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Don't be polite. Blowing your nose can be bad for your health.


stryd_one
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So, I've just returned from the ear doctor, and I bear good news for me, and a lesson which I thought I should share with my fellow musicians. I'll use the technical terms where I know them, because you can find lots of images and explanations online and it's hard to describe.

When your sinuses become blocked, we are taught to blow our nose, or sniff it back. This can, on occasion, cause the blockage material (snot) and infection (pus) to be forced up the eustachian tube. If that sounds disgusting, it's because it is, and I'm trying to convince you not to do it ;) Not only can this cause a fairly painful ear infection, but the eustachian tube is not designed to carry that amount of fluid back to the sinus (surface tension messes it up basically), so you end up with fluid trapped in your middle ear. It has the effect of rendering you partially deaf because the eardrum cannot move. Think of putting jello behind the diaphragm on a mic.

Fortunately in my case the hearing loss is temporary (YAYYYY!!!) but if things go worst-case, you can need surgery which may result in permanent hearing loss (a vent installed in your eardrum). So:

Don't blow your nose, just let it run. Wipe yer face. Be gross, but not deaf. F**k being polite. If anyone complains, blame stryd_one.

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Totally gross. I'm a bit embarrassed to talk about it here, but it's one of those things... I mean...noone warns you about it - because if most people lose 1khz off the top of their hearing, they don't even notice...but we would. If some other dude fell unlucky like I did, I'd feel bad for not saying anything.

Few other things: Don't use q-tips/cotton buds in your ear. don't use your finger. don't put anything smaller than your elbow in there, for real. don't let it get too wet or stay wet if you do, and don't clean the wax out. The wax staves off infection, and water helps it grow. if you think it's blocked, go to the doctor and let a professional decide and clean it if needed.

All this stuff sounds a bit like "yeh whatever, i've been doing that forever and so has everyone i know, and we're all fine"... but trust me when you're personally fearing permanent hearing loss, your perspective is altered.

The thing that amazed me most out of all the cool gizmos they had there today (including a pair of crappy senny cans hah) was seeing what an eardrum looks like. In case you don't already know, that thing is THIN!! it's a membrane that's so thin it's translucent, check it out:

normal%20eardrum.jpg

Not exactly the toughest part of your body!

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The eustachian tubes link the inner side of the eardrum (see pic above) to the sinus (big space behind your nose/above your mouth), so the pressure should normally be the same on both sides of the drum, so the drum can vibrate freely. Same as how the diaphragm mic has both sides exposed to the air in the room, so does your eardrum. The tube normally sits shut flat, to isolate the sensitive insides of your ear from the gunk in your nose filtered from the air you breathe. When your ears 'pop', that's the eustachian tube temporarily opening up to allow the pressure to equalise. It'll do it automatically, but you can make it do it by yawning or breathing really deep sometimes. You can also do that thing where you block your nose and blow, but that can be bad as you can pop the eardrum (see pic above. would you blow into that as hard as you can?)

On the back of your throat are glands called adenoids. They're like tonsils apparently. If your adenoids are inflamed, which is common when you have a sinus inflammation from a blocked nose, then when you blow your nose you create a high pressure in your sinus which has nowhere to escape - normally it could escape down your throat, but the swollen adenoids block it. The pressure buildup of blowing your nose can blow nose gunk up the tube, and in behind the eardrum, where the pressure is lower.

Similarly, if you sniff really hard, you can apparently draw the foreign matter up into the tube through momentum if the tube doesn't close of quickly enough.

The tube can move small amounts of fluid, but not much. Theoretically in time it can drain naturally, but if there are larger amounts of stuff in there, it doesn't drain well, and that area is supposed to have fairly clean air in it, not strange fluid, so it can cause infections. It's the secondary damage from the infection that you want to be afraid of, because it can scar the tissues there and mess with your frequency response forever... but even in the short term, the fluid will stop the drum from vibrating properly.

It's pretty rare, I don't think I'd whip myself if I forgot ;) But it's worth knowing and acting upon.

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Not only can this cause a fairly painful ear infection, but the eustachian tube is not designed to carry that amount of fluid back to the sinus (surface tension messes it up basically), so you end up with fluid trapped in your middle ear.

Yes, this is serious. Once I farted and I can even feel the fluids coming towards Eustachian tube! Because of that experience I decided to never fart again.  ;D  ;D ;D

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stryd,

I know exactly what you are talking about and support your findings. I suffered 3 otitis media (middle ear inflammations) some years ago, accompanied by tinnitus, pain and a small hole in my right eardrum (which healed just recently..). As a sound engineer I need my ears to pay my rent, so I had to work out a plan.

My strategy in the last 2 years is to immediately apply all available "tools" a soon as I feel the slightest onset of an eustachian tube blockade. This includes:

nose drops every 20 minutes, gargling anti-inflammatory fluids, aspirin, vitamin C in HIGH dosage, and, very important once the tubes are full of sticky slime already: Acetylcystein. This is available under the brand name "ACC" for oral intake without prescription and quite harmless for the rest of the body:

http://en.wikipedia.org/wiki/Acetylcysteine

take a HIGH dosage for 4 days, during the first two days you feel nothing, on the third day the slime starts to dissolve, and on the fourth day you just feel like you rentire body turns into liquid...

this seems like throwing "rocks on a sparrow" if you take all this medication in HIGH dosages as soon as you feel the "clogging" creeping up, but it saved my from more severe occurences since I use this strategy.

all the best,

karl.

PS: I just read that Acetylcystein has some very interesting further applications:

"...There are claims that acetylcysteine taken together with vitamin C and B1 can be used to prevent and relieve symptoms of veisalgia (hangover following ethanol (alcohol) consumption)...."

and also:

"...Animal studies suggest that NAC may help prevent noise-induced hearing loss (Kopke et al., 2005)..."

sounds to me like the perfect techno-drug...--)))

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I agree with everything you've said Stryd.  I do a bit of scuba diving here and there and I can tell that I have to be very aware of the pressure in my ear drums and have had to learn how to control that pressure using the eustachian tubes.  It's absolutely essential to safe diving that you learn how to balance the pressure in there.

When descending the water pressure outside becomes greater than the pressure inside the ear and the only way to balance it out is to get your eustachians to open up thus pressurizing your inner ear to match the water pressure outside.  When ascending it's the opposite situation.  The air inside your ear expands as you go up, sometimes the pressure is enough to actually force the eustachians closed so you can't equalize.  So sometimes I have to re-descend a few feet just so I can get the tubes to open up to let the pressure out.  After the first about 20 or 30 feet from the surface it's not really too much of a problem.

If you do blow your nose, don't take a deep breath and plug your nose and mouth off.. you could be asking for it there.  The pressure has no where to go but up into the inner ear, and it may do so violently with a pop because the eustachians are not the most perfect instruments in the world.

Kurt

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I read a lot about the situation for divers, because divers were the source of the best info about this mechanism :) I'm a pilot and we get the same deal in reverse, but the degrees of pressure are not so extreme. Those are some gnarly stories you got there man, scary stuff. It's so true that the eustachian is far from perfect... but you really miss it when it's not working at all! ;)

audio: I went with a similar theory but a slightly different approach - I hammered it with natural stuff. Nothing complex, just eucalyptus (vapors) and citrus (vapors and food) and garlic and chillies (hot peppers) and leafy greens and wheatgrass and you name it ;) I worried a bit when it took some time to heal, so after a week I went to the doctor, but apparently that's normal and it was faring well. Normally I avoid taking drugs but in this case I made an exception and took the doc's prescription for some cortizone. I'm not paying the rent with my ears but losing my hearing was a serious issue for me. Fortunately I avoided the ruptured drum, and I'm really glad to know that yours has healed. If it's something that's still healing then you stand a pretty good chance of regaining your full hearing in that ear, from what I gathered. Fingers crossed!

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