Ear Infections

ClarkKent

Hi All

this has probably been talked about quite a bit on Rebreather World but can any one out there offer me some advice on keeping my ears free from infection. i have just been to my local practioner nurse with yet another ear infection. there appears to be no wax build up and she has given me some olive oil to help lubricate the drum (which seems dry). she (nurse not doctor!!) suggested i use some of the oil pre-dive and or get some ear plugs for the durationm of the dive. i am a little concerned about using anything in the ear and equalising! can any one out there offer some advice?

many thanks in anticipation

decoweenie

I thought The Man of Steel is impervious to everything except for Kryptonite ?

I have always used Swimmer's Ear which is a mild acid solution with alcohol to help clean the inside of the ears after long dive and/or multi-dive trips. Also, I find freshwater is worse for getting infection than saltwater.

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CharlieT

I back Phi's use of Swimmer's Ear and some warm olive oil post dive or at nightime to help keep ear infections at bay.

Charlie

zmcave

Hi,
I have a huge problem with otitis externa, specially in caves, and started to follow some of DAN's recommendations, it works really well for me.
Solutions such as Swimmer's Ear are made of 95% isopropyl alcohol with some glycerine. These solutions really help taking water out but they don't take care of bacterial growth. I mix 50/50 of swimmer's ear with acetic acid 5% concentration (vinegar!). The acid helps bacterial growth, it really works for me.
Navy saturation divers use something called Otic Domeboro, it's supposed to be a prescription drug and I have never tested it. They say it ended swimmers ear in the navy.

Zé.

ClarkKent

many thanks for your replies.. please keep them coming.

for those of you who would like to have a little better understanding of the problem/causes of infection/swim ear then try this link. very interesting if not a shade too long... good all the same

UWTV Program: The Diver's Ear: Under Pressure

6Gill

Definately counter productive.....

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MarkZ

I have been susceptible to ear infections my entire life. Soon after I began diving I came down with an infection that was so severe that the side of my face looked like I had a golf ball growing out of it. After surviving an ear draining that was likely the most painful experience in my life I ran into a friend a week or so later who is a commercial diver by trade. After describing my recent infection he suggested that I mix equal parts of (1) white vinegar (2) hydrogen peroxide and (3) rubbing alcohol in a bottle and flush my ears with it after diving. I used it as suggested, it works like a charm and I have not had an infection since. Initially I used it after every dive but now I have become a bit lax and only use it when I have been in suspect water or when I start to feel like an infection may be coming on. I mentioned this formula to my physician and he approved and is now recommending it to his patients and I also heard rumors that DAN has suggested a similar concoction. It works a lot better then any over the counter I have ever used not to mention that for a couple of $$$ you can make liters of the stuff. Also keep your fingers out of your ears and go easy on the Q-Tips as a thin layer of wax is a natural prophylactic that helps reduce infections

Of course as I am not a physician or in any way associated with the medical field I cannot legally recommend that you use these suggestions, furthermore in the event that.................

CeeBee

Doctor's and/or pharmacist advice before you put any solution, home brewed or otherwise, into your ears. Some of these suggestions, while obviously working for the people who have posted them, may not be suitable for everyone. Some do seem a bit severe. Furthermore, some solutions such as Hydrogen peroxide are available in various % vol, so may be too caustic for this use. Best to check first.

Ear plugs, er, I wouldn't. No poking, prodding, scratching, sticking your little finger in and wiggling it either...

For relief of pain and inflammation in the acute phase, ibuprofen if not allergic. Localised gentle warmth applied to the ear (warm water bottle or heat pad wrapped in a towel). Try and lie on affected side and back to allow drainage.


Er.. this may sound really stupid, but after diving, how do you wash and dry your hood if you use one? Any chance that this could be holding fungal spores?

There you go, Matron's opinion.

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Gene_Hobbs

Ed Thalmann's DAN article:
DAN Divers Alert Network : Can You Prevent Otitis Externa, or Swimmers Ear?

I just use 50/50 isopropyl alcohol and white vinegar.

Here is Ed's Navy report (1974)
Rubicon Research Repository
Rubicon Repository ID#: 123456789/3372

and another on Otic Domeboro® (product no longer available)
Rubicon Research Repository
Rubicon Repository ID#: 123456789/3012

Otic Domeboro® was essentially 2% acetic acid in an aluminum acetate solution. You can have your doctor write a prescription for this.

This recent paper on otitis media is also worth a read if you have access and time. JAMA -- Abstract: Wait-and-See Prescription for the Treatment of Acute Otitis Media: A Randomized Controlled Trial, September 13, 2006, Spiro et al. 296 (10): 1235

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Sutty

I have had intermittent problems with otitis externa (swimmer's ear) in the past, so I had a look around for the solutions. The US navy use a solution with aluminium acetate and acetic acid if I remember right, alcohol-based drying agents are popular etc, etc.
A few things seem important:
The ear canal is normally slightly acidic and diving may remove this, the acidity suppresses the overgrowth of bacteria in the ear canal.
The ear canal is normally fairly dry - bugs grow better in wet conditions.
There is normally a thin film of wax over the skin which helps keep the bugs away - this can be damaged by q-tips, fingers, salt crystals, etc.
Many infections are over-growths of bacteria that are normally present, rather than bugs picked up from the water, so you can get infections after diving in clean water.

My own practice is to rinse my ears with fresh water after the dive if possible to avoid salt crystals forming - if you inadvertantly rub or poke your ears with crystals present you can scratch the skin & wax layer and let in bugs. I try not to put anything into the ear canal (fingers, towels, cotton buds etc). I also use a solution I made up myself with pure acetic acid (glacial acetic acid) and 70% isopropyl alcohol (isopropanol), I diluted the acid to a 4% solution by volume with the alcohol solution. I put a few drops into each ear, leave for a minute and drain out. I try to use it at least once a day on multi-day dive trips. Doing this I have had no further infections, if I forget to use it I do get problems.
Obviously I can't "medically" recommend this for everyone but it works for me, and is like an acidic version of "swim ear" type preparations. The idea is to dry the ear canal, kill a few bugs, and restore the normal acidity. For any of these solutions it is not a good idea to use them if you have any suspicion you may have a perforated eardrum.

Neil

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