Ear infections a constant problem

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mntlblok

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Whilst this is not necessarily related to the original posting, I think it might add something to the discussion.

When I woke up Tuesday morning after having traveled to and dived the Blue Heron Bridge the previous Thursday, Friday, Saturday, and Sunday, my right ear felt totally "full", I could barely hear out of it, it hurt to "tug" on it, and was somewhat painful all the time.

While I was quickly convinced that I was suffering from Swimmer's Ear or Otitis Externa, further scrambling around the interwebs suggested that I was likely suffering from primarily a fungal, rather than bacterial, infection. The key clue was that fungal infections can sit there for weeks or months. I had felt "something" in there for months since my last trip to the bridge - mostly the occasional, vague "itch".

As I read more and more about "Mycotic Otitis Externa", I learnt a few more things that I hadn't known. One was that many of the various fungal ailments (athlete's foot, ringworm, jock itch, etc.), no matter which particular fungus is involved, are susceptible to many different anti-fungal agents.

That got me thinking about how pleased I've been with the latest over-the-counter medicament for Athlete's Foot that we brought home from the supermarket. I've long suffered, off and on, from that ailment, but have found, amazingly, that for the last couple of years, that if I get that itch, that as little as one application from that tube from Kroger's makes it quickly go away.

The active ingredient in that tube is tolnaftate. I put some of it in my ear that morning, and by the next morning, the symptoms had definitely improved. I've continued to apply the stuff from the tube daily - once or sometimes twice per day - and now, Saturday, I barely feel anything there at all.

Another interesting fact that I learnt was that the stuff in Head and Shoulders-type shampoo (I use the Kroger brand of that stuff, too) has some anti-fungal effects. Whilst this is total speculation on my part, I suspect that my regular use of anti-dandruff shampoo had possibly kept my mycotic ear infection mostly subclinical. However, with the ten or more hours under water last weekend, coupled with the fact that I don't bother to carry anti-dandruff shampoo with me when I travel. . . Hmmmm.

Now, had I utilized some of the "drying" techniques recommended in this thread, I may well have prevented this flare up. But, then I wouldn't have learned all this cool new (to me) info. :D

Kevin
Savannah
 

bvanant

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If you do 40 White Vinegar, 40 Alcohol, 20% Glycerin (from a health food store), the vinegar is the same ph as your body, killing off bad bacteria, letting good bacteria live, while the alcohol removes moisture and the glycerine keeps your ear canal from getting too dry and peeling from the alcohol.

Almost true but not quite. Acetic acid has a pH of about 2.9 or a little less in an isotonic glycerin/IPA solution and your body has a pH of 7.4 so the pH is off by a factor of 30,000 or so but that really isn't the whole story. The reason that acetic acid stops bacteria from growing is that it has such a low pH. The alcohol and glycerin are there to keep the surface dry (glycerin is pretty hygroscopic) and if there is any benefit to glycerin as a softening agent it is secondary to its two primary goals, controlling tonicity (osmotic pressure) and drying the surface.

We make our own version of ear drops with 1.6% glycerin, 5% glacial acetic acid and the rest 95% IPA. The key is to leave it in the ear for at least 3 to 4 minutes with 5 being better but I don't think there are any published data that clearly define the best time.
Bill
 

janer

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Thanks for all these great bits of advise guys. I am off diving on the Great Barrier Reef in June so will see how I go then.
 

lowviz

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janer,

Thalassamania's recipe would be the "nuclear" fix: http://www.scubaboard.com/forums/basic-scuba-discussions/385203-ear-infections-2.html#post5923406

There are three things going on. Dehydration (removal of the water in your ear), Acidification to prevent fungal intrusions, and "Toughening" of water-traumatized ear canal tissue. Recreational divers probably only need to mind the first two. However, tannic acid (both acidify and toughen) is a pretty tame substance, so I'm in the process of ordering some for the next dive season.

I have been keeping ahead of things with the simple Trident product (Item #FA20) that only contains 95% isopropanol and anhydrous glycerin. But this would be a "dehydrate only" product.

-I'm planning to use the "Tektite" solution, but skip the pre-dive mineral oil water barrier.
 

SrLagarto

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I was fortunate enough to have an ENT Doctor as one of my students. I used to get 'itchy-ear' on occasion, so I quizzed him about best procedure to
prevent it happening again. He explained that, for regular diving, keeping the ear canal clean with a mild Anti-Dandruff shampoo is best preventative practise - and that many problems occur with over-enthusiastic drying.

You know how your fingers wrinkle and the skin on them becomes weak when wet? The skin in your ears will do much the same... and using something like a Q-Tip to dry your ears can make things worse by creating small abrasions in the weakened skin that bacteria and other nasties love to call home. He advised using a hairdrier (set to 'low', obviously!) as the most effective way of drying the ear canal if you don't have access to a 'Sahara'-type unit.

And, the most important rule he told me - never stick anything smaller than your elbow in your ear! :wink:
 

DandyDon

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I was fortunate enough to have an ENT Doctor as one of my students. I used to get 'itchy-ear' on occasion, so I quizzed him about best procedure to
prevent it happening again. He explained that, for regular diving, keeping the ear canal clean with a mild Anti-Dandruff shampoo is best preventative practise - and that many problems occur with over-enthusiastic drying.

You know how your fingers wrinkle and the skin on them becomes weak when wet? The skin in your ears will do much the same... and using something like a Q-Tip to dry your ears can make things worse by creating small abrasions in the weakened skin that bacteria and other nasties love to call home. He advised using a hairdrier (set to 'low', obviously!) as the most effective way of drying the ear canal if you don't have access to a 'Sahara'-type unit.

And, the most important rule he told me - never stick anything smaller than your elbow in your ear! :wink:
:hmmm: I don't think I have ever heard of using dandruff shampoo to prevent ear canal infections, but since they include anti-fungal agents - makes some sense. Some suggest using vinegar to treat dandruff, but while I can see problems with that idea - white vinegar really seems to work well as an ear canal rinse in preventing a infection along with the alcohol for drying.

I saw an odd discussion on FB the other day when a friend started discussing ear wax, with one fellow asking why cotton-swab boxes always warn against using them inside the ear "since that's all (he) bought them for?" Indeed the Wiki article on ear was shows cotton-swabs being used just for that. :shocked2: Someone should challenge that Wiki piece. Q-tips can cause ear infections!

I saw an interesting article by a Harvard Med School doctor in his column that runs in our local paper about preventing Swimmer's Ear the other day: How can I prevent swimmer's ear? - Ask Doctor K, Harvard Medical School He seems to like vinegar & alcohol, no Q-tips!
 
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In addition to a thorough microscopic ear cleaning (hard to find at most tropical dive locations!) and the solutions mentioned above, this gadget really helps prevent the problem. I always travel with one...

Mack's Ear Dryer

View attachment 114487

I'm sick of otitis externa too. Does this ear dryer machine really help to prevent ear canal infection? I feel that i have tryed everything, but infection just always comes back.
 

sealark

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When I hit 40 I would get ear infections every time I spent more than a couple hours a day in the water. Then I started using the recipe below after EVERY dive. I haven’t had an ear infection in 28 years. I always have a bottle on board and in my truck. I just take the cap off hold my finger over the opening and let a small amount go down into each ear.
All the materials are available at any drug store for less than $10.00. The Alcohol dries the water, The boric acid is what your grandmother used for infections and the white vinegar keeps the wax from drying up because of the alcohol.
[h=1][/h][h=1]Ear wash recipe[/h]1 Pint 70% or less % Isopropyl Rubbing Alcohol
Boric acid powder 6 oz. is more than enough
White Vinegar


Pour out about 2" of the alcohol out.

Pour or put about 2 Table spoons Boric acid into Alcohol and shake up. If acid remains in powder on bottom you have enough if not add until a small amount remains on bottom. Only a certain % will go into solution so you can't overdue the Boric Acid. Fill the remaining area in the bottle with white vinegar and shake up. The solution is now ready to use.

I usually buy 3 or 4 bottles of alcohol and mix them up in a big bowl then pour them back mixed up into the alcohol bottles. This way the powder on the bottom remains in the bowl and won’t make your ears white when the solution dries out after pouring it into your ears.
 
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Hi there,

I have developed chronic ear canal infection and I have tried everything to get rid of it. I have tried several antibiotic Ciproxin ear drops, alcohol+boric acid drops, and my doctor is frequently rinsing ear canal with alcohol liquid. My doctor said that ear canal infection is now chronic and it will stay with me. Doctor also said that I shouldn't wet ear canal at all because it causes microbes to grow in ear canal. He recommended that I should buy Docs Proplugs and use them in shower and at all times.

Ear canal infection
swimmers-ear-combo.jpg

Ear canal with Proplugs
proplug-ear-combo.jpg

3977_3.jpg



original.jpg

P.s. What is happening to the pictures? Why they are shrunked?
 
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DandyDon

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Hi there,

I have developed chronic ear canal infection and I have tried everything to get rid of it. I have tried several antibiotic Ciproxin ear drops, alcohol+boric acid drops, and my doctor is frequently rinsing ear canal with alcohol liquid. My doctor said that ear canal infection is now chronic and it will stay with me. Doctor also said that I shouldn't wet ear canal at all because it causes microbes to grow in ear canal. He recommended that I should buy Docs Proplugs and use them at all times.
That sad news, Juha. Is your doctor very experienced with scuba divers, or can you possibly consult one more experienced in our sport?

I hope a physician here might give you some suggestions about treatment, but as stated in the Proplug link: "Once the diver enters greater depths (deeper than 20 ft with Proplugs), water will be allowed into the ear for equalization." They are really designed to help with equalizing, not ear canal infections.
 
https://www.shearwater.com/products/peregrine/

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