WHEN GOOD EARS GO BAD
by James Farquharson
Lots of my paddling friends have recurring ear problems: - infections, blockages, and deafness. Everyone kind of knows it comes with the terrain (white water), but it seems that no one can really be bothered to do anything about it, content as they are to just get deafer and deafer.
This is my story
Hot, dirty, suffering from pain in both ears, standing at the counter of a pharmaceutical shack haggling for a bulk load of eardrops to take home. That was me in Kathmandu one sunny day during October 1996. This was probably the first time I thought "hmm, these ear infections are getting a bit annoying".
Eventually I made my way back to Britain and moved as close as I could to Hurley weir on the Thames. For the first couple of seasons of regular playboating I just suffered a few ear infections here and there, nothing I couldn't ignore. Eventually I was suffering from worse ear infections and more of them. Also, water having once entered my ear canal, seemed reluctant to leave. My visits to the Doctor became more frequent. He usually peeked into my ears at the same time as reaching for the prescription pad. Antibiotics would apparently fix me up.
It was about this time that Shaun Baker announced to the waiting world that he had been having problems with his ears and was to have his ear canals drilled out. Shaun went on to invent the earwig, and I bought one. I didn't use it though - unless it was really cold. I also experimented with earplugs, but didn't like them. They made me feel a bit off balance and I couldn't hear what people were saying in the eddy. Feeling left out from the social whirl that is the eddy queue I took them out.
About 2 years ago I started to notice that people could generally hear things a little better than I could. I again went to the Doctor. He referred me to the Nurse, who syringed my ears. Syringing caused huge blobs of goo to shoot out of my ears and land in a little cup where I could stare at it. This made disgusting but oddly compelling viewing. After this I started to get my ears syringed every four or five months, but I kept getting deafer, and the ear infections were so continuous as to become an accepted fact of life.
Then in February 2001, I noticed Simon Westgarth had some pretty flash looking earplugs. I asked him why. It turned out that he had been experiencing a few problems with his ears and had some little bony growths drilled out
This was starting to sound serious. I did a little research and went to the Doctor yet again. Before I let him peer into my ears, I told him that I thought I had Diffuse Exostosis (Surfers Ear). I also told him what I thought he had to look for and asked him to refer me to a specialist if he found it. On closer inspection he agreed with me and arranged to escalate my case to a higher level. The consultation was set for 6 months away, and eventually took place 9 months later.
In the meantime I found out that the place to get Swimmers Plugs like Simon's was at a hearing aid shop. I picked the nearest one from the Yellow Pages and made an appointment for a fitting. When I was there I noticed that they had an electric ear probe gizmo attached to a monitor. I persuaded the Audiologist to fire it up and show me what he could see.
Good ear...
This is the ear canal and drum of the hearing aid guy. Notice the nice smooth skin of a wide open ear canal, the natural beauty of the Tympanic membrane and the eardrum at the back.
Bad ear...
This is my ear! In amongst the general wreckage, you can probably see that the ear canal has closed up, there are two fat wads of flesh pressing inwards and upwards leaving only a small hole through which I hear. These bits of flesh cover up bone that is trying to protect my eardrum by growing and sealing up the canal. The effect of this odd mutation is that river debris enters the canal, gets trapped behind the narrowing and rots. Also, an interesting thing about the skin in the ear is that it naturally migrates slowly from the drum at the back of the canal, to the outside world where it flakes off. This is your body's way of getting rid of scussy old skin and putrefying earwax. In my ear the skin has further to go because of the lumpy nodules. It gets stuck, cracks up and gets infected. You can probably see the effects of this. That's the skin that looks like a sun dried tomato with all the bits peeling off and the funny colours. Interestingly if I stick a cotton bud in my ear for a scratch around, then pull it out and smell it, it smells like an old dog's ear (if you've ever had a dog you'll know what that is), pretty nasty!
When I visited the consultant there were basically two possible outcomes:
a. The consultant might decide my case was not bad enough to justify the time/trouble/expense of drilling. My ear canal would look much like the above photo for the rest of my life. I would be a little deaf and probably prone to infections for the rest of my life. Also, of course, I would need to use earplugs all the time whilst kayaking to prevent the condition getting worse.
b. The consultant might decide to re-bore my ear canal by drilling out the nasty little bony lumps (canaloplasty). Fundamentally this would hurt, and worse, I would not be able to get on the river for several months. In addition, as with any surgery there are the potential for mistakes to be made; drilled eardrums, severed facial nerve, skin not reforming properly so requiring further surgery. After all of this unpleasantness, I would need to use earplugs all the time, to prevent reoccurrence.
As it turned out, the ENT consultant at Wycombe District Hospital decided not to drill. The growths have only closed the ear canal by about 50% and are very close to the eardrum. Also, I have stopped the situation deteriating by wearing earplugs. He was surprised to learn that kayaking had caused my problems, as he didn't think we would spend enough time immersed in freezing cold water (!). He does want to monitor the situation and if there are further problems he will happily insert something similar to a Black and Decker drill into the side of my head and set it off at full whack .
So there you have it cold dirty water shoved down your ear is not good for you!
Appendix A.
What are the options for preventing ear unpleasantness occurring in the first place?
An Earwig (neoprene hood): The barest minimum. This doesn't seal the ear, but will slow water down. Also keeps your head warm.
Foamy squeezy earplugs: A multitude of different styles are available. Quite cheap and are easily available e.g. from Boots etc. These are ok, but they are porous, so let water in and then trap it. They are also quite light and easy to lose. The ones I had went hard really quickly and chaffed my ear canals.
Christmas tree style earplugs: Also available from Boots. These are probably the best option on a budget. More expensive than the foam ones, but seal better and don't fall out as easily. Will last longer. Ed Cornfield models these with some style
Proplugs (www.proplugs.com). Invented by surfers in the US. In the UK they are available from various surf and kayak outlets. Not a custom fit but come in various sizes. You would need to go to a retail outlet to make sure you get the right size. Apparently you can hear quite well through them. They are made from a rubbery clear plastic and have a tiny hole in the middle to equalise pressure differences and hear through. These are the most popular plug around. Noted Pro-Plug wearers are; Richard Chrimes, Cheesy, Chris McMurray, Andy Philips, Flea Jarvie etc. etc. They cost about 15.
Custom made Swimmers Plugs: 45 from a hearing aid shop. The Audiologist squirts silicon gel in your ear. This hardens to the exact shape of your ear. They send this off and 7 days later, your plugs return. These will make a perfect fit and will not fall out once inserted. They are made of a long lasting (up to 5 years they reckon) rubber/gel like substance, and come in a wide choice of colours. Truly the Rolls Royce of earplugs, I have not had a single infection in over 6 months of use. These little gems are worn by such luminaries of paddling fashion as; Simon Westgarth, Mark Birkbeck and Me. Don't drop them though as they sink.
Appendix B
(More detailed information on Exstosis/Surfers ear is available by following this link http://www.earaces.com/surfear.htm)
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