Eardrum Rupture (unrelated to diving)

[wolframheart]

Hello fellow dive nuts,

I am having a pretty horrible day. I had (what I thought) was a cold. No big deal. People get colds all the time? I was packing a bag to go on a trip, bent over, and all of a sudden I felt something liquid down the side of my face. Yep. Blood. Ruptured eardrum. I have never experienced something like this diving, yet packing a bag causes my eardrum to self-destruct. Apparently I had an ear infection that I didn't know about.

I have already paid for a dive class that's starts in two weeks (check out dive in one month). Can anyone speak to their experience getting back into diving after a ruptured eardrum? The doctors were not at all helpful and looked at me like I had 20 heads when I said "scuba diving." I am scheduling an appointment with an ENT specialist, but in the meantime, I'm feeling pretty depressed. A knee surgery took skiing away from me, and now here my ears go, taking away my other joy.

Does this tend to be a reoccurring problem after it happens once? If you needed surgery, can you dive on the patched up eardrum eventually? How long until you were able to get back into diving? I'm obviously not putting my head under water until I get clearance from the doctor, but I'm feeling like I'm never going to dive again (dramatic, maybe), but I am hoping to have my fears quelled by some success stories.

Thank you!

 

[outofofficebrb]

I’m so sorry to hear!

By chance do you have DAN? As a member and a dive accident policy holder, you can call them for medical advice and information and even referrals for ENTs that have more knowledge to how it relates to scuba. If you’re not a member yet, i highly recommend them.

Good luck and get well soon!

 

[rsingler]

Good move, scheduling with an ENT.
Don't lose heart.
I have to admit, getting this all worked out in a month may require a bit of luck (and what with your knee, you've been on the down side of it this year), but in the grand scheme it will all work out.
A rupture catching you by surprise is a little bit of a stretch. Pay attention to your body now, and if it doesn't work out this time, there will always be another.

 

[rsingler]

The ENT will be able to tell you the state of your eardrum after the drainage, and your body will heal as long as the middle eat clears up.
Since the pool work is shallow, you may at least be able to get through the confined water dives. If not, just accept it and don't let your body get hurt.
If your ear clears up, the perforation will be a weak spot for months, so you must be able to clear in the most gentle fashion possible, and that may not be with a Valsalva maneuver. If you can clear with the jaw motion of a yawn, that would be better. Pressurizing your middle ear with a Valsalva could rerupture the drum. Don't push it, even though you've already paid. Let things heal.

A most sympathetic diving doc

 

[Duke Dive Medicine]

Hello fellow dive nuts,

I am having a pretty horrible day. I had (what I thought) was a cold. No big deal. People get colds all the time? I was packing a bag to go on a trip, bent over, and all of a sudden I felt something liquid down the side of my face. Yep. Blood. Ruptured eardrum. I have never experienced something like this diving, yet packing a bag causes my eardrum to self-destruct. Apparently I had an ear infection that I didn't know about.

I have already paid for a dive class that's starts in two weeks (check out dive in one month). Can anyone speak to their experience getting back into diving after a ruptured eardrum? The doctors were not at all helpful and looked at me like I had 20 heads when I said "scuba diving." I am scheduling an appointment with an ENT specialist, but in the meantime, I'm feeling pretty depressed. A knee surgery took skiing away from me, and now here my ears go, taking away my other joy.

Does this tend to be a reoccurring problem after it happens once? If you needed surgery, can you dive on the patched up eardrum eventually? How long until you were able to get back into diving? I'm obviously not putting my head under water until I get clearance from the doctor, but I'm feeling like I'm never going to dive again (dramatic, maybe), but I am hoping to have my fears quelled by some success stories.

Thank you!

Hi @wolframheart

Sorry to hear about this. First, you need to clear the ear infection, and second, heal the eardrum. I'd imagine you're on antibiotics by now so that should take care of the infection. Tympanic membrane perforations typically heal very quickly in healthy individuals (1-2 weeks). Talk of surgery at this point is putting the cart before the horse.

As far as diving, I agree with your plan to let the ENT tell you definitively that the TM is healed and your infection is cleared before you think about getting in the water. If the perforation isn't healed, you'll risk water ingress to the middle ear and another infection. Also, you should make sure that you can equalize your ears with a Valsalva (pinch your nose and blow) maneuver on the surface. If you can't do it on the surface you won't be able to do it in the water. It's hard to tell from your initial post whether you're already a diver and this is an additional class or this is your first dive class, so apologies if this is too much detail. Before you descend in the water, it's a good idea to 'preload' your middle ears, so to speak, with a gentle Valsalva. On descent, stay ahead of the pressure, that is, equalize your ears continually before you feel a pressure change. Go slowly unless you're very confident that your ear equalization is effective. If you feel pressure building up that you cannot equalize, stop your descent immediately and try to clear. If that doesn't work, ascend slightly and try again. Don't try to push through it because if the pressure doesn't equalize, your Eustachian tubes will collapse and make it even harder to clear.

I hope this helps. Speedy recovery!

Best regards,
DDM

 

[wolframheart]

I’m so sorry to hear!

By chance do you have DAN? As a member and a dive accident policy holder, you can call them for medical advice and information and even referrals for ENTs that have more knowledge to how it relates to scuba. If you’re not a member yet, i highly recommend them.

Good luck and get well soon!

I don't have DAN, but I had looked in to getting it. Thank you for the tip! It seems like this might need to be my next purchase. I have continuously put it off thinking "I'll get it before my next dive trip" or "next summer," but maybe this injury is a good wake up call to just get the darn insurance.

Good move, scheduling with an ENT.
Don't lose heart.
I have to admit, getting this all worked out in a month may require a bit of luck (and what with your knee, you've been on the down side of it this year), but in the grand scheme it will all work out.
A rupture catching you by surprise is a little bit of a stretch. Pay attention to your body now, and if it doesn't work out this time, there will always be another.

I haven't been diving in over a month (school/life caught up with me). This is also the first time I have ever had anything like this happen. I'm not sure how I could have been more prepared for it. I was already on medication to combat the upper respiratory infection. The doctor called it a "spontaneous tympanic membrane perforation."

@rsingler and @Duke Dive Medicine thank you for your advice on equalizing. Though I am already a diver, I am always appreciate of good advice. I would never claim to know everything! I've been blessed to not have too many problems equalizing while diving. There was only one time in recent memory on the third dive of a day where I had to give myself a bit more time around 25 feet.

I do have some decently good news to share. For this class (rescue cert), the dive shop said I can do my check out dives sometime later, after I have healed. So I don't need to feel any kind of rush to push myself physically. It's nice that they are flexible.

Thank you for your kind thoughts and advice. I have basically zero experience with ruptured eardrums. I just had no idea, practically, how long it will impact my inability to dive. I'm in no rush to worsen my situation. I have no plans to dive until I'm cleared by an ENT.

 

[RyanT]

I experienced a perforated eardrum recently. Mine was the result of complications from an upper respiratory infection, resulting in a secondary middle ear infection or at least middle ear fluid retention. I consulted DAN and an ENT as I had a dive trip scheduled just under 7 weeks post rupture. Both were not terribly positive about my trip and suggested that 7 weeks was in the "gray zone" of healing. The DAN physician suggested that even though the eardrum perforation may be closed, it doesn't necessarily mean the eardrum is healed to to its original "strength." I tried vasalva maneuvers prior to the trip and my ears cleared easily, but the ruptured one sounded a little "crinkly." This wasn't a normal feeling/sound for me, but I took the trip anyway. I made my descents very, very, slowly on the line. Fortunately I had no problems equalizing; my ear drum held up just fine and I had no trouble with my dives over three days. Afterwards I spent some time looking at the medical literature. I found one study that showed 6% of people had fully healed from a rupture at one month and 95% had fully healed at three months. So indeed, that put me right in the middle of the "gray zone" for healing. Interestingly, since my dives I still notice the ear drum that ruptured periodically "moves" spontaneously. Given this experience, I would now shoot closer to 3 months for getting back in the water. And before you get in the water practice some gentle vasalva maneuvers. If your ear drum doesn't cooperate on land, it sure won't in the water.

 

[wolframheart]

I experienced a perforated eardrum recently. Mine was the result of complications from an upper respiratory infection, resulting in a secondary middle ear infection or at least middle ear fluid retention. I consulted DAN and an ENT as I had a dive trip scheduled just under 7 weeks post rupture. Both were not terribly positive about my trip and suggested that 7 weeks was in the "gray zone" of healing. The DAN physician suggested that even though the eardrum perforation may be closed, it doesn't necessarily mean the eardrum is healed to to its original "strength." I tried vasalva maneuvers prior to the trip and my ears cleared easily, but the ruptured one sounded a little "crinkly." This wasn't a normal feeling/sound for me, but I took the trip anyway. I made my descents very, very, slowly on the line. Fortunately I had no problems equalizing; my ear drum held up just fine and I had no trouble with my dives over three days. Afterwards I spent some time looking at the medical literature. I found one study that showed 6% of people had fully healed from a rupture at one month and 95% had fully healed at three months. So indeed, that put me right in the middle of the "gray zone" for healing. Interestingly, since my dives I still notice the ear drum that ruptured periodically "moves" spontaneously. Given this experience, I would now shoot closer to 3 months for getting back in the water. And before you get in the water practice some gentle vasalva maneuvers. If your ear drum doesn't cooperate on land, it sure won't in the water.

Thank you for sharing @RyanT . Your story gives me hope that I might be able to get back into it by mid-summer (of course, still in consultation with the ENT). I didn't have any major dive trips planned (and I will be studying for the bar exam this summer anyway, so I suspected diving would be sparse). Ideally, I'll be part of that miraculous 6% and can participate in the rescue class that I am signed up for! Fingers crossed! I appreciate you sharing your experience with me.