Why Does My Ear Hurt? 7 Possible Causes of Ear Pain

Written by Stacey Jones, MS, BA

• Earwax
• Air Pressure
• Swimmer’s Ear
• Middle Ear Infection
• Other Causes

Parents know how common earaches are in children, but adults can get frequent ear pain, too. You don’t have to have an infection, or even anything wrong with your ears, to have ear pain.

These are the most common causes:

Your ear makes and gets rid of wax all the time. When the process doesn’t work well, the gunk builds up and hardens so your ear canal gets blocked. Your doctor will call this impacted wax. Sometimes, it causes pain.

Don’t use cotton swabs or other objects to try to get wax out. You’ll just push it farther into your ear canal and make it more likely to get impacted. Your ear might hurt, itch, discharge gunk, or get infected. You could even lose your hearing for a while.

You can treat mildly impacted ears at home with over-the-counter ear drops that soften the wax so it can naturally drain. Or go see your doctor if the wax has hardened. She can get the wax out without damaging the eardrum. Learn more about earwax.

Most of the time, your ear does a great job of keeping pressure equal on both sides of your eardrum. That little pop you feel when you swallow is part of the process. But quick changes, like when you’re on an airplane or in an elevator, can throw off the balance. Your ear might hurt, and you could have trouble hearing. This is typically a eustachian tube dysfunction which can be a chronic in some people.

To avoid problems on a plane:

• Chew gum, suck on hard candy, or yawn and swallow during takeoff and landing.
• Stay awake while the plane descends.
• Take a deep breath, pinch your nostrils shut, then gently try to blow air out of your nose.
• Avoid air travel and diving when you have a cold, a sinus infection, or allergy symptoms.

Learn more about air pressure and your ears.

If your ear hurts when you pull on your earlobe or push on the tiny flap that closes it, you probably have this outer ear infection. You get it when water trapped in your ear canal begins to breed germs. Your ear might get red, swollen, or itch and leak pus. It isn’t contagious. To avoid it, keep your ears dry during and after swimming. Your doctor will probably prescribe antibiotic ear drops to clear it up. Learn more about swimmer’s ear.

A cold, allergies, or a sinus infection can block the tubes in your middle ear. When fluid builds up and gets infected, your doctor will call it otitis media. This is the most common cause of ear pain. If your doctor thinks the cause is a bacteria, she may prescribe antibiotics. If not, then she may recommend a decongestant allergy treatment with an antihistamine and a nasal steroid. Let her know if your pain doesn’t improve or returns. If it isn’t treated, a middle ear infection can spread or cause hearing loss. Learn more about ear infection treatments.

You may feel pain in your ears even when the source is somewhere else in your body, like a toothache. That’s because the nerves in your face and neck pass very close to your inner ear. Doctors call this type of pain that starts in one area but is felt in another “referred pain.”

If your earache comes with a severe sore throat, it could be an infection like tonsillitis or pharyngitis. In fact, ear pain is often the worst symptom of one of these conditions. Learn more about sore throat symptoms.

Tooth abscesses, cavities, and impacted molars also can cause ear pain. Your doctor will be able to tell if your teeth are to blame by tapping on a tooth or your gums to see if they feel sore. Learn more about toothaches.

The temporomandibular joint, or TMJ, is the “hinge” of your jaw that sits directly below your ears. You might get TMJ pain from grinding your teeth, or it could be a symptom of arthritis. The ache in your ears or face comes after you chew, talk, or yawn. To treat it, take over-the-counter pain medicine and put warm compresses on your jaw. Try not to clench your teeth. You may benefit from using a mouth guard when you sleep. This can help ease the tension that causes ear pain. Eating soft foods will help, too. Learn more about causes of jaw pain.

Some causes of ear pain can be serious such as tumors or infections, including cellulitis or shingles. If your ear pain is severe, doesn’t go away within a few days of home treatment, or comes with a high fever or sore throat, or you get a new rash, visit your doctor right away for treatment and to rule out something more serious.

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Ear pain in most cases comes from either the outer ear or middle ear.

The outer ear is the most exterior part of the ear and consists of both the pinna and the ear canal. The various causes and treatments of outer ear pain can include:

• SWIMMER’S EAR (External Otitis): Is very painful and occurs when the ear canal becomes wet. Bacteria and fungus love the warm, wet, and dark environment, and can multiply causing infection and swelling. Treatment can involve antibiotic ear drops, antibiotic medications and keeping the ear dry.
• EAR CANAL TRAUMA: Can occur from scratching the skin lining the ear canal as this skin is extremely thin and sensitive. Most treatment involved simple observation and at times antibiotic ear drops may have to be prescribed.

DO NOT PUT ANYTHING SMALLER THAN YOUR ELBOW IN YOUR EAR CANAL.

• NEURALGIA: Is a term used to describe inflammation of the nerves around the ear causing a pain that feels like a jabbing or stabbing inside the ear. One of the most common causes of ear neuralgia is TMJ.
• TMJ: Refers to inflammation involving the “jaw joint”. Because this joint lies just below the ear canal, pain from this joint can be referred to the ear via nerves that are “shared” by both areas.
• TUMORS: Are very uncommon cases of pain of the outer ear.
• REFERRED PAIN: Due to shared nerve supply, rarely a throat condition, but can cause ear pain.

The middle ear consists of the eardrum and the area directly behind the eardrum known as the middle ear space. This space also contains 3 bones which move in response to the vibration of the ear drum. The various causes and treatments of middle ear pain include:

• OTITIS MEDIA: Refers to infections of the middle ear. This can often occur after an upper respiratory tract infection that reaches the middle ear via the Eustachian tube. This is most commonly treated with oral antibiotics.
• CHOLESTEATOMA: Is a benign skin tumor that can grow within the middle ear space and cause infection, drainage, and ear pain. This needs to be treated surgically.
• EUSTACHIAN TUBE DYSFUNCTION (ETD): The Eustachian tube connects the middle ear cavity with the throat. It helps aerate and drain the middle ear space. When this tube does not function, often due to colds or sinus infections, fluid and/or pressure can build up in the middle ear space and cause pain. People may also experience some hearing loss. Treatment of ETD includes oral and nasal decongestants and the valsalva maneuver (pinching the nostrils and blowing hard against them). In severe cases, draining the fluid through the eardrum or placing a tube within the eardrum may be necessary

Foreign bodies in the ear: causes, symptoms and removal

Foreign bodies in the ear are objects of a foreign nature that enter the ear canal, the cavity of the external or middle ear from the external environment. Foreign bodies in the ear are a very common pathology, especially common in childhood, since children often put small parts from toys, balls and fragments of various objects into their ears.

A foreign body can be any object, an insect or other living being, a piece of cotton wool, a sulfur plug, a part of a hearing aid, plant seeds, etc. The presence of a foreign body in the ear is accompanied by pain in the ear, noise in the head, a feeling of pressure, hearing loss, in some cases, dizziness and vomiting may occur. With a long stay of a foreign body in the ear, an inflammatory process develops, which can lead to serious complications, so it is very important to diagnose and eliminate the problem in a timely manner. Foreign bodies in the ear can be caused by a variety of factors. In childhood, this is most often the deliberate placement of fragments of toys in the ear canal, so parents are required to closely monitor the child, not to give small children collapsible toys with small parts and other small items.

For adult patients, accidental ingress of foreign bodies into the ear is typical. Often, the cause of a foreign body can be an injury, as a result of which sand, earth, a piece of glass, a bullet, a fragment of an exploding projectile, etc., get into the ear. A foreign body in the ear can be both relatively safe and quite dangerous for the patient’s life. The level of risk of complications depends on the type of foreign body, its location and the timeliness of the medical care provided.

Classification of foreign bodies in the ear

In medical practice, the classification of foreign bodies is used according to the mechanism of occurrence and the nature of the foreign body. Regarding the mechanism of occurrence, endogenous and exogenous foreign bodies are distinguished. Endogenous foreign bodies are formed directly in the ear, while exogenous ones enter the ear from the external environment. The bulk of foreign bodies are exogenous, but according to statistics, endogenous foreign bodies are also quite common, they are sulfur plugs formed in the ear canal.

The classification of foreign bodies by nature implies the division of all foreign bodies into two large groups: living (movable) and non-living (inert). Live foreign bodies of the ear include various types of insects that enter from the air or by entering the ear of the patient when he sleeps or lies in the grass, as well as larvae and leeches that enter the ear canal while swimming in water. Inanimate foreign bodies can be household items (a button, a battery, a bead, a piece of foam, paper, cotton wool, small parts of a designer and toys), as well as pebbles, plant seeds, sand, etc.

Inanimate foreign body: symptoms, diagnosis, removal

With a non-living foreign body in the ear, sometimes the patient may not feel any symptoms, this happens if a small and smooth object enters the ear that does not injure the skin of the ear canal and the eardrum. Larger foreign bodies block the passage of sound waves through the auditory tube, causing hearing loss, patients in this case complain of congestion in the ear.

Foreign body symptoms

If the foreign body has sharp protrusions, injury to the skin of the external auditory canal and eardrum often occurs, after which a bloody discharge may appear from the ear, while the patient feels pain in the ear. A pointed foreign body can perforate the eardrum, which is fraught with the development of acute otitis media, which can turn into a purulent form.

Any foreign body has an irritating property in relation to the skin of the external auditory canal, which is manifested by hypersecretion of the sulfuric and sweat glands. Increased humidity in the ear canal contributes to the swelling of some foreign bodies (grains of beans, corn, peas) and the complete closure of the lumen of the ear canal, which provokes discomfort, pain, a feeling of fullness in the ear and a significant hearing loss. With a significant increase in the foreign body, the tissues in the ear are compressed, which entails their necrosis. Such a foreign body is wedged into the ear canal, which complicates its removal. A battery that has got into the ear is of particular danger to the patient; it has the property of conducting electric current in a humid environment and necrosis of nearby tissues.

In case of untimely removal of the foreign body of the ear, an inflammatory reaction develops. Patients develop hearing loss, ear pain, mucopurulent discharge from the external auditory canal. In severe cases, there is an increase in body temperature, a headache occurs, the general condition of the patient worsens. Edema of the ear canal develops, which further prevents the removal of the foreign body.

Diagnostics

At large sizes, a foreign body can be seen with the naked eye. During the examination, the otorhinolaryngologist uses a funnel or otoscope, to improve visibility in adult patients and adolescents, the auricle is pulled down and back with one hand, and when examining young children, the auricle is shifted down and back. If you do not seek help in time, edema increases in the ear canal, which makes it difficult to visualize and remove the foreign body. If the inflammatory process is purulent, a bacteriological analysis of the discharge is performed in order to determine the sensitivity to antibacterial drugs for their proper administration.

If a foreign object enters the ear through trauma, the patient undergoes an X-ray examination of the skull. An important point in the diagnosis of a foreign body in the ear is differential diagnosis, the purpose of which will be to exclude a tumor, perforation of the membrane, damage to the external auditory canal and hematoma.

Treatment

It is very important to remove the foreign body as soon as possible before an inflammatory reaction begins to develop. It is highly undesirable to try to remove a foreign body on your own, because in this way you can only harm your own body.

Ear foreign body removal procedure

If there is no suspicion of perforation of the tympanic membrane, which is determined during examination and otoscopy, the removal of a foreign body in an ENT room begins with washing the ear canal. Washing is carried out with distilled water, heated to 34-360C, using Janet’s syringe (water is drawn into the syringe and washing is performed under slight pressure). After washing, the doctor removes the remaining water in the ear canal with the help of turunda. In addition to perforation of the membrane, washing is prohibited if there is a foreign body in the form of a battery or flat, thin objects that can move deeper under the pressure of water.

Also, the removal of a foreign body in the ear can be carried out using a thin ear hook, the bent end of which is wound behind the foreign body with a slow smooth movement, thus picking it up and then pulling it out. When removing swollen seeds, the ear is instilled with 96% ethyl alcohol, which promotes dehydration and reduces the size of the foreign body.

In most cases, the removal of a foreign body in the ear does not require the use of anesthetics, but if necessary, this option is possible. For anesthesia, during the removal of a foreign body, an adult patient uses local anesthetics (ultracaine, lidocaine), if it is necessary to use anesthesia for young children, the method of general sedation is used. A very important step in removing a foreign body from the ear is the subsequent, after removal of the object, a thorough examination of the skin of the ear canal and eardrum for damage and perforation (this is important for determining the correct tactics for further treatment). After examination, turunda with tincture of calendula and Levomekol ointment is placed in the ear, it is recommended that an antibacterial ointment on turunda be placed in the ear in the next 3-4 days, as well as a second examination the next day. In the case of developed complications, in the presence of significant edema and strongly wedged foreign bodies, surgical operations are performed by means of a small incision behind the auricle.

Live foreign body of the ear: symptoms, diagnosis, removal

The ingress of a living foreign body into the ear provokes very unpleasant and painful sensations, tickling and noise in the ear. Continuous movements of a foreign body in the ear irritate the endings of the vagus nerve, thereby causing dizziness and reflex vomiting. Children sometimes have seizures.

Some species of insects are characterized by the secretion of toxic substances that cause necrosis of the tissues of the ear canal. Unbearable discomfort caused by a living foreign body in the ear makes you immediately turn to a specialist. To alleviate discomfort, before the patient is transported to the clinic, it is recommended to drip an oil solution into the ear, but this should be done only if you are sure that the cause of discomfort is a living foreign body. The diagnosis in the clinic is made on the basis of an examination by an ENT doctor of the ear canal using a funnel and a reflector, in some cases an otoscope is used.

Before removal of a living foreign body, it is usually killed. Immediate contact with a doctor minimizes the risk of complications.

Sulfur plug: symptoms, diagnosis, removal

As a rule, sulfur plugs are formed due to hypersecretion of earwax, the difficulty of its release to the outside due to the curvature of the ear canal or its anatomical narrowness. Frequent cleaning of the ear canal with hygienic cotton swabs also provokes increased production of sulfur, and improper cleaning contributes to pushing the sulfur deep and accumulating it there in the form of a sulfur plug.

The clinical manifestation of cerumen may be ear congestion, hearing loss, sometimes a feeling of fullness. When the sulfuric plug comes into contact with the eardrum, noise in the ear occurs.

Sulfur Plug Diagnostics

Sulfur plugs are diagnosed by examination and otoscopy. Often, sulfur plugs are formed due to fungal skin lesions of the external auditory canal and eardrum, such cases are especially dangerous and unpleasant, since inflammation and sometimes perforation are often hidden under the sulfur plug. After removal of such a sulfuric plug, a long period of treatment with antifungal drugs and dynamic monitoring follow.

Treatment of cerumen

Removal of sulfur plugs in most cases is carried out by washing with a stream of distilled water under low pressure. If the plug is large and dense, the patient is advised to instill a few drops of 3% hydrogen peroxide into the external auditory canal for several days, and then come back for a second ear wash. Sometimes ear forceps or hooks are used to remove wax plugs. After removing the sulfur plug, the auditory canal and eardrum are examined, and then alcohol turunda is placed in the lumen of the auditory canal. For the next 2-3 days, the patient is recommended to put alcohol turundas in the ear. If the pain does not stop, you should again contact the ENT doctor to exclude inflammatory processes in the ear.

Otitis ear – causes, symptoms, diagnosis and treatment of otitis media in adults

The ears are one of our main ways of receiving information about the world around us, one of the most complex and vulnerable “mechanisms”. Because of their structure, they are prone to a variety of diseases, some of which can cause severe discomfort, hearing loss, and even damage to parts of the brain. The appearance of symptoms is most often associated with the onset of inflammation of the ear (external or internal). This disease – otitis media – is one of the most common. In this article, we will talk about why ear inflammation occurs, what symptoms you should pay attention to and how it is treated.

Types of otitis

Classification is carried out according to various methods, the main of which is the location of the focus of inflammation. As you know, the ear is a complex organ that consists of the outer, middle and inner ear. The focus of inflammation can occur in any area. If the process began in the outer ear, then otitis media is classified as external, if on average – as middle, if in the internal – as internal. These diseases proceed in different ways and require specific treatment.

Otitis externa can be localized or diffuse.

• in the first case, boils usually form. Their appearance is characterized by sharp pain sensations, which are aggravated by pressing on the auricle or its tragus. The disease is also accompanied by general weakness and fever. Usually, boils form due to infection in the ear, but they can also be caused by pathological conditions of the body, such as diabetes;
• in the second case, the process begins when a fungal infection enters the ear. In this case, the disease is characterized by purulent discharge from the ear and itching in the ear canal. This disease is called otomycosis. Without proper treatment, it can spread to the other ear.

Otitis media – viral, exudative – is a complication of acute respiratory viral infections and a prolonged runny nose, in children it occurs with inflammation of the adenoids. This is a more serious disease, as it occurs in hard-to-reach areas of the ear. It usually begins as a result of the rise of infection through the auditory canal in diseases of the upper respiratory tract. The second reason is damage or rupture of the eardrum. Occurs when injuries or sharp objects get into the ear. The third reason is infection through the blood vessels.

Symptoms of otitis media

Otitis externa in adults is manifested as follows:

• pulsation in the affected ear, sharp pains radiating to the neck, eye sockets or teeth;
• increased pain when chewing, talking, closing the jaws;
• redness in the ear canal, exciting and auricle;
• auditory disorders in the separation of purulent exudate into the ear canal.

Acute otitis media in adults is indicated by fever, shooting pain in the ear. The more purulent fluid with mucus impurities accumulates, the more pronounced it is. The rupture of the membrane occurs on the second or third day. Pus begins to flow from the ear canal, which leads to a rapid improvement in well-being – a decrease in temperature, subsidence of pain. Subsequently, the integrity of the membrane is completely restored.

Symptoms of otitis in chronic form are intense mainly during exacerbation. Severe pain is felt, the temperature rises. Such otitis in adults can cause mesotympanitis. The inflammatory process extends to the Eustachian tube and the lower, middle part of the tympanic cavity with the formation of a hole in the membrane, but with the preservation of its tension. The leading signs of mesotympanitis are:

• hearing loss;
• discharge of pus from the ear;
• feeling of “congestion”;
• noises of various nature;
• dizziness;
• pain.

Epitympanitis is characterized by a sharp decrease in hearing, discharge of pus with an unpleasant odor, pressure in the ear, pain spreading to the temples, dizziness. After a period of exacerbation of inflammation, remission follows. But against the background of a temporary improvement, full restoration of hearing does not occur, there is a slight, but constant discomfort.

Important!
Otitis media can progress if left untreated.

This can lead to serious consequences, including:

1. Facial paralysis.
2. Decrease or loss of hearing.
3. The beginning of inflammatory processes in the inner ear.

Complications that occur often require serious treatment, up to surgery.

If the inflammation began in the inner ear, then the disease qualifies as otitis media (labyrinthitis). It is fraught with various complications, including meningitis, so if you experience the following symptoms, you should immediately consult a doctor:

1. Constant dizziness, nausea and vomiting.
2. Vestibular disorders – sudden loss of balance, falls, etc.
3. Tinnitus, deterioration or loss of hearing.

Labyrinthitis can be caused by

• infection from the middle ear or from the skull;
• activity of viruses, eg influenza;
• head injuries or failed middle ear surgeries.

Causes and prevention of otitis media

We note right away that these diseases are extremely widespread. More or less serious cases happen to almost every person throughout his life.

Interesting fact:
The number of visits to otolaryngologists for otitis externa increases markedly in summer, with the beginning of the swimming season.

Why is this happening? During swimming, water enters the ears, the bacteria in which cause inflammation. This is a common cause of otitis media, but not the only one. The disease can also develop as a result of:

• hypothermia;
• infection in the ear or through the nose;
• injury.

Conclusion 1:
You can significantly reduce the chances of external ear inflammation if you take good care of it.

To do this, just follow a few simple rules:

• In cold weather, do not neglect wearing hats. Scarves and hats will help to avoid hypothermia.
• In hot weather, try not to spend too much time under the air conditioner. Temperature fluctuations can lead to the development of inflammatory processes.
• Wear protective gear if you work in a constantly loud environment. Use special headphones or ear plugs.
• Try not to start upper respiratory diseases. Consult a doctor and do not try to be treated with “folk” methods.
• Do not neglect regular examinations by specialists, especially if you have already had otitis media. Often the disease can be diagnosed and treated even before the first symptoms appear.
• If you suffer from wax plugs in your ears, never try to clear them yourself with a needle or toothpick. In this case, you can bring the infection.

These are simple measures that do not require much effort, but will significantly reduce the risk of developing diseases.

Please note that not all causes of otitis media depend on human activity. This is especially true when it comes to otitis media and otitis media. To prevent these diseases, regularly undergo examinations with a doctor.

Diagnosis of otitis

Otitis in adults is determined on the basis of the clinical situation, examination of the patient, the results of laboratory and instrumental studies. The doctor listens to complaints, asks leading questions, assesses the degree of pain. Using devices and an illuminating device, he performs a targeted examination of the ear canal, eardrum. This allows you to establish or exclude the presence of pus and perforation. To determine the type of infectious pathogens and their sensitivity to antibacterial agents, biological material is sown in nutrient media. Informative in the diagnosis of the disease are the data of such studies:

• general and biochemical blood tests to determine the severity of the inflammatory process;
• x-rays of the paranasal sinuses for suspected sinusitis;
• X-ray of the temporal bone to assess the severity of chronic otitis media.

The results of laboratory and instrumental studies help the doctor determine the therapeutic tactics. Treatment of otitis will be carried out using the most effective antibiotics, the best method of surgical intervention for the patient.

When should I see a doctor for otitis media?

The practice of our specialists allows us to draw a disappointing conclusion:

Many patients deliberately avoid going to an otolaryngologist even after the appearance of characteristic symptoms of ear inflammation.

They usually make one of two fundamental mistakes:

Try to ignore the discomfort until it becomes too severe.

They try to treat themselves on their own, guided by the advice of friends, acquaintances or random people from the Internet.

Both those and others eventually turn to a specialist after the otitis has begun to progress. Treatment at this stage is less effective, and recovery can take a long time. In addition, otitis media can cause complications that can lead to serious consequences, up to complete hearing loss.

To prevent this from happening, it is important to see a doctor in time. Immediate medical attention is required for the following signs of a rapidly spreading infectious and inflammatory process:

• general state of health has deteriorated sharply;
• body temperature exceeded 39 °C;
• the severity of pain in the ear is increasing;
• headaches occur;
• behind the ear, the skin is swollen and reddened;
• purulent fluid profusely discharged from ear;
• increased heart rate.

Timely contacting the clinic will allow you to quickly perform the treatment of otitis media and avoid the appearance of its terrible complications.

The doctor will conduct an examination that will allow you to find the focus of inflammation, regardless of how deep it is located. After that, appropriate treatment will be prescribed.

Conclusion 2:
If you have an ear inflammation or other symptoms of otitis, you should immediately consult a doctor. To do this, contact the specialists of our medical center.

What and how to treat ear inflammation?

Otitis is one of the diseases with which the immune system of a healthy person is not able to cope without outside help. In mild cases, ear inflammation involves conservative treatment: taking painkillers and antihistamines. If they are not enough, antibiotics are prescribed.

Treatment is also supplemented by removal of foreign bodies and pus from the auditory tube, disinfection of wounds, application of compresses and various measures to strengthen the immune system. If the patient is diagnosed with otitis media, then drugs can be injected directly into the cavity behind the eardrum. In some cases, this requires shunting. It is also important to note that the treatment of otitis without fail involves the treatment of all concomitant diseases (the common cold, SARS, and so on).

If conservative treatment fails, surgery may be required. In this case, the ENT specialist performs paracentesis of the eardrum.

Conclusion 3:
Remember that the necessary treatment must be prescribed by a doctor. The use of inappropriate methods may lead to incomplete recovery or aggravate the course of the disease.

Complications of otitis media

If the treatment of otitis media is not carried out or it is irrational, then scar tissue begins to form inside the middle ear. Since it is devoid of any functional activity, there is a persistent hearing loss. It is necessary to treat otitis externa in a timely manner in order to prevent its severe consequences – damage to the cranial nerves, which provokes paresis and paralysis.

Doctors warn of a range of possible complications that are life-threatening for both adults and children. When otitis media is not treated, it progresses rapidly, causing the development of the following pathologies:

• mastoiditis – an inflammatory lesion of the mastoid process of the temporal bone of infectious origin;
• labyrinthitis – inflammation of the structures of the inner ear with vestibular disorders and severe auditory disorders
• purulent meningitis – inflammatory lesions of the meninges of the brain;
• brain abscess – a limited accumulation of pus in the cranial cavity with fusion of the medulla;
• sinus thrombosis – blockage of the cavernous venous sinus of the brain with a thrombotic mass.

In the absence of treatment, the likelihood of sepsis is also high – a general purulent infection resulting from the penetration of pathogens and their toxins into the systemic circulation.

If you need an otolaryngologist consultation or qualified medical assistance, please contact our medical center.