DAN ENT Solved My Ear Issues (I think...)

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GameChanger

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Messages
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Location
Frisco, TX USA
# of dives
500 - 999
For the past few years, I have had issues with water in my ears after diving. It did not matter if it was a shallow (40 ft) or deep (80+ ft) dive. After my dives, I have a clogged sensation in both ears and it oftentimes progresses to a feeling of dizziness or even vertigo. I tried using the "Swimmer's Ear" drops, and while they sometimes provided minimal relief, they never really cleared up my ears.

I have tried home remedies such as those ear wax cleaning kits and the custom potion concoctions some here rave about. None have worked for me.

On occasion, I also get reverse barotrauma while ascending. As you may know, the bad thing about the "reverse squeeze" is that you never know if it will hit you until you ascend. I always try to manage my gas and gas availability for "what if" scenarios, but when you know a reverse squeeze may hit you unexpectedly, it places even greater emphasis on gas management. My last incident was at about 40' and I had ~1k psi and my dive buddy was at ~1200. I managed to slowly ascend and it worked itself out.

I decided to seek an ENT who specialized in scuba issues. I contact DAN and they referred me to an ENT Specialist in Dallas (where I live) and I made an appointment. The ENT is Dr Andy Chung and he did his ENT residency at Duke University where DAN is located. He is also a diver.

Dr Chung provided me with a pre-dive protocol for the reverse squeeze issue. It involves taking pseudoephedrine one hour prior to my dive, as well as some pre-dive exercises to prepare my eustachian tubes for diving. (Similar to Frenzel). I have not had a reverse squeeze since using this protocol.

For the water-clogging issues, Dr Chung said to toss the OTC ear remedies as they can make the issues worse. He prescribed an ottic powder treatment kit that includes Mastoid powder (comprised of ciprofloxacin, clotrimazole, dexamethasone and boric acid) and an insufflator bulb. I use this after my dives for the day are complete. Dr Chung also fitted me with custom vented ear plugs for diving. I have the Doc's Plugs, but my experience has been that they fall-out of my ears too often. Dr. Chung's ear plugs are custom fit by using a molding process. They also go deeper into the ear canal so they stay put. I also use a Mack's Ear Dryer after each of my dives and it works very well! Dr Chung also recommended for long dive trips to do an office visit with him before my trip to clean out my ears with what I can only describe as an ear vacuum cleaner.

So far this has worked for my occasional weekend dives at my local lake.

I have a 10-day dive trip planned for Coz next month (June 2021) where I will do about 25 total dives. I am hoping to be ear-issue free!
 
Glad you got it worked out! I've taken sudafed before diving for years now. I try not to dive without it. I bring it on trips to places like Coz. However....

Pseudoephedrine is straight up illegal in Mexico. You CAN go to jail for possession of it. Personally, I took the risk both times I went to Cozumel and didn't have a problem. Even when they searched my bags and went through my medicine bag with various medicines including a box of sudafed. Just be aware that you're breaking Mexican law if you bring it and you could potentially got to jail.

Sudafed pills land Utah woman in Mexican jail
Information regarding bringing medications into Mexico | U.S. Embassy & Consulates in Mexico
 
I have my ways...
 
For the past few years, I have had issues with water in my ears after diving. It did not matter if it was a shallow (40 ft) or deep (80+ ft) dive. After my dives, I have a clogged sensation in both ears and it oftentimes progresses to a feeling of dizziness or even vertigo. I tried using the "Swimmer's Ear" drops, and while they sometimes provided minimal relief, they never really cleared up my ears.

I have tried home remedies such as those ear wax cleaning kits and the custom potion concoctions some here rave about. None have worked for me.

On occasion, I also get reverse barotrauma while ascending. As you may know, the bad thing about the "reverse squeeze" is that you never know if it will hit you until you ascend. I always try to manage my gas and gas availability for "what if" scenarios, but when you know a reverse squeeze may hit you unexpectedly, it places even greater emphasis on gas management. My last incident was at about 40' and I had ~1k psi and my dive buddy was at ~1200. I managed to slowly ascend and it worked itself out.

I decided to seek an ENT who specialized in scuba issues. I contact DAN and they referred me to an ENT Specialist in Dallas (where I live) and I made an appointment. The ENT is Dr Andy Chung and he did his ENT residency at Duke University where DAN is located. He is also a diver.

Dr Chung provided me with a pre-dive protocol for the reverse squeeze issue. It involves taking pseudoephedrine one hour prior to my dive, as well as some pre-dive exercises to prepare my eustachian tubes for diving. (Similar to Frenzel). I have not had a reverse squeeze since using this protocol.

For the water-clogging issues, Dr Chung said to toss the OTC ear remedies as they can make the issues worse. He prescribed an ottic powder treatment kit that includes Mastoid powder (comprised of ciprofloxacin, clotrimazole, dexamethasone and boric acid) and an insufflator bulb. I use this after my dives for the day are complete. Dr Chung also fitted me with custom vented ear plugs for diving. I have the Doc's Plugs, but my experience has been that they fall-out of my ears too often. Dr. Chung's ear plugs are custom fit by using a molding process. They also go deeper into the ear canal so they stay put. I also use a Mack's Ear Dryer after each of my dives and it works very well! Dr Chung also recommended for long dive trips to do an office visit with him before my trip to clean out my ears with what I can only describe as an ear vacuum cleaner.

So far this has worked for my occasional weekend dives at my local lake.

I have a 10-day dive trip planned for Coz next month (June 2021) where I will do about 25 total dives. I am hoping to be ear-issue free!

Thanks for sharing. I am wondering why do you try to address otitis externa?.. All symptoms you listed are about the middle ear (fluid behind tympanic membrane, reverse block). It is very easy to check whether you have OE, it will hurt if you pull your ear. To me it sounds like you might have a condition that is causing your eustachian tubes to swell, this could be an allergy. Perhaps it is still possible to find a root cause and sort that out.
If you are caught with reverse block, you can tilt your head to right (if your right ear is blocked) and I do not mean just lightly tilting, your ear needs to be parallel to the bottom, this will ensure that expanding ear will be encouraged to go up towards your eustachian tube.
If it gets desperate and you need to ascend, you can apply pressure to your ear with your index finger and encourage the air to the other direction by making it harder for the tympanic membrane to move outbound.
 
For the past few years, I have had issues with water in my ears after diving. It did not matter if it was a shallow (40 ft) or deep (80+ ft) dive. After my dives, I have a clogged sensation in both ears and it oftentimes progresses to a feeling of dizziness or even vertigo. I tried using the "Swimmer's Ear" drops, and while they sometimes provided minimal relief, they never really cleared up my ears.

I have tried home remedies such as those ear wax cleaning kits and the custom potion concoctions some here rave about. None have worked for me.

On occasion, I also get reverse barotrauma while ascending. As you may know, the bad thing about the "reverse squeeze" is that you never know if it will hit you until you ascend. I always try to manage my gas and gas availability for "what if" scenarios, but when you know a reverse squeeze may hit you unexpectedly, it places even greater emphasis on gas management. My last incident was at about 40' and I had ~1k psi and my dive buddy was at ~1200. I managed to slowly ascend and it worked itself out.

I decided to seek an ENT who specialized in scuba issues. I contact DAN and they referred me to an ENT Specialist in Dallas (where I live) and I made an appointment. The ENT is Dr Andy Chung and he did his ENT residency at Duke University where DAN is located. He is also a diver.

Dr Chung provided me with a pre-dive protocol for the reverse squeeze issue. It involves taking pseudoephedrine one hour prior to my dive, as well as some pre-dive exercises to prepare my eustachian tubes for diving. (Similar to Frenzel). I have not had a reverse squeeze since using this protocol.

For the water-clogging issues, Dr Chung said to toss the OTC ear remedies as they can make the issues worse. He prescribed an ottic powder treatment kit that includes Mastoid powder (comprised of ciprofloxacin, clotrimazole, dexamethasone and boric acid) and an insufflator bulb. I use this after my dives for the day are complete. Dr Chung also fitted me with custom vented ear plugs for diving. I have the Doc's Plugs, but my experience has been that they fall-out of my ears too often. Dr. Chung's ear plugs are custom fit by using a molding process. They also go deeper into the ear canal so they stay put. I also use a Mack's Ear Dryer after each of my dives and it works very well! Dr Chung also recommended for long dive trips to do an office visit with him before my trip to clean out my ears with what I can only describe as an ear vacuum cleaner.

So far this has worked for my occasional weekend dives at my local lake.

I have a 10-day dive trip planned for Coz next month (June 2021) where I will do about 25 total dives. I am hoping to be ear-issue free!

Interesting to hear the details, glad it worked out for you.
 
UPDATE:
I have one more day of diving on my Cozumel dive trip. I have done 18 dives using the earplugs and the ear dryer.
I am happy to report that I have had ZERO ear issues!
 
Can you tell us more about these custom earplugs? Are they equalized in some way?
They were custom fit to my ear canal/ear by using a putty type material to create a mold. The mold was then sent to a lab that makes the custom vented earplugs. They are attached by a quality string (like a shoelace) and the earplugs can be removed from the attaching string if need be. They are vented so that a small amount of water can enter the ear canal for equalizing. I just don't get the flooding or water-clogging anymore.

The concept is no different than the OTC Doc's Plugs that are so popular. These are custom fit to my ear canal for better fitment. They are also a lot sturdier. There is a unique left and right plug and they are color coded (red/white) so I know which plug goes into which ear.
 
So glad you had success! I will take some Sudafed to Galapagos in my just-in-case meds kit!
 
I am not a physician, but there is a black box warning for cipro relating to tendon damage. It may not apply in this case.
 

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