Barotrauma- how long can it last?

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CityLod

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Hi all, brand new, been getting a lot of great info reading here last few weeks, thank you. Thought I could make a post to pick your brains, hope that's okay.

The short version- I gave myself barotrauma on my first dive ever 3 weeks ago and symptoms are still persisting. My ENT says it shouldn't take this long to resolve and he's concerned. Has anyone else had experience with barotrauma lasting this long or longer? Is this abnormal?
(Didn't hear Dr. specify but I believe it's Middle Ear Barotrauma- symptoms/severity match MEBT)

Long version -
3 weeks ago today I went on my first scuba dive ever on vacation in the Canary Islands. It was amazing, but I had trouble equalizing. After a lot of discomfort I did get the left ear to equalize, and then finally the right one a little while later.

My ears felt weird right away shortly after the dive- really full and uncomfortable, a feeling like water was inside, the pressure was all messed up and I had to keep popping them. The pressure was so uncomfortable the first night that my jaw was in pain from opening it over and over trying pop them. The right one was worse than the left but they were both giving me issues. I flew home to NY the day after the dive. I had a little more discomfort than usual on the flights, but nothing bad or painful.

The fullness persisted and then Saturday, 3 days after the dive, the right ear started to hurt and become irritated/inflamed- the type of feeling like when I'm getting an ear infection. I went to urgent care Sunday, the Dr. said he saw "a red line" on my left eardrum and that my right ear looked sore and infected, and gave me Amoxicillin and antibiotic drops to use on right ear. The pain only lasted a day.

Tuesday (6 days after dive) I saw an ENT w/ a scuba specialty who is on DAN referral list. He diagnosed me with barotrauma, said he saw blood in the left ear (the red line the urgent care MD saw). Right ear looked clear by then to him, he said no infection, discontinue the antibiotics. He explained there was not much I could do but wait, recommended decongestants, and said give it a week.

A week and a half went by with same symptoms- fullness, kind of a sloshy noise when moving certain ways, feeling the need to pop the ears, uncomfortable to bend over, sinus pressure and pain- when the right ear suddenly got worse one night, felt like much more fluid was in it, became totally "clogged"/un-poppable, started ringing a little on and off. The next morning I had blood (black and red) in my saliva right after waking up, just once. Called the ENT who sounded very confused that my symptoms were still persisting at all. He prescribed a short course of steroids which within hours returned my right ear back to where it was before the flare-up. But still have baseline symptoms.

That's where I am now, 3 weeks out. My left ear has had noticeable improvement, but still not 100%. The right ear still feels like it did right after the dive basically. Saw the ENT in person again yesterday who said he can't see anything when he looks at it, and is basically stumped. Hearing tests came out normal on both visits.

I put this all out there to you experts to see if anyone has had similar experiences, if you think it just needs more time, if you think I should be concerned, etc. Or any tips on how to hasten the healing/help the discomfort. It made me a little nervous when the scuba-specialist ENT was saying it shouldn't take this long!! Thank you so much for reading!!
 
My wife experienced what occurred to you. Dr. ended up performing surgery (basically perforating the eardrum) to relieve the pressure and blood from the middle ear. I don't think anybody other than professional medical can give you a time line on healing.
 
My wife experienced what occurred to you. Dr. ended up performing surgery (basically perforating the eardrum) to relieve the pressure and blood from the middle ear. I don't think anybody other than professional medical can give you a time line on healing.
Thank you so much for your reply! If I may ask, do you remember about how long from the injury until she and her dr decided on surgery? Did she feel like the surgery resolved her problem? Really hoping it doesn't come to that! Thanks again.
 
Had something similar after first diving session long time ago, same symptoms. No infection, but feeling of water inside ears. It looks like mild barotrauma. Lasted for one month and then, one day in shower, it was like boom, eustachian tubes opens and all returned to normal.

Keep in mind, that you should equalize BEFORE you feel the pressure in the ears. And eventually it will be easy for you, cause it's like a training - the more you dive, the better your eustachian tubes works.

Hope you'll be well soon, take care.
 
Citylod: Dr. waited about a month to see if nature would take its' course. Healing on the eardrum was over 2 months. I think the toughest issue was the sound of the sloshing or hollowness that she experienced prior to the surgery. Hope yours does not require the surgery hoping the best for you.
 
CityLod,

As others have noted, it can take a long time for inflammation to go away and for you to return to your normal ability to equalize. @doctormike may have additional information.

Best regards,
DDM
 
Hi,

Really hard to say much over the Internet, but if you have had two normal audiograms (including normal tympaograms?), it's hard to imagine that "perforating the eardrum" (i.e. myringotomy with or without an ear tube) would be very helpful. Subjective ear symptoms can be very difficult to address in the absence of physical findings, so it's really not possible to give you a timeline for improvement. Certainly diving without good equalization can result in symptoms even if there is no middle ear pathology going on once the dive is over.

I wish that I could help you more, but it sounds like you had difficulty equalizing before your injury. In the future, maybe try some different techniques. Some people eventually improve this ability with training and practice, and others may always have trouble with diving.
 
Did your doctor prescribe a steroid? This will speed up the healing process but it isn't a miracle cure. It will still take some time during which you should try to not irritate your ear further.
OTC decongestants like Sudafed can help and Flonase is good and also contains a steroid.
If your doctor didn't prescribe anything I would be curious why as this is a standard treatment for a very common injury.
 
https://www.shearwater.com/products/perdix-ai/

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