A few years ago I was listening to a podcast of a bunch of East Coast dudes talking about Muay Thai. They were laughing about how people who don’t know anything about the sport will ask what belt grade a fighter is (for those who don’t know, outside of individual gyms there are no grading systems of colored belts, prajaet, shorts, etc.) and concluded that for western boxing the mark of a fighter is Cauliflower Ear, but for Muay Thai it’s scars on the eyebrows from elbows. At the time, I hadn’t had any cuts at all but was probably 30 fights into my career. Now I have nearly 100 stitches in my overall count.
Fast forward a few years and I’m waking up from my sleep a million times per night due to the aching pain of my Cauliflower Ear. Yeah, Muay Thai fighters get it, too. My own trainer here in Pattaya, Pi Nu, has noticable disfigurement on his left ear from his years as a fighter. He says it came mostly from clinching with his own older brother (they’re 14 months apart, so the sibling rivalry must have been amazing), and clinching is where mine has come from as well. And, just like Pi Nu, it’s only on the left ear. I can tell that Pi Nu is embarrassed about the disfigurement of his ear – Thai culture is heavily judgemental on appearance – but that he’s also a little proud of it. Probably he had to grow into the pride, now that he’s older, married and the father of two sons rather than a young playboy. His ear isn’t really that bad – again, noticeable but not anything near what you see on wrestlers or MMA fighters. Ever since I noticed Pi Nu’s Cauliflower Ear, I’ve noticed it on many other fighters as well. Rambaa Somdet has it pretty good on both ears, although he had an MMA career so that makes sense. But I was very surprised to see a tiny little bit of it on Dieselnoi – who is such a tower of a man I can’t imagine anyone got a grip on his head at all – and again only on the left ear. You’d never notice it unless you were looking for it. I was looking.
This is actually the second time I’ve had it, but it will be the first time it’s permanent. The first time was pretty mild and I just felt the ache and a little puffiness in the ear, which I could squish between my fingers. I showed it to Pi Nu and he, in his fashion, grabbed it firmly between his fingers and gave it some hard, unsympathetic pulses before telling me it was too mild to bother with and I should just put some Hirudoid cream on it (a topical cream used to break down keloid tissue and reduce scarring). I did so and it went away. That was over a year ago when I had first started training clinch with gloves. My training partners wore gloves too and the wrist part grinding on my ear is what did the damage. But my training partners stopped using gloves, so the damage to my ear stopped as well. This year I was training for a big fight against the best female fighter in the world at my weight (and definitely top 5 pound-for-pound), Loma Lookboonmee, who tosses me around in the clinch. So I was clinching a lot and working with Rambaa, who is close to my size but much stronger and heavier, to get used to that kind of pressure. I’m not sure when the swelling started, meaning I don’t know if it was the collective increase in clinching or whether one person started the bubble and everything else just added on top of it, but pretty soon I had a good little balloon going in my ear. It got big enough that I couldn’t hold the phone against my ear on the left side, everything hurt it, and I couldn’t sleep on that side either. When I showed it to Pi Nu, asking if it was ready to drain, he frowned and mercilessly pinched at it with his fingers before nodding and saying, “yes, you can take out.”
My left ear after already draining twice, just starting to puff up again; my right ear being normal for comparison. (And, yes, I used to have gauged ears, which is why my lobes look a little weird.)
I can’t tell you how amazingly painful Cauliflower Ear is. It’s just fluid building up in the ear, but because it’s swollen and on the side of your head, anything that touches it causes this amazing, wincing pain. I’ve got high tolerance for pain and this was driving me crazy. I was a real sissy about it. So I was really eager to get Pi Nu to drain it for me, just to be able to sleep at night. For a long time he refused, saying to wait until after my fight because it will swell back up after you drain it so it’s better to have a few days off from clinching and punching when you’re going to empty it. With no perfect time in sight, at long last he agreed to drain it. I brought him a syringe and he took a particular, stoic delight in setting about as the expert ear-drainer. It was in the morning and a few of the boys came outside to watch the process; a few of the women peeked around the corner from the doorway and then disappeared in horror at the whole thing. Bank, Pi Nu’s 16-year-old son, stood directly in front of me munching on a bag of chips while he watched the ordeal. I daydreamed about not having a damn giant blister jamming up my ear anymore.
my vlog about the draining, above
With the syringe full of pink liquid, Pi Nu stepped back with pride and then taunted his sister-in-law and wife by waving the grotesque vile in front of them. Then he cleaned my ear and told me to hold a piece of cotton against it, which I did and was so relieved to feel space where there was that squishy lump before. Remember that scene in Lady and the Tramp when the beaver gets the muzzle off of Lady and she kind of rolls her snout to feel that the muzzle really truly is gone and with utter relief sighs, “it’s off!” That was me, a perfect Lady. I went home and stuffed a silicone blob into my ear (re-purposed, the silicone is as an earplug), just over the canal, to keep the area flat that had just been drained so it wouldn’t just balloon back up. The blob ultimately blocked my ear canal anyway when it was taped in place, so I couldn’t really hear out of that ear, but I was still so relieved to have it drained. I fought that night, which meant taking off the silicone blob and a few hours after the fight when I was in my hotel room the area of my ear was far too swollen to put the blob back on. I had to drain the ear again the next morning, this time getting significantly more fluid out than Pi Nu had done and this time it was far more red than the pink in the first drainage. But I put the silicone blob back in place and left it totally untouched for a couple days. (Note: Pi Nu is very experienced at draining Cauliflower Ear, so I trust him. I’m not experienced at it in the least, but I’ve drained my scalp in a similar fashion from some stitches that went awry. Basically, don’t try this at home unless you are comfortable in your abilities to administer medical procedures on yourself – or trust in whomever is helping you – because infection is a serious risk.)
To drain the ear you have to have a significant “pillow” of fluid. When you squish it between your fingers it should have some give to it and, quite honestly, I thought it was ready to drain a long time before Pi Nu thought so. Which means you might be very irritated by a very small swell but actually being able to drain something requires more discomfort than feels tolerable. Other than watching Pi Nu, I also YouTubed the hell out of this before it did it myself. Disinfect the entire area with rubbing alcohol, then feel around on the puffed up area for a thick part. When Pi Nu drained my ear, he first stuck the needle into an area that didn’t produce any fluid and he ended up trying again in a different area, which produced a lot of fluid. So, try not to have to be stuck a bunch of times but also don’t give up immediately if one spot doesn’t work. When I did it myself, after it re-swelled, I used my finger to squish the pillow of skin around and went for the lowest, thickest spot. Insert the needle at an angle that is more parallel than perpendicular – meaning, don’t jab it in from the side but kind of angle it in from above or below – and slowly pull at the plunger. You might need to move the depth of the needle a little bit to really start the fluid coming. Try to get all of the fluid out that you can before removing the needle, then re-disinfect the area with another alcohol swab before applying whatever pressure source you have (magnets or tape or whatever) to fix the skin to the cartilage. If it’s still puffy the pressure won’t connect the skin to the cartilage. Again, if you need a visual you can search for videos of draining cauliflower ear on YouTube or illustrated examples online.
The magic magnet solution, improvised “McGyver” style as some folks on my FB page said
The problem with the blob is that it covers the area that’s been drained, but there’s no pressure from the back of the ear to really be pressing the skin down. So the area under the conch of my ear started filling up a little with that nasty fluid. I grabbed some cotton balls to buffer the plastic of a clothespin and pinned that around my ear like a vice, pinching the front and back together. That definitely felt like it was solving the issue but it was painful after about 2 minutes and I couldn’t sustain it. What you want, after you have drained the ear, is some sort of pressure that closes whatever small channel between the skin and cartilage that is allowing the fluid to re-accumulate, so it can heal. A guy who I met at Petchrungruang, Sean, commented on my Facebook page that there were these insanely expensive magnets used to press the ear after drainage, something called Caulicure, but I can’t afford the pricetag. But it was a good idea and so Kevin and I ripped the little penny-sized magnets off the bottom of his WiFi antennae and put one on each side of my ear – perfect. It still aches after a while, but I’ve adjusted by putting some cotton on either side, under the magnets, to kind of adjust the strength. I’ve had to drain the ear one more time, put some Hirudoid on the area and then put the magnets on directly after, which keeps it flat. So far, really good. I think I will ultimately end up with some keloid scarring and a very slightly deformed ear. I mean, I will have Cauliflower Ear. But it’s significantly reduced from what it would or could have been without the drainage and without the silicone blob and magnet approach. And yeah, I’m a little proud of it. My brother John was a wrestler in high school and a really good one at that. He made it to State and his hard work and experiences as a high school athlete (he also played soccer, ran track, was an astute student… total Captain America, that one) led him to a career as a Sports Psychology Ph.D. But he doesn’t have Cauliflower Ear. I do. Me and Pi Nu, and Rambaa and Dieselnoi… I’m writing here how to treat it, vaguely, and I’m happy that this process is minimizing the scarring and discomfort because, man – it is painful to train and fight with exploding ear pain – but I’m glad it’s not a total erasure. I’ve got scars on my eyebrows and Cauliflower Ear, and I earned all of them.
Some of my tools: a syringe for draining (these can be purchased OTC in Thailand, for insulin shots; I don’t know how you acquire them in other places but the plunger is important to draw the fluid out, as just a needle might make a hole and not actually result in full drainage), Hirudoid cream, my silacone blobs (these are ear plugs for swimming, also OTC at a pharmacy and I had them already from when my eardrums broke a few months ago), and the clothespin that didn’t work out so well. Not pictured: magnets (see the photo above), cotton squares, and lots of rubbing alcohol to disinfect everything.