WEBVTT - Ep 215 The Hidden Depths of Earwax 0:00:00.280 --> 0:00:03.040 A fifty year old woman presented to her GP following 0:00:03.080 --> 0:00:07.080 an episode of ear candling. After fifteen minutes, the person 0:00:07.160 --> 0:00:10.520 performing the candling burned herself while attempting to remove the 0:00:10.560 --> 0:00:14.400 candle and spilled candle wax into the patient's right ear canal. 0:00:14.920 --> 0:00:17.880 On examination, a piece of candle wax was found in 0:00:17.960 --> 0:00:20.960 the patient's ear and she was referred to the local ear, nose, 0:00:21.000 --> 0:00:24.959 and throat department under general anesthetic. A large mass of 0:00:25.040 --> 0:00:28.960 solidified yellow candle wax was removed from the deep meatus 0:00:29.160 --> 0:00:32.159 of the ear. The patient had a small perforation in 0:00:32.200 --> 0:00:35.120 her right to panic membrane. Results of a pure tone 0:00:35.159 --> 0:00:38.640 audiogram showed a mild conductive hearing loss on the right side. 0:00:38.880 --> 0:00:41.640 At a follow up appointment one month later, the perforation 0:00:41.800 --> 0:00:46.520 was still there and the patient's hearing had not improved. 0:01:32.760 --> 0:01:35.920 An account of why not to ear candle. 0:01:35.920 --> 0:01:43.160 I mean, just one example, just one that sounds horrific. Yep. 0:01:43.640 --> 0:01:48.520 I agree. Every single account of ear candling that I 0:01:48.600 --> 0:01:52.720 read was exactly like this. This particular account comes from 0:01:52.760 --> 0:01:55.160 an article from two thousand and seven by Rafferty at 0:01:55.160 --> 0:01:58.200 All published in the Canadian Family Physician that was titled 0:01:58.240 --> 0:02:01.920 ear candling. Should general prec tishners recommend it? The answer 0:02:01.960 --> 0:02:02.920 was no. 0:02:02.520 --> 0:02:11.000 No, firmly. Wow that's awful. Yeah, that's awful. 0:02:11.120 --> 0:02:11.720 It's not great. 0:02:12.400 --> 0:02:14.160 Hi. I'm Aaron Welsh. 0:02:14.000 --> 0:02:14.639 And I'm Erin. 0:02:14.680 --> 0:02:17.800 I'm an Updike and this is this podcast will kill you. 0:02:17.880 --> 0:02:22.799 Today we're talking about ear wax, ear wax, continuing our 0:02:22.880 --> 0:02:23.960 bodily fluids. 0:02:24.440 --> 0:02:27.440 There's so much more that I've been like mentally collecting them. 0:02:27.440 --> 0:02:32.240 There's like saliva would be a great one, belly button lint. 0:02:32.680 --> 0:02:37.320 What's in there tojam on skin cells? 0:02:37.880 --> 0:02:39.240 It's probably the same thing as to jam. 0:02:39.320 --> 0:02:42.280 Aaron, Well, we'll do an episode on it, babe. 0:02:42.040 --> 0:02:42.840 Okay, I can't wait. 0:02:42.960 --> 0:02:46.280 We'll have to see if there's enough material there. But 0:02:46.440 --> 0:02:50.760 don't get it like, I'm sorry, absolutely done, thank you. 0:02:51.200 --> 0:02:53.240 I am thrilled for this episode. 0:02:53.480 --> 0:02:56.720 I can't wait because I have nothing to contribute, but 0:02:56.760 --> 0:03:00.600 I really want to. You have to say, I'm sure 0:03:00.600 --> 0:03:00.840 that you. 0:03:01.040 --> 0:03:03.840 I mean, I want to know what makes up earwax. Yeah. 0:03:03.840 --> 0:03:06.920 I have several pages of notes, but like it's I'm 0:03:06.960 --> 0:03:07.600 here for you. 0:03:08.120 --> 0:03:11.480 I'm here for you. I love you. I love you. 0:03:12.919 --> 0:03:15.200 I also love quarantine time me too. 0:03:15.240 --> 0:03:16.120 That's what time it is. 0:03:17.800 --> 0:03:21.200 How is that done? Was that nicely done? Really? Really good? Good? 0:03:21.320 --> 0:03:22.519 Good? What are we drinking this week? 0:03:22.600 --> 0:03:26.640 Arin, We're drinking the gold Mine gold mine. Yeah, not 0:03:26.720 --> 0:03:29.079 out ear wax is gold some. 0:03:29.000 --> 0:03:37.880 Of it is so many different shades, so many different grays, blacks, yellowish, brown. 0:03:38.120 --> 0:03:40.280 Do you already say brown? I did, Yeah, okay, yeah. 0:03:40.360 --> 0:03:41.520 Lots of shades though. 0:03:41.360 --> 0:03:45.520 Lots of shades within mustard. But we are we're drinking. 0:03:45.560 --> 0:03:48.760 I mean, we named it gold mine because the amount 0:03:48.760 --> 0:03:52.400 of information that you can tell from earwax is more 0:03:52.400 --> 0:03:53.480 than I ever expected. 0:03:53.880 --> 0:03:54.800 I didn't know that. 0:03:55.520 --> 0:03:59.720 So I plus earwax is a resource, like not just informationally, well, 0:04:00.000 --> 0:04:01.000 there's a lot to cover. 0:04:03.920 --> 0:04:08.040 Oh yeah, okay, you're gonna tell me everything. What's in 0:04:08.720 --> 0:04:09.480 the gold mine? 0:04:09.560 --> 0:04:12.279 It's I mean, we wanted to make it look goldish. 0:04:12.600 --> 0:04:16.000 You know. It's got pineapple juice, Jlipino simple syrup and 0:04:16.120 --> 0:04:20.920 lime club soda. It's refreshing, delicious. This episode will come 0:04:20.920 --> 0:04:25.800 out summertime, I think, so it's great in the summer, 0:04:26.040 --> 0:04:28.000 in the summer, in the Northern Hemisphere summer. 0:04:29.200 --> 0:04:31.320 You can find the full recipe on our website, this 0:04:31.320 --> 0:04:34.440 podcastikila dot com, and all of our social media channels 0:04:34.480 --> 0:04:37.120 which you should be following us if you're not already, 0:04:37.160 --> 0:04:42.440 because we're there posting things like this Quarantini recipe. Also, 0:04:45.000 --> 0:04:47.440 I don't remember what else, rate review and subscribe. Thank 0:04:47.480 --> 0:04:49.680 you to everyone who has left us a review. It 0:04:49.839 --> 0:04:52.480 really does help other people find this podcast, and we'd 0:04:52.560 --> 0:04:55.520 like for like I don't know, everyone to listen to it. Yeah, 0:04:55.960 --> 0:04:59.880 if you are watching on YouTube, hi, hi, and we 0:05:00.000 --> 0:05:03.839 we are there on a web subscribe on a website 0:05:03.839 --> 0:05:05.960 we have called this podcast will Kill You dot com. 0:05:06.000 --> 0:05:10.480 You can find transcripts, you can find sources from every episode, Merchpatreon, 0:05:10.560 --> 0:05:15.279 bookshop dot org, bookmobile, bloodmobile. Who does the music? 0:05:16.240 --> 0:05:19.279 There's a lot, there's a lot, and I just I 0:05:19.320 --> 0:05:22.320 know we always thank everyone at the end of these episodes, 0:05:22.360 --> 0:05:26.240 but I was thinking, how there are there's so much 0:05:26.279 --> 0:05:28.479 out there, Like there are so many podcasts out there, 0:05:28.520 --> 0:05:31.239 there's so much media to listen to, to watch, et cetera. 0:05:31.960 --> 0:05:35.920 And the fact that people choose to engage with ours 0:05:36.000 --> 0:05:40.080 is really it's really surreal and wonderful and so thank 0:05:40.120 --> 0:05:43.279 you for choosing to spend your time with us. It 0:05:43.440 --> 0:05:45.599 means the world truly really does. 0:05:45.720 --> 0:05:48.839 It really does. Like we love getting to make this 0:05:48.920 --> 0:05:52.880 podcast as our jobs, yeah, and sharing everything that we 0:05:52.960 --> 0:05:56.200 learn with you. And I still can't believe that anyone 0:05:56.400 --> 0:06:01.360 I know listen. It's truly say. Every time someone's like, 0:06:01.400 --> 0:06:02.359 oh I listen, I'm. 0:06:02.160 --> 0:06:06.880 Like, really, you've heard of this podcast? What why do 0:06:06.920 --> 0:06:10.960 you listen? Thank you, thank you, thank you. 0:06:11.640 --> 0:06:12.760 We appreciate it, we do. 0:06:13.320 --> 0:06:17.520 But enough enough of all that. It's time for earwax. 0:06:17.839 --> 0:06:53.039 Ear wax. Let's get into it right after this break. Earwax. 0:06:55.120 --> 0:06:58.239 That's how I started good. I like it all caps, 0:06:58.800 --> 0:07:01.159 so we all know what it is. It's the junk 0:07:01.440 --> 0:07:04.760 in our ears. The official medical term for ear wax 0:07:04.880 --> 0:07:05.800 is serumin. 0:07:06.680 --> 0:07:09.359 Junk is you know I'm going to take issue with that. 0:07:09.440 --> 0:07:11.640 Oh I can't wait for you to take issue with that. 0:07:13.400 --> 0:07:16.800 So serumin is this waxy substance that our ear makes. 0:07:17.280 --> 0:07:21.280 Our ear makes this in order to stay lubricated, to 0:07:21.480 --> 0:07:24.880 clean and protect our ear canal. And really it functions 0:07:24.960 --> 0:07:29.280 a lot like the mucus in our nose, except it's 0:07:29.400 --> 0:07:31.080 kind of also completely different. 0:07:31.120 --> 0:07:33.160 So it was like, its just ear boogers. 0:07:33.320 --> 0:07:38.360 It's ear boogers, yeah, more or less, but different. So 0:07:38.520 --> 0:07:41.640 it is a protective barrier the same way that our nose, 0:07:41.720 --> 0:07:45.640 mucus is it is a little bit acidic, and so 0:07:45.920 --> 0:07:48.080 in being a little bit acidic, it keeps our ear 0:07:48.120 --> 0:07:51.280 canal acidic, which helps to inhibit the growth of bacteria 0:07:51.440 --> 0:07:56.080 and fungi which would really love to be able to 0:07:56.120 --> 0:07:59.480 grow in our ear canal. There was a nineteen ninety 0:07:59.480 --> 0:08:01.880 four pape which I didn't read this paper, but I 0:08:01.920 --> 0:08:04.280 read a paper that quoted this paper that called the 0:08:04.320 --> 0:08:08.040 ear canal quote the green house of the human body 0:08:09.120 --> 0:08:12.840 end quote, because of how much fung i would love 0:08:12.960 --> 0:08:14.360 to grow in our ear canal. And I was like, 0:08:14.400 --> 0:08:17.600 wouldn't we have a lot of moist dark. 0:08:17.680 --> 0:08:20.880 Eye was, yeah, there's gotta be more. I can think 0:08:20.920 --> 0:08:24.520 of many greenhouses we too populate throughout our bodies. 0:08:24.960 --> 0:08:30.520 But anyways, the potentially I mean every mucus membrane, really 0:08:30.600 --> 0:08:35.800 every mucus membrane. Anyways, just like in our nose, in 0:08:35.880 --> 0:08:39.280 our ears, we have these glands just underneath the skin 0:08:39.720 --> 0:08:43.640 that are what produced the oily substance that ends up 0:08:43.640 --> 0:08:47.560 getting mixed with shed skin cells and debris that all 0:08:47.600 --> 0:08:52.000 together become our ear wax. There's two types of glands. 0:08:52.520 --> 0:08:55.760 There are sabaceous glands and we have subacious glands all 0:08:55.800 --> 0:09:00.319 over our body, and sabacious glands produce a substance called seam, 0:09:00.600 --> 0:09:04.040 which is like this sort of oily type of substance. 0:09:04.640 --> 0:09:07.199 And then we also have in our ears these modified 0:09:07.400 --> 0:09:12.240 apicrin glands, and our apocrine glands are basically like our 0:09:12.280 --> 0:09:14.640 sweat glands are a type of apricin gland as well, 0:09:15.360 --> 0:09:19.640 and these glands produce a variety of substances, including lipids 0:09:19.640 --> 0:09:24.680 so like fats, wax esters, alcohols, something called squaleen, which 0:09:24.720 --> 0:09:29.600 is a kind of fatty substance, and cholesterol, and all 0:09:29.640 --> 0:09:33.520 of these get together, the secretions from our apicrine glands 0:09:33.559 --> 0:09:38.040 and the secretions from our sebum glands and mix with 0:09:38.080 --> 0:09:42.880 our dead skin cells, which I find very fascinating because 0:09:44.120 --> 0:09:48.160 the cells in our ear, like our skin cells, shed 0:09:48.200 --> 0:09:50.520 all the time, right like rub your hand against your 0:09:50.520 --> 0:09:53.000 skin and the top layer is sluffing off. 0:09:54.080 --> 0:09:57.000 Okay, got it, It sluffed the top layer. 0:09:57.679 --> 0:10:01.839 That's happening in our ears as well, and it moves 0:10:02.200 --> 0:10:05.120 from the inside of our ear towards the outside of 0:10:05.160 --> 0:10:09.840 our ear like the cells do this shedding thing in 0:10:09.920 --> 0:10:12.480 a particular way. There's a paper from nineteen sixty four 0:10:12.520 --> 0:10:16.520 that like tracked the way that our ear canal sheds 0:10:16.559 --> 0:10:22.080 its own skin. How is it doing hairs? No, So 0:10:22.120 --> 0:10:26.240 here's what's so fascinating. It's not little hairs or little cilia. 0:10:26.280 --> 0:10:29.800 A big part of what moves the skin and all 0:10:29.840 --> 0:10:33.280 of the debris within it is our jaw movements. So 0:10:33.360 --> 0:10:36.760 when we are talking and chewing, it helps to move 0:10:36.880 --> 0:10:39.600 the ear wax and these skin cells along the ear 0:10:39.679 --> 0:10:44.640 canal itself. And this is all our Technically, our outer ear, 0:10:44.679 --> 0:10:47.760 which is our ear, has three parts in our middle 0:10:47.760 --> 0:10:49.440 and outer and this is all the outer parts, so 0:10:49.480 --> 0:10:53.760 from the tympanic membrane out towards the outside world. Cool. 0:10:54.200 --> 0:10:56.520 I have, very cool. I have a few questions. 0:10:56.600 --> 0:10:57.120 Give it to me. 0:10:57.320 --> 0:11:01.720 Where are these glands located? They located throughout our ear canal, 0:11:01.920 --> 0:11:04.240 just in our inner ear. Okay, so yeah, they're throughout 0:11:04.280 --> 0:11:06.800 our ear canal. This is all outer ear canal. This 0:11:06.880 --> 0:11:09.199 is all outer ear, all outer ear. Okay, yeah, okay, yeah, 0:11:09.200 --> 0:11:10.439 oh yeah, yeah, Okay. 0:11:10.520 --> 0:11:13.520 It feels like it's inner because I like the oracle 0:11:13.600 --> 0:11:15.640 or the pinnow, which is like the visible. 0:11:15.240 --> 0:11:16.600 Part of your ear, the little hole. 0:11:16.679 --> 0:11:18.880 Yeah, but it's yeah, it's a canal that's like usually 0:11:18.920 --> 0:11:21.160 like an inch or so long. It can be a 0:11:21.200 --> 0:11:24.280 little bit windy, so it sometimes feels longer when you're 0:11:24.320 --> 0:11:24.959 looking in it. 0:11:25.000 --> 0:11:32.080 But okay, how much do we produced? And here's the 0:11:32.080 --> 0:11:33.640 other question. Can you answer? 0:11:33.840 --> 0:11:35.600 I don't have an answer to that question, and it 0:11:35.640 --> 0:11:38.520 bothers me so much that I didn't see that anywhere. 0:11:38.559 --> 0:11:39.400 Do you have an answer? 0:11:39.480 --> 0:11:41.320 I don't have an answer. I mean, I I had 0:11:41.360 --> 0:11:43.320 a hard time finding I was trying to find the 0:11:43.360 --> 0:11:46.680 origin of these glands, the like seruminous glands, and like 0:11:46.720 --> 0:11:48.920 when did they evolve and blah blah blah, and I 0:11:49.160 --> 0:11:51.920 I mean maybe my search terms weren't great, but I 0:11:51.960 --> 0:11:54.960 couldn't find anything. Okay, So then the other question is 0:11:55.000 --> 0:11:57.840 does the amount that we produce what affects it? And 0:11:57.880 --> 0:12:02.440 I was just thinking of like, if if you're grinding 0:12:02.480 --> 0:12:05.280 your teeth at night and that's an eight solid hours 0:12:05.320 --> 0:12:08.240 of just jaw movement movement, are you producing more ear 0:12:08.280 --> 0:12:11.280 wax or are you moving more ear wax? Is there 0:12:11.280 --> 0:12:12.520 an impact on earwax? 0:12:13.120 --> 0:12:19.880 That's an excellent question. I have literally no idea. I 0:12:19.920 --> 0:12:22.360 have no idea, but that's such an interesting question. So 0:12:22.600 --> 0:12:25.560 we do are our ear the glands in our ears? 0:12:25.600 --> 0:12:28.400 The cruminous glands. So the semum glands and the apocrine glands, 0:12:28.600 --> 0:12:31.680 they reduce in number as we get older, and so 0:12:31.800 --> 0:12:34.040 that's one thing that's going to affect how much earwax 0:12:34.120 --> 0:12:36.600 we make. So the older that you get, the less 0:12:36.640 --> 0:12:38.840 the dryer your ear wax tends to be because you 0:12:38.880 --> 0:12:40.880 have less of these glands. Why don't ask me, I 0:12:40.880 --> 0:12:44.559 don't know except that, like, I mean, your skin gets 0:12:44.640 --> 0:12:46.439 drier in general as you get older, right, so you're 0:12:46.480 --> 0:12:49.320 just losing sebum producing glands everywhere. I don't I don't 0:12:49.320 --> 0:12:50.680 actually know they fall off? 0:12:50.760 --> 0:12:53.040 Yeah, why do they fall fall off? 0:12:53.120 --> 0:12:55.120 Or they just kind of like dry, you. 0:12:55.080 --> 0:12:58.920 Know, I mean, I get you physically fall off. Okay, 0:12:58.960 --> 0:12:59.720 what about ear? 0:13:00.840 --> 0:13:04.520 Ear hair? Ear hair also increases in number as we 0:13:04.559 --> 0:13:07.000 get older, and so the like, older people might have 0:13:07.080 --> 0:13:09.760 quite a lot of hair in their ears, especially males, 0:13:10.000 --> 0:13:13.080 and that can actually block the ear wax from coming 0:13:13.160 --> 0:13:15.840 all the way out, so it can contribute to serum 0:13:15.840 --> 0:13:17.640 and impaction, which I'll talk a little bit more about 0:13:17.679 --> 0:13:18.320 in a minute. 0:13:18.440 --> 0:13:22.120 Why do we get more ear hair when we get older. 0:13:22.160 --> 0:13:23.240 I don't have it. I don't have an answer. We 0:13:23.320 --> 0:13:25.079 get hair everywhere when we get older. 0:13:24.920 --> 0:13:28.600 Right, Okay, we lose hair body hairs as an episode. 0:13:28.760 --> 0:13:47.479 Listen, I'm down. So there's two main types of earwax. 0:13:47.559 --> 0:13:51.480 It's usually split. There's wet earwax and there's dry earwax. 0:13:51.720 --> 0:13:53.080 And I think you're going to talk a little bit 0:13:53.120 --> 0:13:57.320 more about this distinction, Arin, but it's genetically determined, which 0:13:57.360 --> 0:14:02.560 I think is so interesting, except that obviously it does also, 0:14:02.600 --> 0:14:05.680 like I said, get drier as we age. But the drier, 0:14:06.000 --> 0:14:10.280 flakier earwax, which some people have, is usually lighter in color, 0:14:10.640 --> 0:14:12.640 and it tends to be more common in people of 0:14:12.720 --> 0:14:17.640 Asian and Native American descent. And then the sticky, dark earwax, 0:14:17.679 --> 0:14:21.800 which is what I have say, very sticky wax, it's 0:14:21.840 --> 0:14:26.520 more common in people of African and European descent. And 0:14:26.840 --> 0:14:31.560 apparently the dry, flaky earwax is like a recessive trait. Correct, 0:14:32.160 --> 0:14:34.080 you're gonna tell me more about that I got about 0:14:34.080 --> 0:14:37.480 ear wax. There's not I tried to find if there 0:14:37.600 --> 0:14:40.960 was like a big literature about like who's more likely 0:14:41.040 --> 0:14:44.640 to get earwax impaction or something like that, And there 0:14:44.720 --> 0:14:47.160 isn't a strong association between types of ear wax, like 0:14:47.240 --> 0:14:49.120 you can get too much of it, whether you have 0:14:49.160 --> 0:14:51.520 the dry, flaky stuff or the wet, sticky stuff. 0:14:51.560 --> 0:14:53.480 Okay, that's interesting, Okay. 0:14:53.240 --> 0:14:58.040 Yeah, And so under typical or ideal conditions, our outer 0:14:58.160 --> 0:15:01.120 ear is kind of like a self clean oven. Okay. 0:15:01.320 --> 0:15:04.360 So it makes this wax and then it pushes it 0:15:04.560 --> 0:15:08.920 out in order to keep our ear canals free of 0:15:09.120 --> 0:15:11.880 debris and bacteria and getting rid of all of these 0:15:11.880 --> 0:15:13.720 skin cells once they're dead and done. 0:15:13.760 --> 0:15:14.120 All right. 0:15:15.280 --> 0:15:18.880 The biggest complication that we see is when this mechanism, 0:15:18.920 --> 0:15:21.360 for one reason or another doesn't go as planned, and 0:15:21.400 --> 0:15:24.480 so our ear wax builds up and gets stuck inside 0:15:24.520 --> 0:15:28.040 of our ear canals. And this is called serumin impaction. 0:15:28.880 --> 0:15:31.400 Why problem might that happen? Let me tell you. 0:15:31.440 --> 0:15:35.560 There's so many different reasons. It's probably the biggest ear 0:15:35.560 --> 0:15:38.080 wax complaints, certainly like that you see in primary care 0:15:38.480 --> 0:15:40.560 or things like that. There's lots of other things that 0:15:40.600 --> 0:15:44.080 you can get stuck in your ear canal, bugs and 0:15:44.200 --> 0:15:47.040 legos and other small toys very common. 0:15:47.280 --> 0:15:52.320 I feel like you have an ear invasion phobia. Dem 0:15:52.360 --> 0:15:53.400 I remembering that, correct. 0:15:53.880 --> 0:15:55.840 I love that you remember that and said it on 0:15:55.880 --> 0:15:59.480 a podcast for the world. I do. It's because of 0:15:59.560 --> 0:16:03.560 the wrath of con okay, okay. In the Wrath of 0:16:03.640 --> 0:16:06.840 con they put a little like alien guy in this 0:16:06.960 --> 0:16:10.800 is like the original star track of movie. They put 0:16:10.840 --> 0:16:12.920 a little alien like mind control guy. And then in 0:16:13.040 --> 0:16:16.480 Anamorphs that's also how they control or something. Is that 0:16:16.480 --> 0:16:19.600 what they're called? Wow, something like that. Did you know 0:16:19.680 --> 0:16:21.800 they're making a series, Eric, I do know that. 0:16:21.960 --> 0:16:24.240 I am very excited about it, so excited about and 0:16:24.240 --> 0:16:26.200 I'm also nervous because like those books. 0:16:26.000 --> 0:16:27.840 Were very dark, I know. 0:16:28.480 --> 0:16:30.480 So we'll see how it goes, so we'll see what happens. 0:16:31.120 --> 0:16:34.240 But anyways, so yes, I do have a phobia of 0:16:36.400 --> 0:16:40.520 like mind control creatures being put specifically. 0:16:39.800 --> 0:16:41.480 I just figured it was like any bug. 0:16:42.440 --> 0:16:44.280 I mean, yeah, I don't like the idea of anybody. 0:16:44.280 --> 0:16:46.480 I've taken some cockroaches out of ears, and it's not 0:16:46.520 --> 0:16:49.280 like a pleasant experience for the person who has the 0:16:49.280 --> 0:16:50.560 cockroach in their ear. 0:16:51.440 --> 0:16:56.920 Sorry, I regret going down. It's well, it's. 0:16:56.800 --> 0:17:01.160 Not it's not great, okay, But anyways, ear wax much 0:17:01.160 --> 0:17:04.160 more common to get stuck in your ears than other things, 0:17:05.119 --> 0:17:09.399 and the biggest issue that can happen from this is 0:17:09.440 --> 0:17:13.520 that if the ear wax completely obscures your tympanic membrane, 0:17:13.560 --> 0:17:15.880 which is the thing that separates your outer ear from 0:17:15.920 --> 0:17:18.560 your middle ear, and this is like the membrane that 0:17:18.600 --> 0:17:22.480 allows us to hear. Then, not only can this be 0:17:22.640 --> 0:17:25.600 very uncomfortable, it can create the sensation of fullness, it 0:17:25.600 --> 0:17:29.200 can be very itchy, but it also can cause hearing loss. 0:17:29.280 --> 0:17:31.560 Right if you completely block the thing that we use 0:17:31.640 --> 0:17:35.760 to hear, you can have substantially diminished hearing. And it 0:17:35.800 --> 0:17:39.440 can really exacerbate tintous or that ringing in your ear 0:17:39.480 --> 0:17:42.000 tonitics some people call it. I have that. 0:17:42.240 --> 0:17:44.320 Yeah. It also could set you up. 0:17:44.280 --> 0:17:46.919 For an ear infection because you're obviously blocking a tube, 0:17:47.520 --> 0:17:49.600 which anytime you do that can set you up for 0:17:49.600 --> 0:17:53.000 an infection. So this can happen for a few different reasons. 0:17:53.119 --> 0:17:56.160 Number one, if you just have very tight or very 0:17:56.240 --> 0:18:00.280 like snaky shaped ear canals, then you might be more 0:18:00.280 --> 0:18:02.639 prone to getting those blocked. So we might see this 0:18:02.880 --> 0:18:05.800 in small children who have smaller ear canals that they 0:18:05.880 --> 0:18:08.879 might have be more likely to get ear wax built up. 0:18:09.200 --> 0:18:12.200 Or if for whatever reason developmentally you have a different 0:18:12.240 --> 0:18:15.119 shape of ear canal, or if you just happen to 0:18:15.119 --> 0:18:16.800 be a person who makes a lot of ear wax 0:18:16.960 --> 0:18:19.120 and I don't have any statistics on who you are 0:18:19.240 --> 0:18:22.880 compared to anyone else. Yeah, So the biggest modifiable risk 0:18:22.880 --> 0:18:26.320 factors are using things like cotton swabs that you stick 0:18:26.320 --> 0:18:27.159 in your ear aus in. 0:18:27.320 --> 0:18:30.400 Don't use them because using them will lead to impaction. Yeah. 0:18:30.480 --> 0:18:33.360 Not only can they push the ear wax further in, 0:18:33.400 --> 0:18:35.639 which can lead to impaction, they also can create little 0:18:35.640 --> 0:18:37.919 microabrasions in your ear canal which can put you at 0:18:38.000 --> 0:18:42.240 risk for infection. Also, hearing aids or all of the 0:18:42.280 --> 0:18:45.200 earbuds that we use now, they just shove stuff down 0:18:45.320 --> 0:18:46.080 into your ear. 0:18:46.720 --> 0:18:47.520 Yeah. 0:18:47.560 --> 0:18:49.439 And then, like we talked about, as we get older, 0:18:49.480 --> 0:18:53.200 our earwax gets drier, which can make it sometimes more 0:18:53.320 --> 0:18:55.719 likely to get stuck. But also the hairs that we 0:18:55.800 --> 0:18:58.200 see in the outer, like the very outer part, can 0:18:58.280 --> 0:19:00.679 just prevent all that earwax from leaving. So we actually 0:19:00.680 --> 0:19:04.119 see even though your ear canals are larger when you're older, 0:19:04.200 --> 0:19:08.439 we see more impaction in older adults than we do 0:19:08.560 --> 0:19:11.159 in younger adults or children. Wow. 0:19:11.520 --> 0:19:20.840 Yeah, m hm. How do you manage impaction removal? How 0:19:20.840 --> 0:19:23.440 do you manage You're not supposed to use cotton swabs, 0:19:23.440 --> 0:19:24.640 So don't use cotton swabs. 0:19:24.640 --> 0:19:29.520 This is not a medical advice podcast, but please Yeah, 0:19:29.720 --> 0:19:33.480 if it's impacted, like if you have true serumin impaction 0:19:33.560 --> 0:19:36.040 in your ear, then usually you're gonna need a little 0:19:36.080 --> 0:19:38.480 bit of help to get it out, though not always so. 0:19:38.680 --> 0:19:41.080 In the office, we might use something that's like a 0:19:41.200 --> 0:19:44.639 spray bottle with a special hose nozzle on the end 0:19:44.640 --> 0:19:46.879 of it that we can stick just far enough but 0:19:46.960 --> 0:19:49.600 not too far into your ear canal and spray warm 0:19:49.680 --> 0:19:53.280 like lukewarm water, sometimes with hydrogen peroxide because the bubbles 0:19:53.320 --> 0:19:56.040 can help, and you just spray spray spraying until you 0:19:56.080 --> 0:20:02.520 can dislodge that thing. It's really really satisfying, like so satisfying. 0:20:02.600 --> 0:20:04.520 Sure videos exist on the internet. 0:20:04.640 --> 0:20:09.840 Oh yes, definitely. Sometimes we might use like a curette 0:20:09.960 --> 0:20:13.280 or something, or there's like little vacuum aspirators that, like 0:20:13.359 --> 0:20:16.080 the ant specialists might have to really suck it out, 0:20:16.119 --> 0:20:20.240 depending on how it's in there or at home. There's 0:20:20.280 --> 0:20:22.359 actually a lot of things that people can do that 0:20:22.520 --> 0:20:26.040 are safe to not only help to soften up something 0:20:26.080 --> 0:20:28.520 that might be stuck, but also just help get rid 0:20:28.600 --> 0:20:30.680 of earwax if you feel like you have too much 0:20:30.680 --> 0:20:33.080 of it. Though again, your ears are a self cleaning oven. 0:20:33.119 --> 0:20:34.840 That's going to do it all on their own without 0:20:34.840 --> 0:20:37.640 your help. But over the counter remedies might be even 0:20:37.720 --> 0:20:40.280 just putting water or like saline drops in the ear 0:20:40.280 --> 0:20:44.000 which can help to soften up dry ear wax, hydrogen 0:20:44.040 --> 0:20:47.880 peroxide or there's similar drops that are made of carbamide peroxide. 0:20:47.880 --> 0:20:51.399 That's like d Brox brand drops in the pharmacies here. 0:20:51.840 --> 0:20:54.479 Those basically just help to soften and the bubbles can 0:20:54.560 --> 0:20:56.480 kind of help to loosen up some of that wax 0:20:56.480 --> 0:20:58.359 so that it can come out on their own. Some 0:20:58.400 --> 0:21:01.920 people might use mineral oil, which is totally safe to use, 0:21:02.400 --> 0:21:04.960 but in general, the goal is just to keep that 0:21:05.040 --> 0:21:07.800 ear wax soft enough that your ear can do its 0:21:08.000 --> 0:21:11.359 job of getting it out on its own. Ear candling 0:21:12.680 --> 0:21:14.440 is a thing I want to mention real quick because 0:21:14.480 --> 0:21:17.320 you heard about it in our first hand accounting. The 0:21:17.480 --> 0:21:20.600 claim apparently on how it works is that it creates 0:21:20.600 --> 0:21:24.000 a negative pressure in your ear canal to draw out 0:21:24.040 --> 0:21:24.640 the wax. 0:21:26.119 --> 0:21:27.520 I did not know that was the claim. 0:21:27.680 --> 0:21:32.000 Apparently that's the claim. It also apparently is supposedly this 0:21:32.080 --> 0:21:34.879 negative pressure also helps to treat other non ear wax 0:21:34.920 --> 0:21:39.000 related things like allergic rhinitis or like sinus pressure in general. 0:21:40.440 --> 0:21:43.040 So notwithstanding the fact that you can legitimately just be 0:21:43.080 --> 0:21:46.160 setting yourself on fire, as you heard in our first 0:21:46.160 --> 0:21:48.560 hand account, you can also end up with wax that 0:21:48.680 --> 0:21:51.360 is not the ear variety, the candle variety, that gets 0:21:51.359 --> 0:21:55.359 stuck in your ear, which can potentially cause really serious 0:21:55.400 --> 0:21:59.320 damage to the tympanic membrane. And not only is there 0:21:59.640 --> 0:22:02.520 no evidence in the literature that it works, there is 0:22:02.640 --> 0:22:06.240 actually at least one study that shows that it does 0:22:06.320 --> 0:22:10.920 not work and actually creates deposits of candle wax even 0:22:10.960 --> 0:22:14.040 if you don't have like visible candle wax. Like in 0:22:14.080 --> 0:22:16.160 our first hand account, it was obviously like a big 0:22:16.200 --> 0:22:20.800 deal chunks got stuck. But even in this other study 0:22:20.800 --> 0:22:23.919 there was just like deposits of like debris from the 0:22:23.960 --> 0:22:28.960 smoke and the wax in the ear without removing any 0:22:29.000 --> 0:22:30.199 wax whatsoever. 0:22:31.480 --> 0:22:33.720 So you're just start adding gunk to. 0:22:33.640 --> 0:22:36.880 Your ear, to your ear without removing any actual ear 0:22:36.880 --> 0:22:40.960 wax whatsoever. Also, no negative pressure was created in this study. 0:22:41.040 --> 0:22:42.960 They used like a fake ear canal and they put 0:22:43.000 --> 0:22:45.000 an ear candle in it and they measured the pressure. 0:22:45.280 --> 0:22:48.480 No negative pressure differential created, and they found all of 0:22:48.520 --> 0:22:52.240 this like just stuff that was deposited in the ears, 0:22:52.760 --> 0:22:54.399 I mean, without getting any ear wax out. 0:22:54.640 --> 0:22:57.439 So it seems like there's no there seemed to be 0:22:57.480 --> 0:23:00.320 no clear benefits whatsoever. Benefit just the well on the 0:23:00.320 --> 0:23:03.320 list of cons and potentially severe. 0:23:03.240 --> 0:23:10.240 Outcomes, severe outcomes, and that is Aaron earwax beautiful. 0:23:10.720 --> 0:23:14.360