Ear infection !!!

[Joe-Diver]

My response was to BeachJunkie, not the OP.

Besides, the OP did ask for prevention methods, not for a diagnosis of current condition.

 

[tracydr]

Pramotic drops. They are the best thing I've ever tried for diver's ear. I did a post on them recently.
Just head to your doctor or urgent care. This stuff is brand new, not even on a lot of the shelves so you may have to tell your doctor about it and call different pharmacies to find someone who stocks it.
I've been prescribing them since I got back to Bonaire to all the people with swimmer's ear at the Marriott. (I work at an Urgent care across the street)

 

[tracydr]

I guess the bright side would be at least it waited until you where home. I flew once (a few years before I started diving) with an ear that would not clear. Thought I was going to Die. Ohh and they won't stop the plane from going up because your ear hurts!

I use commercial swim ear stuff mostly alcohol. Keeps the quarry water from infecting my ears.

The pramotic has an indication for prophylaxis and treatment. I won't leave home without it in my dive bag ever again now that my BF and I both sampled it. It works for that stuffy feeling (I guess that's probably inflammation) and the ear infection or pain. The swimmer's ear drops are only effective (according to DAN study) if used both pre and post dive for a full 5 minutes on each side. Yeah, like I'm going to sit around with each ear up in the air for 5 minutes before diving! I guess it might be a good thing to pass the time on the boat.

 

[tracydr]

I just got a screamin' ear infection in my left ear, went to the doctor, got antibiotic drops, ear is doing better, and now the right ear is feeling left out so it started hurting. I'm really hoping this clears up by this weekend since I missed out on a great day for diving this Sunday.

I've found that Motrin works the best for dulling the pain. I don't know why it works better than Advil or generic Ibuprofen, but it does. The doctor offered me something stronger for the pain, but I told him I thought the left over Vicodin I had from surgery was a little excessive for an ear infection. He said that if I wanted a good night sleep, I could just take half of one.

Stupid ears... I haven't had an ear infection in about 20 years.

--Shannon

Cool thing about the pramotic that I liked (because I was having a funky ear second day in Bonaire of a week trip!) is that it has a mild topical pain medication. Really helps with that ear tenderness.
I kept diving, using it 4 times daily and came home with healthy ears.

 

[tracydr]

Hi Don and Joe-Diver,

I, too, read your posts as suggestions for prevention. However, since neither of you, or the others who replied, had a diagnosis, how could you offer meaningful recommendations?

If shark_tamer in fact was contracting external ear infections (otitis externa/swimmer's ear), then your ideas may proven helpful. But, if he was getting middle ear infections (otitis media), then alcohol and vinegar mixes placed in the external auditory canal would have no prophylactic effects.

After your posts were already up, shark-tamer reported that he seems to have gotten one of each type of infection.

See the point?

Regards,

DocVikingo

One thing many non-dive educated doctors fail to diagnose in divers is barotrauma. I see it a lot at my urgent care clinic. (by the way, those in Phoenix I'm opening my own FP clinic and spa in September and will be doing dive physicals/urgent care for divers)
It is extremely unusual for someone, especially an adult, to get a middle ear infection (it's not inner) in one ear and an external infection in the other after diving. More likely is an external ear infection and some barotrauma, which will look like a middle ear infection on exam.
I would be highly suspect of this diagnosis. Make sure you get another exam in a week or two to make sure everything is looking good before diving again.
Middle ear infections are fairly rare in adults and in fact, I generally refer the few that I see for follow-up to ENT as there is usually something (possibly a mass) blocking the eustachian tube. In medical school and residency this is what I was taught to do. (by more then one ENT)
I based my advice on the fact that he had both ears involved, just got done diving. Without an exam, that is of course the best I can do. Of course, I did recommend that he head to his doctor or urgent care to get an exam/treatment.
Surprisingly, I probably see 5-10 divers a week at my urgent care. I believe it's because we're in an affluent area (fringes of Scottsdale/N. Phoenix) and because I actually ask. (ok, the dive t-shirts give it away!!) I even have one commercial diver that comes to see me. I see tons of external ear infections in Phoenix this time of year with all the people swimming. The mechanism is actually that to be a change in the normal flora and a bacterial/yeast overgrowth due to warm/moist conditions. That's why I like the pramotic. It is both a fungicide and antibiotic. (not a true antibiotic but bacterialcidal) I was skeptical and didn't prescribe it at all except for as a pain relief drop until I tried it myself. Since, I've prescribed it quite a few times (would have been more but the pharmacies don't have it in stock yet) and I've been impressed by the results.
It's also cheap. I saw somewhere for cash price it's $18 a bottle!!

 

[DocVikingo]

Besides, the OP did ask for prevention methods, not for a diagnosis of current condition.

Hi Joe,

It appears that I've yet to make my point.

In short, diagnosis can be defined as the determination of the nature and cause of a disease or injury. Within the context of the present inquiry, I'm using the word diagnosis as the equivalent of "what's causing the condition."

With that in mind, let's try it this way: How can one recommend preventative methods when one in fact does not know what has caused a condition in the past (aka the diagnosis)?

Alcohol and vinegar drops or any other type of solution placed in the outer ear aren't going to prevent middle ear infections because given an intact eardrum they can't pass into the middle ear space (which by the way is a very good thing). The OP has contracted at least one middle ear infection in the past and your suggestion will do nothing to prevent such infections in the future. As was said in my immediately prior post, your suggestion might assist in curtailing future outer ear infections.

The point in tyring to drive across is that until you understand the nature and cause of what is to be prevented, you have no way of knowing if your recommendation for prophylaxis is going to be neutral, helpful or harmful.

Regards,

DocVikingo

 

[DocVikingo]

Hi Tracydr,

I presume that when you use the term "pramotic" you more accuratey mean "PramOtic Ear Drops (chloroxylenol/pramoxine hydrochloride)?" If so, the generic equivalent should cost out even better than the already very reasonable cash price you cite for the brand name.

A drug with topical anesthetic, antibacterial and antifungal properties certainly has appeal. Because is not possible to distinguish between a bacterial and a fungal cause for otitis externa while one is out on a dive trip, a medication that addresses both makes excellent sense.

BTW, and apropos of your mention of ear barotrauma, in the absence of a diagnosis one needs to be sure that there is no breach of the tympanum before using this preparation.

Regards,

DocVikingo

 

[Hank49]

Doc Vikingo and Tracydr, I read a German dive doctor's recommendation (not sure of the book title now) which said to leave your ears alone. Do nothing to them if you're diving frequently. I took this advice and it worked for me but I can't say it would be good for everyone. Do our ears have enough protective devices in their design to ward off infections of fungus and bacteria? Does the daily cleaning with Q tips make us more susceptible to infections if we swim or dive?

 

[DandyDon]

I am pretty sure that the MDs here will tell you to never use Qtips inside your ears!

Does the daily cleaning with Q tips make us more susceptible to infections if we swim or dive?

 

[Joe-Diver]

My response was still directed at BeachJunkie, not the OP.