Ear problem, Tinnitus & Buzzing - Never Diving Again

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Back in 1999 I ruptured the round window between the inner ear and middle ear. Nothing happened on the dive to cause this or on previous dives. I got very dizzy and took about 4 hours to be able to walk and another 10 to be sort of normal. However, I had tinnitus and some lose of hearing in that ear.

Back in Sydney I went to an ENT specialist who diagnosed what I already knew was the problem. He told me to never dive again. Since then I have completed well over 2500 dives without a problem. I still have the tinnitus and the lose of hearing, but both are minor and do not affect me.

From what you said, you have had nowhere near the problem I had. However, I would suggest that perhaps diving is not a career for you based on what has happened. Keep it as a recreational pursuit.
 
I saw an ENT in Sydney for barotrauma last March, he wasn't a diving specialist but was obviously familiar with equalisation and other things impacting divers. My ear filled with fluid and took about a month to calm down his advice was to wait 2-4 weeks after symptoms had mostly gone before diving and that was pretty accurate. He had hearing tests done and an exam - he said standard treatment was a steroid course to calm down inflammation and it could also prevent tinnitus becoming permanent if started early enough. We decided not to start the steroids as I was not that bad and COVID had just hit and a suppressed immune system from steroids was probably not ideal.

I'd happily recommend him if you wanted to see an ENT - located in Miranda in the south of Sydney. Let me know if you want his details.
 
Hi to everyone who is writing in my post here. Thank you very very much! I didn't expect so many answers in such a short time. You're awesome guys.

First of all thanks for the discussion about the correct and healthy equalizing method. It sounds a bit complicated and much for me as a new diver but I read your advice and I'm trying. But for now I can only test on the surface. I think (as Dan says) the method to pinch the nose and just swallow is a very healthy and good way to do it isn't it?

I was thinking a lot the last days what to do and if I just stop diving even though I really love it and all my future plans are based on it. But before I do so I wanted (as everyone here recommends) to get a 2nd opinion. Unfortunately there is no ENT with diving medicine or who dives himself here in Australia that I can find.

So on the 24th I got a appoinment now with a very special Professor in ENT who offers diving ent on his website too. And his Career sounds great too. I think he really is a good Prof. Dr. His name is Dr Nicholas jufas from Sydney.

Anyway as this takes so long I went to a normal diving doctor (gp with diving medicine) yesterday. He is also the doctor for the navy here in this state. He checked my ear (just a short look into it) and listened my whole story. He said it doesn't make sense to say don't go diving ever again from the ent. He is pretty sure I got a middle ear barotrauma. And not even a very bad one. Because I have no hole or rupture. Also the hearing test was good so it's probably. Not the inner ear. He said I need to test 4-5 weeks and should be able to dive again. But to make sure we well do a tympanogram first to see if my middle ear is good. If yes I go diving. If not we will fix it and I can go diving later on.

Now I got 2 opinions completly different. But this doctor sounds way more professional. I called my school to study diving 1 month later.

What do you think about it? Can I trust just a GP who is a diving medicine trained one? Should I still go on the 24th to Dr jufas? (private doctor very expensive)

Thanks again guys for all the answers!

Hi @Oezkan

That's a hard question to answer via the internet. How were your symptoms when you saw the diving doctor yesterday? Did you still have the tinnitus?

Going only by your description in your first post, I would not characterize middle ear barotrauma that leaves you with tinnitus for (at least) two days as mild or not very bad, though that is admittedly mincing words with someone who's examined you in person. The tympanogram will help him determine whether you have some sort of Eustachian tube dysfunction, which would warrant further study.

The first ENT you saw probably thought that you had inner ear barotrauma, which would explain her advice to not dive again. That is our recommendation to divers who have had severe IEBT where one of the vestibular apparatuses is permanently injured and loses function. It generally takes a long time to recover from that type of injury so going only by your description, that seems less likely, though not impossible. Did she do any type of tests of your inner ear function? If so, what were the results?

Regarding Dr. Jufas, I think it depends. If you are still symptomatic, that is, you are still experiencing tinnitus or any other inner ear symptoms like vertigo, nausea, or hearing loss, OR if the first ENT found some sort of inner ear abnormality, then I think it would be a good idea to see him. If you are asymptomatic, that is, you feel perfectly fine, then a reasonable course of action would be to wait until you have the results of the tympanogram. If it shows some sort of abnormality, then you could see Dr. Jufas for further studies and recommendations.

If you are asymptomatic AND the tympanogram is normal, then it might be reasonable to follow the diving physician's recommendation, rest your ears for a few weeks and try diving again. Given that you have injured yourself twice in a brief period of time, I would give it at least 6-8 weeks and be extremely careful if/when you do return to diving, but that's an armchair assessment from 10,000 + miles away.

Best regards,
DDM
 
Hi @Oezkan

That's a hard question to answer via the internet. How were your symptoms when you saw the diving doctor yesterday? Did you still have the tinnitus?

Going only by your description in your first post, I would not characterize middle ear barotrauma that leaves you with tinnitus for (at least) two days as mild or not very bad, though that is admittedly mincing words with someone who's examined you in person. The tympanogram will help him determine whether you have some sort of Eustachian tube dysfunction, which would warrant further study.

The first ENT you saw probably thought that you had inner ear barotrauma, which would explain her advice to not dive again. That is our recommendation to divers who have had severe IEBT where one of the vestibular apparatuses is permanently injured and loses function. It generally takes a long time to recover from that type of injury so going only by your description, that seems less likely, though not impossible. Did she do any type of tests of your inner ear function? If so, what were the results?

Regarding Dr. Jufas, I think it depends. If you are still symptomatic, that is, you are still experiencing tinnitus or any other inner ear symptoms like vertigo, nausea, or hearing loss, OR if the first ENT found some sort of inner ear abnormality, then I think it would be a good idea to see him. If you are asymptomatic, that is, you feel perfectly fine, then a reasonable course of action would be to wait until you have the results of the tympanogram. If it shows some sort of abnormality, then you could see Dr. Jufas for further studies and recommendations.

If you are asymptomatic AND the tympanogram is normal, then it might be reasonable to follow the diving physician's recommendation, rest your ears for a few weeks and try diving again. Given that you have injured yourself twice in a brief period of time, I would give it at least 6-8 weeks and be extremely careful if/when you do return to diving, but that's an armchair assessment from 10,000 + miles away.

Best regards,
DDM

Thank you very much for the reply. Let me give you more Information :)

All symptoms I had were only
After the first time happened:
- very mild Pain in left ear (1 day)
- loud buzzing in left ear (1-2 days)
- pressure feeling in left ear (3-4 days)
- mild constant tinnitus as beeping in left ear which I only hear when it's very quiet (eversince, Still there! 3 weeks after)

After the 15 days break as per ent I went diving again and had the exact same symptoms. The only difference is that I did not have pain this time and that the buzzing was louder. 2 days later I again had no symptoms left except the beeping tinnitus.

I never had hearing loss.

I just checked now and the ENT actually did already a tympanogram which was good. Also she did a audiogram to see of hearing is alright. Because those 2 test were OK she said my inner ear is not injured. But she also said my eardrums and middle ear looks good and I had no Barotrauma. (that doesn't make sense because I must have something).

And the dive dcotor didn't do any test except looking into my ear shortly. He said its a middle ear barotrauma which should be healed in 5-6 weeks. And that we do a tympanogram before. But as I just see this was done with my ent.

When I visited my ent I had all symptoms because it was just a day after the dive. When I visited the dive doctor I only had the mild tinnitus left because it was 1 week after the second dive after the 15 days break.

Does audiogram and tympanogram results really can say its not a inner ear problem?

I'm a bit confused because I got 2 doctors with different opinions and many different advises here. I think maybe it's the best to see Dr. Jufas anyway and see what he says? When I look at his career I think he really is a good person to talk to.
 
Back in 1999 I ruptured the round window between the inner ear and middle ear. Nothing happened on the dive to cause this or on previous dives. I got very dizzy and took about 4 hours to be able to walk and another 10 to be sort of normal. However, I had tinnitus and some lose of hearing in that ear.

Back in Sydney I went to an ENT specialist who diagnosed what I already knew was the problem. He told me to never dive again. Since then I have completed well over 2500 dives without a problem. I still have the tinnitus and the lose of hearing, but both are minor and do not affect me.

From what you said, you have had nowhere near the problem I had. However, I would suggest that perhaps diving is not a career for you based on what has happened. Keep it as a recreational pursuit.

When you had much worse problems and had no issues with 2500 dives that gives a bit hope. But why can I not do diving as a career then as it might heal completely? :(
 
I saw an ENT in Sydney for barotrauma last March, he wasn't a diving specialist but was obviously familiar with equalisation and other things impacting divers. My ear filled with fluid and took about a month to calm down his advice was to wait 2-4 weeks after symptoms had mostly gone before diving and that was pretty accurate. He had hearing tests done and an exam - he said standard treatment was a steroid course to calm down inflammation and it could also prevent tinnitus becoming permanent if started early enough. We decided not to start the steroids as I was not that bad and COVID had just hit and a suppressed immune system from steroids was probably not ideal.

I'd happily recommend him if you wanted to see an ENT - located in Miranda in the south of Sydney. Let me know if you want his details.

Hey thanks for sharing this with me. I would like to at least check his website if that's OK :)
 
Thank you very much for the reply. Let me give you more Information :)

All symptoms I had were only
After the first time happened:
- very mild Pain in left ear (1 day)
- loud buzzing in left ear (1-2 days)
- pressure feeling in left ear (3-4 days)
- mild constant tinnitus as beeping in left ear which I only hear when it's very quiet (eversince, Still there! 3 weeks after)

After the 15 days break as per ent I went diving again and had the exact same symptoms. The only difference is that I did not have pain this time and that the buzzing was louder. 2 days later I again had no symptoms left except the beeping tinnitus.

I never had hearing loss.

I just checked now and the ENT actually did already a tympanogram which was good. Also she did a audiogram to see of hearing is alright. Because those 2 test were OK she said my inner ear is not injured. But she also said my eardrums and middle ear looks good and I had no Barotrauma. (that doesn't make sense because I must have something).

And the dive dcotor didn't do any test except looking into my ear shortly. He said its a middle ear barotrauma which should be healed in 5-6 weeks. And that we do a tympanogram before. But as I just see this was done with my ent.

When I visited my ent I had all symptoms because it was just a day after the dive. When I visited the dive doctor I only had the mild tinnitus left because it was 1 week after the second dive after the 15 days break.

Does audiogram and tympanogram results really can say its not a inner ear problem?

I'm a bit confused because I got 2 doctors with different opinions and many different advises here. I think maybe it's the best to see Dr. Jufas anyway and see what he says? When I look at his career I think he really is a good person to talk to.

Hi @Oezkan , thanks for the details.

Persistent tinnitus suggests something beyond middle ear barotrauma, likely inner ear barotrauma. I agree that it would be good to see Dr. Jufas. Please keep us updated, and I do recommend that you refrain from diving until you know more.

Best regards,
DDM
 
When you had much worse problems and had no issues with 2500 dives that gives a bit hope. But why can I not do diving as a career then as it might heal completely? :(
I also think you will be able to heal and dive again. Go to that third doctor, a further opinion cannot hurt you.

Your last question instead would require half a book for being answered entirely. This topic was already debated several times here on FB.
Starting a professional diving career is not a "light" decision, it is something which will affect your entire life.
Physical health issues is just a part of the facts to be weighted in.
I was also fascinated by diving, having started at 16 years old. At 20 years I was already an instructor (out of the rules, because at that time, in 1978, you had to be 21 y.old for becoming instructor).
I did teach for some years in a diving club (unpaid, as a volunteer, and also operating as a volunteer in the civil protection agency).
Only in 1985, when I was 26, I started my professional career, working in touristic resorts in Italy and Maldives.
The pro career lasted just 5 years, during which I and my wife (also a diving instructor) did enjoy the best years of our life!
But everything goes to an end. I had started also my academic career at the University, and the wife was pregnant, so we took the decision of giving up, and went back to normal rec diving.
This was also a great fun, teaching our children to swim underwater since 6 months age, and giving them their first air tank in the pool at 2 years, and in the sea at 3 years. The other parents were looking at us as criminals, but our sons did enjoy this immensely, and they grew up as very proficient divers.
Some people continue their life as professional diving instructors for all their life. I know many of them, but as the age grows, these guys become very strange people. At a certain point of their life they see that they cannot anymore switch back to "normal life"; as there are no more jobs for them. So they are stuck becoming old, skinned diving instructors, but loosing many other opportunities which "normal life" provides.
So it is really a big decision to choose scuba diving as your main activity in your life.
I suggest you to evaluate other possibilities than becoming an instructor.
First of all you can choose to become "just" a diving guide, what in the US is called a "dive master". You have no teaching responsibility, and in general you will be doing much better, deeper and more interesting dives than those made by an instructor with novices.
Another possibility is to become a scientific diver, which is what I am now, thanks to my academic career. Of course you need a proper master degree (marine engineering, marine biology, environmental sciences, oceanography, etc.) and possibly also a PhD (which nowadays is highly recommended in any field, as a standard Master Dgree is actually providing a much worst level of knowledge than 40 years ago). In a year you will probably do just 1/10 of the dives a typical dive master is doing, but the number is not everything, better to make less dives but very interesting ones, than to repeat every week the same 12 diving sites with different customers...
Also the wage for a scientist is usually much better (and permanent) than an instructor or a dive master.
See here an Italian research center at Maldives, where I, my wife and our two sons spent a period of time in 2018. Marine scientists are doing their research activity in nice sites like this one:
MaRHE Center
The third option is to become a commercial diver. These are incredibly well paid (compared to instructors, but also to scientists), but the work is hard, at great depths, in muddy cold water, soldering pipes or the like. I discourage you entirely to follow this path. My former instructor did the one-year long training required for becoming a certified commercial diver, then he worked on gas platforms in the Adriatic sea for just one year, and then he gave up and went back to "normal life". It was a terribly had work, 4-5 hours per day in the water with a narghile' (aka as an hookah), scraping away mussels from the legs of the platform. I and my wife went a couple of times helping him in this hard work, so we did experience by first hand how that job of a commercial diver is hard and unsatisfying...
So, factor your current medical problems in the decision, but please take into account also all the other factors affecting your future life before jumping in the world of a professional diving career. My experience is that this is the proper choice for just a very small number of people, and for most humans it is far better to keep scuba diving as a serious hobby, but not relying on it for sustaining you economically.
 
Quit practicing equalization until your ear calms down.

I just about to post the same as I agree with this sentiment. It would only stress an area that needs to heal. In fact, I would be careful of blowing my nose or sneezing "the wrong way." However, as I do not have a medical background I would like to see @Duke Dive Medicine 's input on this.

Good luck @Oezkan Thanks for sharing your experience, please keep us updated.

Couv
 

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