My ear is ringing

[joewr]

A friend has ear wax pbs and he used to go to his physician twice yearly to get a "flush". Recently his physcian "gave" him a medication that he can use himself. It comes with an applicator top and is used monthly to cleanse his ears.

Interestly, prior to getting his twice annual rinses, he had hearing problems...now there are no excuses for....

Further, I had an ear infection this summer. And my ear is still sensative to altitude changes and seems to be sensative to colds. My physician told me that I would likely continue to have such sensativity because I had a little "scar" tissue from the infection. He also said that there were no problems with diving...just be sure to change depths with the usual care: i.e., if there is a problem equalizing, go up a few feet, etc. Since that has been my normal approach, nothing has changed in regard to techique.

Joewr...eh, what did you say?

 

[Laurence Stein DDS]

To all with earwax problems;

Living in Florida, I have the opportunity to dive nearly every weekend. I routinely rinse my ears with a solution of 50% white vinegar and 50% isopropyl alcohol (95%). Leave it in the ear for several minutes. The alcohol mixes with the residual water in your ear and helps dry it. The vinegar (acetic acid) acidifies the ear canal and makes it less hospitable to the germs that like to live there.

You can also get your MD to Rx Modified Burrow's solution. It is in a glycerine base. Glycerine is a trialcohol and almo mixes with water. The Burrow's solution is aluminum acetate and when dissolved smells just like vinegar.

Professional divers use the Modified Burrow's solution when doing saturation diving. In their dive chambers, it is humid and their ears never get a chance to dry properly. When used 15 minutes in each ear canal, the incidence of external ear infections is dramatically lowered.

There are other over the counter ear rinses. Some contain salisylic acid. This can cause pealing of the skin within the ear canal and creates an "onion skin" type of build up of dead skin and ear wax. This causes even more water to be trapped in the ear canal--the dead skin absorbs moisture and expands so you can't get the water out of your ears. Then you start poking at it with a Q-tip and packing the mixture against the ear drum. Soon it's off to the ear doc.

I have seen aluminum acetate powder in some pharmacies. It is mixed with water. So, it is possible to brew your own.
But without preservatives it might not have a decent shelf life once mixed.

Doc V might be able to tell you more.

 

[bluebanded goby]

Hi ToothDoc,

Like you, I use a 50/50 mix of vinegar and alcohol in my ears after diving. However, I don't get in the water as often as you.

I've heard it said that using this mixture too often (perhaps as often as weekly, but maybe it would need to be more often than that) can cause the ears to become overly dried and lead to problems from that. Have you run across this?

 

[Laurence Stein DDS]

Hi bluebanded goby

I haven't had a dryness problem with the vinegar and alcohol but I did with over the counter drops (salicylic acid). When I used them I had to see the ENT to clean out the cobwebs.

I'm only using it once a week and sometimes I just forget. It's easier to remember when the ears get itchy (ugggg!).

Salicylic acid is used for acne and to remove warts too. It causes peeling of the skin. I'm surprised it didn't peel my eardrum right off.

That's when I started using the vinegar alcohol mix. I haven't been back to the ENT since. The aluminum acetate/glycerine medication doesn't dry the ear at all--It removes the water but the glycerine is slippery--almost like oil and it remains for several days.

The only problem with these rinses are that they make your ears smell like salad dressing!

 

[watergal]

Earwax, huh? I have it on good authority that earwax was created to help struggling ENT docs who couldn't quite afford the Lexus. No, wait, that was Q-tips! Tom's wife is neither the first nor the last to make that unfortunate impaction discovery.

I have had many patients who overproduce earwax (called cerumen by the over-educated) keep it under control by using ear candles a couple times a month. The are made out of a special wax and sold in health food stores--at least around this area; regular candles will not work.

For people with otherwise healthy ears who prefer a less dramatic solution, a Waterpic type tooth/gum cleaner works great for flushing ears. I have not compared the price to the device mentioned above, but it is not only "like the doctor uses", but it IS what the doctor uses; I have one at my office and I learned it from another doc in FL.

I only recommend home earwax removal to patients who have been examined, have been found to have waxy, but otherwise normal ears including intact eardrums, and are not currently having any ear problem that isn't clearly related to the wax. related.

For patients with healthy ears who want to prevent problems after diving, I too often recommend the alcohol/vinegar mix mentioned above. I suggest people add some hydrogen peroxide--the bubbles distribute the mix and feel really good too!

I hope this information is usuful, but none of the above is intended as medical advice, nor is it directed at any one in particular. It is not intended to diagnose or treat any condition and does not imply a physician-patient relationship

(BillP, we may have very few HMOs here, but the lawyer business is booming. Still want to come down?)

HTH

 

[BillP]

With all due respect for Watergal's expertise and deference to her experience, I have to express my thoughts on ear candles by mentioning this link:

http://www.ncbi.nlm.nih.gov:80/entr...eve&db=PubMed&list_uids=8849790&dopt=Abstract

and, particularly, this one:

http://www.quackwatch.com/01QuackeryRelatedTopics/candling.html

The Waterpic idea works great for removing earwax if you're real careful how high you set the Waterpic.

Just my 2¢,

Bill

(So far I've gotten nothing but good experiences and good jokes from lawyers. HMO's on the other hand, are the spawn of Satan. Ahh, South Carolina...)

 

[watergal]

Thanks for the links and info, Bill. I review quackwatch regularly, but hadn't seen that one.

As I said, just anecdotal tales from happy people, but I will probably remind them that there are reasons the things are only in health food/new age stores and not pharmacies/medical supply places and that some people have had bad outcomes.

Oh, I hope I didn't hurt any feelings with the lawyer comment either. In fact, Mom is a lawyer (Hi, Mom!). It was supposed to be a rueful comment on the obligatory disclaimer.

So, now that we are better aquainted, please tell me what you really think of HMOs. You are welcome here any time. Coastal wrecks, deep lake with flooded town or underwater fossil beds--whats your pleasure?

 

[Laurence Stein DDS]

Dear Watergal,

A waterpic in your ear!!???. It'd good to know that it actually IS good for something. It doesn't do a very good job of removing plaque where it's needed most. It doesn't remove plaque at the gum line although it does remove food particles. With severe periodontal problems, it does irrigate in places nothing else gets to--but without removing the external plaque, the pockets re-populate very quickly.

For dental use, the instructions are to use the lowest pressure you can tolerate and DON'T SEAL THE NOZZLE AGAINST THE GUMS. Pressure can gradually be increased as the gums improve--except that for the most part, the same people who use the waterpic are the ones who should be using floss so there is not a big change unless the patient truly sticks to the periodontal regimine. You can actually peel a gum pocket open with the device at high pressure.

For "ear use", I would imagine that the device is used at it's lower settings and not inserted into the meatus.

The waterpic is great for debriding wounds prn--especially "road rash". I've seen it used on dog bites too but I would be afraid it would inject the bacteria deeper into the wound.

FYI, I did a residency following Dental School--a year of general anesthesia, ER Trauma and the Cardiac arrest team when covering anesthesia. This was in 1975 but the training gave me a much better understanding of Medicine and it makes me more comfortable when an emergency happens.

I have seen ear candles but I would only use them in a hurricane when the lights go out.

=-) :doctor:

 

[watergal]

Hi, Toothdoc!

Nice to meet you!
Wow, what a great life. In 1975 I was learning multiplication tables and reading Nancy Drew under the covers after 'lights-out'. It is great to have so many people volunteer the accumulated knowledge of their experiences to save others time and trouble. If only I could remember to stop and listen more often.

The Waterpic idea came from a ENT collegue who takes them on mission trips to developing countries. Yes, as several folks have pointed out, only the lower settings and he used half tapwater, half peroxide to irrigate.

Actually I have never used it either it or an ear candle on myself for anything.

Now I am curious :

except that for the most part, the same people who use the waterpic are the ones who should be using floss

Who doesn't have to use floss? May I excused? Am I wasting a minute of every day? Oh, no, nevermind, it feels so good, I might just keep it up anyway!


:tree::doctor:~Watergal

 

[BillP]

Originally posted by watergal

Oh, I hope I didn't hurt any feelings with the lawyer comment either.

Dang it, Watergal, if you don't quit apologizing for offending me so much, I'm going to get seriously offended that you think that I could be offended so easily! (grin) No my feelings weren't hurt. My comments about lawyers and HMO's were just another example of my dry humor. (Please pay no attention to the people who will tell you that my humor must have gotten wet at least once because it's seriously warped now.)

Bill