my pain is a special snowflake

April 12, 2009 1:58 AM

YANMD-filter: I'm having ear pain and want to avoid going to the hospital if I can. Yucky details inside.

My right ear canal has been very tender for the past three days. After noticing some itching, I cleaned it out with hydrogen peroxide on Friday and was alarmed to discover pus gunking up my ear. A few months ago, I had a painful infection that sent me to the doctor, and I really don't want to go through that again. Three days later, I don't have any further symptoms (decreased hearing, fever, dizziness) but I still have some pain and itchiness in the canal. I have continued to clean my ears a few times a day with peroxide, and the gunk has gone away/is not aggressively regenerating, but the ear canal still feels sore, especially just after I clean it. Could it be sore just because I've been cleaning it too much for the past few days?

Normally, I would already have called my doctor, but I would like to treat this at home if it is at all possible. I'm currently living in a small town in China, about two hours from the nearest "foreigner's hospital." I went to the local hospital for my previous ear infection, and it was not a great experience (clouds of cigarette smoke, strangers crowding into the examination room to stare at me, unusually painful treatment, difficulty communicating with doctor). I have resolved to suck it up and go back to the hospital if I develop any other symptoms (stuffy ear, dizziness, etc.) or if the pain and itching increase, but I would like to know how I could (or should) be monitoring my ear in the meantime. At my last hospital visit, the doctor advised me to clean my ear canal three times a day with hydrogen peroxide, using a Q-tip. Leaving aside the fact that other doctors have repeatedly advised to never ever put Q-tips in my ear, three times a day sounds like a lot.

My plan is to take decongestants and vitamins and hope that the ear clears itself up on its own, but to try to make arrangements to go to the hospital in the city if things take a turn for the for worse.
I've read the posts tagged earinfection, earinfections, and earpain and I've looked on other forums, but I'm still hoping that someone on metafilter can advise me about whether I should leave the ear alone for awhile or whether I should keep cleaning it or if there is anything I should be doing/avoiding. Thank you and, please, no victim-blaming, metafilter!

posted by mustard seeds to health & fitness (14 answers total)

Overuse of Hydrogen Peroxide can really dry out your ear canal, not to mention it damages live cells. Cool it for awhile, and if you can stand it put a light layer of the neosporin that contains pain killer in the canal to "plump" the cells again.

Good luck at the hospital. It sounds like a whole 'nother nightmare in itself.
posted by Acacia at 2:10 AM on April 12, 2009

To add: Dont use the neosporin if you eardrum perforated
posted by Acacia at 2:12 AM on April 12, 2009

IANAO (ontolairngologist), but you probably have a little infection. Pretty common, 3 days is not bad, but definitely resist the q-tips and messing with the ear much at all, not hydrogen peroxide or even neosporin or neosporin as suggested, as it should resolve on it's own in less than a week. The reason for not using q-tips is that 1) the area is delicate and should not be disturbed 2) that it's quite easy to lodge that mud up farther into the canal. (q-tips should only be used around the part of the ear you can see, not in the canal).
You can keep the area moisturized using a little olive oil.

Western docs have prescribed anitbiotics, but that has lessened to a degree now, and they don't speed the process much anyway.
Your mentioning dizziness is concerning though.
I'm with you that you should seek medical help if any of these symptoms worsens or does not clear up within a few days.

What's the old saying? put nothing in your ears but your elbows!
good luck
posted by artdrectr at 2:36 AM on April 12, 2009

With the standard IANAD: this could be something as simple as a pimple in your ear canal. Pus would be a natural result of pimply-ness, and itchiness and soreness could be side effects of over-attention and healing. I'm not sure the best course of action, but probably, akin to normal pimples, leaving it alone causes it to go away in the end.
posted by that girl at 2:37 AM on April 12, 2009

I've had chronic ear infections my entire life. A few years ago I discovered by accident that in my case at least, simply taking aspirin / ASA takes care of it. Not only does it make the pain go away but I get little bumps from swelling right in front of the ears and it significantly reduces that.

Also, as a complete factoid that's probably irrelevant, I saw in a documentary on anthropology a claim that ear wax is of a significantly different composition between Asians and non-Asians.
posted by XMLicious at 2:44 AM on April 12, 2009

Keep your ear dry and stop with the cotton swabs. Avoid swimming, getting water in ear while showering, etc., until this clears up. If it doesn't clear up or gets worse you should definitely be seen by someone. You might be interested in reading the wikipedia article on Otitis Externa.
posted by sero_venientibus_ossa at 3:07 AM on April 12, 2009

Thanks guys! I'll switch to aspirin and see how it goes. Just want to reiterate that *I* know that Q-tips in the ear are a bad thing, but that the two doctors and one pharmacist I have seen here all recommended that I swab the inside of my ears with them three times a day while my ear is healing. I'm not usually scared of going to the doctor; my experiences here have made me skittish about the hospital here is all. I guess I should also clarify that, although I am in China, these are "Western" doctors and I did go through a few rounds of antibiotics the first time around.
posted by mustard seeds at 6:38 AM on April 12, 2009

Like any sequestered infection, allowing the infected site to drain is often important to allow normal immune response to work its magic and prevent further tissue damage. I assume the presence of some infection from the pus you report.

Unfortunately, when the middle ear becomes infected, swelling in the area tends to cut off its natural drainage passage - the Eustachian tube - which connects the middle ear to the nasal passages. Nasal lavage with saline can greatly aid the opening of the infected passage. Given your location, I'd add that you should obtain the cleanest water available and boil it hard, letting it cool before use; irrigating your insides with more pathogens is a bad idea. A neti pot as shown in the link is very low tech allowing you to improvise if needed.

Another mild treatment that is commonly used for swimmer's ear is filling your ear canal with isopropyl (rubbing) alcohol and allowing it to drain. Isopropanol in high enough concentrations (91% is best if available) is strongly hydrophilic and serves to "pull" some water out of the middle ear and into your towel when you tilt your ear upright. Although isopropanol is far less noxious to your flesh, you may want to wait until the peroxide irritation gets a chance to heal before trying this.

IANAD but had too much experience with inner ear infection prior to an adult tonsilectomy.
posted by fydfyd at 7:13 AM on April 12, 2009

Difficult to give advice when we can't see your ear. Sounds like otitis externa (infection of the ear canal) assuming the pus is not from a perforated eardrum (you would know you have perforated if you can't hear out of that ear). For mild OE, you can use diluted white vinegar (half vinegar, half water) twice or 3 times a day. Just drop it in - no swabs etc needed. If it doesn't start clearing up in a few days go to the doctor. OE can have some nasty complications if it gets out of hand. As you mentioned, if you start feeling systemically ill - ie feverish etc please go to the doctor. ASA or ibuprofen for pain is not a bad idea.
posted by madokachan at 7:28 AM on April 12, 2009

Just realize if it is an ear infection, and it goes untreated, you could lose your hearing. Look here under otitis media and here.
posted by 6:1 at 7:48 AM on April 12, 2009

Definitely avoid the peroxide, it's irritating to skin, inhibits wound healing, and dries out the skin. That was crazy advice. In fact, peroxide shouldn't be used on any wounds except maybe for the initial cleaning to remove debris and kill germs.

If it is otitis externa (which it sounds like), madokachan is exactly right. Dilute vinegar. I'm a doc at a clinic that takes care of poor and homeless people and we recommend this all the time. Of course, it would be ideal to look at the ear and get an accurate diagnosis, but if I were in your situation and didn't have access to good health care, this is what I would do before traveling two hours.

Note: if you develop fever (a real fever, measured with a thermometer) or tenderness at the mastoid (that bony knob on your skull just behind the ear), loss of hearing or ringing in the ear, or if things aren't getting better in 3 days, definitely make that two hour trek to the hospital.
posted by Slarty Bartfast at 9:53 AM on April 12, 2009

Isn't there a non-western, holistic clinic somewhere nearby? Many socialist countries generally use holistic healing rather than medicine dependent western styles. I am just guessing here but I would think China would be especially big on that. Just for comparison, when in Cuba, where the number of doctors per citizen is higher than in most first world countries, alternative and holistic medicine is practiced regularly at the local clinics.
posted by JJ86 at 12:14 PM on April 12, 2009

Not to mention peroxide seems to kill off healthy blood cells as well as infection. If there is a good reason for you to irrigate your ear (such as when you suspect impacted earwax) in the future, just use water. In case of infection, I'll have to take madokachan's suggestion (and Slarty's second) of diluted vinegar.
posted by IndigoRain at 11:51 PM on April 12, 2009

I might add if you can take pseudoephedrine it will open your Eustacian tubes, and the drainage might help. They often try that on ear infections for a few days before they escalate to antibiotics.
You need a doctor, but that's not always an easy option.
posted by unrepentanthippie at 4:03 AM on April 13, 2009