PDA

View Full Version : Diving and Ear issues: Divers or Docs advice?


Nightfall
10-04-2010, 20:02
I tried to find something addressing this, but I didn't seem to come across anything. Lots of tinnitis and blown eardrums though. Something I would like to avoid.

My question is either for the divers here or the medical guys.

I've been going through SCUBA school and have been having problems with my right ear equalizing. My left seems to clear just fine. But twice now I've been tasked to go to the bottom to demonstrate skills (mask removal, reg removal, BC removal, neutral bouyancy, that type of thing), and my ear just will not equalize. Starts hurting at about 12ft. My instructor recommended taking an antihistamine and chewing gum before class. I intend to try this, but antihistamines make me drowsy however with 15+ hours of PT a week, just under 25 hours of work, and another 12 hours of classes, I'm already pushing the envelope, and I don't want to be doing something such as diving less than 100%. I experienced something similar when skydiving in the exact same ear, but it eventually equalized, I'm wondering if my ear will just equalize after a bit, but I don't want to do any lasting damage. I tried everything I could think of, blowing through my nose, rubbing the base of my jaw under my ear, chewing, and so on...

Any suggestions you divers or meds might have? Perhaps a trip to the Dr to get my ear canal cleared/checked out? I'm not even sure if that would even help as I'm unclear of the physiology involved. Regardless, I thought if anyone had any ideas, some of you might. I'd appreciate any advice. My openwater is in 3 weeks.

cold1
10-04-2010, 20:42
Diver here NOT A PROFESSIONAL anything. My wife had similar problems learning to dive. The Doc said try afrin 15-20 minutes before a dive. It cleared her.

Eagle5US
10-04-2010, 21:28
Understand that you are treating the problem in order to "get through" the course...but may not be addressing a physiologic abnormality that you may have that prevents you from adequately clearing.
What this translates into is you taking meds before your school dives, learning to do the same for your open water dives...and your meds running out while under water or on the boat prepping for boat dive #2 and you then failing to be able to equalize either on the way down or up.

My suggestion would be to utilize a mask with ear cups such as THIS ONE (http://www.amazon.com/Protection-Snorkel-Snorkeling-Authorized-Warranty/dp/B001L9MQ06) that connects the front portion of your mask (the eye portion) with your ear portion. Exhaling through your nose in order to equalize your mask during decent also equalizes the chamber around your ears...thereby preventing any sort of squeeze.

It may look goofy, but I have recommended these types of masks to multiple friends and have nothing but positive reports. And (gasp), my ex-wife used one for the three years we were in Hawaii without a single reported issue after almost not certifying due to ear equalization issues on decent.

Always remember - meds wear off. Always think...what then?
FIX the problem and you will be better off.

Good luck - hope this helps.

Eagle

craigepo
10-04-2010, 22:10
I have some fairly significant allergy problems, especially in the fall when the ragweed pollen is high.

I take some of the non-drowsy allergy meds. Works pretty well, lets me clear my ears, but I still have to descend pretty slowly during hayfever season. Taking the meds is much better than coming up and having blood coming out of my ears.

I don't have the allergy/ear problem diving in the Caribbean. Just doing freshwater stuff here in Missouri.

Pete
10-05-2010, 05:49
........while watching TV.

No really - you should be able to "clear" anywhere. Can you do it at the surface with no problem? Can you do it on the surface all the time or just some of the time?

If you can "clear" on the surface - and practice all the time - but can't clear at 12' maybe you'll need to start clearing at 2'. If you can feel the pressure it may be too late.

PedOncoDoc
10-05-2010, 06:41
I have similar problems when SCUBA diving. Did you have a lot of ear infections or get ear tubes because of infections as a child? If so, you may have an under-developed eustachian tube (opening attaching the middle ear to the back of the throat which allows for pressure equalization.)

I have to blow very forcefully in order to get one of my ears to equalize and I hear a squeaking noise when I finally get it to normalize.

Otherwise, the allergies/inflammation are a pretty good bet. You may want to see if you can visit an ears/nost/throat (ENT/otolaryngologist) for evaluation regardless.

HTH...

swatsurgeon
10-05-2010, 09:25
Make an appointment with an ENT doc and make sure there is no anatomic reason the ear won't clear, i.e. a polyp in the nose that is blocking the eustachian tube, etc
All of the responses have been a temporary fix...not a good solution.

ss

Peregrino
10-05-2010, 09:54
Good advice all around. Start with what Pete said - clear early and often. If you can't clear on the surface, you won't be able to clear under pressure. (The eustacian tube is collapsible, too great a pressure differential and it "locks" - you'll never clear it without reducing pressure.) Stressing or rupturing your eardrums is non-habit forming. Breath hold diving is more difficult than SCUBA WRT clearing recalcitrant ears. All medications only provide temporary relief, some also have a dependancy factor or cause a rebound effect (Afrin is one of the worst). If using a decongestant - NOT RECOMMENDED - stick with 12 hr delayed release versions. Side effects tend to be less and the chances of wearing off during the dive are reduced. Check with a competent diving medical expert to verify side effects ICW diving - pressure, especially in excess of 3ATM causes strange interactions that get worse the deeper you go. DAN offers the information with a phonecall. Anything else requires medical intervention. Scar tissue from childhood infections, abnormal eustacian tubes, polyps (usually a factor in sinus squeezes), etc all require examination by an EENT specialist. They are the only ones qualified to offer diagnosis and possible resolution to a chronic problem. Or you can find another, equally expensive hobby, lift and shift, and try something that doesn't depend on equalizing pressure in your ears.

doctom54
10-05-2010, 21:46
For temporary use only.
Sudafed 30 mg 2 tablets every six hours (antihistamines will not help with keeping the eustachian tube open.)
Afrin 2 sprays every twelve hours.
If you need to see the medic/doc as for a Medrol dosepak.
Finally once you are finished with the course get an appointment to see an ENT.
Follow Pete's advice and good luck in the class

ZonieDiver
10-05-2010, 23:38
But, above all, seek out medical advice to find the root of the problem - if there is one.

Do NOT be like the multitude of new divers I regularly see who use Sudafed/Afrin/Fill-in-the-Blank as a prophylactic pre-dive ritual.

I'm ashamed to say, as a long-time OWSI, that all too often, this failure to clear is the result of poor instructional technique, and a rush through training. While instructing in Denver, during weekend trips to the Blue Hole, in Santa Rosa, NM- students would ask when they should start clearing. I'd say, "About Raton..."

T-Rock
10-10-2010, 04:48
All medications only provide temporary relief, some also have a dependancy factor or cause a rebound effect (Afrin is one of the worst). If using a decongestant - NOT RECOMMENDED - stick with 12 hr delayed release versions. Side effects tend to be less and the chances of wearing off during the dive are reduced

X1000

FWIW, although uncommon, I observed firsthand two round window ruptures from reverse squeeze brought on by the rebound effect - one in Dive school, and another while working with the NCDOT. Both were friends who relied on Afrin. Both were booted from diving...

FWIW, practice clearing till it can be easily done with a simple flick/movement of the mandible, tongue and throat muscles - research the Frenzel Maneuver - once you master it you won't have to pinch your nose.

> http://www.freedivingfinland.net/index.php?Itemid=12&catid=9:physiology-of-a-freediver&id=275:the-frenzel-technique&option=com_content&view=article

Good Luck!!

ohboy
10-10-2010, 13:19
Per Eagle5US, ZonieDiver & T-Rock: similarly advise against decongestants. Higher chance of reverse block during ascent.

For now, IMO, Pete's advice is solid - equalize early and often, BEFORE it becomes an issue. Recommend you do so at-surface and continuing every 2 ft of descent. Just hug that line and get it done.

As far as techniques go, begin with pinching nostrils shut while blowing out, gently but firmly. Never should you blow hard - instead, ascend 2-3 ft back up the line and work it out from there. I'd also recommend trying swallowing, with or without nose pinched.

Good luck and stay focused during your buoyancy exercises.

swatsurgeon
10-10-2010, 16:48
Per Eagle5US, ZonieDiver & T-Rock: similarly advise against decongestants. Higher chance of reverse block during ascent.

For now, IMO, Pete's advice is solid - equalize early and often, BEFORE it becomes an issue. Recommend you do so at-surface and continuing every 2 ft of descent. Just hug that line and get it done.

As far as techniques go, begin with pinching nostrils shut while blowing out, gently but firmly. Never should you blow hard - instead, ascend 2-3 ft back up the line and work it out from there. I'd also recommend trying swallowing, with or without nose pinched.

Good luck and stay focused during your buoyancy exercises.

ohboy,
your medical or practical expertise is in what field?
Look at the contribution you just made/posted.....and think, did you do this to add something new or just to post.....we attempt to keep medical both practical, applicable and valid interms of experience (i.e. in this thread: master diver, doc, PA with experience, SEAL, QP, etc............)

Post when the info meets the above criteria please. Simple is sometimes the best way but based on what has already been stated, you need to post above and beyond it to have it impart a difference in the medical care/treatment/diagnosis/discussion.
Thank you for your attempt.....advice done.

ss

The Reaper
10-10-2010, 16:53
Per Eagle5US, ZonieDiver & T-Rock: similarly advise against decongestants. Higher chance of reverse block during ascent.

For now, IMO, Pete's advice is solid - equalize early and often, BEFORE it becomes an issue. Recommend you do so at-surface and continuing every 2 ft of descent. Just hug that line and get it done.

As far as techniques go, begin with pinching nostrils shut while blowing out, gently but firmly. Never should you blow hard - instead, ascend 2-3 ft back up the line and work it out from there. I'd also recommend trying swallowing, with or without nose pinched.

Good luck and stay focused during your buoyancy exercises.

Did you read the sticky at the top of this forum, Mr. I'm Not Going to Post Very Much?

TR

ohboy
10-10-2010, 21:52
SwatSurgeon:

Understood - my post did NOT match the criteria and this forum is no place for the unqualified to dispense casual advice. Will not happen again.

The Reaper:

Sticky read. No excuse, just lack of awareness. Future posts will follow all guidelines. Back to observing.

Nightfall
10-11-2010, 12:10
Well you guys are a wealth of knowledge as usual. Thanks again.

I went to see the Doc, he didn't find anything wrong other than a slight sinus infection, but nothing serious or that would cause a problems clearing. He did say that the Medrol Dosepak was an excellent idea. So he prescribed that in case everything wasn't resolved prior to my open water, as well as advised as previously stated that the Afrin and Sudafed should resolve any temporary issues I might experience until my head clears. This is all combined with an antibiotic to clear out those pesky sinuses. Apparently a diver himself, he mentioned that common ear plugs may also help in the meantime, if for no other reason than the air that would be trapped is less dense than water and would reduce some of the pressure in the pool (not so much for the open water, hard bottom I believe is 60').

That mask with the ear protection is pretty sweet by the way, I've never seen one of those.

And yes I agree, this is a really expensive hobby. I was actually doing this to make myself a bit more marketable in the military, perhaps a silly notion, but I figured the more certs I could get prior to my ship date, the better. Either way, it was an excuse to learn to do it just for the fun as well. I failed to note the expense though. Everytime I think I've got all the gear I need, something else comes up. Beginning to remind me of Fly Fishing, or God forbid, golf... :)

RichL025
10-11-2010, 18:12
Do not wear ear plugs in the pool!!!!!!!!!!!! That is the worst advice I have ever heard.

You need to be able to equalize your ears, period.

ZonieDiver
10-11-2010, 20:37
Do not wear ear plugs in the pool!!!!!!!!!!!! That is the worst advice I have ever heard.

You need to be able to equalize your ears, period.

While I echo that advice, there are some earplugs being marketed to divers. Supposedly, they are "safe" and can help in ear clearing. I don't know anyone who uses them, nor does the store I work with sell them, and since I don't have trouble clearing my ears, could not evaluate them.

Here's a link to a DAN article on the subject:
http://www.diversalertnetwork.org/medical/articles/article.asp?articleid=33

Generally, I'd say RichL025's advice would be the one to take - don't do it. Learn to clear. Practice. Dive often. (Yes, you can dive locally - I don't care where you live!)

SF_BHT
10-11-2010, 21:16
While I echo that advice, there are some earplugs being marketed to divers. Supposedly, they are "safe" and can help in ear clearing. I don't know anyone who uses them, nor does the store I work with sell them, and since I don't have trouble clearing my ears, could not evaluate them.

Here's a link to a DAN article on the subject:
http://www.diversalertnetwork.org/medical/articles/article.asp?articleid=33

Generally, I'd say RichL025's advice would be the one to take - don't do it. Learn to clear. Practice. Dive often. (Yes, you can dive locally - I don't care where you live!)

ZD is spot on......

Learn to clear. For me the pool was worse than any dive, the deeper I go the easier I can clear. Practice makes perfect. Just did 5 dives this weekend. Bug's always taste better when you catch them fresh....... and the price is much better.

AZ has such good dive sites...behing every home in Phonez :p;)
ZD come on down here and get wet in PR......Door is always open.

Nightfall
10-11-2010, 22:01
ZD is spot on......

Learn to clear. For me the pool was worse than any dive, the deeper I go the easier I can clear. Practice makes perfect. Just did 5 dives this weekend. Bug's always taste better when you catch them fresh....... and the price is much better.

AZ has such good dive sites...behing every home in Phonez :p;)
ZD come on down here and get wet in PR......Door is always open.

Yeah, I've been practicing as often as I think of it throughout the day, I'm sort of an anti-crutch guy. I want to be without add-ons, if you know what I mean, able to function without sprays, plugs, the works. I plan to dive as much as possible but I'm in this class until late December then I ship out to Knox January then to Benning right after, so I may not get a dive in until sometime late June it looks like (just found out the wife's with child too - there went our OSUT graduation vacation). I'll miss my newest's birth, but it's what I volunteered for ya know? I don't have any doubts I'll be in the Sandbox very shortly after (a fellow new recruit friend got 3 weeks from grad to hit Afg.), as I tend to be that guy who gets picked for such. Can't imagine a need for a recon trooper in Korea, but anything can happen - needs of the Army and all.

Not too many places to dive 'round these parts either, as I live in a mudhole, no clear water for about 150 miles in any direction. With classes and PT, and the fact that the nearest dive spots are weekend trips, I don't have a lot of time or money to get much more than what's with the class. Going to try to work in Nitrox cert as we can take it in addition to this class (+ another dive), but I'm already at 45+ hours with class and working part time, then a 3 y/o daughter, not to mention PT - and I'm not 18 anymore :) Would like to do some of the rivers up S. MO or N. AR, I think they might be some interesting spots, but we'll see where I land once I get my orders.

Really, though, thanks again for all the advice guys, if I get stationed close by any of you, would be my pleasure to buy a couple of rounds.

ZonieDiver
10-14-2010, 12:10
ZD is spot on......

Learn to clear. For me the pool was worse than any dive, the deeper I go the easier I can clear. Practice makes perfect. Just did 5 dives this weekend. Bug's always taste better when you catch them fresh....... and the price is much better.

AZ has such good dive sites...behing every home in Phonez :p;)
ZD come on down here and get wet in PR......Door is always open.

(Be careful, I retire next July! We could turn your place into a PS.com R&R site!
My kids got spoiled with the "lobster" I'd bring home from visits to the Bahamas. Flash frozen an hour out of the water and on my grill within a few days after that. Yum!

Actually, I was in Lake Pleasant last weekend, and it was... well... pleasant. Water is cooling and at its lowest point, so I can dive areas I cannot in spring and early summer.

Heading to Lake Havasu in the not too distant future, and San Diego sometime soon as well - Wreck Alley.)

Back to the topic - if there are no physical problems, clearing is technique. Practice, practice, practice. Dive, dive, dive.

There are some places where clearing difficulty can present BIG problems - i.e. drift diving in Cozumel. You will be far from the group if you can't quickly submerge to the depth of the dive.

Only one time did I have a reverse block... from using drugs to facilitate clearing. It was a working dive, guiding tourists, in the Bahamas. Unlike getting down, with this I knew at some point I would have to surface. Long ago, someone had told me to surface slowly, head down-feet up. I tried... it worked...but with that long, screeching sound in your ears.

Don't do it, you may regret it.

SF_BHT
10-14-2010, 13:15
No problem. The spare rooms are always open to ant QP. Gear is in the dining room ready to go out of the door. Here alone and always ready to dive. Lots of bugs to be caught.

Nightfall
10-24-2010, 20:08
As of today I got my OW Cert without any more meds to help clear my ears. After the dosepack suggested, my ears cleared up and everything went "swimmingly" (sorry couldn't resist)...

That being said, thanks again for all the advice - you guys are the best.

Oh and if any of you QP's were at Pelham, AL this weekend, I just missed you.