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Swimmer's ear

Otitis externa (also called swimmer's ear or ear ache) is an inflammation, irritation, or infection of the outer ear and ear canal. more...

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Causes, incidence, and risk factors

Otitis externa is fairly common, especially among teenagers and young adults. Swimming in polluted water is one way to contract swimmer's ear, but it is also possible to contract swimmer's ear by swimming in a pool that is well maintained or even from water trapped in the ear canal after a shower, especially in a humid climate. Water trapped in the ear canal is not the only cause, however -- the condition can be caused by scratching the ear or an object stuck in it. Trying to clean wax from the ear canal, especially with cotton swabs or small objects, can irritate or damage the skin. It is occasionally associated with middle ear infection (otitis media) or upper respiratory infections such as colds. Middle ear infections can occur after the ear drum is perforated by a fungal growth from the outer ear. Moisture in the ear predisposes the ear to infection from fungus or water-loving bacteria such as Pseudomonas.


  • Ear pain -- may worsen when pulling the outer ear
  • Itching of the ear or ear canal
  • Drainage from the ear -- yellow, yellow-green, pus-like, or foul smelling
  • Decreased hearing or hearing loss

Signs and tests

When the physician looks in the ear, it appears red and swollen, including the ear canal. The ear canal may appear eczema-like, with scaly shedding of skin. Touching or moving the outer ear increases the pain. It may be difficult for the physician to see the eardrum with an otoscope. Taking some of the ear's drainage and doing a culture on it may identify bacteria or fungus.


The goal of treatment is to cure the infection. The ear canal should be cleaned of drainage to allow topical medications to work effectively. Depending on how severe the infection is, it may be necessary for a doctor to aspirate the ear as many times as twice a week for the first two or three weeks of treatment.

Effective medications include eardrops containing antibiotics to fight infection, and corticosteroids to reduce itching and inflammation. Use of antibiotics to treat ear infections may result in treatment of the wrong cause of the infection because not all ear infections are bacterial; some are fungal, and it is possible to have both a bacterial and fungal ear infection.

Ear drops should be used abundantly (four or five drops at a time) in order to penetrate the end of the ear canal. If the ear canal is very swollen, a wick may be applied in the ear to allow the drops to travel to the end of the canal. Occasionally, pills may be used in addition to the topical medications. Analgesics may be used if pain is severe. Putting something warm against the ears may reduce pain.


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Ask the experts: answers to your questions from the leaders in natural medicine - Cover Story - various tips on how to care for swimmer's ear, hernias,
From Natural Health, 8/1/01 by Robert Anderson


Now that I've added pool laps to my exercise routine I've suffered two cases of swimmer's ear. What's the best way to treat this?

LAUREL VUKOVIC REPLIES: This common bacterial and fungal infection of the outer ear canal causes symptoms like pain, swelling, inflammation, and crusting in the ear. Despite its name, swimmer's ear (or otitis externa) doesn't afflict only swimmers. It can occur anytime water gets trapped in your ear canal, even when you take a shower. And vigorous ear cleaning with a cotton swab can promote infection, because the wax that coats the lining of the ear canal is a natural antimicrobial.

I've had swimmer's ear a couple of times, and I always find that a warm hot water bottle placed against my ear eases the pain. (Cover the hot water bottle with a towel to prevent burning yourself.) Also put 3 to 4 drops of a mixture made from equal parts distilled white vinegar and an alcohol-based echinacea extract (Echinacea spp) in your ear up to four times a day. Vinegar restores the pH balance in your ear canal, echinacea combats the infection, and the alcohol in the extract dries up excess water.

To prevent swimmer's ear, wear earplugs when you swim, and consider using earplugs even when you shower or shampoo your hair. Dry your ears thoroughly with a soft tissue, and avoid using cotton swabs. If you know you've gotten water in your ears, administer 3 to 4 drops of the vinegare-chinacea mixture in each ear.

Does Tea Deplete Nutrients?

My mom tells me that drinking tea with meals hinders nutrient absorption. Is this true? If so, is this because of the caffeine?

CAROLYN DEAN, M.D., N.D., REPLIES: It's true that drinking tea can hinder mineral absorption. And your instincts were right about caffeine being the culprit. Drinking four cups of black tea a day (which provides 200 mg of caffeine) significantly depletes your body of minerals like magnesium, sodium, and chloride, according to Susan Brown, Ph.D., director of the Osteoporosis Education Project, a nonprofit research organization in East Syracuse, N.Y., and author of Better Bones, Better Body (NTC/Contemporary Publishing, 2000). Caffeine flushes these nutrients out of your body, and losing them may cause or aggravate symptoms of heart palpitations, insomnia, PMS, and stomach ulcers.

Caffeine also flushes calcium from your body (thereby lowering calcium levels in your blood) and increases the production of parathyroid hormone, which signals your body to draw calcium from your bones. In fact, some studies link an increased risk of osteoporosis and bone fracture to regular caffeine consumption. Therefore, it's particularly important that women abstain from caffeine, especially before they reach menopause when bone density begins to decrease. (For a list of the caffeine levels in common foods, beverages, and over-the-counter medications, see "Nutrient Thieves")

Of course, drinking tea has many benefits; it's rich in antioxidants, which help prevent damage to cells and build stronger bones, and its bitter taste helps your body digest food more efficiently by stimulating bile production in your stomach. You can still get these benefits, though, by adding antioxidant-rich fruits and vegetables (like kiwis, avocados, and carrots) to your diet and by replacing caffeinated tea with fruit-flavored herbal teas (especially those fortified with rose hips). Also try eating bitter-tasting vegetables like arugula, spinach, and watercress instead of drinking tea, or drink uncaffeinated bitter tea made with dandelion root.

If you decide not to eliminate caffeine from your diet, be sure to keep your intake below 75 mg daily.

Vaginal Dryness Solutions

I'm 57 and experiencing vaginal dryness and pain when my husband and I attempt intercourse. I have tried everything from K-Y Jelly to Premarin cream to flaxseeds to wild salmon oil. So far, nothing has worked. Can you help us?

ADRIANE FUGH-BERMAN, M.D., REPLIES: Your problem sounds frustrating, but it might help you to know some details about your anatomy. Vaginal lubrication comes primarily from two sources: mucus production from glands in the cervix, and moisture from the walls of the vagina. Mucus production does decrease after menopause, probably because of hormonal changes. Additionally, lower hormone levels after menopause can contribute to a feeling of dryness because they can cause changes in vaginal cells.

The most effective way to make sex enjoyable again is through lots of foreplay, even if that wasn't necessary before menopause. It's important at this life phase to allow sufficient time for vaginal muscles to relax and juices to flow. Half an hour of foreplay is a good start. You might even consider expanding your sexual repertoire to include items like erotic movies.

The flaxseeds you are eating contain phytoestrogens, or plant estrogens, However, they are much weaker than drug estrogens and it is unclear whether they are strong enough to moisturize vaginal cells. In any case, they have not worked for you. Fish oil helps a lot of problems, but I don't see why it would help vaginal dryness.

In your case, it makes the most sense to use a vaginal moisturizer on a daily basis. I would recommend applying one dose of Replens or another vaginal moisturizer that contains polycarbophil every night for two or three weeks (additionally, you should use a sexual lubricant before sex). If using a daily moisturizing agent takes care of the problem, you could try just using it every other night or twice a week.

Help for Herniated Disks

A few months ago, my doctor diagnosed several herniated disks in my lower back and said they would heal over time. A recent MRI showed that they have returned to normal, but my right thigh and kneecap still cause pain and feel stiff. Why is this, and can you recommend alternatives to the painkillers she prescribed?

ROBERT ANDERSON, M.D., REPLIES: It sounds like you have some residual nerve irritation in your right leg. Your pain may also have kept you from fully rehabilitating your leg, which can relieve discomfort. It's a good idea to look for alternatives to prescription pain relievers, because they can become habit-forming.

The best painkilling substitute is willow bark (Salix spp), an herb that achieved excellent results in a recent double-blind study published in the American Journal of Medicine. Take 120 to 240 mg daily. But I strongly urge you to consider managing your pain with psychological techniques (which, by the way, have other benefits like relieving stress and improving relationships). For instance, cognitive therapy (a therapy built on the theory that our perceptions of situations affect us emotionally) and biofeedback are enormously helpful. Hypnosis, too, offers substantial relief for most people who have back problems. And meditation is surprisingly effective for pain.

I bring up the last option because I've used it to manage the continual pain in my lower back that I've had since I was about 45, due to a congenital anomaly in my lumbosacral joint. I have pain most days, but rarely take any medication for it.

Meditation has done more to help me manage my discomfort than several other things I have tried, including exercise, massage, and acupuncture. It is so helpful that I am not usually aware of the pain unless I think about it. And it has enabled me to continue doing activities like running, skiing, and hiking.

To get you started on meditation and the other mind-body techniques I've mentioned, see "How to find a ...," next page. One of the better books on the subject is How to Meditate (Little Brown & Co., 1999) by Lawrence LeShan.

The Ulcer-Morning Sickness Connection

I recently read that women who have H. pylori bacteria (the kind that cause ulcers) are likely to have severe nausea during pregnancy. I have the bacteria; should I subdue the bacteria if I'm considering becoming pregnant?

ADRIANE FUGH-BERMAN, M.D., REPLIES: There is some preliminary evidence that women who have Helicobacter pylori are more likely to have severe nausea during pregnancy, but there is not a direct correlation (in other words, lots of women with the bacteria don't have morning sickness, and lots of women without it do). So you may or may not be bothered by severe morning sickness, and eradicating H. pylori doesn't mean you won't be nauseated.

While a number of herbs, including garlic, will kill H. pylori in a test tube, the one study of garlic done with humans could not prove that garlic works (jalapeno peppers didn't work either). If I were you, I would wait to see whether I suffered from morning sickness before considering treating myself for H. pylori (especially because there isn't evidence yet that getting rid of it will help).

There are a number of benign treatments for morning sickness, including acupressure bands; ginger (Zingiber officinale), take it either in 2 to 3 cups of tea a day, 250 mg capsules up to four times a day, or small amounts of crystalline ginger or ginger candy several times a day; or vitamin [B.sub.6], 50 mg three times a day.

How Your Floor Plan Affects Your Finances

My house is square-shaped except for two deviations: a small wing off the left wall of the house, and an alcove in the front wall. I've heard that according to feng shui these types of deviations affect the energy flow in a house. Is this true?

DAVID KENNEDY REPLIES: Yes. Projections and "missing areas" can indeed affect the energy in your home. To find out how, first you need to overlay what's known in feng shui (the Chinese art of placement) as a ba-gua on your floor plan (see diagram, above). The ba-gua, according to Master Lin Yun's feng shui method (a widely practiced type of feng shui), is a map that indicates the types of energy, or qi, in each area of a home. Financial well-being, for instance, is always in the upper left-hand corner from the entrance and marriage is always in the upper right-hand corner.


The energy flow in a projection is generally considered positive. In particular, the projection in the upper left-hand area of your floor plan bodes well for your finances, because it enlarges the Wealth section of your house. However, because your projection is a bathroom and bathrooms contain drains--symbolizing a loss of money--the negative energy in this Wealth area exceeds the positive energy. To reverse the negative energy, keep the bathroom door closed, place a full-length mirror on the outside of the door, and keep the sink and bathtub drains closed and the toilet lid down when you aren't using them.

The front of your house may appear at first to contain a projection but according to the laws of feng shui, the position of your front doorway actually makes the area to the right of your door negative space (see shaded area). Negative space diminishes energy; in your situation, it falls in the Career and Helpful People and Friends areas of your home. To increase the positive energy in this corner of your home, simply plant a tree (any type will do) outside at the corner indicated in the diagram above, which will symbolically form the corner to the missing area and improve your career and network of friends.

Preventing Colon Polyps

I'm a 45-year-old woman who recently had benign colon and anal polyps. What causes them and can I prevent them?

VIRENDER SODHI, M.D., N.D., REPLIES: Polyps are growths that can occur on the walls of the intestine, the rectum, or the cervix in women, or on the vocal cords. You may be surprised to learn how common they are; up to 50 percent of adults older than 50 have had at least one. Polyps tend to be multiple and occur most often in the large intestine and rectum. Smaller polyps are usually benign.

However, small polyps in the colon and rectum can grow and become precancerous. These larger growths--usually protruding at least 1/2 inch--are known as adenomatous polyps. It's generally believed that the bigger the size of an adenomatous polyp, the higher the risk of developing colon cancer. One of the best ways to prevent polyps from becoming precancerous is to get screened by having a flexible sigmoidoscopy or colonoscopy every five years beginning at age 50 to detect them and then have any polyps removed.

Scientists believe that adenomatous polyps are DNA mutations that result from eating a diet high in red meat and low in fiber. Therefore, your best defense against these growths is to limit your red meat intake to two servings a week. Instead, eat more fish and boost your fiber intake by getting at least two servings of vegetables and four to five servings of fruit daily. Calcium supplements may also help prevent recurrence. A study published in the New England Journal of Medicine in 1999 found a correlation between taking 1,200 mg of calcium carbonate and lower recurrence of colon polyps.

I have found that food allergies, poor digestion, and stress may also increase the risk of developing polyps. If you suspect that you're allergic to a particular food, get tested. To improve your digestion, eat one to two servings daily of organic yogurt, which contains the beneficial bacteria acidophilus (if you're allergic to dairy, take supplements of acidophilus). Also use the following digestive herbs in your daily cooking: 1/4 teaspoon ginger (Zingiber officinale), 3 cloves garlic (Allium sativum), teaspoon cumin (Cuminum cyminum), 1/2 teaspoon turmeric (Curcuma domestica), and 2 tablespoons flax (Linum usitatissimum). To combat stress, exercise regularly and practice meditation daily.

Triglyceride Troubles

I'm a 37-year-old man who eats a healthy diet and exercises aerobically, yet my triglycerides are above 200, even though my LDL ("bad") cholesterol is low. What's going on?

ROBERT ANDERSON, M.D., REPLIES: Triglycerides are a type of fat your body manufactures. Your body burns them as fuel or uses them for several other purposes, including building cell membranes. But high levels can contribute to the risk of atherosclerosis (narrowing of the arteries). Triglycerides, however, have less influence on atherosclerosis than a high ratio of total cholesterol to HDL ("good") cholesterol. If your HDL is in the average range of 45 to 60 mg/dL, your cholesterol is truly not a problem.

Isolated elevation of triglycerides is usually related to heredity or excessive intake of alcohol or processed sugar. Since you exercise regularly, you are probably not overweight; losing extra pounds can markedly lower triglycerides.

You can also improve your triglyceride reading by taking supplements. Striking evidence supports taking 1.2 to 1.8 g daily of inositol hexaniacinate (IHN), a form of vitamin [B.sub.3] (niacin). Also consider one or more of the following supplements. I have listed the more promising options first:

* Fish oil, 2 to 4 g daily

* Vitamin C, 3 to 5 g daily (Reduce your dose if diarrhea occurs.)

* Garlic powder (Allium sativum), 300 mg three times a day

* Gamma oryzanol (derived from rice bran), 100 mg a day

Ask your doctor to check your triglycerides six to eight weeks after starting IHN. If your numbers are down to normal (near 100 mg/dL), you may have found a solution. If the fall is only modest, you could add the other nutrients one by one.

Growing Migraine Relief in Your Garden

I often treat migraines with feverfew, but I'm tired of driving to the store 30 miles away to buy it. Can I plant it myself?

LAUREL VUKOVIC REPLIES: Easy-to-grow feverfew (Tanacetum parthenium) would be a great addition to your garden. Although it can be started from seed, I find it easier to buy seedlings. (Plants can be purchased at many nurseries.) Once established in your garden, feverfew, a perennial, will reseed itself for many seasons.

Feverfew likes sun or partial shade and a compost-rich soil (or place it in a south-facing window). Its small daisylike white flowers bloom abundantly from early summer through fall. However, it's the leaves that treat headaches, so pinch off the flower buds as they form to promote leaf production.

To ease migraines, eat one or two fresh leaves daily when necessary. Feverfew is extremely bitter and can cause mouth irritation; wrapping the leaves in a small piece of bread helps to buffer the irritating compounds. To preserve feverfew leaves for a few months, freeze the leaves in an ice cube tray.

Quick Tip

MAKE A QUICK HERB-FLAVORED honey to sweeten your tea by adding about 6 drops of a pure essential oil (no synthetics) to 1 cup of honey. Try ginger (Zingiber officinale), lemon (Citrus limon), orange (Citrus sinensis), or peppermint (Mentha piperita). --Laurel Vukovic


How to Find a ...

COGNITIVE THERAPIST: Call the Academy of Cognitive Therapy at 610-664-1273, or visit its website at,

BIOFEEDBACK CLINIC: Visit the Association for Applied Psychophysiology and Biofeedback at

MEDITATION CLASS: Call the Maharishi Vedic University at 888-532-7686.

Have a Question? If you have a health question you'd like our experts to answer, send it our way: Ask the Experts, Natural Health, 70 Lincoln Street, 5th Floor, Boston, MA 02111. You can also reach us via email at

Meet the Experts

Robert Anderson, M.D., is a semiretired family doctor and president of the American Board of Holistic Medicine. He is an advisor for the medical journal Alternative Therapies in Health and Medicine and author of A Clinician's Guide to Holistic Medicine (McGraw-Hill, 2000).

Carolyn Dean, M.D., N.D., is a New York City-based naturopath. She is the author of Natural Prescriptions for Common Ailments (Keats, 2001) and other books and a guest on the TV talk show "The View."

Adriane Fugh-Berman, M.D., teaches at the George Washington University School of Medicine in Washington, D.C. She is on the executive board of the National Women's Health Network, and is author of Alternative Medicine: What Works (Lippincott, Williams and Wilkins, 1997).

David Kennedy is a disciple of feng shui Master Lin Yun and president of the International Institute for Grandmaster Lin Yun Studies in Berkeley, Calif. He is also the author of Feng Shui for Dummies (IDG Books Worldwide, 2001).

Virender Sodhi, M.D., N.D., is an Ayurvedic physician and a naturopath. He runs the Ayurvedic and Naturopathic Medical Clinic in Bellevue, Wash., and lectures in the United States and abroad. He is currently working on a book about Ayurvedic medicine.

Laurel Vukovic is an herbalist in Ashland, Ore. She is the author of Herbal Healing Secrets for Women (Prentice Hall, 2000). Her most recent book is The Journal of Desire (Prentice Hall, 2001).

COPYRIGHT 2001 Weider Publications
COPYRIGHT 2001 Gale Group

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