbed, creating a vacuum, and fluids accumulate in the middle ear. This reduces hearing ability and can trigger repeated ear infections.
Another cause is when children drink from a bottle while lying down.
But researchers are divided; no studies have shown a connection between water in the middle ear and water that enters the ear, for example, during a child’s bath or shower or while swimming in a pool.
It’s important to take the child to an ENT specialist or pediatrician, who will give treatment and/or send the child to a clinical communications specialist for hearing tests. This can prevent continuing hearing and speech problems. This age is a critical one for diagnosing such problems, because it is when the child is learning many social and cognitive skills.
My 89-year-old mother is suffering from a “water infection,” probably due to the fact that she has a uterine prolapse and an overactive bladder, so she cannot have an operation to repair it.
Instead, she use a pessary ring, which I assume is the cause of the infection. Her doctor prescribed antibiotics. She takes cranberry tablets on a regular basis, but she has still contracted the infection.
Now that she is taking antibiotics, it is right to continue taking the cranberry tablets? I also read that orange juice, coffee and chocolate are irritants of the bladder lining. Should she avoid consuming these while taking the antibiotics? But then I read that for such an infection, one should drink orange juice, as the body needs vitamin C to combat it.
What is correct? Also, is there a special diet while having a “water infection”?
E.N., Givat Shmuel
Dr. Menachem Oberbaum, director of the Center for Integrative Complementary Medicine at Jerusalem’s Shaare Zedek Medical Center, comments:
I am not sure what you mean by water infection; I assume you refer to a recurrent urinary tract infection. If that is the case, then cranberries are the most common complementary and alternative medicine therapy for the condition.
But the most effective way to manage a recurrent UTI is taking prescribed antibiotics suited to the infection.
Non-antibiotic prevention strategies such as cranberry and vitamin C lack strong evidence of being useful as alternatives to antibiotics. On the other hand, among all so-called alternative methods, cranberry therapy seems to be the method with the best evidence for usefulness for this indication, and can be used safely in addition to antibiotics therapy. There is no evidence to any contraindication in using both methods together.
A balanced diet including vegetables and fruit contains enough vitamin C for your mother’s needs. Orange juice is a welcome addition to nutrition, but is not essential. Orange juice, coffee and chocolate can be used together with antibiotics, and are not irritants. Caffeine, which is found in tea, coffee, chocolate and other foods, elicits a diuretic effect by acting on the kidneys and not on the bladder – and as such, these foods cannot be seen as irritants.
Rx for Readers welcomes queries from readers about medical problems. Experts will answer those we find most interesting.
Write Rx for Readers, The Jerusalem Post, POB 81, Jerusalem 91000, fax your question to Judy Siegel-Itzkovich at (02) 538- 9527, or e-mail it to jsiegel@jpost.com, giving your initials, age and place of residence.