After recently getting a nasty ear infection from too much diving fellow divers told me about ear drops that you can take which protect your ears. I've since asked about them in pharmacies to no avail.
Does anyone know about this product? I know there are antibiotic ear drops for cure but something mild just for protection??
Many thanks!
o[-_-]o
Thalassamania
September 27th, 2007, 07:54 AM
Good discussion of the issue: Effect of Diving and Diving Hoods on the Bacterial Flora of the External Ear Canal and Skin (http://jcm.asm.org/cgi/reprint/15/5/855.pdf)
DAN recommends half and half white vinegar and rubbing alcohol. While Vinegar/alcohol is good, what we used for earwash on the Tektite Project back in 1969 was equal parts of 15% Tannic Acid (15 gm. diluted to 100 ml), 15% Acetic Acid (15 ml diluted to 100 ml) and 50% isopropyl or ethanol (50 ml diluted to 100 ml) in a wash bottle. On Tektite we used ethanol because we had a bunch in the lab for pickling specimens. If you leave a wash bottle full of solution in the sun (e.g., on the dash of your car) it feels so good after the dive.
If you have access to any High School or College chemistry lab you can make it. Or you can likely get a pharmacist to make it up (get you doc to write it out as a prescription) or just get the stuff you need from any Chemical Supply company
1) Tannic acid (crystals), weight out 15 grams, transfer to a 100 ml volumetric flask and fill with water.
2) Acetic acid (liquid) put 50 ml or so of water into a 100 ml volumetric flask, slowly add 15 ml of glacial acetic acid then dilute to 100 ml with water.
3) Dilute an appropriate volume of alcohol with water so that you get 100 ml of a 50% alcohol solution.
Combine equal parts of the three solutions (in this case 100 ml each to make 300 ml of Tektite Solution).
Mineral oil in the ears before the dive and Tektite Solution after. I've done this since '69 and never had any problems with my external acoustic meatus.
matts1w
September 27th, 2007, 08:45 AM
After getting a rash of nasty ear infections three years ago , I went to an ENT as I was getting smashed with pain every 2-3 months. He told me one of the first things I neede to do was quit using q-tips to clean my ears. He said soap and a gentle fingertip would be plenty to stay clean, but still allow enough wax in my ears to help stay protetced. In a nutshell, my dry/wax fee ears were already pretty raw, and the constant swimming pools and oceans made it worse.
I have to admit he was pretty dead on as I have only had one mild case of swimmer's ear since then.
doctormike
September 27th, 2007, 10:21 AM
As an ENT doc who just got a NASTY case of swimmer's ear in Bonaire (20 dives in a week, totally worth it!), I can sympathize...
The point about ear wax is a good one. It's amazing to me how many people think that ear wax is some sort of problem that needs to be regularly removed. Cerumen (ear wax) is protective, and using a q-tip can pack the wax deep in the ear canal, making swimmer's ear (and other problems) more likely.
I have used the rubbing alcohol and white vinegar mix with good success as well, although I use a bit more alcohol and a bit less vinegar. You really only need enough vinegar to drop the pH and keep the Pseudomonas bacteria from growing, other than that you want as little water as possible in the solution, since the alcohol works by drying the ear.
This also is very helpful: Sahara Dry Ear - Warm Air Ear Dryer (http://www.dryear.net)
I didn't have this in Bonaire, so I had to hook up a bunch of bendy bar straws so that I could blow air in my ear to help with drying..!
Mke
matts1w
September 27th, 2007, 10:32 AM
Doctor:
I have been told that using the alcohol treatments with frequency can be a bad idea as it dries out the ear and it cracks- kind of like the bottom of one's feet- which can make one prone to infection. Any truth to that?
As an ENT doc who just got a NASTY case of swimmer's ear in Bonaire (20 dives in a week, totally worth it!), I can sympathize...
The point about ear wax is a good one. It's amazing to me how many people think that ear wax is some sort of problem that needs to be regularly removed. Cerumen (ear wax) is protective, and using a q-tip can pack the wax deep in the ear canal, making swimmer's ear (and other problems) more likely.
I have used the rubbing alcohol and white vinegar mix with good success as well, although I use a bit more alcohol and a bit less vinegar. You really only need enough vinegar to drop the pH and keep the Pseudomonas bacteria from growing, other than that you want as little water as possible in the solution, since the alcohol works by drying the ear.
This also is very helpful: Sahara Dry Ear - Warm Air Ear Dryer (http://www.dryear.net)
I didn't have this in Bonaire, so I had to hook up a bunch of bendy bar straws so that I could blow air in my ear to help with drying..!
Mke
doctormike
September 27th, 2007, 10:51 AM
Doctor:
I have been told that using the alcohol treatments with frequency can be a bad idea as it dries out the ear and it cracks- kind of like the bottom of one's feet- which can make one prone to infection. Any truth to that?
Absolutely, I should have been more specific... this is really a way of managing this problem on a short term basis (such as early otitis externa on a dive trip), not as a simple preventative measure for someone who swims every day. The ear is surprisingly well put together, and generally does not need much in the way of instrumentation or cleaning unless some activity breaks down the normal barriers to irritation.
A good analogy is diaper rash, where healing really comes from drying things out and keeping things clean. However, overcleaning (or the use of excessive alcohol solutions) can cause different problems, like cracking, etc...
That mechanical ear dryer is a good preventative measure that won't cause the problems of excessive or long term alcohol treatment.
Of course, if you get a really bad swimmer's ear with bacterial overgrowth, the best treatment is careful cleaning by someone who can use a microscope and suction (i.e. an ENT doc), and the use of topical antibiotic/steroid solutions. The alcohol/vinegar solution is more appropriate early on in the course of the problem.
Mike
scubacoots3
September 27th, 2007, 11:17 AM
I have a bad ear problem right now, it has been going on now for about 4 weeks. It drains every night and i can hear and feel the water behind it. I have tried ear candles, swimmers ear, over the counter ear cleaning treatment, witch hazel, none of these have helped the left ear is the worst, it continues to drain and has an slight oder to it, there is no real pain involved with the actual ear. I have an apointment with a DAN ENT doctor monday. I need to get it cleared up to go diving again soonly.
any suggestions would be welcome.
SC3
BikerManiac
September 27th, 2007, 11:20 AM
I have never found the solution and 80% of the time I get ear infections while diving. One thing that has helped is using Pro Ears. Plugs that can be vented while diving. It's not 100% effective, but it has decreased my chances of getting ear infection, drainage, etc.
I just got a Henderson HyperStretch hood thinking it would help to reduce infections..but according to the article it's the other way around. Hmmm.
I will try the alcohol + vinegar solution on my next dive trip. When is the best time to apply this?
doctormike
September 27th, 2007, 11:31 AM
I have never found the solution and 80% of the time I get ear infections while diving. One thing that has helped is using Pro Ears. Plugs that can be vented while diving. It's not 100% effective, but it has decreased my chances of getting ear infection, drainage, etc.
Yeah, those can be good, I like the proplugs, don't know if that is the same thing as Pro Ears: Doc's Proplugs: The Doctor's Choice for Ear Protection (http://www.proplugs.com/). The biggest problems with them is if you wear them too long, they can trap sweat and moisture in the ear and cause some of the same problems. Venting is, of course, important to allow for equalization of the external ear canal... However, I was always a little worried about them, possibly failing to equalize on descent and having a damaged or broken piece of earplug forced into the canal. I doubt that this would be too much of a problem with the Pro Plugs, if they are in good shape...
I will try the alcohol + vinegar solution on my next dive trip. When is the best time to apply this?
Just after the dive, when it's just starting to itch a little. If you feel fine, you are better off using nothing, or maybe that ear dryer if you have a tendency to get swimmer's ear...
Thalassamania
September 27th, 2007, 12:30 PM
Just after the dive, when it's just starting to itch a little. If you feel fine, you are better off using nothing, or maybe that ear dryer if you have a tendency to get swimmer's ear...I've always used a drop of mineral oil before and the wash after, any thoughts?
doctormike
September 27th, 2007, 12:41 PM
I've always used a drop of mineral oil before and the wash after, any thoughts?
Many of these strategies go under the "whatever works for you" category... All people have different external auditory canal environments, related to differences in canal size, the presence of fixed obstruction (osteomas, or "surfer's ear"), and the composition of the ear wax - which can vary from thick, greasy plugs to thin flakes. Interestingly, ear wax composition seems to be genetic, and may be associated with fat metabolism and even cardiac risk factors!
That having been said, I often recommend baby oil for people who have dry, flaking earwax, once a week or so.. However, in the context of diving, this might trap infected debris and make healing of an inflammatory swimmer's ear more delayed.
So it really depends on why you are using the oil... it's OK for general dryness, but not if a bacterial infection is developing (with a bad smell and severe tenderness)...
Mike
Thalassamania
September 27th, 2007, 12:58 PM
.... So it really depends on why you are using the oil... In my case I will likely continue since that's what I was taught to do on the Tektite Project back in 1969 and I've done so ever since with good effect. I just did not want to be passing on what might be bad advice for someone else.
doctormike
September 27th, 2007, 01:11 PM
I just did not want to be passing on what might be bad advice for someone else.
Yup, for the most part, the "if it works for you" rule is a good one! It is unlikely that you will be passing on something really dangerous if it hasn't caused you a problem in years...
Hard to get people to stop using q-tips, though..! I talk about q-tips like other doctors talk about cigarettes....
Gotta admit, they do feel good! :)
DocVikingo
September 30th, 2007, 03:46 PM
Hi Mucksavage,
You will find a very complete answer to your inquiry in my DAN Alert Diver magazine article entitled "Swimmers Ear - Additional Advice About A Pesky and Sometimes Painful Problem" in Mar/Apr 07 issue.
You may also read it at Doc Vikingo's Preventing Swimmer's Ear (http://www.awoosh.com/DocVikingo/Preventing_Swimmers_Ear.htm)
Regards,
DocVikingo
Thalassamania
September 30th, 2007, 03:51 PM
Hard to get people to stop using q-tips, though..! I talk about q-tips like other doctors talk about cigarettes....
Gotta admit, they do feel good! :)Like my Mom always said (she's a physician), "nothing in your ear except your elbow."
DocVikingo
September 30th, 2007, 04:17 PM
I have a bad ear problem right now, it has been going on now for about 4 weeks. It drains every night and i can hear and feel the water behind it. I have tried ear candles, swimmers ear, over the counter ear cleaning treatment, witch hazel, none of these have helped the left ear is the worst, it continues to drain and has an slight oder to it, there is no real pain involved with the actual ear.
Hi SC3,
Whatever ear malady you are suffering, using ear candles (see below), OTC swimmer's ear drops which typically are nearly all alcohol and witch hazel are only likely to aggravate the problem. You should cease using them immediately.
Regards,
DocVikingo
1. "Laryngoscope. 1996 Oct;106(10):1226-9.
Ear candles--efficacy and safety.
Seely DR, Quigley SM, Langman AW.
Spokane Ear, Nose, and Throat Clinic, WA 99204, USA.
Ear candles are a popular and inexpensive alternative health treatment advocated for cerumen removal. A hollow candle is burned with one end in the ear canal with the intent of creating negative pressure and drawing cerumen from the ear. If effective, significant savings could result from the use of ear candles. This study evaluates the efficacy and safety of this alternative method for cerumen management. Tympanometric measurements in an ear canal model demonstrated that ear candles do not produce negative pressure. A limited clinical trial (eight ears) showed no removal of cerumen from the external auditory canal. Candle wax was actually deposited in some. A survey of 122 otolaryngologists identified 21 ear injuries resulting from ear candle use. Ear candles have no benefit in the management of cerumen and may result in serious injury."
2. J Laryngol Otol. 2004 Jan;118(1):1-2.
Ear candles: a triumph of ignorance over science.Ernst E.
Complementary Medicine, Peninsula Medical School, Universities of Exeter & Plymouth, Exeter, UK. Edzard.Ernst@pms.ac.uk
Ear candles are hollow tubes coated in wax which are inserted into patients' ears and then lit at the far end. The procedure is used as a complementary therapy for a wide range of conditions. A critical assessment of the evidence shows that its mode of action is implausible and demonstrably wrong. There are no data to suggest that it is effective for any condition. Furthermore, ear candles have been associated with ear injuries. The inescapable conclusion is that ear candles do more harm than good. Their use should be discouraged."
gert7to3
October 1st, 2007, 06:54 PM
The ear plugs are Doc's Pro Plugs. They help by reducing the amount of water you get in your ears.
The other solutiuon I would suggest folks with chronic ear issues try is the Pro-Ear mask. This mask has earcups which permit you to keep your ears dry. The ear cups have little hoses connecting them to the mask. Equalizing your mask also equalizes the earcups.
I have 40 or so dives with mine and am happy with it. There have been a couple of threads in the Fins, Masks & Snorkles forum.
