Monsoon ear infections in Rajkot, what works, what doesn't

Every monsoon, OPD numbers in Rajkot for ear pain almost double. There's a pattern to it, humidity goes up, water gets into ears more often, and the warm wet ear canal becomes a perfect place for bacteria and fungi to grow. By August, half our morning slots are people pulling at one ear in pain.

Most monsoon ear infections fall into two camps. Outer ear infections (also called swimmer's ear or otitis externa) are by far the most common in adults. Middle ear infections (otitis media) are more common in children whose adenoids and eustachian tubes get blocked by colds and allergies.

Outer ear infection, what to expect

• Constant ear pain, especially when you tug the ear or chew
• Itching that came first, then turned into pain
• Swelling at the entrance to the ear canal
• Sometimes thick discharge, yellow, white or even black (fungal)
• Hearing dip on the affected side

Middle ear infection, what to watch for in children

• High fever, often after a cold or runny nose
• Pulling at the ear, crying that gets worse lying down
• Sometimes a sudden discharge from the ear (eardrum has burst)
• Reduced response to sound or speech
• Disturbed sleep, poor feeding

What works at home (within reason)

• Keep the ear bone-dry, no swimming, no head wash with shower water entering the ear
• When bathing, plug the ear with cotton coated with petroleum jelly
• Paracetamol or ibuprofen for pain (per age-appropriate dosing)
• Warm (not hot) compress over the ear can ease discomfort

What does NOT work, and may make things worse

• Pouring warm oil into the ear (a popular remedy across Saurashtra), can trap infection deeper and complicate examination
• Putting cotton buds inside the canal to 'clean' it, pushes wax against the drum and worsens canal injury
• Buying random antibiotic ear drops at the pharmacy without an ENT examination, many infections are fungal and worsen with antibiotics
• Self-medicating with leftover oral antibiotics from a previous illness

When to actually see an ENT

• Pain that hasn't settled in 48 hours of paracetamol
• Any ear discharge
• Hearing dip that lasts more than a few days
• Fever above 38.5°C with ear pain
• Recurrent infections (3 or more in 6 months)
• Any infection on a side where you've previously had ear surgery

The proper ENT evaluation takes 5 minutes

We look into the ear with an otoscope or microscope, suction out any debris, and examine the eardrum. Based on what we see, treatment is usually a specific antibiotic ear drop, an antifungal drop or, in middle ear infections, a short course of oral medication. Most patients are dramatically better in 48 to 72 hours.

Don't let an ear infection ruin your monsoon. The fix is usually quick, but only if you stop pouring oil into it first.