Raging ear infection...

[erparamedic]

Well... I'm one week into my raging ear infection, and it's getting worse! I just finished 7 days of Levaquin (took the last pill today). I saw my doc again today, and he says it looks bad... red, lots of fluid, and a tiny hole in the eardrum. He prescribed cortisporin ear drops... 4 drops 3 times a day.

Something that I've noticed, that seems odd to me, is that my outer ear is incredibly painful to the touch. I can't touch, or even sleep on that side of my head without intense "deep, bruise-like" pain.

I'm not very concerned about the small hole... I almost always have a small hole in that eardrum... but no infection in it for nearly 10 years. I've dove many, many, dives with that tiny hole, and never had any pain or problems from it. In case anyone wants to know... my last dive was 3 weeks ago... and I've only had the infection for 1 week... so I don't believe it is dive related at all.

I'm off to see my ENT (who is a diver) in one week. (He's the ENT that grafted 80% of a new eardrum for me 11 years ago... all so I could learn to dive!) I have a dive trip scheduled for Feb. 28 to get my AOW cert. I know that gives me over a month to heal... but I'm just a bit anxious.

Any ideas or suggestions to aid in or quicken the healing?

 

[fisherdvm]

This is the label warning for Cortisporin otics:

Do not use hydrocortisone, neomycin, and polymyxin B otic if the ear drum (tympanic membrane) has ruptured (broken). It may be dangerous for medicine to get into the inner ear. A ruptured ear drum usually causes a considerable amount of pain. A decrease in hearing may also occur. Call your doctor if you suspect a ruptured ear drum. Your doctor will know if the ear drum is ruptured by looking into the ear with a special device (otoscope).

The problem here is the neomycin portion of cortisporin, it is toxic to the inner ear. I am not sure your doctor is wise to prescribe it in the face of a known ruptured ear drum. Here is a quote of the risk:

The problem:
Some of the treatments given for various ear conditions, particularly infections, have the potential to injure the inner ear. In recent years considerable attention has been focused on aminoglycoside antibotics, as many common ear drops contain these drugs. Examples of aminoglycosides are gentamicin, streptomycin, kanamycin, tobramycin, and neomycin. Gentamicin and streptomycin are toxic to the vestibular (balance) part of the inner ear. Neomycin is very toxic to the hearing part of the inner ear. Some of the solvents for the antibiotics have also been reported as being ototoxic. Propylene glycol is an example (Morizono et al, 1980). As you can see below, numerous commonly used ear preparations contain these drugs.

The question I ask of you, is what was the cause of your perforated ear drum. If it is due to chronic ear infection, certainly your eustachian tubes might be well scarred.

Grafting it close does not necessary correct the eustachian tube dysfunction, and now the price you pay is an ear infection.

I am not sure if it is safe to dive with a known perforated ear drum. You certainly are allowing possible aquatic bacteria a nice point of entry.

Certainly, you wouldn't have to worry about barotrauma to an ear that has a perforated ear drum, but the one that received the graft is at risk for barotrauma if the eustachian tube is not functioning well.

Hope you get a clear answer from your ENT before you go back to diving. In the mean time, I would stop the cortisporin unless you want to lose some hearing from the neomycin.

 

[Missdirected]

I'd beg to see if I could be seen sooner. Let them know you have a trip coming up. Sometimes you get someone nice that will get you worked in. Perhaps get on their waiting list for when they have cancellations?

 

[Steve_Dives]

I'm no help, but get well and good luck on the AOW.

 

[DandyDon]

I'd beg to see if I could be seen sooner. Let them know you have a trip coming up. Sometimes you get someone nice that will get you worked in. Perhaps get on their waiting list for when they have cancellations?

I'd go in the office first thing in the morning, bed, then not leave - letting the pain show. Get worked in.

Take all meds with you. It's better to see the bottles than trust your memory and accuracy.

I used to get bad ones before I got better with alcohol & vinegar rinsing. My condolences. I had days I couldn't go to the bathroom without the ear drops in hand, and I don't think of myself as a softy.

 

[nivla80]

Wish I could help, but all I can offer are my well wishes. Get well soon, and feel better!

 

[erparamedic]

The question I ask of you, is what was the cause of your perforated ear drum. If it is due to chronic ear infection, certainly your eustachian tubes might be well scarred.

Grafting it close does not necessary correct the eustachian tube dysfunction, and now the price you pay is an ear infection.

I am not sure if it is safe to dive with a known perforated ear drum. You certainly are allowing possible aquatic bacteria a nice point of entry.

Certainly, you wouldn't have to worry about barotrauma to an ear that has a perforated ear drum, but the one that received the graft is at risk for barotrauma if the eustachian tube is not functioning well.

Hope you get a clear answer from your ENT before you go back to diving. In the mean time, I would stop the cortisporin unless you want to lose some hearing from the neomycin.

Your 3 posts were quite informative! Today, my family doc did say that there was a tiny perf. This is likely the same tiny perf that I've had for years. I will certainly be on the phone tomorrow though... cause I don't want any set-backs or further problems with the med that was prescribed. I did tell him that I have an appt with the ENT next week, and he said that was the safe idea.

History of my left ear: As a child, several infections, and 3 blow-out bloody ruptures. These ruptures would heal up to about 90% (never fully healed), but then with every sinus infection/cold, etc, it slowly ate away at my eardrum. When I was 18, I wanted to dive, but was missing 80% of my eardrum by then. I saw a local ENT, who happens to be a diver. He grafted a new eardrum out of muscle tissue taken from my scalp, behind that ear. Everything went well, and I went thru my OW class. Shortly after my OW class, I noticed that I could "blow bubbles" out my ear. Shortly after that, I was told that I had a tiny perf. It was patched once, but the patch didn't take. Shortly before a trip to the Bahamas (about 10 years ago), I was worried about diving with the perf. Per my ENT, he said as long as there was no pain or disorientation, or feeling of "water rushing in" that I would be fine to dive. I've always gone by what he said, and NEVER had any problems with infection, pain, larger perfs, or anything. The only thing that I've ever noticed about that ear (while diving) is that I have to clear it more often. But, it clears easily, so no problem there.

Thanks to everyone for the well wishes too! Now, if I could just get comfy enough to sleep.

 

[DandyDon]

Thanks to everyone for the well wishes too! Now, if I could just get comfy enough to sleep.

Try a heating pad. May help.

 

[rakkis]

Hope you get better! PM me your email. I'll send you a medical form to bring to your ENT before the trip.

 

[erparamedic]

Hope you get better! PM me your email. I'll send you a medical form to bring to your ENT before the trip.

Thanks, Rakkis! PM sent.