A Snorkeller who's worried about ear infections.

[Paul Renucci]

A friend (James) is planning a trip to the Maldives very shortly and asked me this question.

Can he go snorkelling with ear plugs? :eek: He is planning to dip down a few times.
He explained that he had been told that the algae in the Maldives at this time of year is likely to give him an ear infection. :(

Is there anything he can do to reduce the chance of an infection?
He has already seen his doc about this and has been given some ear drops just in case.

I did suggest several ideas especially about the ear plugs but he is insisting that he wears them. I said I would ask some buddies for their suggestions too, so fire away please.

I'll print them off for him and hopefully he'll take on board those suggestions.

[Andy Wade]

A friend (James) is planning a trip to the Maldives very shortly and asked me this question.

Can he go snorkelling with ear plugs? :eek: He is planning to dip down a few times.
He explained that he had been told that the algae in the Maldives at this time of year is likely to give him an ear infection. :(

Is there anything he can do to reduce the chance of an infection?
He has already seen his doc about this and has been given some ear drops just in case.

I did suggest several ideas especially about the ear plugs but he is insisting that he wears them. I said I would ask some buddies for their suggestions too, so fire away please.

I'll print them off for him and hopefully he'll take on board those suggestions.

:eek: indeed.
I agree with your concerns, if he dives with ear plugs in his ears, there's a good chance they'll be pushed into his ears by the water pressure. Then he will likely need to see a Doc, and prodding around trying to get squashed ear plugs out is as likely to cause damage to the delicate lining of the ear, increasing any risk of infection anyway.
Even if this doesn't happen, they wouldn't be likely to stop water entering his ears anyway.
If he's just laying on the surface with a mask and snorkel on looking down into the water without dipping his head under, then maybe he'd get away with it, but I wouldn't risk it.
The ears are well protected anyway, they really don't need anything adding or shoving in them.
Planning where he goes snorkelling and avoiding sewage outfalls is a better way to avoid any potential infections.
To quote what most doctors would advise you: "The smallest thing you should put in your ear is your elbow" :)

Maybe if he's that worried he could try a dry hood? Or one of them masks that also covers your ears? Never used them myself though.

[ChrisA]

There are some ear plugs you can dive with try here www proplugs.com also in Spain many divers rinse their ears with a 50/50 water vinegar or 50/50 water alcohol mix.

[Paul Morris]

also in Spain many divers rinse their ears with a 50/50 water vinegar or 50/50 water alcohol mix.

Would reccommend the acetic acid (vinegar) mixture and or alcohol based preventatives. Available from pharmacists in products such as "Swim Ear".

When I started diving I had to see a medical referee, it just so happened he had just written an article about looking after your ears so had plenty of information and advice to dispense.

Essentially, always dry your ears thoroughly. Use Swim Ear after every immersion, don't wait until you have soreness. If you do start to get sore, then ibuprofen will manage the pain, and the vinegar based remedies can help to combat bacteria/fungi.

The alcohol based treatments work by drying the ear, the vinegar ones work by lowering the ears pH to a level that does not favour bacteria/fungal growth.

Following this advice, I've never had a problem in tropical climes, though I have come close!

All IMHO, I'm not a doctor so the advice is worth what you paid for it ;)
I blame my interest on a Medical Biochem degree that refuses to be forgotten no matter how hard I try :rolleyes:

[Ben Thompson]

I thought the vinegar option was better- as you've said, the Alchohol solution works by drying out the ear- which can actually promote infection, as dry skin isn't as good a barrier- Swim Ear, whilst it works, probably isn't best for repeatedly going in the water- more for getting the water out of your ears after a weekly swim.

I read about this a while ago- basically the 50-50 vinegar water mix (or if you're feeling realy daft, add 1% or so peroxide) should sort things out...

[Ian@1904]

Oceanic do a mask with ear protectors. I knowseveral dives prone to ear infections who use these masks and they have not had an ear infection since.

[Paul Morris]

I thought the vinegar option was better- as you've said, the Alchohol solution works by drying out the ear- which can actually promote infection, as dry skin isn't as good a barrier- Swim Ear
As I said, my qualifications barely amount to being able to spell words like bacteria and acetic. :rolleyes:
Just repeating my recollection of what the doctor said. I'll have a dig around later to see if I can find the article he gave me (as a reference).

Swim Ear was definitely reccomended as a preventative, warm moist environments are cracking places to grow an infection. Drying is definitely a good idea. The surfaces of your ear canal are hardly likely to crack given all the wax lubrication there. However, there is no doubting the efficacy of the vinegar solution at tackling early infection - they don't like it up 'em :D

[Paul Renucci]

:) A big thank you to Andy, Chris, Paul, Ben and Ian for your brilliant replies. :)

Basically, I've said he could try using a hood or the mask idea which I was aware of although I had suggested a home made job using neoprene pads to limit the water getting in.
The Oceanic mask suggested by Ian sound like a good idea too - especially as Ian knows divers who have used it with great success.

:cool: The vinegar idea is very interesting too, never seen that being used overseas.

I'm sure all this evidence will convince him not to use ear plugs although Chris's idea witrh Robin Hood watersports retailing them http://www.roho.co.uk/ ) is worth a look for anyone susceptible to this sort of problem.

Big thanks to everyone
Webmaster Paul

[PeteM]

The ears are well protected anyway, they really don't need anything adding or shoving in them.
Planning where he goes snorkelling and avoiding sewage outfalls is a better way to avoid any potential infections.

Got back from the Maldives about a month ago - of ten guests and two dive guides on the boat three people did not get an ear infection of some type; and this was with everyone washing out thier ears with fresh water immediately after every dive. So with a 75% hit ratio I think there is something in the warning quoted by the OP

[Paul Renucci]

Got back from the Maldives about a month ago - of ten guests and two dive guides on the boat three people did not get an ear infection of some type; and this was with everyone washing out thier ears with fresh water immediately after every dive. So with a 75% hit ratio I think there is something in the warning quoted by the OP

That's a bit worrying - next worse thing is probably toothache.
We were there several years ago in August. No one was affected - just goes to show. :)

[Andy Wade]

Got back from the Maldives about a month ago - of ten guests and two dive guides on the boat three people did not get an ear infection of some type; and this was with everyone washing out thier ears with fresh water immediately after every dive. So with a 75% hit ratio I think there is something in the warning quoted by the OP

:eek: Sheeeeesh.
Thanks for that, have a green. :)
That's quite worrying. Such an idyllic spot too, makes you wonder what's in the water.
I was more concerned with solid earplugs getting shoved in by water pressure, but they could use the ventilated proplugs (http://www.proplugs.com) I guess, although I wonder how effective they are at stopping water ingress if they have a hole in them? Does surface tension stop the water entering through such a small hole?
I'm not sure I'd like to dive there if it's that risky. Of course I would like to dive there, who wouldn't? But still....
Did the three who didn't get any infection use any drops or other protection methods?

[PeteM]

Did the three who didn't get any infection use any drops or other protection methods?

Nope, one was the main dive guide who said he is prone to infections and therefore washed his ears very carefully with water after every dive, and he wore a (very thin) hood.

We were diving fairly intensively, I did 39 dives on the holiday which increases your risk of picking something up purely by the amount of exposure and to be fare not all of the infections were not that serious, mine did not stop me diving but about half of those affected (including one of the guides) missed dives.

I always take some broad spectrum antibiotics on holiday, normally I do not use them but I am glad I had them this time.

[Glenn Ford]

These 2 DAN articles may be of interest especially regarding the source of the bacteria that is frequently to blame.
http://www.diversalertnetwork.org/medical/articles/article.asp?articleid=48
http://www.diversalertnetwork.org/medical/articles/article.asp?articleid=49

[Paul Renucci]

I've been reading about these ProPlugs and I cant help noting that they are for sale in Music shops for Drummers, to Wind surfers and canoeists including snorkellers. I've also seen that there are reports about their effectiveness but I've not had a chance to read those due to time constraints.

James sends his thanks for all the very kind replies you have all sent to him - I printed them off for him.

He liked the idea of the 50/50 alcohol mix suggesting that he could drink any surplus after treating his ears :D

But he believes the 50/50 vinegar and water solution would be his best bet.

He's the managing director of a local business here in Carlisle.
I've just had an e-mail from a frined who is heading off to the Red Sea next week - I must be in the wrong occupation :( and is asking if there are any problems out there. Having mentioned to him that their is something happening in the Maldives at the mo.

Has anyone any info on the side of the world please?

[Paul Renucci]

These 2 DAN articles may be of interest especially regarding the source of the bacteria that is frequently to blame.
http://www.diversalertnetwork.org/medical/articles/article.asp?articleid=48
http://www.diversalertnetwork.org/medical/articles/article.asp?articleid=49

That's a fascinating read - anyone suffering this condition will also find these articles and cures very interesting.

Excellent work Glenn.

[Glenn Ford]

This may not be the correct forum to post this but here is a link to an excellent video that talks about the divers ear. By better understanding the physiology of the ear it can help avoid many of the problems with equalisation and the ear inflammation that contributes to infections.
http://www.uwtv.org/programs/displayevent.asp?rid=789

[Paul Renucci]

This may not be the correct forum to post this but here is a link to an excellent video that talks about the divers ear. By better understanding the physiology of the ear it can help avoid many of the problems with equalisation and the ear inflammation that contributes to infections.
http://www.uwtv.org/programs/displayevent.asp?rid=789

Fascinating material for everyone looking to know more about basically anything http://www.uwtv.org/programs/
Enjoyed the link Glenn - cheers. :)

[puddlediver]

I used to get lots of ear infections and a build up of earwax which needed syringing quite often.

I bought the vented proplugs from my local music shop and have had no trouble at all since.

They cost around £12 and I would recommend them highly.

Cheeers

Lyvia

[knightr54]

Hi,

I have just got back from the Maldives and only went snorkelling but I picked up an awful ear infection which meant on my return to England I ended up in hospital for an over night stay.I even washed my ears out with fresh water after snorkelling each time but still ended up with an infection. The doctors were really worried as it was so severe, so I advise anyone snorkelling or diving to take care and perhaps stock up with some kind of antibiotics and ear drops before they go. The infection actually affected both of my ears, though not at the same time, thank goodness, and this went all the way down my face, and my jaw was out and I couldn't bite my teeth together. On the plane journey home there were also some other passengers who had picked up infections. The snorkelling was absolutely brilliant though, it was just a shame I couldn't enjoy the last 2 days. Perhaps there is something in the water at this particular time of year? Both my husband and I felt as if something was stinging us on our arms and legs but couldn't see anything.

[ChristianG]

Oceanic do a mask with ear protectors. I knowseveral dives prone to ear infections who use these masks and they have not had an ear infection since.
Oh gawd,

Not the ProEar again.

A convoluted piece of an accident waiting to happen somewhere, especially when we're talking snorkelling.

[ChristianG]

Do your dive.

Surface.

Look around, orientate yourself.

Bash each ear, in turn, against the flat of the water - the minor pressure imbalance will release any water in the ear - except that which is attached to the surface of it, which is largely immaterial.

Sorted.

[Thalassamania]

DAN recommends half and half white vinegar and rubbing alcohol.

There's a good discussion of the issue here: Effect of Diving and Diving Hoods on the Bacterial Flora of the External Ear Canal and Skin (http://jcm.asm.org/cgi/reprint/15/5/855.pdf)

IWhat we used for earwash on the Tektite project back in 1969 was equal parts of 15% Tannic Acid (15 gm. diluted to 100 ml), 15% Acetic Acid (15 ml diluted to 100 ml) and 50% isopropol or ethanol (50 ml diluted to 100 ml) in a wash bottle. Mineral oil in the ears before the dive and Tektite solution after. I've done this since '69 and never had any problems with my external auditory meatus. f you leave a wash bottle full of solution in the sun (e.g., on the dash of your car) it feels so good after the dive.

If you have access to any High School or College chem lab you can make it. Or you can likely get a pharmacist to make it up (get you doc to write it out as a perscription) or just get the stuff you need from any Chemical Supply company

1) Tannic acid (crystals), weight out 15 grams, transfer to a 100 ml flask and fill with water.

2) Acetic acid (liquid) put 50 ml or so of water into a flask, slowly add 15 ml of glacial acetic acid then dilute to 100 ml with water.

3) mix 50 ml of alcohol with 50 ml of water on Tektite we used ethanol because we had a bunch in the lab for pickling specimens.

Combine the three solutions.

[ChristianG]

Something that a lot of people don't seem to understand is that whilst underwater, whether as a snorkeller or a diver, we will have water injected into our ears (the ambient side) because of pressure imbalance as we go deeper and this imbalance is most extreme in the 10 metre water column.

It follows that the water (and the air in there before we went diving) is naturally ejected as we ascend and sometimes, perhaps often, the air escapes before the water is fully expelled leaving you with at least some water adjacent to the ear drum - not a good idea.

Most people recognise that there is water in there and will use a number of means, some of them fairly bad, to get rid of that water. My late father, a surgeon, used to say that you shouldn't use anything other than your opposite elbow to attend to things in your ear.

The best way to get rid of it is when still in the water and on the surface. Belt/bash your ear against the flat of the water. The (slight) pressure imbalance will allow the remaining water (heavier than air) out and air in.

Sure, that ear canal is still damp, water is still clinging to its surface, but at least it's not a lake in there.

[ll00031]

hello knightr54

i used to get really bad ear infections after scuba diving. i spoke to my GP about it and they gave me sofradex ear drops, which i use every time i go diving. they are really good and help unblock ears. maby your GP will give you some if you ask.

[Diver@50]

I have recently done 10 dives in the Maldives, and I did not hear of anyone getting an ear infection, either from diving or snorkelling, however the dive staff were very careful about rinsing out ears with clean water. I also dunked m,y head in the islands swimming pool, chlorine kills just about anything!!!

[carol sheridan]

I was in the Maldives in December, 2006, and snorkelled every day, without any problems - perhaps I was just lucky, or does it depend on the time of the year? I was on Paradise Island - disappointed with the coral, which had been bleached, but did not notice much algae.
I gather the islands further away from Male still have good coral.

[jimmysdevoted]

When myhusband was taking diving instruction his instrutor got us into teh habit of using a ocmbination of vinegar and alcohol to use afterwards.
It was supposed to prevent an ear infection.

I get this bottle of swimmer ear liquid from teh dive store or I use sweet oil or a drop of oilve oil before I go in.. It prevents water from being there and doesnt hurt your ear.

Theer are these high pressure ear plugs that you can get that allow for equalization of pressure but nothing else can get in. Its a one way valve for surface divers and others whowork in contaminated environments, but i dont think they are worth the price.
butthe oil does owrk so does the ear wash afterwards....

[pawel]

Guys, what do I do if my ears do not want to pop when underwater. I can go down to 7-8 metres and then the pain becomes to much. I have enough air to blow the ears but nothing works. Has anybody tried any ear-drops?

[IainC]

pawel - if yo ucan;t clear you ears it means you have a cold or other blockage in your tubes.

You MUST NOT FORCE THEM, this could permanently damage your ears and your hearing.

The solution - wait until your cold has fgone away.

If it is always like this then you may need ot see a docotr to see why your ears are always bunged up.

Other than this - clear often (before it hurts), lots of little steps is easier than one big blow..

[thescubaisland]

There is actually a solution designed specifically for divers and sold by trident. I believe it is called "dry ear" or something similar. You put a drop in each ear and it evaporates the water. As mentioned, ear plugs are not the best bet.

[Kenno]

Sorry to dig up an old post, but does anyone know if there's likely to be an ear infection issue in the maldives in the next couple of weeks? Is it a time of year thing or something local to the maldives? I've never heard of it until this thread. I'm going to make sure my girlfriend doesn't read this otherwise she won't go near the water! but I guess we'll both just have to be careful.

[Gareth]

Kenno

First, I am not a doctor, so this is not medical advice, & being free it is worth what you have paid:D .

The first point is any tropical area will have similar risks relating to ear infections. This relates to the fact that there are to the micro-organisms in the water, the temperature, which can infect your ear. Also the continued emerision dry the ear, adding to the risk of infection.
At least that is my understanding.

As has been suggested here.
1. Drying the ear reduces the problem.
2. Rinsing the ear with something that 'kills' any micro organisms.
Swim ear, which is an off the shelf product helps, although the 50/50 vinigear/water is probably a better solution, in as stated previously, it reduces the ph of the ear.
3. Protecting the ear prior to getting it wet.
The best solution is probably something like olive oil. Which is reasonaly passive, will leave a water repelling barrior. Prehaps used at the start of the day, & last thing at night. It also has the added benefit of helping the ear to avoid drying out.

As a general rule, things like ear plugs are a bad idea (although there are products specifically designed for this). Or products to stop water entering the ear, these are not a 100% guarentee.

Enjoy the honeymoon, enjoy the maldives.

Gareth

I'm sure someone will be along soon with a few further suggestions, & to qualify my suggestions:D

[Kenno]

Thanks. I'll make up a bottle of vinegar and water to take with me. How do I apply it?
I've got an olive oil spray bottle that might be overkill but should get the job done for that!

I'm just about to go to a dive shop now so I'll check what ear drops and stuff they've got there.