Ear Problems During/After Diving

[NoseDive]

So I went on my first dive trip this weekend after being certified a year ago... Overall it was awesome, we did 4 shallow (15-40 ft) dives and one deeper dive (~60 ft.) Throughout the day I was having a little difficulty clearing my right ear, but was able to do so just by taking my time and using the 'nose-pinch' method. The deep dive actually went very well in this respect, I was completely comfortable throughout the dive with the exception of a little longer descent time than normal.

After I ate lunch, however, I started having some serious trouble clearing my right ear, to the point where I could not continue a 50 ft dive we had planned on doing. I spent probably 15 minutes at about 15 feet trying to clear my right ear and just could not relieve the pressure. After this I returned to the surface and spent a little time in the shallows then took a break for about 40 minutes.

My last dive we stayed shallow, probably less than 25 feet the whole time and I was able to cautiously and slowly descend and be comfortable.

After the last dive I noticed my right ear felt and sounded muffled, and I experienced an extremely slight discomfort as well. I went to sleep thinking it would clear by morning and it didn't. I still had this feeling all day yesterday and today. I've read about several different things that could be causing this and none of them sound severe, but I'm looking for some real life experience with this issue.

To be clear here are the facts:
-relatively shallow dives (65 ft max)
-all descents/ascents were done cautiously clearing as I went
-I was wearing a hood, which I feel added to the difficulty equalizing
-at no point was I in real pain, just mild-severe discomfort a few times while descending
-I now have muffled hearing, and a 'full' feeling in my right ear
-I have taken decongestants for the past 12 hours without result
-there is no discharge from the ear, and air cannot pass through when doing the 'pinch method' of clearing, leading me to believe I DID NOT rupture the eardrum
-anytime I swallow I hear a fluctuation in the ear, almost like water sloshing around

Any help would be greatly appreciated. I'm not really concerned with long-term problems at this point, since this seems fairly common, but I just would like some anecdotal advice as to what to expect/watch out for. Thanks guys!

Edit: I just read that bursting an eardrum in cold water can cause a sudden rush of vertigo... After reading this it may be important that on one ascent I didn't bleed the BC fast enough and the last 4 feet or so of my ascent was a little out of control. I'm not sure if it was just the panic feeling of not being able to slow my ascent or not but I did get a sudden rush of vertigo, that seemed to go away immediately after surfacing. I did not, however, experience severe pain, or any feeling I would consider consistent with rupturing an eardrum, just the usual mild discomfort of ascension.

 

[A2thaK]

I would guess water in the ear. Happened to me this past weeked with a few shallow dives. Came home and everything sounded dampened and I could hear the same type noises when I chewed. After some creative head shaking and pounding my ear against my bed (probably not the best way to get water out, but I have done that way since I was a kid and had water in from the pool) a bit of water came out and I was back to normal.

So maybe try shaking your head with your ear towards the ground, or buy some of that swimmers ear stuff. I think vinegar works too, but don't hold me to it.

 

[joe8mofo]

Based on reading what some very knowledgeable people on this board have stated (TSandM being one of them) you may have middle-ear barotrauma. Give DAN a call if you would like to speak with someone regarding it. A regular doctor may not identify what is really going on so you could also see an ear specialist.

Here are some posts on the subject: http://www.scubaboard.com/forums/introductions-greets/329680-partial-deafness-after-2-dives.html

http://www.scubaboard.com/forums/accidents-incidents/308292-barotrauma-my-open-water-dive.html

 

[Bubbletrubble]

Most likely diagnosis: barotitis media (middle ear barotrauma)
It's almost certainly not an outer ear infection (otitis externa a.k.a. "Swimmer's" ear) which can be prevented by the ear beer formulas containing vinegar and rubbing alcohol.

It's important to realize that an ear problem noticed immediately following diving is usually a pressure-related issue rather than an infection (otitis media or otitis externa).

Please read this webpage on the Divers Alert Network website.

I'd try some decongestants for a few days. The issue will likely resolve on its own. Best way to deal with this kind of thing is to prevent it in the first place. Equalize early and often. Pre-pressurize at the surface before descending. Don't go diving if you are at all congested. Treat allergies so that they aren't a problem when diving. For ear equalization techniques, check out the link to Dr. Kay's website in my sig. Lots of great info there.

If the decongestants don't help or the pain increases or you start to have a fever or there's a weird discharge from the ears or it doesn't get better in a few days, definitely see a physician. He/she may be able to give you more options (prescription-based decongestants, corticosteroids to reduce inflammation if necessary, myringotomy is possible if ear pain is incapacitating and intractable). Generally speaking, the physician should take a conservative approach. If a middle ear infection is suspected or the ear drum is already ruptured, then the doctor might prescribe a course of antibiotics.

Good luck and keep us posted on your progress...

 

[NoseDive]

I take it from the fact that you copied and pasted that response that this is a familiar topic here... I am now one of the army of inexperienced divers that let this happen? Am I correct in thinking that, like most of the aforementioned army's, my issue will most likely clear up on its own in the next few days?

Just a note of caution; I am fairly certain the 'tipping point' from when I was able to equalize and unable, which occurred sometime around my lunch, was a cigarette I had after lunch... It wasn't until after returning home that I read that tobacco, or any smoke for that matter makes equalization problems worse. Thinking that this all could have been avoided by foregoing one cigarette is really got me kicking myself.

 

[Bubbletrubble]

I take it from the fact that you copied and pasted that response that this is a familiar topic here... I am now one of the army of inexperienced divers that let this happen? Am I correct in thinking that, like most of the aforementioned army's, my issue will most likely clear up on its own in the next few days?

The answer to all of your questions is: Yes.
To clarify, I "plagiarized" myself. I wouldn't have cut-and-pasted someone else's response and then passed it off as my own.
In these "ear" threads, there are typically several posts on what everyone likes to use to prevent an outer ear infection (various concoctions containing rubbing alcohol and vinegar). Your clinical picture is inconsistent with an outer ear infection based on the timeline of symptoms.

Just a note of caution; I am fairly certain the 'tipping point' from when I was able to equalize and unable, which occurred sometime around my lunch, was a cigarette I had after lunch... It wasn't until after returning home that I read that tobacco, or any smoke for that matter makes equalization problems worse. Thinking that this all could have been avoided by foregoing one cigarette is really got me kicking myself.

Umm. Do yourself a favor and stop smoking. As a diver, you are at an increased risk of lung-overexpansion injuries. As you probably already know, you are at an increased risk of any number of cardiovascular diseases and lung problems (cancer, etc.). That being said, the surface interval cigarette probably had little to do with your ear issues. The damage had already been done during initial descent of the previous dive.

 

[NoseDive]

^Thanks for the clarification, I wasn't accusing you of plagiarizing, I just figured that was a sign of how common my question is.

As for the smoking, I actually am not really a smoker, which is what makes me disappointed in myself. Every once in a blue moon I have poor enough judgement to have a cigarette, and this was one of those times unfortunately. Not really something I need to get into on here, but I have taken your advice to heart and I do appreciate your concern.

 

[TSandM]

I agree with Bubbletrubble -- this is almost certainly barotrauma. It doesn't take a whole lot of negative pressure to get some fluid to exude into the middle ear, and it's EXTREMELY common with new divers, who are often so distracted with all the things they are managing on their first dives, that they leave equalizing too late. You don't have to have pain to have barotrauma!

In addition, you might enjoy watching THIS video, which has a lot of information about the diver's ear.

Most mild cases of barotrauma resolve within a week or two. Decongestants may help, as may nonsteroidal antiinflammatories like ibuprofen, if you have no contraindications to their use.

 

[Bubbletrubble]

Edit: I just read that bursting an eardrum in cold water can cause a sudden rush of vertigo... After reading this it may be important that on one ascent I didn't bleed the BC fast enough and the last 4 feet or so of my ascent was a little out of control. I'm not sure if it was just the panic feeling of not being able to slow my ascent or not but I did get a sudden rush of vertigo, that seemed to go away immediately after surfacing. I did not, however, experience severe pain, or any feeling I would consider consistent with rupturing an eardrum, just the usual mild discomfort of ascension.

I apologize for not seeing your post-script sooner.

You may have experienced some slight, transient dizziness related to a fast ascent. It should take you 30-60 seconds to ascend from safety stop depth (15 fsw) -- it's OK to go even slower if you like. Beginner divers tend to pop up to the surface waaaaaaay too quickly from safety stop depth. That's a big mistake IMO.

You should not be feeling a "usual mild discomfort of ascension." That's odd. A well-controlled ascent should be very relaxing with no pain involved at all. Having good buoyancy control does take practice, though. So get out there and practice (after your barotitis media resolves, of course).

 

[knowone]

I would guess water in the ear. Happened to me this past weeked with a few shallow dives. Came home and everything sounded dampened and I could hear the same type noises when I chewed. After some creative head shaking and pounding my ear against my bed (probably not the best way to get water out, but I have done that way since I was a kid and had water in from the pool) a bit of water came out and I was back to normal.

So maybe try shaking your head with your ear towards the ground, or buy some of that swimmers ear stuff. I think vinegar works too, but don't hold me to it.

I suppose the people waiting for a summary on Finished pool dives will have to find this diamond. To original poster land lubber bog in Eustachian tubes. Go swimming.