blocked eustation tubes - diver

[scarlet1119]

I'm a college-aged marine biology major trying to finish my scuba diving certification but I'm unable to equalize pressure in my left ear - meaning I can't dive. I went and saw an ENT and she tested my hearing, poked around and looked at things, and did a pressure test on my ears. She said my hearing was perfect and that I had some trouble naturally equalizing pressure in my ears but that there was no sign of polyps or anything, so she referred me to an allergist, thinking that the tube was swollen due to allergies. Well, after a comprehensive allergy test, the allergist concluded that I'm not allergic to anything! He told me no antihistamines will help and my only hope was to continue using flonase, decongestants, and a decongestant nose spray to try and clear the tube. I've been doing this diligently for a couple days but have not seen much improvement yet. I'm a little concerned because the nose spray and decongestants say not to use for more than 3 days else congestion may worsen.

I'm not willing to give up on this and accept yet that "it's just the way I am" as diving and marine biology are my life's dream. The ENT told me, had I wanted to be a pilot, they could put tubes in my ears, but as I want to dive, there is much to much risk of infection.

I'm not sure what to do/where to go from here. I'm open to any suggestions or advice.

I don't think it's an infection as antibiotics never altered the situation, and I was never prone to ear infections as a child.

I did however get sinus infections, but as currently my sinuses are clear.

 

[Web Monkey]

decongestant nose spray to try and clear the tube. I've been doing this diligently for a couple days but have not seen much improvement yet. I'm a little concerned because the nose spray and decongestants say not to use for more than 3 days else congestion may worsen.

I'm not willing to give up on this and accept yet that "it's just the way I am" as diving and marine biology are my life's dream. The ENT told me, had I wanted to be a pilot, they could put tubes in my ears, but as I want to dive, there is much to much risk of infection.

FWIW, the more you clear your ears, the easier it gets. You might just need to practice more (even on land).

The warning on the 12 hour nose spray is correct. It's amazing stuff, but if you use it for more than a few days the rebound is huge. It will close you up like stuffing plaster in your nose.

Also, you also might want to check with another ENT, expecially one who dives or treats divers. DAN can generally find someone qualified in your area.

Terry

 

[scarlet1119]

Well, I'm not currently a member of DAN because I have yet to become dive certified.
If anyone who is a member, could search the DAN website or recommend any dive medicine physicians or ENTs in the Rhode Island/Massachusetts area, I'd be immensly thankful.

 

[Web Monkey]

Well, I'm not currently a member of DAN because I have yet to become dive certified.
If anyone who is a member, could search the DAN website or recommend any dive medicine physicians or ENTs in the Rhode Island/Massachusetts area, I'd be immensly thankful.

They'll talk to anybody, regardless of whether you have their insurance or not.

Terry

 

[pickens_46929]

Yep, don't use nose sprays. Lots of rebound, worse than straight old pseudoephidrine tables I think personally.

Keep practicing -- does get easier a bit. Even though they *say* you have no allergies there's no way they can be 100% sure. Claritin is my friend.

Also learn the other methods of equalizing too. There's about 30 or 40 ways (kidding, but it's not just one or two). Sometimes it might take a combination of stretching your neck and another method. Dunno.

Don't give up just yet.

Dave

 

[tonka97]

Valsalva Maneuver Tips:

Squeeze nostrils so that some air will escape nose during maneuver. (don't pinch tightly) This will protect against excessive baro forces.

Tilt head so that eyes look upward (extend neck) This will elongate eustachian tube and make clearing easier.

Perform valsalva. You will hear a small pop/click. Do not use excessive pressures or you may bruise eustachian tube tissue or the eardrum itself.

Tip: Start performing Valsalva maneuver BEFORE you get into the water, then keep performing maneuver as you descend.

The trick is to clear your ears before you need to!

Good luck!

 

[scarlet1119]

Tip: Start performing Valsalva maneuver BEFORE you get into the water, then keep performing maneuver as you descend.

right. I'm nowhere near water ... and still working on it.
One thing that is particularly frustrating is that one of my ears will clear perfectly. So whenever I try a Valsalva maneuver, the pressure created is all lost via that one ear. I've tried covering that ear, but still nothing moves on the left side.

 

[Web Monkey]

Well, I'm not currently a member of DAN because I have yet to become dive certified.
If anyone who is a member, could search the DAN website or recommend any dive medicine physicians or ENTs in the Rhode Island/Massachusetts area, I'd be immensly thankful.

Also, check out this link. It contains a ton of information on various ways to equalize

http://faculty.washington.edu/ekay/index.html

when you get there, take a look at: PREVENTION OF MIDDLE EAR BAROTRAUMA

 

[doctormike]

Hi..

I'm a (pediatric) ENT doc...

There are a LOT of myths out there about ear disease, as well as a bunch of commonly confused conditions. Middle ear infections (the kind that little kids get, pus behind the eardrum) are VERY uncommon in adults. Middle ear effusion, on the other hand ("water" behind the eardrum), is a common condition in divers, and is often related to pressure changes with diving or flying.

Allergies have really not been shown to be related to middle ear effusion. It makes sense, if the nose is clogged, why wouldn't the ear be clogged? However, there have been some big studies that haven't shown much of an advantage of allergy control in terms of clearing effusion.

Furthermore, the dysfunction of the Eustachian tube that causes this to be an ongoing problem seems to be an intrinsic quality of the tube itself (which you can't easily see in a person). The fact remains that there is a bell curve for everything, and some people just will have a harder time dealing with pressure changes than others, and a few will really never be able to get the hang of it. Remember, we didn't evolve to tolerate big swings in ambient pressure (like diving mammals).

Make sure that the problem equalizing isn't just the result of an acute condition (like an upper respiratory tract infection). Usually, evaluation by an ENT doc won't turn up anything obvious - many people who can't dive for this reason have normal hearing and middle ear pressure at sea level.

Practice help, using a gentle Valsalva maneuver (or the Toynbee maneuver - swallowing with a pinched nose). The maneuvers that people are referring to here are also useful. Medical therapy (decongestants, steroids, etc..) may help you get over the equalization problems that come with an acute infection, but aren't any sort of long term fix if you are one of those people with poor Eustachian tube function.

There are even a couple of products that help with this in kids, but neither is really something that you can use at depth!

http://www.invotec.net/otovent.html
http://www.earpopper.com

Good luck!

Mike

 

[johnnyseko]

I'm no doctor, but did they look at your adnoids??

When I went to the ENT, he looked up my nose with a tube to check things out. I was told my adnoids were blocking my eustachian tubes. Did your ENT do this?

I tried the spray for a couple of weeks and went back so he could see if their size had reduced. They did not. The option for me was surgery to have my adnoids removed - which I did. (can't quit diving!)

Since, I can fly and dive - no problems. Still tricky at times but I believe it is true, the more you equalize and work them the easier it gets.