[Zankou]

19. What is cauliflower ear, and how do I fix it?

What it is:

Cauliflower ear is term commonly used to describe the appearance of an ear that has had a perichondrial hematoma. This occurs when the ear is struck, hit, or excessively and abrasively rubbed. The skin on the ear tears away from the underlying cartilage. The perichondium, which supplies nutrients to the cartilage, is also ripped off of the cartilage. If left untreated, the cartilage will be starved of nutrients and die. The blood and puss that filled the gap when the skin was torn off of the cartilage will harden and leave a cauliflower like appearance.

How it happens:

Cauliflower ear occurs when the ear receives a hard strike, or is grinded against for extended periods of time. This is why it is so common among combat athletes and rugby players. In rugby, when tackles occur, the ear can be hit against the athlete being tackled, resulting in cauliflower. In jiu jitsu and wrestling, the ear can not only be struck hard (for instance: during a takedown, your ear hits his hip bone), but also abrasively rubbed (escaping from chokes, headlocks etc…). Some people are more susceptible to cauliflower.

Treatment:

Multiple treatments are available for cauliflower ear. It is possible to have cauliflower ear surgically fixed after it has hardened. This operation is typically quite expensive and is performed by a plastic surgeon or ENT. If you don’t want to do that, then you must treat cauliflower ear as soon as possible. If you leave it for a while(more than about 5-7 days), it will harden and the only way to fix it is the above described treatment.
The most common treatment is to drain the fluid using a syringe (I will go into detail later). Sometimes you hear horror stories about doctors who have never treated cauliflower ear and are not sure how to go about doing it. There are many accepted ways for doctors to treat cauliflower ear. One way to treat it is to have the ENT lance the front of the ear and scrape/suck all the gunk out. After all of the debris is out of the ear, the ENT should bolster the ear. To do this, he/she will put a piece of gauze or a cotton roll on each side of your ear, front and back. The doctor will the sew through the gauze. This keeps the perichondrium attached to the cartilage in the ear, allowing the cartilage to continue living.
The easiest way to treat cauliflower ear is to simply drain it with a syringe. Below is a step by step guide for draining cauliflower ear. Once again, I take no responsibility for any damage or harm you do to yourself or your ear by following the directions below. You do so at your own risk. I highly recommend getting cauliflower ear treated by a doctor so that the risk of infection is lower. The ear doesn’t have a lot of blood flow and is at a higher risk of infection. Only your doctor can prescribe antibiotics.
1. Take a shower. Be sure to wash your hair, ear, and the area surrounding your ear very well. It may be a little painful to touch the ear, but at least run some water over it for a while. You want these areas to be particularly clean so that you lower the risk of infection.
2. Clean the ear. I have used Hibiclens in the past with good results. It is a surgical grade antiseptic skin cleanser. CAUTION: Do not get Hibiclens in your ear. Pour a little Hibiclens on a cotton swab and wipe the ear with it. Let it sit for a few minutes, then wipe it off using water. You can also use alcohol prep pads. Just wipe the ear with the alcohol swab or prep pad and let it sit for about 20-30 seconds.
3. Now you need to stick the syringe in the ear. Insert the syringe at an angle into the area that has cauliflowered. Insert the needle in the front of the ear, not the back. Pull back the plunger of the syringe a little bit. You don’t want to pull back too much at first. This should start a trickle of blood flow into the syringe. If the flow of blood and puss stops, give the plunger another little pull. Keep repeating this process until the ear has completely drained. If you fill up a syringe, DO NOT SQUIRT THE BLOOD/PUSS OUT AND REUSE THE SAME SYRINGE. Make sure you have another unused, sterile syringe on hand. Simply cap and set aside the filled syringe insert and use the new one in the same manner as the first. When you are done, and the ear looks normal, cap the syringes. You should dispose of them properly in a sharps container. Wipe the ear down with another alcohol swap after it is drained.
4. Sometimes (if you’re lucky) the ear will simply look normal after draining and will not refill. It is best to not take the chance of it refilling (and you having to repeat the above process again). To do this, you will want to make a compression bandage. To do this, take a bunch of gauze, or a cotton roll, and fill the outer crevices of the ear with it. Then use tape (paper tape or cloth medical tape works best) and tape the ear. Hold it down (pinch your ear, thumb in back, forefinger on front) for about 5-10 minutes. This will keep the perichondrium attached to the cartilage and is vital if you want your ear to be normal again.
5. Change the compression bandage often and if the ear refills with blood and puss, just repeat the process. Sometimes it will refill multiple times, but usually with less and less blood each time. Eventually, it should look pretty normal.

Prevention:

Many people have jobs where cauliflower ear is unacceptable. An ounce of prevention is worth more than a pound of cure - if you don’t want cauliflower, wear headgear. It’s cheap and easy. In my opinion, the most comfortable headgear is made by Cliff Keen. Try either the Tornado, Twister, or Signature model.

20. How do I cut weight for a tournament?

Step 1 Follow Berardi's 7 habits! Especially in season. They are as follows:

Habit 1: Eat every 2-3 hours.

Habit 2: Eat complete, lean protein with each feeding opportunity.

Habit 3: Eat vegetables with each feeding opportunity.

Habit 4: Eat veggies/fruits with any meal. Eat "other carbs" only after exercise.

Habit 5: Eat healthy fats daily.

Habit 6: Don't drink beverages (soda, beer, etc.) with more than 0 calories.

Habit 7: Eat whole foods whenever possible.

Habit 8 is drink lots and lots of water. If you're already dehydrated, how are you going to cut any water weight? Sticking to the 7 habits will take care of 80% of most people's cutting problems.

Step 2
As competition nears, caloric restriction is necessary. A calorie IS NOT a calorie, but you can't stuff yourself with 4000 calories and expect to drop 20 pounds in a month. Calorie amounts do vary for different people, so find what works for you. You should be dropping roughly 2 pounds per week in fat if you're dieting properly. Remember to keep hydrated, and increase your water intake as you reduce calories, both to combat hunger and to keep healthy. You should of course be doing cardio to speed your weight loss. Remember to take your multivitamin and fish oil.

Step 3
The week before a competition (two if you have a lot of weight to lose) is the time drop the carbs, which will speed up fat loss and give you a nice drop in water weight as well. This is not Atkins, so don't try gobbling bacon, sausage, cream, etc. Your caloric intake should consist of vegetables, lean proteins, and some healthy fats such as fish/flax oil. Increase water intake further, try to get above two gallons a day. Add extra cardio. Long distance cardio on an elliptical or bike is a good choice as it is good on the knees.

Step 4
3 days out from the competition, switch to distilled water and drink only as much as you you're thirsty for, some where just south of one gallon. Further reduce your food intake by cutting down to 3, possibly 4 meals a day of fibrous veggies and extra lean protein such as egg whites, chicken, and fish. Now is the time to add a fiber supplement such as benefiber, (a natural laxative) and dandelion root (a gentle diuretic). Keep up with the fish oil and a multi, as it will be needed. Continue with cardio.

Step 5
The day of the weigh in. Drink very little water, only as much as you absolutely need Depending on whether you are within 3 pounds of your target weight, either keep your food the same, or further reduce caloric intake by lowering your protein. Eat only 2-3 meals this day, mostly veggies, a hard boiled egg or two, and a little chicken, and take your vitamins. Eat your last meal and drink your last water at least 12 hours before the weigh-ins. You should be within 2 pounds of your target weight at this time. If you are not, this is the time to sweat it out. Cut arm holes in a trash bag, put on some sweats and do low intensity cardio like riding an exercise bike. The sauna is another option.

*CAUTION- if have to sweat excess water out, you've fucked up somewhere along the way. This is okay once, maybe twice, because cutting weight is a learning experience and rarely exact, but making a habit of sweating water weight the night before a competition is unacceptable. The drastic dehydration measures taken by many not only lead to health issues and possibly death, they kill your performance.

Step 6
After the weigh-ins. Sip a recovery drink such as Accelerade, Pedialyte, Surge, etc. immediately afterwards. Eat normal, non aggravating foods and lots of slow release carbs; eat foods like apples, bread, nuts and turkey. Eat small healthy meals, every 2 hours until competition, and drink plenty of fluids. Sports dinks are a good product for rehydrating at this time.

Step 7
DON'T BINGE! You've made your weight, now stay within ten pounds of it throughout the rest of the season, 15-20 if you're a fighter.