Barotrauma, fistula, or just a fluke?

[Kristina McLaughlin]

After our first diving class, I had a strange reaction. We were in the water for a few hours and they said it was 80, but my toes and fingertips were blue and you could watch people shivering. Anyway, going down to 12 feet, I waited too long to clear my ears and felt some pressure that was painful in both ears. I held my nose and cleared them, without any trouble. We left class and drove home, about an hour in the car, and that is when the trouble started. When I got out of the car, I could hardly walk I was so dizzy. In the car, I do remember thinking that I had water in my right ear but not enough to make me dizzy. Anyway, 30-40 minutes later, I had such vetigo that I threw up. After another hour of vertigo, then scaled back to just dizzy, but still throwing up, we went to the ER. The doc initially thought there was a tear in my eardrum, but when my boyfriend asked if it was possible to tear it and not feel anything he said "well sure," which didnt make sense to me. I left with anti-dizzy and anti-nausea pills and a referral to an ear/nose/throat doc. At that visit, he said there was no tear and he thought it was a fistula. However, he kept saying that he did not understand why there was a delay in my symptoms. He thought it should have been a problem immediately, not an hour later. He did not think I should dive again this weekend, but he also said he could not verify what went wrong.

It has been 5 days now. I am no longer dizzy, but there is tinutis in my right ear and I can still feel pressure in my ear, but not painful or anything. I just know it feels different. Our second dive class is Saturday and I am terrified. The doc it could have been a fluke and that it might never happen again. Then again...it could. he said he could only verify a fistula with surgery. oh, there is slight hearing loss, but more due to age or genetics he said.

So I guess i have a few questions... Is it weird to have a time lapse of an hour between diving and ear problems? Do I dive again? If so, should I do anything different?
Thanks,
Kristina

 

[Davemohio]

Kristina,

I have had no official medical training. but have had lots of ear issues over the years.

I am going to let more experienced medical folks answer.

But..I will tell you this, I would not dive THIS Saturday. Too soon IMHO.

 

[clownfishsydney]

My guess is you have torn the round window between middle and inner ears. Have a look at the page on my web site where I had the same thing Michael McFadyen's Scuba Diving Web Site. It will eventually repair itself, but you should still see and ear, nose and throat specialist.

 

[Duke Dive Medicine]

Hi Kristina,

Your description of the events and your symptoms fits with inner ear barotrauma. As your physician said, it's impossible to tell whether you had a fistula without surgical exploration, and it's certainly possible to have a delay in symptoms like you did. The fact that you recovered from the vertigo without surgery is a good sign, but I concur 100% with Dave; do not dive until you've seen the ENT physician, and plan to be off for several weeks after. Typically, an ENT physician will conduct a hearing test and an electronystagmogram, which should reveal any residual damage to the vestibular apparatus.

Best regards,
DDM

 

[Davemohio]

+ 1 on the ENT.

I know it is frustrating to wait.

I had a middle ear barotrauma several years ago. For me, various symptoms lasted 3-4 weeks.

I was cleared to dive but gave myself longer than that to get back in the water.

I am fine now..diving almost weekly.

 

[Kristina McLaughlin]

Hi Kristina,

Your description of the events and your symptoms fits with inner ear barotrauma. As your physician said, it's impossible to tell whether you had a fistula without surgical exploration, and it's certainly possible to have a delay in symptoms like you did. The fact that you recovered from the vertigo without surgery is a good sign, but I concur 100% with Dave; do not dive until you've seen the ENT physician, and plan to be off for several weeks after. Typically, an ENT physician will conduct a hearing test and an electronystagmogram, which should reveal any residual damage to the vestibular apparatus.

Best regards,
DDM

Thanks everyone. I'm glad I found this forum - great help!! However, I wasn't clear enough in my post - I did go see an ENT. He did the hearing test and something else (essentially a pressure test). The pressure test came back fine but there is some hearing loss that they attributed to genetics and/or age (the high frequency level). I will go back to him in 2 weeks for a follow-up. Anyway, I will take the next two weeks off and see what he thinks! Thanks again!