Swimmer's Ear- Home Remedy

Here in Texas we are nearly done with school, and thoughts are veering away from finals and towards days filled with swimming, boating and all kinds of water activities. Austin boasts terrific natural swimming spots, including our lakes and our famous spring-fed Barton Springs pool, where the refreshing water stays at a cool 65 degrees even when we are baking in 100-plus temperatures. Not surprisingly, we tend to see an increase in swimmer's ear infections (otitis externa), which can not only be painful, but can limit your water fun. The good news is that prevention works extremely well, and even when that fails, you may not need to head straight to the doctor. The solution is EAR DROPS.

What drops do we use? We make our own home brew of half and half, alcohol and vinegar. (Yes, rubbing alcohol and generic cooking white vinegar.) To be honest, I like the convenience of the over-the-counter little bottle, so I actually buy one and pour out the contents, replacing it with our home remedy. An extra tip is to set it outside (in the shade in Texas) where it will warm up a bit before you put drops in your ears, so it's not cold and irritating.

This mix will actually work both for prevention and for treatment, if you forgot to use it ahead of time. Nine times out of ten, this will be all you will need! The vinegar kills the fungus, and the alcohol dries up any moisture that remains.
If you are an ear-wax-builder-upper, you may need to flush your ears periodically (such as once per month) using an infant bulb syringe and luke warm tap water, to remove packed in ear wax prior to putting in the home brew drops.

BOTTOM LINE: As always, an ounce of prevention is worth a pound of cure, but remember vinegar/alcohol ear drops for swimmer's ear and you'll be set!

ADD- Is Zinc the answer?

We are always looking for more and better solutions to Attention Deficit Disorder, so I was pleased to read a study published last month in the Journal of Child and Adolescent Psychopharmacology, entitled Zinc for attention-deficit/hyperactivity disorder: placebo-controlled double-blind pilot trial alone and combined with amphetamine, that looked at the role of ZINC in treating ADD. There have been some studies published in other countries that suggest supplemental dietary zinc may improve symptoms of ADD. This pilot study was small (as pilot studies should be) including just over 50 children.

The kids received zinc or placebo alone for the first two months, and there was no consistent, statistically significant advantage to taking zinc alone (vs. placebo). Then, the children were randomized to receive either zinc plus amphetamine (such as Ritalin) or a placebo plus the amphetamine for the next five weeks. Here is where the results are encouraging. Although the symptoms of inattention were not better for the kids who received the zinc plus amphetamine, the good news is that those receiving the zinc supplement required 37% less amphetamine to receive the same results compared with those taking amphetamine plus placebo.

Simply restated, the zinc seemed to help the amphetamine work more efficiently, so that a LOWER DOSE of the amphetamine achieved the desired results. Why is this important? Because lower effective doses mean LESS SIDE EFFECTS. So, should you rush out and buy zinc to supplement your child's ADD medications? No, I wouldn't do that based on a study with only 50 kids. However, while we're waiting for future studies with more significant numbers, why not be sure your child is meeting the recommended daily allowance for zinc? (~10mg per day for teens) What foods contain the most zinc? Seeds (pumpkin, sesame, watermelon), wheat germ, chocolate and peanuts. Hmm...maybe Snickers had the right idea! Or a healthier choice would be to head for the hummus (made with tahini- sesame seed paste.)

BOTTOM LINE: Zinc may help reduce the amount of amphetamine medication needed to improve symptoms of ADD.

Beyond Chicken Soup- What Helps the Common Cold?

This week I've been talking about colds and the role of vitamins can play in treating them. We know that the common cold is caused by a virus, so therefore antibiotics (which kill bacteria, not viruses) do NOT help. What DO I recommend for my patients?
Much of what your parents may have offered you works well, by the way...

1. Oral decongestants- phenylephrine or pseudoephedrine- work well to relieve nasal stuffiness, but can have significant side effects of raising blood pressure, causing palpitations/jitteriness or insomnia
2. SHORT TERM (3 days) use of nasal decongestant sprays; also relieve nasal congestion with less side effects
3. Nasal saline sprays and washes often relieve congestion as well as the medicated versions
4. Aromatic oils (menthol, camphor, and eucalyptus) used topically provide subjective improvement in nasal congestion- don't forget about the topical "vaporub" or the forms of these oils that you add to a warm bath!
5. Analgesics: acetaminophen (tylenol) or ibuprofen (Advil/Motrin) help with headache and body aches
6. HYDRATE! Remember chicken soup? ANY liquid helps, but drinking warm broth often has the double benefit of sore throat relief along with hydration. The more you hydrate, the less headaches and looser mucus (so it will de-congest) you will have.
7. Salt water gargles ease sore throats as well; repeat several times a day for the first day or two, and don't be shy with the salt: use 2 tablespoons per 8 oz of water- it wont even all dissolve, but that's how much you really want to increase effectiveness.
8. Cough suppressant: try OTC products with "DM"- dextromethorphan. More on this tomorrow...

BOTTOM LINE: Symptomatic relief of the COMMON COLD is important, but antibiotics are NOT part of the equation.

Zinc for Colds?

If Vitamin C is not the answer to prevention or treatment of colds, what about zinc? Around 25 years ago, studies showed that zinc lozenges could significantly reduce the duration of the common cold. Since that time, the medical literature has been conflicting, with roughly half of the studies showing benefit, and half appearing equal to placebo.

Zinc nasal preparations were then released, but in 2009, the FDA issued a warning that these intranasal zinc preparations had the potential to cause permanent loss of smell, so they are no longer recommended.

It turns out that you need to have ionic zinc in the lozenges to be effective, and the vast majority of products out there do not have this type of zinc. Taking zinc supplements in pill form doesn't work either, so don't be fooled into swallowing yet another pill.

What DOES work? Well, the best prevention is what your mom most likely taught you growing up: WASH YOUR HANDS! It doesn't matter if you use the hand sanitizer or old-fashioned soap and water, but whatever you use, scrub for 20 to 30 seconds, and try not to touch your face or eyes.

BOTTOM LINE: If you are going to use zinc to try to shorten the duration of your cold, get an ionic zinc lozenge preparation. More importantly, however, WASH YOUR HANDS!