Middle ear infections from dives this week

My wife and I just had a wonderful four day dive trip, where we dove at the Mill Pond Saturday-Monday, then dove Madison (Godzilla Room) and Peacock I (Dark Water tunnel + Well) on the 4th, and we felt great after a wonderful extended dive trip. However, on our 6 hour drive home, our ears both started feeling odd so we did our standard alcohol/glycerin ear drop regimen, and it seemed to go away for the most part. On Wednesday morning, my wife's ears were killing her, so she went to our doctor. She has a middle ear infection in both ears. On Wednesday night, my ears started acting up, and I went to the doctor on Thursday with the same diagnosis - middle ear infection in both ears. :?

Anyone have any idea what's going on here? One of us occasionally gets an outer ear infection that can be treated by antibiotic drops, but rarely do we get a middle ear infection, let alone both of us in both ears at the same time!

We're both on antibiotics and various decongestants as prescribed by the doctor, and it seems to be helping somewhat.

We didn't dive through any algae blooms or noticeable bacteria in the water, so we're at a complete loss as to why. Has anyone else experienced anything like this in the past? Anyone noticed an increase in infections lately?

I got the same thing after diving in Orange Grove Sink a couple months back. I put a bottle of ear salad (50% Isopropyl alcohol 50% Vinegar) in my gear bag now and put a few drops in each ear when I am done diving for the day.

Me and 3 friends were taking Cavern/Intro to Cave 2 weeks ago at Peacock and Orange Grove. 3 out of the 4 got ear infections. If you dive those areas you will want to make sure to use ear drops after every dive.

CJ

I have a bottle that's got equal parts of vinegar, isopropyl alcohol and peroxide in it labelled "Ear Beer". It lives in my truck.

I use it after diving in fresh water. I don't know why I don't get nailed when diving in the ocean, but I don't - but if I forget after cave-diving, its a good bet that I'll get a nasty ear infection a day or two later.

I use the same recipe.equal parts alcohol,vinegar and peroxide.The secret is to tilt your head sideways completely so it makes a pop and you can almost feel it behind your eye.That gets to the inner ear better than just putting it in a slightly tilted ear.Im sure there are microscopic algae in the water especially in summer.Interesting name[ear beer]never thought of that.Occasionally I get a short throb even after use of the ear beer,and I just keep adding it several times during the day and havent had to see the doc about it.Q-tips are the doctors best friend,keeps em in buisness for ear ache prescriptions so they tell me.

Yes, ear tonic is part of my travel ditty bag too. Every night before turning in while diving, each ear gets a shot for 5 minutes.

With regards to ocean vs. fresh, I asked this same question of Dan a few years back. I was told that fresh water had infintely more bacteria and crud than sea water has. The salt content of seawater keeps the bacteria level much lower than fresh......hence ear infections are therefore more prevalent in fresh.

Two years ago I got a raging case of swimmer's ear in both ears while diving in Akumal. (pain, pressure and incredible deep inner itch) Woke me up in the middle of the night before the last dive day. To say the least, I didn't get to dive the last day of our trip. It was totally my fault as I had slacked in my "ear tonic" a few nights. Fortunately another diver had a bottle of ear meds with her just in case. Now I do the same. Every couple years I get a script from my doc for swimmer's ear meds to take on vacation. When the bottle expires, I get a new script. So far, I haven't had to use them as I've stayed faithful to my preventive ear tonic.

There was a doctor on that Akumal trip that told me to take Advil for the itch and pain. I knew it would help with the pain, but amazingly it relieved the itch too. I could tell when it was time for another dose of Advil and ear drops as my ears would start to pain and the itch would creep back up. Lovely two days of my vacation!

Moral? Take ear tonic (beer, salad) with you as a preventative and use it every night of diving....DAN recommends 5 minutes in each ear. Also, get a script from your doc for drops if you happen to get an infection so you don't have to go hunting around in a foreign country, or go out of network in the US.

An ounce of prevention is worth a pound of cure!

TIP: Use white vinegar instead of apple cider....you'll smell less like a salad!

The current (july/august) issue of DAN's "Alert Diver" has an excellent discussion of all the diving related issues associated with the ears...your problem sounds like otitis externa (external not middle ear infection). According to one of the articles this is caused by your normal ear bacteria that is able to penetrate skin that has swelled iside your ear due to frequent iimmersion in water, hence the common term swimmer's ear. The article also provides a number of "home brew" mixes you can use to prevent the infection. The mix is supposed to remain in the ear a full five minutes to be 100% effective. Also solution should be used only in a normal ear with an intact eardrum. Bill Huth

Thanks for all of the suggestions, but here's the odd thing... We did use our ear concoction after every dive this trip... and it is a middle ear infection (Otitis media) - pain, fluid behind the eardrum, fever, etc... not external which is what we have experienced in the past. Very odd.

Quote:

---

Originally Posted by divers4life

Thanks for all of the suggestions, but here's the odd thing... We did use our ear concoction after every dive this trip... and it is a middle ear infection (Otitis media) - pain, fluid behind the eardrum, fever, etc... not external which is what we have experienced in the past. Very odd.

---

Well the dan article discusses this as well....they say that otitis media is "not a diving malady, but may look the same as middle ear barotrauma to a medical practioner not trained in dive medicine." Did you give dan a call maybe they can explain the oddity. Bill Huth

Quote:

---

Originally Posted by divers4life

Thanks for all of the suggestions, but here's the odd thing... We did use our ear concoction after every dive this trip... and it is a middle ear infection (Otitis media) - pain, fluid behind the eardrum, fever, etc... not external which is what we have experienced in the past. Very odd.

---

yes, odd indeed.
But having the OM (otitis media) is not far fetched, if you valsalva too forcefully it is possible to "blow" whatever is in the back of your throat through the Eustachian tubes and into the very cozy bacteria-breeding conditions of the middle ear....
Like when in Mexico, do not drink the water (or gargle with it...), be careful of when you valsalva and how you do it.
Hope you are well soon.

Celia

When I did cavern and intro a couple years ago I ended up driving home to Houston with a middle ear infection in one ear an outer ear infection in the other. Over four days we did 17 dives at Ginnie, Devil's and Manatee... But now I know about the ear beer and have not had any problems on subsequent trips.

Quote:

---

Originally Posted by amphipod06

But having the OM (otitis media) is not far fetched, if you valsalva too forcefully it is possible to "blow" whatever is in the back of your throat through the Eustachian tubes and into the very cozy bacteria-breeding conditions of the middle ear....

Celia

---

I think Celia has correctly identified the problem here. A forceful valsalva can be responsible for middle ear infections by forcing water borne bacteria into the eustachain tubes and thereby providing a prime/cozy site for those bacteria to grow.

I am not a physician and have never played one on TV. I am just passing along what physicians have told me.

Many animals {including humans} use our spring basins as toilets & as a consequence horrendous amounts of fecal matter & bacteria are suspended in the basins, which become even more contaminated during the summer months. Both Gators & Turtles, along with River Otters, Beaver & Water Fowl love to cool off & go potty in our favorite spring pools. In essence it is their bactaria & resulting infectious viruses that we pick up while swimming or returning from deep within some of the cave systems, where we deco or exit into the spring pools. Sludge {Russell} turned me onto his 'Ear-Beer' potion last year, & I haven't had any ear infections since I've been using his receipe. Perhaps if he would be so kind as to re-post it again for everyone, all of us will stay healthy during the summer dive season-!

Jack 8)

Quote:

---

Originally Posted by Jim Wyatt

I am not a physician and have never played one on TV. I am just passing along what physicians have told me.

---

Hahaha, Jim, that's funny, I did play "doctor" over the phone line while at DAN, I don't think we tracked middle ear related calls specifically but a large number of the monthly totals involved ear problems and issues.

An excellent reference for ear physiology is a little green book by Noel Roydhouse: Underwater Ear & Nose Care from Best Publishing Company, goes for $25 or so. Well worth the $$ and the read, it explains why your ears hurt and when to seek medical attention pronto, as well as case studies.

Dive safe and don't drink the water...

Celia

Here is a very good article that my friend Ed published in Alert Diver (years before he passed away), yes it's a plug for DAN too.

In any case you will find the article and Ed's US Navy "home brew" ear solution great information and handy to have at the dive site.

Go ahead, read it and impress your friends with the newly acquired knowledge.

Diving Medicine Articles
Can You Prevent Otitis Externa, or Swimmers Ear?

The Answer is in the Solution

By Edward Thalmann, M.D., DAN Associate Medical Director

https://www.diversalertnetwork.org/m...p?articleid=48
Dive save,

Celia

I've had my share of ear infections since I started diving, always fresh water related. I use (when I remember to bring it) a 50/50 mixture of rubbing alcohol and distilled vinegar as a preventitive before and after diving. And also repeat it once or twice later that same day.

Supposedly the alcohol is to help dry the ear, and the vinegar is to lower the Ph making it unfriendly to bacterial growth.

Also in the past, a vigorous gargle/snort with a warm very saline saltwater water mix has seemed to help after the fact. Just don't swallow it.

I think Celia is right. Often people have scratchy throats and sinus problems when they travel. Florida inspires that! Do a forcefull valsalva and there you have it, bugs in the tubes of your ears. I take a non-decongestant type antihystamine at least for a couple of days before I dive. Also drinking more water works well because dry scuba air will dry you out and make things worse. Coke makes you more dehydrated by the way, not less.

I have had two ear barotrauma "events". I knew it had happened before I hit the surface. Both times I felt very dizzy at the end of the dive and stone cold deaf in the affected ear when the ear filled with blood. Another reason for the antihystamines. :D

I dove both Madison and Peacock today. Used the earbeer at Madison and plum forgot to do it after Peacock. I'm going to douse my ears right now! Madison was great today, great vis. Also met Daedalus and his buddie at Madison although we didn't formerly meet only talked a bit.

Yeah, I got a nasty infection after diving at Ginnie for about three days. The little slough from Little Devil to Devil's Eye looked like it was full of the stuff JE was just talking about. Namely, fish poop.

As I was swimming back and forth through that channel it dawned on me that the water looked a little doodoolicious. The next morning I was in alot of pain in both outer ears and the pain lasted for about 1 week before I could dive again.

Ear beer is now a mandatory item when I go cave diving. As for middle ear infections, I don't know what would cause that but it seems logical about it being caused by an overly forceful valsalva. That is something to remember.
.
.

I've gotten a couple of infections from diving Peacock & OG... Never had a problem anywhere else.

FYI, I used to use equal parts white vinegar, 91% alcohol and peroxide and then a doc told me that peroxide is very bad for the inner ear workings. I changed to 50/50 vinegar and alcohol after that. Both seem to work fine though.

Rick

The fill stations should start carrying this stuff.... Tri ear mix

"Fill er up with 50/20, no no, I'll take a 70/20, the water's pretty nasty today."

:lol:

Quote:

---

Originally Posted by Jim Wyatt

I am not a physician and have never played one on TV. I am just passing along what physicians have told me.

---

But you did stay at a Holiday Inn express , Right?

My two cents worth..I got an outer ear infection after forgetting to use ear beer and came home to find my current copy of Alert Diver dedicated to Ear problems in the mail box. You gotta love Karma sometimes. I have not had the middle one but I think you hit the nail on the head. That issue was a keeper.
Tom

Quote:

---

Originally Posted by tomhauburn

Quote:

---

Originally Posted by Jim Wyatt

I am not a physician and have never played one on TV. I am just passing along what physicians have told me.

---

But you did stay at a Holiday Inn express , Right?

My two cents worth..I got an outer ear infection after forgetting to use ear beer and came home to find my current copy of Alert Diver dedicated to Ear problems in the mail box. You gotta love Karma sometimes. I have not had the middle one but I think you hit the nail on the head. That issue was a keeper.
Tom

---

Tom,

You are right, AD has a lot of good information. The DAN medical article section on their website is also a very good resource for a multitude of medical issues. Highly recommend it. It's not as cool as playing MD on TV but it's a close second... :-D

Dive safe,
Celia

{edit from moderator: I repaired the BBCode error}

I was intending on quoting Jim... Sorry, forty lashes with a long hose for the incorrect quote! Good info in your post and I have also had good luck with Dan when I called on issues.
Tom

No need for the forty lashes (although that does sound intriguing, can't picture anyone flogged with reg long hose somehow...).

Dive safe and try not to catch any more bugs with your ears, very painful and it may scar the middle ear and Eustachian tubes as well.

Take care,

Celia