instruction: hello doctor three months before I got an ear infection in my right ear and I had a ringing sound in my right ear I went to a doctor and was given ear drops and medicines the ear infection went away but the right ear still felt blocked I was told to take a tympanogram and they said that I had fluid behind my ear I was given a medicine for it after a few days my left ear started getting blocked too and it started ringing too my nose also started getting blocked every morning and I had a popping sound in both my ears when I swallow and sometimes it randomly pops I was told to use otrivin and have alaskan am tablet for five days the next week the issue was still there and I also started having a cough I was told to have alex of cough syearup for a week avamys nasal spray for two weeks two puffs in each nostril morning and night and relent tablet after two weeks the cough went away but I still had the issue with my ears but my ears started feeling less blocked I did another tympanogram and they said I still had fluid behind my eardrums I was told to continue the avamys nasal spray and the relent tablet and was also given predmet my tablet for five days a month passed and my ears still had the popping sound when I swallow and randomly I went to the doctor again and took another tympanogram and he said the fluid is almost completely gone and I should continue the avamys nasal spray and relent tablet I also had a pure tone audiometry test which he said was normal I have been using the avamys nasal spray and relent tablet for the past two months throughout and I was told I did not have to take the relent tablets anymore and the fluid was completely gone I still had popping clicking sounds when I swallow and my ears still feel a bit blocked so I was told to keep using the avamys nasal spray at the end of last month I could not get the avamys nasal spray so I was told to use fluticone it instead I have been using it ever since and I was also told to do the valsalva maneuver 10 times every morning and night which I have been doing my right ear pop with no issues but my left ear usually does not pop and it has only popped three times last month I found something online called the eustachi that says it helps with popping ears is it safe to use I still have popping crackling in my ear when I swallow I feel like the ringing sound has reduced but I am not sure I have not been able to go to the hospital because of the coronavirus warnings and would like to ask what exactly is wrong with me and how long will it take to heal it is already been three months should I keep using the nasal spray
output: hello the whole problem is due to malfunction of eustachian tubes we call it eustachian tube catarrh initially it was an infection that resulted in blocked tubes causing fluid accumulation inside the ear otitis media with effusion subsequently the fluid has gradually drained but the tube is still not functioning to its fullest you seem to have undergone a decent treatment you have taken decongestant drops antihistaminics antibiotics steroid tablets and sprays you have also religiously tried valsalva maneuver now what you need to understand is when the tube gets blocked it takes some time for it to become fully functional you need to continue the steroid nasal sprays if you are using fluticone it then that is good it is better than avamys do you know how you should use the spray and what it is meant for you also should note if you have any nasal allergies any nose block sneeze or runny nose even if not you are supposed to avoid all allergens you should wear a mask avoid smoke dust pollution pollen molds etc you should be very careful you may continue valsalva for another month you need an antihistamine medicine for another two to three weeks till your problems get resolved completely drink plenty of warm water and fluids keep yourself well hydrated do revert back to me if you need further support