Monday, September 15, 2014

September 15, 2014 Monday


Exostosis

"Exostosis," it's called Exostosis. Surfer's ear is Exostosis.

This morning I took care of my Surfer Ear problem. Dr. Romero Agbayani using a 1-millimeter chisel operated on my left ear to remove the boney material that had developed in my ear canal. At Marin General Hospital, his team put me to sleep, operated for two hours, claimed the operation was a success and released me in the afternoon. I walked out with a small sponge taped inside my ear canal, a bottle of eardrops and some antibiotics for good measure. I was told to keep it dry and to return in a week to see how it was doing. With luck I would be back in the water in three weeks.

Per Wikipedia, "exostosis is the formation of new bone on the surface of a bone, because of excess calcium forming...It is most commonly found in places like the ribs, where small bone growths form, but sometimes larger growths can grow on places like the ankles, knees, shoulders, elbows and hips."

Again from Wikipedia, "Surfer's ear is the common name for an exostosis or abnormal bone growth within the ear canal. Surfer's ear is not the same as swimmer's ear, although infection can result as a side effect. Irritation from cold wind and water exposure causes the bone surrounding the ear canal to develop lumps of new bony growth, which constrict the ear canal. Where the ear canal is actually blocked by this condition, water and wax can become trapped and give rise to infection. The condition is so named due to its prevalence among cold water surfers...Most avid surfers have at least some mild bone growths (exostoses), causing little to no problems. The condition is progressive, making it important to take preventative measures early. The condition is not limited to surfing and can occur in any activity with cold, wet, windy conditions such as windsurfing, kayaking, sailing, jet skiing, kitesurfing and diving."

Other interesting facts from the California Ear Institute -

  • Will exostosis improve if left untreated? No. The bone growth is irreversible once formed.

  • In general one ear may be much worse than the other. If so, this may be due to the prevailing wind direct direction in the areas most visited by the patient.

  • The widespread use of better wetsuits has allowed people to participate in water sports in much colder water, likely increasing the incidence and severity of exostosis.

  • Cold-water surfers experience exostosis at a rate 600% higher than warm water surfers. The colder the water, the quicker exostoses grow.

Of course I knew none of these facts in the 30 years of surfing leading up to this operation. My hearing had been fading; a condition Kate often reminded me of. I had a family history of poor hearing; both my father and brother had worn hearing aids for years. So every six months I was going to the ear doctor to have my hearing tested and ears cleaned. And every time, the doctor reminded me that I had surfer's ear in both ears and that my left ear was really bad.

"Loren, your left ear canal is over 95% shut." Dr. Agbayani finally put it to me bluntly, "When it closes down, your hearing will be severely impaired, and if you get an ear inflection, I will not be able to help you." That did it, I signed up for the operation.

FYI...Dr. Agbayani is the only doctor in Marin that does this procedure. He has done over 100 of them, all for surfers. He did a good job, I highly recommend him.

He reminded me several times that removing the bony material does not cure the condition. It can grow back, and thus I have to protect my ears while in the water. I discovered that a couple of close friends have also had the surfer ear ream job. My close friend and long time surfer buddy Greg has had the operation twice, and he urged me to get it done. Our Bolinas clan surfer, Rob (Mr. Malibu) first had it done in the year 2000 and then again in 2013. Lesson learned; I'm using earplugs every time.

I had the complete ear overhaul this summer. While getting ready for the exostosis operation, Kim Zeller Hoppin of the Marin Hearing Center tested and fitted me for hearing aids. Kim also was alarmed at the bony build up in my left ear. With her nano camera mounted on a thin wire, she gave me an inside view of my ear canal, that's the before view on the left in the above photo taken last July and the post operation view on the right taken in October. So now I'm ready for any noisy restaurant due to my new hearing aids and the Roto-Rooter job on my left ear canal.

All you Marin surfers, take it from me, protect your ears and get them checked. 

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