Managing scuba ear problems (not equalizing)

[Lorenzoid]

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A ScubaBoard Staff Message...

This thread has been split off from a side discussion in another thread. Marg, SB Senior Moderator

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. . . I buy all my antibiotic ear drops during my twice a year Mexico trip, as the cash price is less than what my co-pay is in the US, and the Mexican version has a topical pain killer that the US version doesn't.

I went to a walk-in clinic here in the US--a chain affiliated with a local hospital--after returning from Mexico with an ear infection. The nurse practitioner there prescribed some antibiotic drops--neomycin/polymyxin with hydrocortisone (I'm reading off the bottle I saved). The visit was something like $100. My ear infection not only didn't improve but it worsened, so I went to an ENT. The ENT told me the docs-in-a-box places always prescribe those kind of ear drops and they are not what I need, so he prescribed some other antibiotic drops. I don't know what the ENT charged; probably at least another $100. My health insurance is a high-deductible/HSA plan, so it all came out of my own pocket in the end. The infection resolved with the drops. However, my hearing in one ear has never been quite the same.

My takeaways from this experience are that quality medical treatment isn't a given even in the US, and I would not trust anyone less than a specialist to treat an ear infection, let alone self-medicate using something I bought over the counter in Mexico.

 

[DandyDon]

I went to a walk-in clinic here in the US--a chain affiliated with a local hospital--after returning from Mexico with an ear infection. The nurse practitioner there prescribed some antibiotic drops--neomycin/polymyxin with hydrocortisone (I'm reading off the bottle I saved). The visit was something like $100. My ear infection not only didn't improve but it worsened, so I went to an ENT. The ENT told me the docs-in-a-box places always prescribe those kind of ear drops and they are not what I need, so he prescribed some other antibiotic drops. I don't know what the ENT charged; probably at least another $100. My health insurance is a high-deductible/HSA plan, so it all came out of my own pocket in the end. The infection resolved with the drops. However, my hearing in one ear has never been quite the same.

My takeaways from this experience are that quality medical treatment isn't a given even in the US, and I would not trust anyone less than a specialist to treat an ear infection, let alone self-medicate using something I bought over the counter in Mexico.

That's a surprising story. I learned the hard way about swimmers ear if I don't use an alcohol-vinegar mix on dive trips, ended up in a doc's office on the verge of tears that last time, but the neomycin/polymyxin with hydrocortisone ear drops (available only on prescription) that have always saved me worked again. I get them other times too so will not leave home overnight without a bottle. Surprised at our different experiences.

 

[Lorenzoid]

That's a surprising story. I learned the hard way about swimmers ear if I don't use an alcohol-vinegar mix on dive trips, ended up in a doc's office on the verge of tears that last time, but the neomycin/polymyxin with hydrocortisone ear drops (available only on prescription) that have always saved me worked again. I get them other times too so will not leave home overnight without a bottle. Surprised at our different experiences.

It surprised me too that the ENT implied general practitioners seem to prescribe that antibiotic mixture for every ear infection whereas ENTs don't mess around with it. (It was my impression he was implying that.) It is possible that that stuff is generally considered the first line of defense, and if it doesn't work, then the general practitioners know to move on to what the ENT prescribed (and apparently would have prescribed from the get-go). More likely, a GP would have sent me to the ENT. I'm convinced the delays involved in those visits exacerbated my infection. Sorry for the rant, but I now understand ear infections are nothing to mess around with. I would suggesting getting them treated immediately, preferably by an ENT, and definitely not chancing it by delaying while you first try self-medicating.

p.s. I brought the swimmers ear drops on that trip and used them ... sporadically. Nowadays I use them religiously!

 

[DandyDon]

and if it doesn't work, then the general practitioners know to move on to what the ENT prescribed (and apparently would have prescribed from the get-go).

What did he prescribe? I have had such good results from the antibiotic-hydrocortisone drops that I figured that they would fix any swimmer's ear infection, but I guess yours didn't respond to that particular antibiotic. Good that we have so many different antibiotics, but I wish the feds would outlaw antibiotics in animal feeds even tho meats would cost more.

I brought the swimmers ear drops on that trip and used them ... sporadically. Nowadays I use them religiously!

I mix white vinegar with 4% acid equally with 50% alcohol and apply after every dive or shower of a dive trip. The store brands don't have vinegar because of the short shelf life of the mix. I saved the store brand bottles to refill and have for many years.

 

[BRT]

I went to a walk-in clinic here in the US--a chain affiliated with a local hospital--after returning from Mexico with an ear infection. The nurse practitioner there prescribed some antibiotic drops--neomycin/polymyxin with hydrocortisone (I'm reading off the bottle I saved). The visit was something like $100. My ear infection not only didn't improve but it worsened, so I went to an ENT. The ENT told me the docs-in-a-box places always prescribe those kind of ear drops and they are not what I need, so he prescribed some other antibiotic drops. I don't know what the ENT charged; probably at least another $100. My health insurance is a high-deductible/HSA plan, so it all came out of my own pocket in the end. The infection resolved with the drops. However, my hearing in one ear has never been quite the same.

My takeaways from this experience are that quality medical treatment isn't a given even in the US, and I would not trust anyone less than a specialist to treat an ear infection, let alone self-medicate using something I bought over the counter in Mexico.

In February we were in Cozumel. I got a bad stomach bug that I lived with for a week. Finally went to a pharmacy with a doctor in the back. He prescribed an antibiotic that made me feel better within the hour and the problem never came back. Doctor wanted 60 pesos. Pills were 200 pesos or so. Another in our party appeared to have the same bug at the same time. They decided to return to the USA early to get good care. A couple of weeks later they were getting over it.

 

[Shasta_man]

I was also the beneficiary of access to medicine in other countries, maybe the ear medicine discussed here, when halfway through a 10 night Raja Ampat liveaboard trip one of my ears closed up and I could not equalize. I didn't really feel bad otherwise but ear closed so that's it diving was kaput. Mentioned to main guide and they gave me a bottle of ear drops medicine and the next day I was diving again for the rest of the trip which turned out fantastic. That medicine was likely available here but I suspect the availability was why it was readily available onboard in Indonesia.

I saw example how insurance isn't necessarily paying the monster prices we might think they are shielding us from. I had serious surgery on my jaw which required an overnight in the hospital. The hospital sent me a bill because insurance pretended it wasn't pre-authorized (Multiple experiences taught me insurance tries to see if you will pay anything before paying out). Bill was $75K, just for hospital, not the surgeon. I called insurance and said it was pre-authorized and they pretended to suddenly notice that. Hospital sent followup: hospital knocked $69K off, leaving ~$6K for which insurance paid slightly more than me. Perhaps that price is because insurance brings the hospital volume business but makes me wonder if we could all pay less if insurance wasn't taking a cut.

 

[mediumone]

I mix white vinegar with 4% acid equally with 50% alcohol

Isopropyl I presume.
What %?

 

[Manatee Diver]

It surprised me too that the ENT implied general practitioners seem to prescribe that antibiotic mixture for every ear infection whereas ENTs don't mess around with it. (It was my impression he was implying that.) It is possible that that stuff is generally considered the first line of defense, and if it doesn't work, then the general practitioners know to move on to what the ENT prescribed (and apparently would have prescribed from the get-go). More likely, a GP would have sent me to the ENT. I'm convinced the delays involved in those visits exacerbated my infection. Sorry for the rant, but I now understand ear infections are nothing to mess around with. I would suggesting getting them treated immediately, preferably by an ENT, and definitely not chancing it by delaying while you first try self-medicating.

More than likely if you are going to an ENT for an ear infection you've already been treated with that first line of defense. Particularly as getting into specialists was a hard affair before ACA and the shrinking networks, now it is even harder. To get an infected cyst drained I had a call a half a dozen places before I would get one to see me that week. Most were a month or more out.

 

[DandyDon]

Isopropyl I presume.

Yeah, but you can use 100 proof vodka or tequila. I mix a new batch for every trip as the vinegar can breakdown, but it's virtually free. I stick a bottle in my mask box to use after every dive and a bottle in my toilet kit to use after a shower.

50% alcohol

Was I not clear?

Discussions on the Medical forum have mentioned various mixes, but that's the convenient one I use with great success as a preventative, not as a treatment after acquiring swimmer's ear - too late. Some online sites suggest that swimmer's ear is more common with nonswimmers after exposure to the elements, but I question that. It's not how it got its name. I have had cases without swimming which I blame on my allergies.

 

[mediumone]

Was I not clear?

Probably, but I read that as a solution made up of one half vinegar and one half alcohol.
The vinegar that you use is 4%. I didn't read 50% as the alcohol content.