Ear Problems and a Renewed Love of Diving

[DandyDon]

Ben, we'd like our docs to cure our ear barotraumas, the common cold, malaria, and cancer - but they can only do so much. How did your ear problem start? I've had a few, but never one that lasted more than a week.

[Ben Prusinski]

Ben, we'd like our docs to cure our ear barotraumas, the common cold, malaria, and cancer - but they can only do so much. How did your ear problem start? I've had a few, but never one that lasted more than a week.

Agreed- I had a nasty sinus infection and ear pain that lasted a month. It got better. Now, after a couple of weeks of feeling well, my ear infection came 2 days ago. I went to urgent care and the verified that I had an ear infection. I am taking antibiotics and ear drops and hope it heals. Need to schedule another appointment with an ENT specialist to get well before I dive again. My current ENT is not a diver nor does he have experience with dive medicine. Thats why I would prefer an ENT who has experience in dive medicine to help me get well so that I can get back to diving.

[chordrider]

Hi Ben,

Contact DAN for the doc in Palo Alto. We saw one sone time ago at Stanford Medical Center. Not sure if he's still there.

[DandyDon]

Agreed- I had a nasty sinus infection and ear pain that lasted a month. It got better. Now, after a couple of weeks of feeling well, my ear infection came 2 days ago. I went to urgent care and the verified that I had an ear infection. I am taking antibiotics and ear drops and hope it heals. Need to schedule another appointment with an ENT specialist to get well before I dive again. My current ENT is not a diver nor does he have experience with dive medicine. Thats why I would prefer an ENT who has experience in dive medicine to help me get well so that I can get back to diving.

And we'd like them to fix us cheaply, huh?

I'm sharing a non-pro here, and I could even be wrong about some of my experiences and understandings, but several physicians do post on this forum and ear problems are the most common subject - so lots of additional reading is available here.

You didn't mention which ear drops you're taking, but I am guessing they have an antibiotic and hydrocortizone? Works wonders for my outer ear infections, otitis externa. I think oral antibiotics are often prescribed in case of middle ear infections, and I think it's really difficult to be sure which it is - so they treat both possibilities. Hope you heal within a week, or before you can get to a new doc.

Preventing outer and middle ear problems are ongoing challenges for divers. Many of us us a mix or white vinegar and rubbing alcohol every dive day to dry ears and restore acid balance, and careful equalizing is essential at all times. I still get out ear problems with my hay fever, or maybe there's something else about me - but I won't travel overnight without my ear drops, just in case.

Hi Ben,

Contact DAN for the doc in Palo Alto. We saw one sone time ago at Stanford Medical Center. Not sure if he's still there.

[TSandM]

Ben, did you dive before the symptoms of the ear infection came up?

Barotrauma can look very much like infection. But divers ARE prone to external ear infections, which usually present with pain when you move the pinna, or external ear. Barotrauma, with the accumulation of fluid behind the drum, CAN convert into infection with time. Such middle ear infections are treated with oral antibiotics, while the outer ear infections are treated with drops, unless they don't respond to them, in which case oral antibiotics can be used.

When a patient is first seen, it is important to make a decision as to WHICH kind of ear problem you are dealing with, and treat it appropriately. Unless you had a really SEVERE otitis externa, it was odd to put you on both oral and topical antibiotics immediately.

I agree that you should see someone who is familiar with the issues divers have with their ears. It would be a rare urgent care doc who would have this experience.

[DandyDon]

Dr TSandM gives some of the best information here. Always glad to see her post...

Unless you had a really SEVERE otitis externa, it was odd to put you on both oral and topical antibiotics immediately.

Ok, I've learned that since by reading from you doctors here, but it was quite common on my first few ear infections. I could be mistaken, but my guess it they wanted to treat both possibilities just in case.

Now I just treat the out ear problem with Neomycin-plus drops from Cozumel.

[FPDocMatt]

I could be mistaken, but my guess it they wanted to treat both possibilities just in case.

If someone has an external ear infection, and because of the exudate in the ear canal I can't see the ear drum to figure out if she has a middle ear infection as well, I will sometimes prescribe both ear drops (for the external ear infection I know she has) and an oral antibiotic (for the middle ear infection which she might have).

The ideal approach is to suck out all the stuff and get a good look at the ear drum, but as a family practitioner I don't have that kind of equipment. Otorhinolaryngologists do.

[DandyDon]

If someone has an external ear infection, and because of the exudate in the ear canal I can't see the ear drum to figure out if she has a middle ear infection as well, I will sometimes prescribe both ear drops (for the external ear infection I know she has) and an oral antibiotic (for the middle ear infection which she might have).

The ideal approach is to suck out all the stuff and get a good look at the ear drum, but as a family practitioner I don't have that kind of equipment. Otorhinolaryngologists do.

Thanks for the clarification. And I guess this will vary some with practitioners as well as patients.

[Ben Prusinski]

@TSandM- yeah had no issues diving before on my trip last year to the Dominican Republic. It happened from a sinus infection while traveling in South America.

@DandyDon, thanks for the ear drop tips. Will bring these with me along with suntan lotion and mosquito repellant on my next dive trip! I've seen multiple ear nose throat (ENT) specialists and docs since then.

Anyways, I saw another ENT specialist last week who did a great job cleaning my ears out and examination. He even showed me the details on video. No fluid in the middle ear even though I had otitis media infection and finished the antibiotics. Its been 10 days and no more ear pain. I do hear my ears pop a lot still. I have a follow up with a local primary care doc who is familiar with scuba divers and dive medicine so he can give me the status since last couple weeks.

[DandyDon]

@DandyDon, thanks for the ear drop tips. Will bring these with me along with suntan lotion and mosquito repellant on my next dive trip! I've seen multiple ear nose throat (ENT) specialists and docs since then.

I hope you are referencing the mix of white vinegar and rubbing alcohol every dive day to dry ears and restore acid balance. Neither of us should use prescription meds without seeing a doctor.

Glad you're feeling better.