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Old 06-17-2020, 12:30 PM   #1
musubi
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Middle Ear Infection Prevention

Lately I've been getting infections of the middle ear on the regular following a session of spearfishing, putting me out for weeks at a time. It's been getting more frequent and the infection worse and worse each time it happens. It happens to both ears, but so far not at the same time. I do wait until complete healing until diving again.

I have a suspicion on why I'm getting it and it's because of my sinuses and allergies. My nose gets irritated because of the mask pressure, allergies partially kick in, and mucus builds and collects (I can barely feel this). When I'm diving, I can sometimes hear some mucus or fluid in the eustachian tubes when clearing. Nothing that I'm concerned about for clearing, but I'm starting to suspect that the presence of fluid there is the reason for the infection, since through my readings online, that's how it all starts.

So, two things come to mind: using an antihistamine before I dive or using a decongestant. Or both, but I'd rather not need to take both. I read using a decongestant also increases your heart rate, which is not desirable for diving, but I guess it's better than suffering with ear infections right?

I'm scheduling to see an ENT on this since I need to figure this out before I get injured. Does anyone have a similar circumstance as me and, if so, how have you prevented middle ear infections?

My main concern of course is this affecting me to the point of not being able to dive because of the risk of getting this infection, consequently ending this activity for me. So, I'm working on getting the medical attention (which can take months here), but curious to see if anyone has been through this or something similar.
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Old 06-21-2020, 10:49 AM   #2
Sebastian2
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Re: Middle Ear Infection Prevention

I used to get ear infections, especially diving in dirty cold water. I think they were mostly infections of the outer ear canal, so not sure if my solutions would work for you. Both of these were recommended to me by Martin Stepanek a long time ago and they solved my issues.

First, don't use q-tips to clean your ear canal. The wax protects it and prevents infections.

Second, I carry a small bottle of custom bottle of 50% isopropyl alcohol and 50% white vinegar, with just a few additional drops of either olive oil or glycerine. It's easiest to just buy a bottle of swimwear, which already has the alcohol and often 5% glycerine, empty half of it and fill it with vinegar + drops of olive oil. If I go diving in dirty water I put drops into my ear before and after the dive.
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Old 06-21-2020, 11:42 PM   #3
2fishin2
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Re: Middle Ear Infection Prevention

Are you diving with a hood? If so, maybe a good sanitizing of the top....

Probably a medical issue you have been ignoring because lack of care difficult. Do you have a history of these problems? I suspect not.
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Old 06-22-2020, 06:38 PM   #4
musubi
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Re: Middle Ear Infection Prevention

Thanks for the tips.
I ended up getting an ear infection in both ears which I'm still recovering from. After my last two dives, I have used a mixture of rubbing alcohol and white vinegar (50% each), but somehow I still ended up getting ..this.

I do dive with a hood and I'm always careful of washing my wetsuits after each dive with wet suit soap. I honestly don't know what to think of this. I've been diving for years without issue and only recently I've started to get ear infections.
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Old 06-22-2020, 10:30 PM   #5
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Re: Middle Ear Infection Prevention

Musubi, could be that your ears are inflamed from the first infetions and now that they are inflamed they are trapping water. That happened to me once a long time ago but I had to take a break from diving anyways as it became winter.. and over the months of not diving it improved.

I use 70% Alcohol. NOT 95%. and after dives I Put some in my ears and push down on my ear 20 times to swish it around then I let it drain. So much of Ear infections is water being trapped due to inflamation. And then once it's trapped the problems get worse..

One trick I use is to use a big Syringe like you'd find for administering a baby or kid cough medicine.. (since I have some around) this way I can put the alcohol directly into my ear without spilling it into my eye etc.. Others will know better than me, but so many times it's inflammation. Also stop dairy.. and if you feel your self getting congested while diving, take some time and blow your nose.
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Old 06-23-2020, 12:12 PM   #6
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Re: Middle Ear Infection Prevention

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Originally Posted by Behslayer View Post
Musubi, could be that your ears are inflamed from the first infetions and now that they are inflamed they are trapping water. That happened to me once a long time ago but I had to take a break from diving anyways as it became winter.. and over the months of not diving it improved.

I use 70% Alcohol. NOT 95%. and after dives I Put some in my ears and push down on my ear 20 times to swish it around then I let it drain. So much of Ear infections is water being trapped due to inflamation. And then once it's trapped the problems get worse..

One trick I use is to use a big Syringe like you'd find for administering a baby or kid cough medicine.. (since I have some around) this way I can put the alcohol directly into my ear without spilling it into my eye etc.. Others will know better than me, but so many times it's inflammation. Also stop dairy.. and if you feel your self getting congested while diving, take some time and blow your nose.
Thanks Jon. When you mention trapping water (because of the inflammation), are you talking about the ear canal or behind the eardrum (or both)? Just curious. I suppose either isn't good.

While I have a good ear dropper, I think I need to improve on rinsing out my ears, whether that's keeping the fluid in there longer or swishing it around like you mentioned. Dairy and I don't get along much, so that's easy for me to stay away from.

Another question, do any of you feel that pee getting into your ears causes or contributes to ear infections?

Especially when I head out with my kayaks for a dive, I really should take frequent rests to clear my nose. I get backed up often, which I think is due to my regular allergies.
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Old 07-12-2020, 07:11 PM   #7
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Re: Middle Ear Infection Prevention

I felt like I had an ear infection once that was so bad I couldn't dive anymore. Fortunately, it was the last day of a three day trip. I went to the ENT who told me there was nothing wrong with my ears. I wanted to tell him to go back to school because my ears were completely jacked up. He told me he believed I may have TMJ issues. It turns out he was right. I had to get some mouth piece stuff but its all better now.

I'm just throwing it out there on the off chance you may be mis-diagnosing yourself. But, I doubt that given the level of detail you have. I called DAN once and they told me that TMJ pain from biting on snorkels and/or regulators was extremely common and it was commonly mis-diagnosed as ear issues.
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Old 07-13-2020, 02:39 PM   #8
musubi
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Re: Middle Ear Infection Prevention

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Originally Posted by Greg4339 View Post
I felt like I had an ear infection once that was so bad I couldn't dive anymore. Fortunately, it was the last day of a three day trip. I went to the ENT who told me there was nothing wrong with my ears. I wanted to tell him to go back to school because my ears were completely jacked up. He told me he believed I may have TMJ issues. It turns out he was right. I had to get some mouth piece stuff but its all better now.

I'm just throwing it out there on the off chance you may be mis-diagnosing yourself. But, I doubt that given the level of detail you have. I called DAN once and they told me that TMJ pain from biting on snorkels and/or regulators was extremely common and it was commonly mis-diagnosed as ear issues.
Thanks Greg4339. That was one of the first things that the ENT I visited suspected, that perhaps I was biting too hard on my mouth piece. I had pain from biting too hard once and it was bizarre for me because I hadn't experience a paint like that in my jaw before. Plus I had been diving already for a few years and wondered "what the heck". I also have TMJ issues and a mouth piece was also recommended to me. I never did end up getting one, but I never had a pain like that again since I've been monitoring how hard and bite onto the mouthpiece.

So, in visiting my ENT there was some positive and some frustration. The frustration was that she couldn't diagnose me with anything (even after explaining all the telltale symptoms of an ear infection, which I had). I guess she needed to SEE the infection, but by the time I went, it was already gone. By the way, I think the most frustrating part about all this is how I'm not able to schedule with an ENT (any ENT) until weeks or months later and by then the infection is gone, with no way of confirming or finding a solution to the problem. Note: Some ENT's couldn't schedule me until December.

Back to my visit, so half the discussion was speculation since she couldn't confirm anything. I had also developed this rash on both ears following the infection and fortunately still had it when I visited the ENT. She blew that off as "coincidence" and unrelated to the ear infection. I'm in complete disbelief on that since I've never had a rash like that on my ears and they both came out during my ear infections on both ears.

The positive is somewhat related to the infection. During the time I had the infection, I took a variety of antibiotics, but one was Cortisporin. If you don't already know, this leaves a white residue inside your ear and had contributed greatly to creating a false tympanic membrane, or a hard cap over your eardrum. The ENT saw this and, in short, removed it from my right ear. I keep my ears very clean and was astounded at what came out. Never had that before.

She was only able to get one side out and so I still have a false cap in my left ear which is greatly affecting my hearing.

I've done two dives since the infection went away and have done the following to help prevent the infections:
- Take an antihistamine (Claritin) the night before
- Flush my ears out with 50/50 vinegar and alcohol mix
- Use drops of Acetic Otic solution

I haven't gotten an infection since (or yet).

Since my ENT was really no help (for reasons that I understand and not), my personal diagnosis is I did have a middle ear infection and what's helping me more than anything is taking the antihistamine, not the drops. I noticed a significant reduction in mucus build-up during the dive and thus less likelihood of fluid or mucus getting behind my eardrum (which I could hear in my pre-infection dives).
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Old 10-13-2020, 09:30 PM   #9
musubi
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Re: Middle Ear Infection Prevention

It's been 4 months of diving every week and no ear infections since I started taking antihistamines before my dives. I remember earlier int he year I was starting to get these infections every other week. So, for me, the cause was allergies and it was middle ear infections. My ear drums are all back to normal, finally. I haven't been taking any ear drops of any kind. Anyway just an update on my thread. Maybe this will help someone who's stumped.
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Old 10-14-2020, 10:45 AM   #10
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Re: Middle Ear Infection Prevention

I would also consider a regular sinus rinse/neti pot regimen. Keeping the sinuses clean, to me, seems a good way to keep bacteria from entering the Eustachian tubes. The antihistamine is probably assisting with this, but a sinus flush will keep things moving in there.

Safe diving!
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Old 10-14-2020, 08:58 PM   #11
musubi
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Re: Middle Ear Infection Prevention

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I would also consider a regular sinus rinse/neti pot regimen. Keeping the sinuses clean, to me, seems a good way to keep bacteria from entering the Eustachian tubes. The antihistamine is probably assisting with this, but a sinus flush will keep things moving in there.

Safe diving!
Thanks for the advice. That's a good idea. I tried some sinus rinsing for the first time a couple weeks back and that was a interesting feeling. Not the most pleasant, but bearable. I noticed that some of the solution would get into my eustachian tubes during every rinse. The moisture quickly went away in the tubes, but just an observation. Probably worthwhile to perform before my dives to flush any unwanted bacteria like you mentioned. Thanks for that.
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Old 10-15-2020, 01:44 PM   #12
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Re: Middle Ear Infection Prevention

Musubi, what antihistamines do you take? I meet need try this. I do a Lot of landscaping..
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Old 10-15-2020, 02:01 PM   #13
musubi
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Re: Middle Ear Infection Prevention

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Musubi, what antihistamines do you take? I meet need try this. I do a Lot of landscaping..
I'm taking Claritin right now daily. Allegra also works for me. Zyrtec makes me drowsy. Xyzal also works but makes me irritable for some reason. I'm taking Claritin in combination with Nasacort.

I would suggest you buy the smallest pack or quantity of these and try them for yourself. What works for me may or may not work for you.

Of course Benadryl works on me the best and the fastest, but because it's a 1st gen antihistamine it makes me super drowsy. It also no longer works as well as it used to. I've taken it so much that my body is used to it.
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Old 10-15-2020, 03:51 PM   #14
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Re: Middle Ear Infection Prevention

Hey buddy, I can relate to most of your problems.
But if you're saying that antihistamines are solving your problems, then most of you problems are due to congestion and not infection.
Infection would be something getting into your ear and infecting it. Then you need antibiotic to solve your problem.
If you're having congestion problems due to allergies, then you inner tubes are swollen and when you push to equalize, you get irritation and its starts inflammation in your inner ear. Than you can't equalize and huts like hell.

I to get a lot of allergies and after many years of diving, I also got "surfer's ear". So my ears are really sensitive.
The only thing I can do is be really careful when I dive down. As soon as I feel pain, I don't push it and stop descending, go up a bit to equalize. Yes, it's a bitc* when free diving but it's either that or no diving..
A while ago when I thought, like you that it was infection problems, I got "Doc's Proplugs" (vented ear plus for diving). They didn't change much for me and I stoped using them but if your problem is infection, then maybe give them a try.
When out in the water and I get congestion, I just put my head back and let salt water go into my nose and sinuses. Not really pleasant but it gets the job done. Also clear you nose(mucus) often.
After dive, simply dry out your ear or use an alcohol solution.
Good luck !
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