Dry Equalizing Over-Training?

[bolts]

Earlier I posted about problems I had during a freediving clinic equilizing my left ear. Since then I visited an ENT and he said (after a very brief look-over...maybe too brief?) to practice equalizing on land (dry) 10-15 times a day to stretch my e-tubes. I've been doing this religiously, and experiementing with various methods to try to get my left ear to "pop". I've now got it such that I have to "twitch" my jaw while I equilize to get the left ear to pop.

Anyways, the past few days, I've woken up with dried blood in my left nostril, along with hacking up a bit of blood from my nasal drippings (for lack of a better, less disgusting word). Is this likely a case of over-agressive equalization training? Any thoughts?

 

[simbrooks]

Not even remotely medically trained, but i found when i practiced too much i developed an ache just below my ear, particularly if i tried to equalise by pulling my e-tubes open with the soft palate (cant recall name). I take it you are doing valsalva with a twist (the jaw twitch)? Blood doesnt sound good, are you sure you arent congested or anything else? How hard are you blowing? It is possible to rupture blood capillaries (sp?) from blowing too hard and that is often what happens to over-eager new divers when learning how to equalise, they blow to hard to try to make up pressure when what they should be concentrating on is descending slower and only equalising with slight pressure increases (ie every 2-3ft early on (<30ft) and 5ft thereafter) rather than trying to hit it at 10ft and blowing really hard as your e-tubes dont want to open under that large a pressure gradient (sucked shut by lower pressure in middle ear than throat). Maybe you should lay off the equalising for a day or two, let the capillaries heal and then next time just blow gently, its harder on land to do it as there is no pressure difference/gradient and so you end up blowing hard. Can you open them with swallowing or just the jaw movement? I have found that swallowing seems to work best for me and i can get my ears to pop 15 times in a minute or so if i push it, you just need the spittle to do it!

 

[bolts]

Blood doesnt sound good, are you sure you arent congested or anything else? How hard are you blowing?

Can you open them with swallowing or just the jaw movement?

My right ear pops no problem at all. I've been experimenting with various ways to get my left ear to do the same thing. I've found that tilting my head to the right, along with jaw movement tends to get the left ear to "pop" in a similar fashion. I suppose I do blow pretty hard, just to get that left ear to pop.

I'm just concerned that it's something physical that's preventing my left ear from equalizing, and would much rather get it looked at, diagnosed, and/or remedied before the diving season starts. I'm REALLY eager to get back in the water!

Strangely enough, there's been some odd things going on with my sinuses lately. A few weeks ago I started to notice a sore throat after a hard cardio workout, in addition to that feeling you get in the back of your throat when you have a lot of post-nasal drip. The sore throat worsened, then went away after a few days. Since then I've been noticing the blood in my left nostril when I wake up in the morning. Typically, I'm really stuffy anyways when I wake up in the morning, so the stuffiness is nothing new, just the blood. Perhaps my equalization "training" has aggrevated them? *shrug*

 

[simbrooks]

Something i do to get my e-tubes in shape include stretching my neck out, rolling it around etc (not tilting it backwards) and chewing gum for 30-60 mins before diving, seems to have helped a bit. Also getting outside rather than breathing recirculated air in the house (AC etc) seems to help too.

I really dont know about your sore throat, nasal troubles or blood beyond what i put above, hopefully one of the docs will be along shortly

 

[pipedope]

Watch my favorite video at;
http://faculty.washington.edu/ekay/index.html

Lots of information on ears and diving including several ways to equalize.

I have had lots of nosebleeds but not that I can relate to my ears/equalizing. Usually taking less aspirin and more vitamin E helps me not have the nosebleeds.

If it happens only once I would not be too worried but if it keeps happening a trip back to the ENT would be in order.
Wait, I see you are already seeing the ENT so give them a phone call and they can better advise you.

 

[bolts]

Watch my favorite video at;
http://faculty.washington.edu/ekay/index.html

Lots of information on ears and diving including several ways to equalize.

...

If it happens only once I would not be too worried but if it keeps happening a trip back to the ENT would be in order.
Wait, I see you are already seeing the ENT so give them a phone call and they can better advise you.

Yup, seen that video a few times. Well done, but the Frenzel technique is pretty tricky, I'm not so sure I'm doing it correctly and effectively.

The ENT I went to basically looked in my ears, said I was fine and keep practicing. That's it. I had to bug him a bit to even have him look in my nose, as pleasant as that sounds. Thorough, eh? I wasn't impressed, I just went to him to be re-assured it wasn't anything more serious.

 

[LubaScuba]

Valsalva method tends to be rather aggresive to the gracile architecture of the ear. It is nearly always possible to see some signs of violence on the otoscopic exam after the dive if this method is the method of choice. It is tempting for me to speculate that the problems with Valsalva are psychological as well because human nature strives often for less over more activity (ie we tend to be lazy when we can) so any manuever that involves hand movement to the nose is probably not going to be performed as often as it should. To compensate for that 'laziness' more aggresive inflations follow. Did you ever see experienced diver descending all the way continuously pinching the nose? Well, i didn't. At the other hand (actually without it), divers who use so called BTV method (non reflex contraction of the muscles that lift the soft palate and open the tube ostium) have usually totally 'clear' otoscopic finding after the dive. In the literature it is usually noted that there is no best method. Nevertheless, in the absence of data about harmless effect of frequent minor ear pressure stress on the long term it makes sense to assume that there is actually the best method and that is the one that produces the smallest stress to the ear. So far BTV seems to be the gentliest. I believe that continuous Frenzel (not Valsalva which is rather like trying to inject the mouse with the elephant size syringe! How gentle you can do it? Well...why would someone inject the poor little mouse in the first place?) could be equally gentle but like i said we are too lazy to move our hands that much and nobody holds the nose all the way down neither. BTV gives the luxury of free hands that might be important issue especially for instructors. (I have seen few badly injured ears of instructors that tried to stop one or two sinking students. No hand was available to pinch the nose in the critical moment until too late.) The good way to learn the BTV is to use our natural reflexes that already contract those particular muscles. The best example is yawning reflex. By observing what is happening during the yawning one might start to get the feeling what is the BTV all about. BTV could be described as doing the same thing as yawning but this time without actual yawning and with mouth closed. One little trick might significantly speed up the way to the success...after contracting those "yawning muscles", gentle exhalation through the nose (into the mask) should follow. That would open the remaining part of the tube. So one does not have to be the master of the whole Eustachian tube to have a very handy (actually hand-free) equalizing technique which seems to be the gentlest way to deal with pressure changes aplied to the ears.

 

[SteveDiver]

You are probably blowing to hard....Drink plenty of WATER to moisten your mucus membranes. Mask too tight? (squeeze). Are you taking any sinus/allergy medications? most of the sinus/allergy meds create dryness as well. I always squirt normal saline in my nose before diving to moisten up....

 

[liberato]

...BTV could be described as doing the same thing as yawning but this time without actual yawning and with mouth closed. One little trick might significantly speed up the way to the success...after contracting those "yawning muscles", gentle exhalation through the nose (into the mask) should follow.

:idea: I never quite grasped the BTV (or rather I could never make it work). I will try the exhalation tip. That actually makes sense: If the tubes are pulled open the gentle backpressure from the mask should be all the pressure needed to equalize. I've always felt Valsalva is inherently traumatic but have just lived with it because it is the simplest and always seems to eventually work but I hate it.

 

[ShakaZulu]

I guess if you push hard enough, you could cause your eyeballs to pop out..........blood, unreal.