2nd Ear & Vertigo Episode in Six Years

[Lopaka]

I thoroughly searched the board and got a lot of info, much new since I last looked. Why I am posting is frustration at this happening again after two ENT's could not find any reason for the first ear/vertigo incidence six years ago, and I want to resolve this and make sure nothing is overlooked in treatment.

First time it happened I was nailed with slowly increasing vertigo about an hour after two dives in Kona. Vertigo slowly increased to the point of incapacitation: could only sit still with head down. Local ER doc could find nothing looking into the ear, though hearing had shut down in my right ear by then. Absolutely no signs of DCI, nothing but the vertigo. No computer violations, first dive was EAN, second air. Doc thought barotrauma and gave me Dramamine for nausea. Hearing came back shortly, and vertigo subsided to the point I could walk and return home two days later.

Went to my usual (non-diving) ENT immediately on return. He found nothing during a quick checkup. Asked for another local ENT to see and went to one with diving experience, if not an expert in diving medicine. He detected some residual eye jitter and ordered an MRI. Did that and they found nothing. He also tested for a fistula and that was negative. He saw no reason to stop diving and I did several months later (nervously at first).

No further issues until two weeks ago, again in Kona. Had dove the week before here on Oahu with no problem other than somewhat tight ears from several months with no dives. The Kona dives were both on EAN31, first to 100' and then shallow, second to 80' and some extended time around 50'. Dive ended when the air divers started getting into the computer yellow. I stayed in the green.

No glitches at all out of the water with ears. About 1.5 hours later as I carried both gear bags into the condo, I started feeling vertigo. Sat down immediately as it increased. No where near as violent as the first time, but felt the right ear shut down and a feeling of slight pressure with some popping/bubbling noises. Noises faded away after an hour or so and the vertigo dropped off a lot. Hearing stayed dead. Absolutely no DCI indications, download of the computer shows in the green the whole time.

Asked DAN for an ENT referral on Oahu but they had none. Suggested I contact U.H. Hyperbaric and they gave me several names. Am seeing one now that has me on Predisone after hearing tests showed 30-40% lower frequency loss in the right ear. Been on that for a week now and the hearing is still mostly dead other than a bit of higher frequency. Next visit is for another hearing test after I run the course with Predisone.

I have read in the meantime of Acoustic Neuroma and mean to ask the ENT about that and an MRI. What is really odd right now is I accidentally found a spot on the back of my skull (lower right side) that if I press can cause a funny popping/tinkling noise in the ear. Sounds like a fingernail dragged over a metal comb. The harder I press, the faster the popping. What does a spot on the skull have to do with the ear??

Any of the experts on the board have a suggestion on anything I should discuss with the ENT when I return? I do not want to miss anything this time.

 

[DandyDon]

I see you're still waiting on replies. I am not at all one of the experts you hoped to hear from, but I see we have a few active threads with vertigo. I wonder if they are more common in the spring?

Well, you don't have seasons in Hawaii, but you said the problem dive was off of Kona - on the Big Island? That volcano has been spewing some bad stuff into the air lately; I wonder if that could be connected...?

And have you ever had sinus or hay fever type problems, do you take meds for such, did you before that diving? I avoid mine when I dive Nitrox because of the sudafed contradiction.

 

[frankc420]

The last time I had the type of vertigo you are talking about with the popping also, I cleared my ears and had some salt water in the back of my throat, it got sucked up my tubes and into my middle ear. Not only did I get dizzy as heck, it burned.

I've done it two other times and didn't get dizzy too bad, it just hurts!

 

[Lopaka]

I am fairly religious with taking Allegra D or Claritan D several days before diving to forestall sinus squeeze. Had allergy shots for several years as well. Dunno if I still need to do this, but I do anyway. Sinuses and ears were fine before, during, and up to an hour after the dive. Vertigo and deafness were fairly quick to come on, maybe 5-10 minutes from first feeling dizzy to having to sit still and the ear going dead. From all I have read, a PLF would most likely happen during the dive, not an hour+ after, and IEDCS is almost unheard of without other DCS symptoms.

No real issues with clearing, I am paranoid about that and overdo it if anything. The Vog was bad but did not bother anyone.

Main connection to Kona that occurs to me is the length and depth of dive can be considerably greater than most other places I have dove. That gets back to DCS, but neither the ENTs before or DAN now think that likely considering Nitrox and never getting into the yellow on bottom time.

I see you're still waiting on replies. I am not at all one of the experts you hoped to hear from, but I see we have a few active threads with vertigo. I wonder if they are more common in the spring?

Well, you don't have seasons in Hawaii, but you said the problem dive was off of Kona - on the Big Island? That volcano has been spewing some bad stuff into the air lately; I wonder if that could be connected...?

And have you ever had sinus or hay fever type problems, do you take meds for such, did you before that diving? I avoid mine when I dive Nitrox because of the sudafed contradiction.

 

[vtascuba10s]

I thoroughly searched the board and got a lot of info, much new since I last looked. Why I am posting is frustration at this happening again after two ENT's could not find any reason for the first ear/vertigo incidence six years ago, and I want to resolve this and make sure nothing is overlooked in treatment.

First time it happened I was nailed with slowly increasing vertigo about an hour after two dives in Kona. Vertigo slowly increased to the point of incapacitation: could only sit still with head down. Local ER doc could find nothing looking into the ear, though hearing had shut down in my right ear by then. Absolutely no signs of DCI, nothing but the vertigo. No computer violations, first dive was EAN, second air. Doc thought barotrauma and gave me Dramamine for nausea. Hearing came back shortly, and vertigo subsided to the point I could walk and return home two days later.

Went to my usual (non-diving) ENT immediately on return. He found nothing during a quick checkup. Asked for another local ENT to see and went to one with diving experience, if not an expert in diving medicine. He detected some residual eye jitter and ordered an MRI. Did that and they found nothing. He also tested for a fistula and that was negative. He saw no reason to stop diving and I did several months later (nervously at first).

No further issues until two weeks ago, again in Kona. Had dove the week before here on Oahu with no problem other than somewhat tight ears from several months with no dives. The Kona dives were both on EAN31, first to 100' and then shallow, second to 80' and some extended time around 50'. Dive ended when the air divers started getting into the computer yellow. I stayed in the green.

No glitches at all out of the water with ears. About 1.5 hours later as I carried both gear bags into the condo, I started feeling vertigo. Sat down immediately as it increased. No where near as violent as the first time, but felt the right ear shut down and a feeling of slight pressure with some popping/bubbling noises. Noises faded away after an hour or so and the vertigo dropped off a lot. Hearing stayed dead. Absolutely no DCI indications, download of the computer shows in the green the whole time.

Asked DAN for an ENT referral on Oahu but they had none. Suggested I contact U.H. Hyperbaric and they gave me several names. Am seeing one now that has me on Predisone after hearing tests showed 30-40% lower frequency loss in the right ear. Been on that for a week now and the hearing is still mostly dead other than a bit of higher frequency. Next visit is for another hearing test after I run the course with Predisone.

I have read in the meantime of Acoustic Neuroma and mean to ask the ENT about that and an MRI. What is really odd right now is I accidentally found a spot on the back of my skull (lower right side) that if I press can cause a funny popping/tinkling noise in the ear. Sounds like a fingernail dragged over a metal comb. The harder I press, the faster the popping. What does a spot on the skull have to do with the ear??

Any of the experts on the board have a suggestion on anything I should discuss with the ENT when I return? I do not want to miss anything this time.

Hi,

Name's Matt. I was a dive instructor with 3000+ dives. I also had an Acoustic Neuroma removed three years ago. Question: Did you have contrast with your MRI? Good luck,

Matt

 

[Lopaka]

Hi,

Name's Matt. I was a dive instructor with 3000+ dives. I also had an Acoustic Neuroma removed three years ago. Question: Did you have contrast with your MRI? Good luck,

Matt

Yep, MRI with contrast was done. No tumors. They did see several spots on the brain that I will see a neurologist next week about. Said they could be from age and blocked blood vessels. I have read of the correlation of divers with a PFO and lesions on the brain. I'll be bringing that up with the neuro.

Hearing has not improved, only have some high frequency distorted sound left. Looks like the hearing loss is going to be permanent. Funny thing is, the loss of stereo is frustrating, not knowing where a sound is coming from.

 

[xtine]

Hi Lopaka,

Hi Lopaka,

I'm not a scuba diver but stumbled upon this forum while doing my own research for my dizziness.

Just to let you know a fistula test is not 100%. I have done many, many tests and have passed fine but still experience vertigo with pressure changes and exertion.

After dealing with this for 18 months it was finally deduced that I do indeed have a fistula or at least enough suspicion to warrant exploratory surgery.

I'm not sure if you're still having problems but if you are, I would investigate further and avoid diving until you have a better idea of what's going on. It certainly sounds like you can have an intermittent fistula which opens and heals related to your activity level. unfortunately, ENTs don't know or accept much about perilymph fistulas so you'd need to be pretty persistent on your end.

Good Luck,
Christine

PS- my fistula started for diving into a pool.. so, it's certainly possible