Eardrum rupture during CESA

[TSandM]

Catherine, it's a shame people aren't given more and better information about ear issues in OW, because this is quite simply one of the most frequent complaints that people have after their classes or their first few dives.

The fact is that, no matter WHAT the problem is that is making it difficult to equalize on descent (whether it's your anatomy, or congestion, or some other issue) it's going to cause problems coming back up, too. For many people, because of the physics of things, equalizing on ascent is easier than on descent (the Eustachian tube is being expanded by the expanding gas, rather than tending to collapse). But serious problems equalizing on descent should be a warning.

I don't know if you got a chance to watch Dr. Kay's video on the ear and diving, but it really is a must-see.

I think we've all been in the position of not being able to assess just how bad our ears are until we get in the water. But you learn not to push it -- if it takes more than a couple of tries to equalize, it's time to go have lunch and dive another day.

 

[DeltaWardog]

I will add to TSandM's post that a lot of it is learning "how" to do it. My wife had big problems clearing when we started, even in the pool. Turned out she just wasn't doing it forcefully enough, which is understandable - you don't want to rupture something. Also watching the video that TSandM is referring to (I think it's the same one) helped a lot. She finally figured out a technique and hasn't had any problems on subsequent dives.

 

[driftwood]

On our last trip to Bonaire, one of the members of the group ruptured an eardrum on his first dive. All of us felt so bad for him. Lay down 2 grand and get one poor 60' dive on Klein Bonaire. Ears are a major issue that do not get the attention it deserves.

 

[Catherineskii]

The video is good - very informative. I watched it last week, actually - and tried to incorporate some of the techniques that Dr Kay talked about. Unsuccessfully, it would seem. I obviously need more practice

On the plus side, at least I actually managed to finish my certification in spite of the rupture. In addition, I'm now practically an expert on ear physiology and am considering it as a second career if the bottom ever falls out of IT....

 

[fisherdvm]

I've heard a divemaster telling a student, "with CESA, you'd want to go up as fast as possible". Can't really argue with him, as I was just a DM student. When he was under the water, I spoke about it a little more with the student, about how you need to ascend at a slow safe rate.... Unless you're like 130 ft below.

I am NOT saying that you ascended too quickly, but certainly that can contribute to the risk of barotrauma if you didn't control your rate of ascend.

 

[Catherineskii]

UPDATE... I went back to the Doc yesterday, after a week of waiting to see if the perforation would heal by itself... and it has! Well, it's 90% healed, at least. I was very surprised, as was the Doc. I was convinced it wouldn't heal (just call me a pessimist), and was kind of mentally preparing myself for ENT visits and possible minor surgery..... but I guess I just got lucky, finally!

I'm going back to the Doc in another 7 days, just to make sure that it has fully healed, and I'll speak to him then about when I might be able to risk another dive. Although I'll probably err on the side of caution and wait at least a couple of months. In the meantime, I'll be practicing those Dr. Kay techniques daily!

 

[frankc420]

That's great! Once it's healed, I would wait a least a month before diving again (I would anyway).

Remember, if it's ever hard to clear, ascend and try again, if it's still hard, ascend more, after a few attempts, if your still unsuccessful, call the dive. If you ever have trouble getting down, you will most likely have issues coming up, as that compressed air that you just pushed into your middle ear will expand and need to get out the same way it came in.

 

[Zoomer]

Speaking from experience (barotrauma that is) it takes anywhere from 4 to 6 weeks before the ear is healed and a couple more weeks to really get to feeling normal again... unless you can get into a ENT to actually relieve the pressure for you... yes they will in some cases perforate the eardrum to relieve pressure and discomfort.

If you have allergies that are causing some stuffiness, I suggest you see an Allergist.

 

[DwayneJ]

The Navy dive manual has some great info on ears and equalization issues - Around Page 3-25.

http://www.scubaboard.com/forums/nedu-q/228701-usn-manual-rev-6-a.html