[HN Gopher] On the Subject of Earwax and Unsupported Medical Arg...
___________________________________________________________________
On the Subject of Earwax and Unsupported Medical Arguments
Author : luu
Score : 53 points
Date : 2022-12-05 08:31 UTC (14 hours ago)
(HTM) web link (www.residentcontrarian.com)
(TXT) w3m dump (www.residentcontrarian.com)
| frou_dh wrote:
| I stopped doing it not because of real or imagined wax impaction,
| but because I had been doing it exactly the same way forever and
| one day it actually did perforate my eardrum. I guess my luck
| finally ran out. Now that's healed and I don't feel it's worth
| the risk to start again.
| branon wrote:
| Ah, damn. This sounds a lot like me except I haven't had my day
| of reckoning yet. I really don't stick 'em all that far in
| there, though...
| chasingthewind wrote:
| What was that experience like? Did it hurt? How did they treat
| it?
| frou_dh wrote:
| It was actually a very uncomplicated process.
|
| Not much pain. I significantly lost hearing in that ear
| immediately. There was not really any way to treat it apart
| from waiting for it to heal itself, which it did after about
| 4 weeks. Hard to tell whether it's truly as good as new
| though.
| addingadimensio wrote:
| I've never used a Q-tip. I don't know why people clean their
| ears. Some kind of generational trauma brought to us by the Q-tip
| corporation no doubt.
|
| It's clearly a case of garbage in garbage out
| baking wrote:
| Personal anecdote, but I have a strong feeling that if you
| never clean your ears, you never feel the need to. But once you
| start cleaning them, and you feel the difference it becomes
| something that is hard to stop doing. I wish I had never
| started.
| jjgreen wrote:
| Me neither, my mother said to me: "never put anything in your
| ear smaller than your elbow"
| LightG wrote:
| Personal experience of someone who previously had a lot of
| trouble with wax (due to narrow tubes I'm told).
|
| 1)Normal soapy water around the ears during daily shower. Not in
| the ear.
|
| 2) Let the inner ear clean itself via natural oils.
|
| 3) Annual microsuction if needed.
| swader999 wrote:
| My biggest issue is ear hair that grows around and around and
| never comes close enough to pluck out. Drives me nuts. I know
| this because I've stuck a camera thing down there and have seen
| it. I suppose I need to see a specialist. This wasn't in the
| getting old brochure.
| jollyllama wrote:
| The thing that's lost on a lot of the discussion around earwax is
| that your ears will generally adjust to producing the right
| amount of wax, taking into account what activities you do. In the
| spring, when I first swim, I won't have enough earwax because I
| haven't been swimming, and water gets stuck in my ears. By the
| summer, they adjust, and water stays out of my ears. In the fall,
| when I stop swimming, I find that I now have too much ear wax and
| it feels uncomfortable. It tapers off in the winter back to the
| proper level.
|
| Note also that if I use q-tips, this will also increase ear wax
| production, but will remove the protection it provides, and water
| will get stuck in my ears until it builds up again.
|
| I've also found that using earplugs will increase production, as
| will drinking alcohol.
| halpmeh wrote:
| Yes, this one surprising realization I came to during the
| pandemic. I habitually cleaned my ears before leaving for the
| office. When I needed to WFH, I stopped cleaning them because
| the habit had been disrupted. There was a lot of wax at first,
| but now I have just the right amount and never need to clear
| them.
| RC_ITR wrote:
| The secret behind grooming (I've made it, I've finally
| discussed proper hygiene on HN _and_ its contextually
| relevant) is that it boils down to 3 types:
|
| 1) Preference/Social - This is primarily smell and
| appearance-based. For example, you won't see medical problems
| from irregular bathing (as long as you keep wounds/orifices
| clean), not cutting your hair, or not wearing deodorant,
| society just politely asks that you do those things.
|
| 2) Modern-life Adaptions- This is things like tooth brushing.
| We need to do it more because of our modern diets than
| anything else.
|
| 3) Comfort - This is things like cutting your finder nails so
| you don't scratch yourself.
|
| Using this framework, you realize you _can_ get away with not
| doing a lot: pretty much everything except 2 is medically
| optional (especially after you let your body get back to
| homeostasis) - but keep in mind just because you and those
| close to you can 't smell you, that does _not_ mean strangers
| can 't smell you.
|
| Ear cleaning, FWIW falls mostly in 3, but _maybe_ in extreme
| cases it becomes 1; if you 're swimming a lot maybe it's a 2,
| but rarely is that true.
|
| But also, given the above, please be considerate of others
| and do as much 1 as you're capable of.
| the_gipsy wrote:
| Swimmers and divers usually rinse their ears with fresh or
| sterile water after being in the water. I don't think many
| do q-tip cleaning.
| the_gipsy wrote:
| How does water get stuck in an ear? How could earwax possibly
| prevent water getting stuck? I.e. disallowing entry of water
| would also mean disallowing air and thus being clogged by wax.
| jollyllama wrote:
| Have you ever seen (in real life or a movie or a cartoon)
| when someone is hitting the side of their head against their
| hand after being submerged? Or hitting their hand against the
| side of their head, but this can be harmful. That's a thing
| people do when they get water stuck in their ear. You can
| feel it rolling around inside but it doesn't get out no
| matter how you orient your head. Only force, time, or special
| ear drops will dislodge it.
| googlryas wrote:
| That isn't the question. It's how does earwax stop water
| from staying in your ear. I suspect it's the opposite. If
| you have almost no earwax and your ear canal is fully open,
| water can drain out. But if the canal is say 80% smaller at
| one point due to wac buildup, then perhaps water can be
| forced in from pressure and be difficult to drain.
| sacrosancty wrote:
| It's a water repellant. My guess is that it's hydrophobic and
| causes the water to bead and roll out instead of smearing
| over the surface and clinging on.
| PhasmaFelis wrote:
| This is interesting to me, because water doesn't get stuck in
| my ears, ever. I can literally fill my ear with water and it
| flows right out as soon as I tip my head.
|
| I don't have much earwax, but I do have an unusually large head
| 2XL hats barely fit), so I wonder if it's just that my ear
| canals are too big for surface tension to hold water against
| gravity.
| holler wrote:
| Funny I just had the thought this morning that the common held
| view of q-tips being bad feels bogus. I couldn't imagine not
| using them as after a day or two my ears start to feel noticeably
| clogged. My strategy is to twirl the q-tip around the outer edge
| of the inner ear, gently moving it further up a tad. It seems to
| work well.
| vl wrote:
| PSA: they sell _Ear Wax Removal Kits_ which contain bottle of
| diluted peroxide and washer bulb.
|
| You put liquid in your ear and wait for it to soften wax for the
| few minutes. Then you turn over so the ear is facing down and use
| washer bulb with water to wash it out. You can wash out most
| plugs like this without going to the doctor.
|
| Also they sell bluetooth ear cameras on Amazon so you can take a
| look inside to see if it requires additional cleaning.
| throwawaydad12 wrote:
| This is what I do. Whether genetics or what, my ears get
| stopped to the point of deafness once or twice a year. Tried
| cleaning them out with just water and ended up with an ear
| infection. It's excruciating.
|
| Now: Use Debrox (etc) following directions. Several
| applications of the liquid over a day or two. But most
| importantly, flush with bulb with very warm water (as hot as
| you can stand). Repeat, over and over. Once you start, don't
| stop, because you won't be able to fully dry your ear canal
| until you get all of the wax out. Water means infection. Make
| sure everything is very clean throughout the procedure.
|
| Do it over a stopped sink or bowl, so that you can observe
| what's coming out.
|
| After it's done, dry completely. I use the twisted end of a
| tissue, etc., to sop up most of the water. Then blow warm air
| into my ear for several minutes.
|
| No problems since I learned this approach.
| lstodd wrote:
| Cheap solution: lots of warmed to ~40C 0.05% Chlorhexidine.
| Idk, but I bet it's cheaper than that Debrox thing, and
| almost nil chance of infection.
| crucialfelix wrote:
| No less than an hour ago I found myself googling "endoscopy
| wifi password" and laughing.
|
| The bluetooth endoscopy / ear camera I have has its own little
| wifi router inside. The thing looks like a pen flashlight. You
| stick it in your ear, use your "smartphone" to connect to the
| wifi and using an app shows the video inside my ear. And I'm
| wondering what happens if I can't recover the password. Vaguely
| wondering if there is somebody in China who can see inside my
| ear now (er... no)
| zhengyi13 wrote:
| I swam a lot, and got a few ear infections as a kid, at least
| once resulting in a pretty extensive manual cleaning at an
| ENT's office.
|
| As an adult, I would get my ears similarly stopped up at least
| once a year, and I found Debrox and what have you infuriating -
| that stuff would itch abominably as it worked, and make the
| problem worse for a week at least before the wax came out. I
| never saw instructions on flushing with water; likely that's my
| fault.
|
| ... but since I became engaged to a Japanese woman, I've had a
| mimikaki (a Japanese ear pick, often made of bamboo) which I
| use regularly, and never _once_ have I plugged up since.
| vikingerik wrote:
| Yes, flushing with water is the important part. Temperature
| matters too, warm/hot water works better.
|
| I swim a lot too and get a blockage at least once or twice a
| year. I used peroxide on it to varying results, sometimes it
| would work, sometimes not. Then I read that hot water
| flushing after the peroxide is the key part, and that works
| consistently for me now. I do it by getting in the shower and
| aiming a stream of hot water into the ear for a minute or so.
| modeless wrote:
| Continuing the theme of the article, there is no evidence that
| peroxide or whatever else they put in those kits works any
| better than lukewarm water. But peroxide is definitely more
| dangerous if you have an ear injury. I highly recommend just
| going with the water.
|
| Also, it's definitely possible to rupture your eardrum with a
| squeeze bulb too. Given how incredibly loud it sounds when you
| do it, I bet it can damage your hearing even if you don't
| rupture your eardrum. Furthermore if you're doing it yourself
| there is no way to know if you've actually cleaned everything
| out or you need to do it harder, so you just have to go for it
| until you get tired. I find it exceedingly unpleasant.
|
| My approach is to use an endoscope designed for earwax
| cleaning. Works great and (in the absence of reliable evidence)
| it seems to me to be the least risky way to do it since I can
| see exactly what I'm doing and know when I'm done. I highly
| recommend getting one, preferably the fiber optic kind rather
| than electronic, for latency and reliability reasons. They make
| them in Japan.
| biggieshellz wrote:
| I had a doc recommend me this instead of a Q-tip:
|
| https://ototekloop.com/
|
| Works great, and the guard keeps you from pushing it in too far
| and damaging your eardrum.
| number6 wrote:
| My wife had to go to the doctor to get some cotton removed cause
| she was using qtips
| Lendal wrote:
| Me too. This article is missing one obvious detail. If you rub
| a Qtip back and forth against your skin, you will find that
| cotton fibers rub off. It doesn't take much to imagine this
| same phenomenon is also happening inside your ear canal when
| you rub the Qtip in there. When it does, those fibers stay
| inside there, collecting oil and dirt, leading to more earwax
| build-up, leading to more Qtips, leading to even more cotton
| fibers, etc. It's just a really bad solution to the problem.
| You don't need a study for something you can just observe
| first-hand yourself.
|
| They do make plastic earwax cleaners that don't leave any
| debris inside your ears when used. Roughly shaped like a Qtip
| but without the cotton. Pretty cheap and also reusable, unlike
| Qtips. Available at any local pharmacy.
| helmsb wrote:
| I always assumed that the reason that the guidance was against
| using Q-Tips to clean your ears was one of legal exposure for the
| cases where there is a problem.
| agolio wrote:
| Only tangentially related, non-scientific, probably not
| interesting to anyone else comment checking in. My puppy always
| licks the inside of my ears and since then they are super clean
| all the time (like no external earwax at all) but I am scared of
| getting an ear infection.
| the_gipsy wrote:
| Can't you just clean the outside yourself, like in the shower?
| You can easily get infections for example from seawater
| residue.
| lovehashbrowns wrote:
| I stopped using q-tips because after like 20-something years of
| using q-tips safely, it took one bad left-handed cleaning job to
| hurt my ear. I think I mostly got lucky. I went in too far with
| my non-dominant hand and caused some sharp pain on what is
| probably my ear drum. No hearing loss, nothing major, but it was
| pretty painful and more than enough to get me to stop. I was just
| like the author! I was like there's no way this can be bad as
| long as you don't go in too deep.
| icpmacdo wrote:
| This is quite salient, two days ago I did the same thing. Left
| non dominate hand with a q-tip, no pain at all though really. I
| don't think i went too overly deep but the entire left side of
| my has felt blocked since, this article is making me think
| maybe I pushed the wax deeper and might have a blockage? Is
| this something you would consult a doctor over or does it
| usually work itself out?
| lovehashbrowns wrote:
| It's really not a big deal! It might work itself out over
| time but you can get one of those ear wax cleaning kits. In
| my uneducated experience, the formulation they come with
| doesn't help a whole ton, but the key part is the rubber bulb
| you get to flush water into your ear. You're gonna want to
| follow the kit's instructions around safety, but it's overall
| pretty easy and doesn't take too long to clear up some fairly
| significant blockage.
| a_t48 wrote:
| Your local drug store has cleaner that can sit in your ear
| and dissolve ear wax, along with a special ear pick. In my
| experience it works well, especially if you have someone to
| do the awkward scooping after. YMMV if it works better than
| hydrogen peroxide and a qtip
| snarfy wrote:
| When I was in school, there was a guy with a large over-ear
| hearing aid in one of his ears. I asked him about it.
|
| He said he was cleaning his ear one day with a q-tip. His
| sister snuck up behind him with an aired up paper bag and
| popped it. "BOO!" He jumped and smashed the q-tip into his ear.
| noasaservice wrote:
| Damn that's a user hostile site. Ublock origin blocking to the
| rescue.
| rasengan0 wrote:
| I agree with the author, "you shouldn't listen to me over actual
| doctors"
|
| The article completely misses the medicolegal aspect of do no
| harm.
|
| Not sure why people would risk safeguarding one of their main
| senses in name of "There's Basically No Evidence For This"
|
| Ignorant is, as ignorant does. -\\_(tsu)_/-
|
| Has anyone seen blood leaking out of the ear when the crochet
| hook was retracted? How about stench of pus and dealing with
| infection from toothpicks, q-tips, bobby hairpins and other
| assorted instruments. Doctors and other providers see this more
| frequently than probably most HN readers.
|
| As a former ex-NP student, I know syringe irrigation works, the
| patient was profusely 'life altering' thankful with a souvenir
| chunk of cerumen to prove it.
|
| I really believe it takes real world experience, personal or
| clinical to provide evidence of outcomes, until then Dr. Google,
| like talk is cheap.
|
| OR
|
| dismiss clinical experience, keep on with the internet home
| remedies and support your local EENTs to clean up the mess :-)
| post_break wrote:
| This is gross but I wish I could clear my ear wax like blowing my
| nose. I make way too much ear wax and hate it. I have a camera
| that connects to my phone for clearing it out. Wish I didn't make
| so much.
| jmull wrote:
| > you shouldn't listen to me over actual doctors
|
| This part is right. Everyone should stop reading right there.
| gernb wrote:
| The advice being complained about also seems to leave out things
| like, there are 2 basic kinds of earwax, wet & dry
|
| https://www.google.com/search?q=kinds+of+earwax
|
| they require different care
|
| Western medicine says "don't put q-tips in your ears". Japanese
| (and Chinese?) seem very different. You can find these at any
| medicine store in Japan, possibly even every convenience store
|
| https://www.amazon.co.jp/%E8%80%B3%E3%81%8B%E3%81%8D/b?ie=UT...
|
| they look far more dangerous than a q-tip
|
| Here's a specialty shop
|
| https://mimikakitei.com/
|
| They also have sticks with cotton on them and one of the first VR
| experiences I ever had was of having your ears cleaned.
|
| https://play.google.com/store/apps/details?id=com.dlsite.nag...
|
| also, also, here's a funny silly game about cleaning your ears
|
| https://play.google.com/store/apps/details?id=jp.co.liica.mi...
|
| https://apps.apple.com/jp/app/%E6%AF%8E%E6%97%A5%E3%81%AE%E8...
|
| You drag the stick around until you find the hotspot (background
| changes when you're close). Then, once you find it you need to
| drag it back out. The joke is it either tells you how many grams
| if "ear-shit" you pulled out or you find some random silly item.
| In the Apple app store screenshots one card shows pulling out a
| dandelion.
|
| Not that even in Japan, some doctors advise you shouldn't do it
|
| https://www3.nhk.or.jp/news/html/20210317/k10012917781000.ht...
|
| ---
|
| All that said, my father told me he had a friend that lost
| hearing in one ear when he had a q-tip in and his wife bumped his
| elbow. I have no idea if that was true but it stuck with me and I
| although I use q-tips to clean my ears I stop if there is anyone
| in the same room.
| earboi wrote:
| I am a primary care physician, so ear wax is something I deal
| with every day (or every other day).
|
| Medical advice is tailored to meet the needs of everyone, erring
| on the side of extreme caution.
|
| Do I trust myself to insert a q-tip into my ear and not rupture
| my eardrum? Yes. Do I trust most highly intelligent hacker news
| readers? Probably.
|
| Do I trust the bottom 10% of the general population (in IQ,
| dexterity, and good judgement)? Hell no.
|
| Our medical system is a "no-miss" culture that has extreme life
| altering penalties for physicians that give medical care that
| leads to harm. Is rupturing an ear drum a big deal? I'm not so
| sure, but I bet you can find a plaintiff's attorney hungry enough
| to sue over it.
|
| Don't go to medical school.
| ponow wrote:
| > Our medical system is a "no-miss" culture that has extreme
| life altering penalties for physicians that give medical care
| that leads to harm.
|
| That is the problem. We expect physicians to be faultless, but
| they're not. If we applied the same standards to everything in
| life, then life would stagnate, if not grind to a halt.
|
| This idea that everyone who passed their exams is equally
| qualified is a fiction. Let quacks back in and end defamation
| lawsuits that silence critics and leave it up to reputation and
| the market, contracts and standard criminal law. A much more
| dynamic market in medicine is necessary.
| AlbertCory wrote:
| My PCP cleaned out one of my ears recently. I'd trust her more
| than I'd trust myself.
|
| Although I can criticize lawyers for saying this, "out of an
| abundance of caution" is a _totally_ reasonable thing for a PCP
| to say. Thanks, Doc.
| rawgabbit wrote:
| I noticed there are several medical doctors on Hacker News
| which is interesting.
|
| My son is currently attending college in the USA. His dream is
| to get accepted into medical school. When you posted "Don't go
| to medical school.", are you being sarcastic? Or are you
| serious. Is medical school a dead end in 2022 in the USA?
| throwntoday wrote:
| I can't speak to this personally but my brother is a
| physician and despite scoring well on his exams it took years
| to get a residency. Pedigree is still an issue, as-is
| nepotism and age discrimination it seems.
|
| There are a limited number of residency slots allotted by the
| government each year so if you don't get one it's a whole
| year before you can apply again. It's certainly an archaic
| system, and the incentive by the medical lobby to expand
| residency programs is low presumably to protect wages. Even
| if you do jump through all the hoops, life as a doctor is a
| grind. Hospitals are businesses and your job is to see as
| many patients as possible. This is all coming from him and
| other family members who went through the whole ordeal.
| bombcar wrote:
| I would find some doctors you can trust to speak honestly off
| the record, and talk with them.
| youniverse wrote:
| I work with a few Drs and will pass along some common
| thoughts, doing this quickly on mobile so apologies.
|
| In general:
|
| If you want a nice balanced life, you should aim to open a
| private practice. However private practices are a dying breed
| due to cost for renovating/acquiring an office (150k at the
| very least for renovating yourself here in LA), shitty
| payouts by insurance (and getting worse), I saw a pay stub
| just today for $37 for a specialist visit (cash visit would
| be around $250 so Drs really hate taking even PPO insurance
| these days), etc. Few specialties can pull off a private
| practice such as: Plastic/Aesthetic, ophthalmology (doing
| LASIK and cataract surgery), and some others but usually
| these two have it the best. It's even harder if not in a very
| populous area, but then competition is rife, should be ready
| to shell out for marketing. The majority of physicians work
| in groups or hospitals. There is a lot of stress and
| responsibility if you are a surgeon, you should know that
| this kind of life is what you want.
|
| In the end it depends on his goals, these days and evermoreso
| going forward physicians are just cogs in the system. You can
| get away by opening a private practice but there are plenty
| of challenges there. Getting into a nice residency program is
| mostly luck and medical school is rough. Not to mention the
| costs if you aren't well off.
|
| If anyone wants to ask anything I'd be happy to answer in a
| bit more detail when I get time.
| rawgabbit wrote:
| Thank you for the thoughtful reply.
| philosopher1234 wrote:
| Choosing to trust everything you wrote here based on the
| devotion displayed in your username
| nixpulvis wrote:
| IDK why, but I really needed to hear this right now. (I guess
| it's a good thing I keep my ears clean)
| zhengyi13 wrote:
| To me, the way you've signed off with "Don't go to medical
| school" reads vaguely like "Carthago delenda est" - I have no
| idea if you actually say this all the time, but I wonder if you
| do.
| Cupertino95014 wrote:
| It does seem to be a lousy job nowadays, with the insurance AND
| government hassling you.
|
| On the other hand, you get to help people. Sometimes they're
| even grateful for it. I imagine that's worth something, even
| after all the hassles.
| freejazz wrote:
| The standard for malpractice isn't "advice leading to harm" and
| is a much higher burden to establish.
| kgbcia wrote:
| not a doctor, but i noticed an increase in calcium leads to an
| increase in air wax production
| SaberTail wrote:
| My anecdote is that I've tried to clear out wax with a Q-tip only
| to "clog" the ear. I could still hear a little out of the
| affected ear, and it wasn't painful, but it was very annoying.
| The only thing that eventually fixed it was flushing the ear with
| lots of warm water to get the wax plug out.
| gwbas1c wrote:
| Once, after watching a video of a giant earwax plug being
| removed, I realized I probably had quite a bit stuck in there.
|
| I very gently slid a q-tip into my ear, and all it did was push
| some earwax to a funny angle in my ear canal. It was quite
| painful. I went to the doctor and they used pressurized water to
| get the earwax out.
|
| Unfortunately, they dumped the bin before I could see how much
| came out.
| [deleted]
| bcrosby95 wrote:
| I had a plugged ear and had to get it cleaned out by a doctor.
| It was problematic for about 5 years, but I could just push on
| my ear a bit and hear again. Eventually, that stopped working.
|
| When the doctor cleaned it out, a chunk of earwax about the
| size of a cigarette butt came out.
| prometheus76 wrote:
| I use a waterpik with warm water on the lowest setting, and
| it's like magic for the problem you had.
| mpol wrote:
| I used a few drops of paraffine oil in both ears, then in the
| next few weeks some small pieces of dark and hard earwax came
| out. I am using q-tips too and had slight worries about pushing
| wax into my ears. Turned out to be rightful worries somewhat.
| erehweb wrote:
| Randomized control trials are great, and doctors are sometimes
| wrong, but RCTs are not the only way to reason about things. As a
| contrast, there are no RCTs about the effects of poking yourself
| in the eye with a sharp stick, but it's generally agreed to be a
| bad idea even without this evidence.
| Arrath wrote:
| I often spend entire shifts with foam ear plugs in, they fairly
| regularly come out with some earwax on them. I found my
| replacement for q-tips, with no danger of perforating my eardrum!
| ollo wrote:
| don't the ear plugs push the ear wax in?
| bjelkeman-again wrote:
| They can do. So a earwax remover (drops) is good to use from
| time to time. I use in ear protection from loud sounds (my
| rock band).
___________________________________________________________________
(page generated 2022-12-05 23:01 UTC)