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How to treat that pain in the ear

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Ear pains can be outside the eardrum, or inside.  The first is common with swimmers in summer, and the second with airplane travelers any time of year.  Let’s take a look at some strategies to avoid trouble.

 

OUTSIDE THE EARDRUM: 
For swimmers, when water enters the ear canals, bacteria can come along, from ocean, lake, or pool.  Once entrenched as an infection along the wall of the ear canal, it can become very painful.  A simple tugging of the outer ear can produce great pain.  A visit to your doctor can quickly identify and treat the problem,  usually with antibiotic drops.  However, a good way to prevent these is to use a freezer  zip-lock bag, with a handful of cotton balls.  Add a few ounces of rubbing alcohol to the bag, zip it shut, and roll it up with your beach towel.  As soon as you come out of the water, open the bag, and squeeze the contents of one of the cotton balls into your ear, while tipping the head to the side.  Hold it for a few moments,  then use a fresh cotton ball to do the same in the other ear.  Re-zip the bag and you are ready for the next time.  The alcohol doesn’t need to contact the bacteria for long, as we can see when we use the same swab technique to sterilize the skin before an injection.  Great trick for the kids, and handy for  adults as well.

INSIDE THE EARDRUM:

Fluid inside the drum is produced all day, every day.  The problem is when the drain is clogged.  The drain, or Eustachian tube runs from the middle ear chamber behind the eardrum to the nasal passage on that side.  

The mucous membrane that lines the drain also lines the nasal passages, including the sinuses.  So any common cold or allergy that makes the nose stuffy can restrict the drain, causing the middle ear to back up with watery fluid.  One way to respond to this is to take non-prescription (oral) medications  such as antihistamines with “cold and sinus “ properties.  Take one or two a day, as directed.  If you are in an airplane and have stuffy ears, carry a short acting tablet to take about 90 minutes before descent, not before landing.   Then use a nasal spray, such as plain saline, or one with a decongestant added.  Point the spray to the back of your head, not to the top, as the nasal passage runs over the roof of your mouth, (not up into your brain).  Tip your head to the same side as the nostril you are treating, and trickle the spray so that it will run over the opening of the Eustachian tube, helping to open the drain.  Try chewing gum, or yawning to see if you can further  make the drain open.  If not, try the Valsalva maneuver:   plug both nostrils, and blow out against a closed glottis, to make your cheeks bulge, and you may be able to force the drainage tubes open. 

The above can be done without prescription meds, but if you have any ear pains, please consult your doctor.  If you are flying, you may need prescriptions for antibiotics or for nasal steroid spray to enhance the above.

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Ear Wax Prevention and Treatment

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One of the most common conditions we see in the ear canal is wax.  Wax is supposed to be created in the outer quarter of our ear canals every day as a protective measure.  This forms a barrier against debris or dust that might damage the ear drum.  With normal movements of the jaw (eating, speaking, and yawning) this wax will  fall out harmlessly. 

There are a few people, however, who tend to keep their wax in one or both canals, and these are the ones that end up in my office for treatment.  There are three reasons for people to have retained ear-wax problems:

1. Bad luck.  Simply the shape of the ear canal, for example if it is quite narrow at the exit, could make a "bottleneck" effect, clogging pieces of wax. 

2. Ear pieces, for music or phone, have now become extremely popular.  Unfortunately, they also can be like a drain plug for the ear canal.  The situation only gets worse if wearers use the molded ones that really fit tightly into the canal.  For people who need hearing aids, the deeper fit is sometimes necessary to ensure good sound. In younger people, the object is to avoid needing a hearing aid, especially after loud music concerts, or exposure to loud noises such as gunfire etc. 

 

 

 

 

 

 

 

3. Q-tips - Instead of reaming out wax, these devilish weapons act more like a ram-rod in a rifle barrel.  

These pack the wax deep inside the canal, up against the ear drum.  This makes it almost impossible for the wax to be removed at home, and will require a visit to your doctor for syringing or curetting safely.  Some times even more damage is done, with the tip actually piercing the drum. 

 

 

 

 

So how do I prevent and remove wax in my ears?

1. Lubricate, with clear oil.  A few drops (or capful) of oil will lubricate and partially liquify dry wax in the ear canal.  Use olive oil, mineral oil, or any other clear oil.  (note to guys, NOT 10W30 ! ).  Tip your head to the side, insert the oil drops, then wait until you are bored (at least a few minutes).  Then catch the oil with a tissue, and jump into your shower (so oil won't end up dribbling onto your clothes). 

 

2. Do NOT use a candle.  This is about as idiotic a home remedy as one can imagine.  

 Great way to set fire to your hair.  The object is supposedly to create a vacuum in the ear, which actually never happens.  Then you get hot wax dribbling onto the side of your head, plus you look like a dolt.  If you have impacted wax, PLEASE don't try this at home!!  You will end up having your ear syringed with a FIRE HOSE!

3. Be very careful if you use a home bulb device. 

Really easy to hurt yourself if you force the issue.  Also, you are shooting blind, and could easily complicate the issue if the drum is already perforated, or if there is infection along the external canal.  Remember, even a doctor who treats himself at home has two problems: a fool for a doctor, and a fool for a patient!

4. Please see your doctor.  If you are a regular wax former, then get on a schedule to have the doctor or his assistant professionally syringe the wax out.  Then follow by regular oil every week, with revisits as required.   

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