Ear infections

[Robin T]

I think a few posters have really hit the nail on the head!

Think of it from the infection's perspective! You need a consistent and appropriate pH, fairly consistent temperature, and damp conditions for ideal growth, plus of course an absence of any nasty lethal chemicals (ie alcohol, various antibiotics, high enough concentration of chlorine, etc).

Disrupt any of these factors, and the infection should be at least reduced, get two or more factors dealt with, and you likely won't have a problem for long.

I dive in a lake that in summer time is really bad for swimmer's itch/ear, the local goose population is out of control and I'll leave it at that.

My personal set of solutions?

Right now I'm training full time for eventually an instructor role, and I'm alternating between the lake, the LDS' training pool, and local public pools for fitness. I can't imagine a bacterium likes going from cool freshwater, to superchlorinated public pool water, then to open exposure in dry conditions (I'm careful about making sure my ears dry well). Final nail in the coffin? I'm also doing fairly deep chamber dives in my training (165' the other day), and high partial pressures of oxygen just can't be very good for aquatic micro-organisms.

As for ear infections slowing me down? Having experienced an OUTER ear infection, it sucked, but only when it got really bad did I start having trouble equalizing (due to swelling). Personally I'd keep diving and stop only when equalization was giving me trouble, adding prescription drugs to the mix if it started feeling "bad enough" to warrant antibiotics. It's just not realistic to slow down much for an outer ear infection as a pro, you have to change your hygiene practices instead to include stuff designed to keep that under control, and if you mess up once in a while, just improve your ear-care routine and try and carry on, since hopefully a little jaw pain and irritation is all it adds up to. (because we're being such proactive divers!)

If I ever experience unusual vertigo or other INNER ear warning signs, I'll stop diving immediately and talk to the best specialist I have available. Fortunately this is an infection you usually have to have a bad squeeze or a ruptured eardrum to have to worry about. Hopefully by trying to be a smart diver I can steer clear.

 

[mgmonk]

.In all cases, the most knowledgeable doctors have stressed NOT jumping the gun on the use of antibiotics. The more you use them the less effective they become. With regard to full time working divers with chronic swimmers ear I can attest to the fact that working hurt is a fact of life for many instructors.

I agree about over usage of antibiotics. In retrospect, I think I was desperate to do whatever I could to get back to work. When she cleaned my outer ear it was stuffed with dried puss, so something had exploded in there!! I was just ahppy to bea ble to hear again.

The ear beer mix of 50/50 vinegar/isopropyl alcohol is a very popular solution.

This I've never heard of, and on your advice, I'll start looking at it as a preventative measure. I've always been careful to wash my ears out with warm, fresh water after my last dive of the day, but maybe that's not doing anything at all.

Anyway, this has been my first infection that caused time off in two years, so...

Thanks again for all the posts

 

[alex_tx]

This might be better placed in the instructor to instructor thread, but it applies to all divers too, so...

How long have you continued to dive when you know you have a mild ear infection? Outer ear, pain, saw a doctor, red, but not hideous. For me, having to dive everyday, I look at it like an athlete playing hurt. Sometimes, you just have to do it. For years I've managed to deal with them as they come and go. Only once previously did I stop diving for 5 days when it was an obviously bad infection, but recently I had something new come up.

I came out of the water 5 days ago and my left ear was completely blocked. It was like having cotton stuffed in my ear. I went to the clinic, and she pulled out what was apparently puss that had solidified and blocked my outer ear. I could dive fine. I fact, I felt better in that out, but I took her advice and went on meds and stayed dry for the past 6 days.

Anyway, the question is, how many of you "play hurt" and how many of you bail on the first sign of an infection. Asking around other instructors I work with and know on the island, I get everything from machismo to rush to the nearest hospital.

What do you do?

What I suggest is either be proactive and oil your ears before a dive. Or after a dive use White Distill Vinegar and wash our your ears. You might want to do a combination of both. Read this link's article to find out more information. Snorkel Riddle

 

[CaptainKen]

I used to mate on a charter dive boat, diving every day. Then ran my own boat, diving once a day. Now I travel and dive for a week or two at a time, 3 times per day. I almost always get outer ear infections after the first 3 to 4 days, if I don't go proactive. After 3000 or so dives, My recommendation is to have three meds on hand for any extended diving. First to use every day, right from the start, Swim Ear or even better, the similar stuff you get when in Mexico, that still has a trace of acetic acid in it. SwimEar in the US now does not contain the acetic, which shifts the PH to acid in your ear canal, and makes it hard for the nasty agents to take hold. My doc said mix one part white vinegar to 3 parts isopropyl alchohol, instead of SwimEar. I still have some of the good stuff from Mexico, so haven't tried the vinegar. Just turn sidways on a pillow, fill the ear canal, then after 30 seconds or so, sit up and drain it on a tissue. THEN (despite stage 1 actions), if you feel the early onset of symptoms, such as itching, slight tenderness when you touch the external ear, go to stage two. This requires you to get out the prescription meds you asked your Doc for BEFORE you went away (or to work). So, stage two is Vosol Otic. It is a mix of acetic acid and a soothing liquid (oil or glycerine I think.) This one can be let sit in the ear for a few minutes, so soak in a little, before sitting up and draining. It is slow to work, but will usually turn it around in a day or so. If things are still getting worse, or you actually have pain, go to stage three. Cortisporin (spelling?). It is an anti-bacterial, anti-fungal, with soothing cortisone. As in stage 2, I let it sit in the ear canal for a few minutes before draining the excess. It can turn real pain into non-pain in a few hours. I have been told it is best to hold off on the big hammer (cortisporin) unless your really need it. When the symptoms have abated for a day or so, then drop back to stage 2 for a day or so, then back to stage one. I'm no Doc, and everyone is different, so ask your Doc about this method before you try it. In any case you will have to sweet talk him/her into writing the prescriptions you need ahead of time. They may give you a line about "can't do that without you actually having symptoms", so you may have to fall to the floor and scream in pain from the instant earache you just got.

 

[CaptainKen]

I used to mate on a charter dive boat, diving every day. Then ran my own boat, diving once a day. Now I travel and dive for a week or two at a time, 3 times per day. I almost always get outer ear infections after the first 3 to 4 days, if I don't go proactive. After 3000 or so dives, My recommendation is to have three meds on hand for any extended diving. First to use every day, right from the start, Swim Ear or even better, the similar stuff you get when in Mexico, that still has a trace of acetic acid in it. SwimEar in the US now does not contain the acetic, which shifts the PH to acid in your ear canal, and makes it hard for the nasty agents to take hold. My doc said mix one part white vinegar to 3 parts isopropyl alchohol, instead of SwimEar. I still have some of the good stuff from Mexico, so haven't tried the vinegar. Just turn sidways on a pillow, fill the ear canal, then after 30 seconds or so, sit up and drain it on a tissue. THEN (despite stage 1 actions), if you feel the early onset of symptoms, such as itching, slight tenderness when you touch the external ear, go to stage two. This requires you to get out the prescription meds you asked your Doc for BEFORE you went away (or to work). So, stage two is Vosol Otic. It is a mix of acetic acid and a soothing liquid (oil or glycerine I think.) This one can be let sit in the ear for a few minutes, so soak in a little, before sitting up and draining. It is slow to work, but will usually turn it around in a day or so. If things are still getting worse, or you actually have pain, go to stage three. Cortisporin (spelling?). It is an anti-bacterial, anti-fungal, with soothing cortisone. As in stage 2, I let it sit in the ear canal for a few minutes before draining the excess. It can turn real pain into non-pain in a few hours. I have been told it is best to hold off on the big hammer (cortisporin) unless your really need it. When the symptoms have abated for a day or so, then drop back to stage 2 for a day or so, then back to stage one. I'm no Doc, and everyone is different, so ask your Doc about this method before you try it. In any case you will have to sweet talk him/her into writing the prescriptions you need ahead of time. They may give you a line about "can't do that without you actually having symptoms", so you may have to fall to the floor and scream in pain from the instant earache you just got.

 

[alex_tx]

I would go the natural inexpensive way first. I would put in my ears
Mineral oil or Olive oil (before a dive)
or
Wash my ears with White Distilled Vinegar (after a dive)
You might want to try a combination of both, I personally do both and haven't had ear issues since using this method above.

 

[eliminator]

I use to always get ear infections from diving and I actually had a few serious ones that lasted for over a week that we so bad I could barely sleep. Now, after every dive I use a squirt of hydrogen peroxide and havent had an infection in years. You may also want to flush out your ears with water or even use a hair dryier to help dry up the inside. I think my issue was related to the architecture of my ears, apparently I have spots that collect and trap water.

 

[MauiScubaSteve]

I used to regularly use Hydrogen Peroxide as a first step in my ear self treatment; it will release the oxygen molecules in the ear wax so a warm squirt of water will rinse it away (ear wax remover is diluted hydrogen peroxide IIRC). I also used a lot of Isopropyl Alcohol to keep the ear dry (swimear is diluted alcohol IIRC). After a few ear perforations (cliff diving) my North Shore Oahu Doctor told me; hydrogen peroxide does it's work on healthy tissue as well as unhealthy, too much will weaken the ear drum, and too much alcohol will make the ear canal too dry. Weak and brittle my ear drum was, compared to my ear after changing to the 50/50 ear beer (I use apple cider vinegar; prefer the flavorful smell and the color tells me which alcohol bottle is the mix).

Lay on your side and fill the ear with the beer (just barely cover the cap bottom - if you have the same size canal as me). I let it sit in there for a minute at least; one reason for the alcohol is so the trapped water will float to the surface (specific gravity and all). When you tilt and drain (I use paper towel), the water comes out and the alcohol/vinegar evaporates leaving dryer ear. I emphasize again, the ear canal is not supposed to be dry; we are just not wanting it to be continually soggy, along with changing the ph. Extensive alcohol and hair driers will probably cause ear itch.

 

[joe27march]

Anyone ever heard of a vinegar solution used after dives? When my wife tried the open water course the instructor talked about how he always had ear infections, but once he stared using a vinegar solution it reduced them to almost zero.

 

[ALAN243]

I use either a domboro solution which is a aluminum acetate solution, or the one I use the most is a 70/30 mix of white vinegar and isopropal (sp) alcohol, use it after the dive to help change the PH in your ear and get the water out. When I was diving at the casino and doing 5 dives a show everyday this was the only way to keep from getting ear infections