Ear Wax - A Novella

Thoughts and input on anything related to wet shaving or men's grooming.
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drmoss_ca
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Post by drmoss_ca » Wed May 31, 2006 3:13 pm

Well, I'm sorry to lower the tone in this way, but this is too good to not share with you fine folks!

Ear candling is garbage, but are you ready for this?
Credit to Orac at Respectful Insolence for bringing it to my attention. As he says "If it isn't a joke, this has to be the lamest altie entrepreneur I've ever seen."

Chris
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Austin
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Post by Austin » Wed May 31, 2006 3:17 pm

Thanks for the link Chris. I think. :-k

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drmoss_ca
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Post by drmoss_ca » Wed May 31, 2006 3:22 pm

Of course, I shall be waiting for your review before recommending them to anyone....... :P

Chris
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ScottS
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Post by ScottS » Wed May 31, 2006 3:23 pm

drmoss_ca wrote:Well, I'm sorry to lower the tone in this way, but this is too good to not share with you fine folks!

Ear candling is garbage, but are you ready for this?
Credit to Orac at Respectful Insolence for bringing it to my attention. As he says "If it isn't a joke, this has to be the lamest altie entrepreneur I've ever seen."

Chris
The FAQ says it all!
Q: Should I be concerned about bodily gas?
A: The unique design and shape of the ButtCandle . allows for any natural gas to either dissipate or burn w/o fear of personal discomfort or injury.
There's even a potential shaving crossover!
Q: My spouse has a hairy backside, will this interfere with the process?
A: It depends on just how hairy this backside is. An average amount of hair in this area presents no real problem. If you're still concerned, however, you can use a plant mister to moisten the area beforehand. If we're talking about a really hairy bottom there is some risk of folicular ignition and special caution must be exercised. Certainly use the mister first.

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Nitrox
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Post by Nitrox » Wed May 31, 2006 3:25 pm

:shock: :shock: :shock:
Yikes, that is scary stuff. No thanks, not my cup of tea. :lol:
I wonder what would happen if you had to flatulate, maybe the flame would ignite the gas and send that candle up like the 4th of July. :lol: :lol:
Bruno

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shave every day and you'll always look keen."

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ScottS
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Post by ScottS » Wed May 31, 2006 3:26 pm

Nitrox wrote::shock: :shock: :shock:
Yikes, that is scary stuff. No thanks, not my cup of tea. :lol:
I wonder what would happen if you had to flatulate, maybe the flame would ignite the gas and send that candle up like the 4th of July. :lol: :lol:
Already handled in the FAQ, Bruno, and echoed here because of my immature lack of self control! I do wonder if they optimized the shape through field testing

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ScottS
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Post by ScottS » Wed May 31, 2006 3:41 pm

phishkabob wrote: ScottS- I would be very interested in hearing more about your vestibular lesion research. This is actually one of my areas of greatest interest. Truthfully, I have considered specializing in vestibular assessment and treatment.

Sam
The research involved knocking out the sacculus without knocking out the utricles, which was fairly successful. We were trying to figure out if head roll was detected by actually mapping out the entire gravity vector, or if the brain were cheating and just using the saccular projection of the gravity vector. The answer, both through this procedure and another lab's clever investigations in the Space Shuttle, where there is no gravity, is the cheater's method.

Clinically, though, vertigo is one of the most common complaints of the elderly. Common testing techniques for the endorgans are largely limited to caloric evaluation of the horizontal canals.

Much vertigo that a doctor will see, especially in younger patients, is actually migraine. I know one German collaborator who runs a dizzy clinic, and he runs every patient through a migraine clinic before he even sees them. Other docs just try Amytriptaline as a matter of course if they can't pin a reason for the vertigo down.

Another big population will be BPPV, which is often very successfully treated with physical manouvers. I diagnosed my mom's BPPV over the phone. When she got around to see an ENT, he correctly diagnosed it as well, but tried to send her for auditory evoked potentials testing after the successful Eppley. I suggested she follow up with that, and she didn't. There was absolutely no indication of any nerve involvement.

The biggest part of any clinical practice involving a dizzy clinic will be patient education. By the time a patient finds a good dizzy clinic, that person has been suffering with vertigo, often for years, and is worried about things like brain tumors. Just explaining what's wrong with them goes a very long way.

If you can't pin down a cause, "treatment" is often meclizine and occupational therapy.

I'd recommend picking up a copy of "The Neurology of Eye Movements", by Leigh (my old mentor) and Zee. The last chapter is on the clinical evaluation at bedside, and is absolute gold. It's amazing what you can do with a Maddox rod, an ophthalmoscope, and a piece of paper to occlude one eye.

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Rockn'Roll

Post by Kalypso » Wed May 31, 2006 4:57 pm

I got a bad case of tinnitus from working as a bartender in a live band rock club for a year. The band was to my right & I hear loud hissing constantly, (even in noisy rooms). I do have decent hearing for soft noises but the hissing is always there......sounds like it's way past my inner ear. More like "white noise" in my brain.
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Post by phishkabob » Wed May 31, 2006 5:15 pm

...
Last edited by phishkabob on Tue Feb 20, 2007 11:02 pm, edited 1 time in total.

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Post by tonyespo » Wed May 31, 2006 5:47 pm

I think my wife has bad hearing. She can make out some sounds OK but she doesn't hear words that start with the letter S and end with the letter X. Just the other day I said honey where are my SOX and she just walked away like she didn't hear me. Do you think it could be wax build up?

HEHEHEH, I bet you guys though I was going to say something else.
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ScottS
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Post by ScottS » Wed May 31, 2006 6:14 pm

phishkabob wrote:ScottS-

I am very impressed with your balance-related knowledge. Are you a physician? If so, what is your specialty?

My wife is a third-year medical student and she has a great interest in neurology. We have considered a joint vestibular/balance/dizziness clinic upon her residency completion. On of my professors is Dr. Richard Gans, a Ph.D. audiologist, who owns the Balance Institute of America. His success has inspired me.

I am currently completing a balance rotation within the neurological institute of a local hospital. I regularly complete calorics, VEMPS, otolith repositioning, informal assessment (Fakuda, Romberg, headshake, dolls eye, etc.), and VNG/ENG. Being an audiology student, most of my assessment is for vestibular involvement. Of course, we complete occular-motor, VOR, and central testing as well. Being within a hospital setting has not allowed me a chance to learn posturography, as PT claims this test as their own. I completely agree with you about the value of a bedside informal assessment. I have clinic preceptors/professors who can make a very accurate balance-related diagnosis with only a history and inormal bedside test(s). As I am sure you know, the balance system is very complex and I feel like I still have so much to learn!!! I feel like I have a basic handle on the anatomy/physiology of the vestibular, occular, and somatosensory systems, but making a diagnosis is still very hard for me. I still have 2 more years of school, so hopefully I can feel more confident by graduation!

I appreciate your feedback,
Sam
Not a physician, but its probably safe to call me an expert in vestibular areas. Try this site for a research description. I don't do clinical work, but I've been fairly close to the clinic for years, with a clinical mentor. The NIH steers me mostly to vestibular, posture, and multisensory stuff when I review grants for them.

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Post by phishkabob » Wed May 31, 2006 8:42 pm

ScottS- (or should I say, Dr. ScottS :D )

Very impressive!!! Now I understand your vast knowledge of the vestibular system. I come from a psychology background (specifically neuropsych. and physio. psych.), so the topic of neurobiology interests me. Being a doctoral audiology student, I also have a great interest in the vestibular system. It is a rare pleasure to meet an expert (such as you) in these areas.

Sam
Last edited by phishkabob on Wed May 31, 2006 9:08 pm, edited 1 time in total.

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Re: Rockn'Roll

Post by phishkabob » Wed May 31, 2006 8:53 pm

Kalypso wrote:I got a bad case of tinnitus from working as a bartender in a live band rock club for a year. The band was to my right & I hear loud hissing constantly, (even in noisy rooms). I do have decent hearing for soft noises but the hissing is always there......sounds like it's way past my inner ear. More like "white noise" in my brain.
Have you actually had your hearing evaluated? Tinnitus is often related to hearing loss (specifically noise-induced hearing loss). With your history of excessive noise exposure (I assume you did not wear hearing protection), this would be my first guess. Hearing soft noises does NOT mean that you do not have inner ear damage from excessive noise. Noise-induced hearing loss actually causes hearing loss in somewhat specific frequency regions (at and around 3 kHz). A better question would be, how do you hear in noisy environments with excessive background noise?

If the tinnitus is very bothersome, seeking help from an audiologist or neurologist might be a good idea. Please remember, I am still a student and NOT an audiologist. I just thought that I would share some of the basic knowledge that I do have. :lol:

Sam

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Post by Squire » Thu Jun 01, 2006 10:47 pm

Well, hearing loss does occur, as we age, but it can happen eariler. All my ex-wives say I could never listen to them, or I think that is what they said.
Regards,
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Post by roberev » Fri Jun 02, 2006 6:24 am

I'm curious to hear our resident experts' thoughts on using a WaterPik to clean out the ear canal...at low pressure, of course.

I remember, as a child, that my pediatrician used a WaterPik to clean out my ears. As I reflect on it today, it seemed very effective. The nurse put a little olive oil in afterwards, to prevent swimmer's ear.

Funny, I also remember this event as the first time I ever unwittingly offended someone. The doctor started talking to the nurse while bombarding my ear with water. Since he wasn't paying full attention, the stream started to hit too deep, causing me to cringe in discomfort. After about 2 minutes, he finally noticed my grimace and asked me what was wrong. I told him that the water stream was hurting. When he chided me for not telling him that I was in pain, I respectfully (honestly!) said that I didn't speak up because I figured that he knew what he was doing. He took it as an offense and walked out, leaving the nurse to wrap things up.

Rob

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Post by phishkabob » Fri Jun 02, 2006 8:49 am

roberev wrote:I'm curious to hear our resident experts' thoughts on using a WaterPik to clean out the ear canal...at low pressure, of course.

I remember, as a child, that my pediatrician used a WaterPik to clean out my ears. As I reflect on it today, it seemed very effective. The nurse put a little olive oil in afterwards, to prevent swimmer's ear.

Funny, I also remember this event as the first time I ever unwittingly offended someone. The doctor started talking to the nurse while bombarding my ear with water. Since he wasn't paying full attention, the stream started to hit too deep, causing me to cringe in discomfort. After about 2 minutes, he finally noticed my grimace and asked me what was wrong. I told him that the water stream was hurting. When he chided me for not telling him that I was in pain, I respectfully (honestly!) said that I didn't speak up because I figured that he knew what he was doing. He took it as an offense and walked out, leaving the nurse to wrap things up.

Rob
From what I have been told, general-care practitioners typically use water to irrigate the ear canal for cerumen removal. They use this method because it is easy and they receive VERY little training in this area. Unfortunately, using water to irrigate the ear can easily lead to tympanic membrane (ear drum) perforations. I recently read a statistic that said tens of thousands (over 10,000) ear drums are perforated yearly by general-care practitioners (and their nurses) performing water irrigations. In the right hands, cerumen can be flushed safely with water; but, I would only allow someone who specializes in the ear partake in this task. Audiologists, ENTs, and neuro-otologists will sometimes use water to flush the ear canal, but this is typically not their "weapon" of choice. Most of these professionals will use suction or a curette to extract ear wax. These methods are much more safe and effective, but take a higher level of practice/expertise.

I have heard that water picks can be used to flush cerumen out of the ear canal. Personally, I would feel a little nervous about using a tool with this much power that has the potential to perforate the ear drum. The ear drum is relatively thin and a high pressure water stream might be a little risky (especially in the hands of someone who does not have training in this area). Even set on a low-pressure setting seems like a risk that I would not take! Using a rubber bulb (similar to the type used to remove mucous from a child's nose) filled with water, might be a better option. REMEMBER to always use water that is body temperature. Water that is cooler or warmer than body temperature can cause extreme dizziness!

One more thing, what if your eardrum already has a perforation before you begin a water irrigation? Having water pass through a hole in your eardrum and into your middle ear space seems quite uncomfortable! I hope your physician was always completing a tympanogram (the test that seals your earcanal and varies the pressure) before irrigating it. Just observing an eardrum with an otoscope is not alway enough.

It is interesting that the physician put oil in your ear after it was flushed. Mineral oil is often put in the ear canal to help soften wax before it is flushed.

I hope this helps,
Sam

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Post by Sam » Fri Jun 02, 2006 8:58 am

phishkabob wrote: Using a rubber bulb (similar to the type used to remove mucous from a child's nose) filled with water, might be a better option.
I use one of those from time to time. How can I tell if I have damaged my ear drum then?

Sam

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Post by drmoss_ca » Fri Jun 02, 2006 8:59 am

phishkabob wrote:In the right hands, cerumen can be flushed safely with water; but, I would only allow someone who specializes in the ear partake in this task.
Sam
I guess I'll have to quit doing it! Actually, water is far safer for the eardrum that a solid tool.

Chris

BTW, this thread is one that would be moved to Off-Topic under the posting guidelines. Since it is older than they are we'll grandfather it in!
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Post by phishkabob » Fri Jun 02, 2006 10:41 am

drmoss_ca wrote:
phishkabob wrote:In the right hands, cerumen can be flushed safely with water; but, I would only allow someone who specializes in the ear partake in this task.
Sam
I guess I'll have to quit doing it! Actually, water is far safer for the eardrum that a solid tool.

Chris

BTW, this thread is one that would be moved to Off-Topic under the posting guidelines. Since it is older than they are we'll grandfather it in!
Chris- you are right. A solid tool can be dangerous if used incorrectly. I personally feel a solid tool used with proper lighting and insertion depth is very safe. I guess I should have been more specific... I have absolutely no problem with GPs performing cerumen removal. My biggest concern is believing water is completely safe; this false sense of security leads to tens of thousands of perfs. annually in the U.S. I also have great concerns when a completely impacted ear canal is flushed, without the TM being visualized. What about perfs? I have also seen nurses perform irrigation on pediatric patients without paying attention to the water temperature (leading to a dizzy/ill child). Finally, I am sorry if my post seemed offensive. My concern is not with GPs performing cerumen removal, rather I am worried about patients using water picks to flush their ear canals! I do feel that having cerumen removed by an ear specialist is a patient's best option.

Sam

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Post by drmoss_ca » Fri Jun 02, 2006 11:33 am

No offense at all, but it just isn't practical here (or in the UK) to say go to a specialist to remove ear wax. There are very long waits to get to an ENT surgeon in both places. You might be luckier in the US in this regard.

Chris
"Je n'ai pas besoin de cette hypothèse."
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