Ear Pain - Possible Barotrauma - TCI, NYC doc?

[dohdoh]

Almost a week ago I did a 2 tank dive to a max depth of 80ft. On the descent I has trouble equalizing my right ear. I ascended a few feet and after a short time was finally able to equalize. After I got on the boat someone pointed out my nose was bleeding, i blew large gobs of phlegm and blood out of my nose and mouth. Five days later my ear is still bothering me. I'm still on vacation (Turks and Caicos) and am not scheduled to return to NYC until Wed.

Has anyone experienced this before? DOes anyone have a recommendation for a doctor in NYC that might have a good understanding of scuba injuries?

 

[Searcaigh]

Not suffered from a similar injury but for sure you have possibly equalized a bit too hard and caused some trauma ENT wise.

Get yourself to a medical center as soon as possible and have your ears checked out, I am guessing you are flying back to NYC and that will entail some minor equalization during the flight, in particular during descent.

 

[TSandM]

It's very difficult to diagnose issues over the internet, but a little more detail as to your precise symptoms might help -- is it pain, muffled hearing, popping or crackling noises, or vertigo/dizziness?

It does sound as though this is barotrauma. The most common injury is simply a collection of fluid (and/or blood) in the middle ear, which causes a feeling of fullness, sometimes pain, and some decrease in hearing. More severe injuries can rupture the eardrum, or in the worst case, damage the inner ear, resulting in permanent hearing loss or vertigo. Only an examination by a physician can tell for sure.

First aid for barotrauma can include decongestants (to try to allow the fluid to drain more easily), antiinflammatory medications (to reduce swelling and relieve pain) and mechanical adjuncts like gum chewing (to massage the Eustachian tube and encourage fluid drainage). But persistent symptoms will require medical evaluation.

 

[dohdoh]

Hearing is slightly muffled in that ear. And it feels like there is a little pressure. If i pinch my nose and blow (Valsalva) there is a bit of a crackling or wrinkling sound.

 

[Duke Dive Medicine]

Dohdoh,
It sounds like you have a combination of sinus and ear barotrauma. Had you been having congestion issues prior to this dive?
Sinus squeeze on descent can cause trauma to the mucous membranes, sometimes badly enough to make them bleed. Often, a diver won't even feel this happening. On ascent, the air that's left in the sinuses expands per Boyle's Law and will force mucus and blood from the nose. Typically, it looks a lot worse than it is. TS&M hit the ear barotrauma already - first aid for sinus squeeze would be the same as she's already described. You might consider gently performing the Valsalva maneuver every once in a while - it may help clear the fluid from your middle ear. Also, I hate to say this while you're sitting in a prime dive spot, but if you're still feeling crackles in your ear I would avoid diving. You'd risk more severe injury to that ear. I'd also echo what TS&M said about seeing a physician if your symptoms persist.

Dr Mike is a frequent poster in this forum. He's a pediatric ENT specialist in NYC who could probably refer you to someone back home.

 

[prettyfish]

Good luck Dohdoh I had problems equalizing at 30 feet in Sept. and have had drainage, ear fullness and minor discomfort ever since. The decongestant didn't work so I went to an ENT doctor who changed my decongestant and ordered a CAT scan. I am planning on diving in June at Bonaire and do not want my trip spoiled but I would never risk my hearing and will do whatever the doc says.

Good luck and be careful. You can always come back and dive later but not if hurt your ears.

 

[doctormike]

Dohdoh,
It sounds like you have a combination of sinus and ear barotrauma. Had you been having congestion issues prior to this dive?
Sinus squeeze on descent can cause trauma to the mucous membranes, sometimes badly enough to make them bleed. Often, a diver won't even feel this happening. On ascent, the air that's left in the sinuses expands per Boyle's Law and will force mucus and blood from the nose. Typically, it looks a lot worse than it is. TS&M hit the ear barotrauma already - first aid for sinus squeeze would be the same as she's already described. You might consider gently performing the Valsalva maneuver every once in a while - it may help clear the fluid from your middle ear. Also, I hate to say this while you're sitting in a prime dive spot, but if you're still feeling crackles in your ear I would avoid diving. You'd risk more severe injury to that ear. I'd also echo what TS&M said about seeing a physician if your symptoms persist.

Dr Mike is a frequent poster in this forum. He's a pediatric ENT specialist in NYC who could probably refer you to someone back home.

Hi, Dohdoh...

You have some good advice from my colleagues... hope that you are feeling better soon!

If you want someone to take a look when you get back to the city, feel free to PM me and I can find you a good adult ENT doc to see you. I usually just see children, but I have also seen the occasional dive buddy...