Middle Ear Infections

[skip]

WOW...Thanks for posting that information Skip. I would love to add it to my system pages.

Feel free. I'll probably leave the page up and running for the next year or so and I'll be adding to it. The NACD site will be nicer looking, but same info.


by the way, the middle ear is a sterile environment (generally). the only way bacteria get in is via the eustachian tube or a hole in the tympanic membrane riding along with foreign material. As stated earlier, it is unlikely that the water is a cause of infection. however a cold or congestion does cause swelling of the tissues of the eustachian and the changes in pressure push and pull mucus in and out of the eustachian as you clear. the swollen tissues provide a good holding ground for bacteria that then grows in number and rides the pressure changes into the middle ear. nearly all bacterial infections are bacteria that we carry with us everyday, but due to fatigue, reduced immune system, and the addition of other people's bacteria (shake hands then pick your nose your eat a sandwich without washing first, or simply breath the air near a sick person) causes an inordinate number of colonies that then overpower the immune system....

you can see how repetitive diving, lack of sleep, etc., could be the cause of ear infections.

I am not a doctor, but have spent so much time in the ENT office this past year that I see that darn middle/inner ear anatomy chart in my sleep!

-skip

[Webmaster]

This last one did rupture the ear drum, it was pretty severe, the whole side of my head swole up until I was pretty lopsided. Nasty overall.

Whether the source of the bacteria was my own sinuses, or the water, it sounds as though flushing it might be beneficial in any case. It's definitely diving related, and feels like I need to do something because any bacteria there are not going to be affected by anything I put in my outer ear.

I won't go into my 7 hour ordeal in Lake City seeking treatment, but I still have to return to the doctor here now that the swelling is all gone. I'll inquire about irrigation methods and see what they recommend.

Marbry

[Ken Hill]

Dr. Jay Farrior in Tampa is world renowned and the very best. He treats divers. He has done and invented the tympanic membrane replacements. He gave my wife and Bernie Chowdhury a new ear drum and a chance to go diving again. If you look into the development of ENT medicine he, his father and grandfather have half the chapters.

He put an end to the shoulder shrugs we were getting from most MD's who didn't understand diving and pressures and couldn't make up their minds how to treat save for saying stay out of the water. /Ken

[FW]

It's definitely diving related, and feels like I need to do something because any bacteria there are not going to be affected by anything I put in my outer ear.

I agree with that. The only times I got a middle ear infection was diving, but both times I was clearing my ears at odd angles, like head down, and also sideways.

[Angie Reim]

If I dive too often or with congestion I will get a middle ear infection. I've been known to get an ear infection from taking a bath and dunking my head. In my case I have badly scarred eustachian tubes and ear drums from repeated ear infections as a small child. Now the lack of flexibility in the tubes coupled with swelling can cause me trouble clearing and then the backup of oral bacteria, blah, blah blah. So, I take my time during descent and ascent. I use saline spray solution to clear the sinus' and ear beer to kill external bacteria. . NO SUDAFED or AFRIN.

That rid me of most problems.

Addendum: With practice one can learn to snort homemade saltwater. Just a old-fashioned home remedy that sounds a lot like Dr. Grossman's Nasal Irrigation system (all puns intended). It's quite effective and lasts for hours. TMI?

[cavediver27]

If this is the little teapot gizmo with the salt packets??? I did this for the first time over the holidays since everyone I seem to talk to was sick and I had a three day trip planned. Boy this really works for clearing out the goo. The only question I have is is too clean, Too Clean? or is the gunk in there all bad? Any Doctors on the board?

According to my ENT, who actually recommended the nasal irrigation to me, clean nasal passages are healthier and don't provide an atmosphere for infections. I've used my on an almost daily basis for 8 years and simply don't get colds any more and I don't get sinus infections.

It does work!

[Jim Wyatt]

You can find recent water qualilty data and reports at:

http://www.mtsu.edu/~psyskip/wqwp.htm

Excellent information Skip, thanks!!

[Cave Ranger]

I started using "Ayr" saline nasal gel on a daily basis over 3 years ago. I have not had a cold or upper respiritory infection since. You can get it at Walgreens.
I've always had allergies and I used to get at least 1 or 2 a year sometimes followed by inner ear issues.
Anomaly? I think not....and besides it gives me a really good excuse if I'm caught with my finger up my nose
I also use the tried and true Ear Beer mix of 1 part each, rubbing alcohol, hydrogen peroxide, and white vinegar after diving in freshwater.
Sometimes simple home remedies seem to trump everything else.

[rotor60driver]

I may be a bit odd on this one. From childhood through early adult years I regularly had ear infections. For the last few years as I have been diving and especially this past two years that my diving has been more frequent the infections slowed in frequency and then stopped completely. This is probably due to me taking better care to rinse my ears with a vinegar and peroxide solution after each dive and doing a nasal cleaning with a solution of warm salt water at least once a week.

[Bob Cree]

Just got home from a week in N. Florida and read this thread. I used to have consistent (diagnosed) middle ear infections every time I came down...get to the doctor, get AB's...EVERY time. I either found a solution, or feared having to stop cave diving, so I contacted DAN.

I got a call back from a hyperbaric medicine MD out of Syracuse NY who also happened to be a diver. He said the same thing as others on here - middle ear infections come from the inside due to forceful clearing and shoving inner body nasties up in you ear. Just in case, he recommended the same ear beer treatment with Hydrogen Peroxide/Vinegar/Isopropyl + a couple drops of Glycerin if I wanted...but not only to do it after the dives, but before as well and when done for the day, 5 minutes in each ear. He said the before thing pre-kills bacteria that would nest in the tissues when they naturally swell during the dive and the 5 minute thing - well, he just said, for sure nothing could live through that...lol.

But...it is the other thing he recommended that I believe does the trick - NEVER had an infection since. And it follows from what others have said in the thread.

What he does before diving is take Mucinex expectorant to act directly on the mucus to break it up and allow it to drain out naturally (same stuff as in cough syrup and totally different from Sudafed that acts by shrinking tissues - maybe other more medical types can comment?). I take one 600mg tablet only 1X per day - he said to start about 5 days ahead, continue through while diving and maybe for a couple days after. Keeps the sinus cavities clear so it does not shove up to the middle ear during clearing.

I can feel a liquid feeling rolling around inside my ear when a middle ear infection is coming on. On two occasions since using Mucinex (the two I relaxed a bit on the earplan), I felt one coming on. Interesting - now this is all me (and I am not a doctor, just seemed logical) - I stepped up the Mucinex to the recommended "on the box" dosage and added in Sudafed (now that I was done diving - it was okay). Break 'em up and open 'em up - cleared it up, both times - never had to go to the doctor. Now I follow the plan.

Just did 6 cave dives/10 hours in water, last one yesterday morning - flew home this afternoon, and my ears are totally clear.

Hope you find something useful. I know how you feel.

The pulsating, balanced salt water, hose up the nose thing - it does make sense to kill the nasties in the cavern zone...but yuck...

Bob