Ears, nose, throat, sinus, etc... (ie, I've got issues)

[jl_va_21]

So I think I'm about due to finally got to an ENT doc and get things checked now that I've got a little cold weather lull in my diving schedule. I checked with DAN for a recommendation, their guy is about an hour drive from my house, but there are several others very close to where I live. So the first question is, does it make a difference who I go to? Are there special scuba related factors for which I should go to a specific person or will any ENT do the same basic stuff.

So, in case any of you have any other tips, here are my general issues. I have one ear that does not equalize very well. Always the same ear. I've only been diving a couple years, but I noticed about a year prior to my first dive that this same ear was starting to have issues whenever I flew somewhere too. Anyway, between more flying and a couple years of diving, I've learned more about how to equalize and so forth and things are better, but still not ideal. Here is my routine: about 5 days before flying or diving I start taking regular doses Pseudophedrine and stop drinking/eating milk products. I do this to start getting the passages clear (apparently mine typically aren't very clear on their own maybe?) and usually (unless I have a cold or something too) then I'm ok to fly or dive. The flying part I have down pretty well and can valsalva my way through it, occasionally needing to simultaneously swallow a gulp of water.

Diving is tougher. Part of it may just be the regulator changing the position of my mouth (anyone ever tried taking it out to equalize, I'm considering it) and the fact that the dryness makes it hard to swallow at least at first. At any rate I have done about 25 dives over the last couple years and have worked out a system that generally gets the job done, but it takes me a long time to descend (really long) and I tend to use up a larger than desirable percentage of my air, wrestling with my ear during the descent.

On my last day of diving (granted I was just barely over a cold too) I took a long time to equalize my ear, but eventually got down ok on dive 1. On dive 2, my ear was better (usually not as bad on repetitive dives) but I had my first ever sinus squeeze. I just went really slowly and waited every so often and it seemed to work itself out.

In general, when my good ear equalizes, its a quick "pop" and its good. My other ear though, even when I get it to equalize a little when diving, it is not a full equalization... I need to get several equalizations at each depth before it feels really "equalized."

Anyway - there are a whole list of issues - let me know if anyone sees anything suspicious or has any other tips.

I'll let you know what the ENT doc says once I decide which one to go to.

 

[zider]

Check out the "Diver's Ear" video on this page. I also have had problems clearing my ears and some of his alternate techniques really worked for me. Doc's Diving Medicine Home Page

 

[doctormike]

Check out the "Diver's Ear" video on this page. I also have had problems clearing my ears and some of his alternate techniques really worked for me. Doc's Diving Medicine Home Page

Yup, that's a good compilation of all of the tricks that people use to equalize...

If you can find an ENT with some diving experience, that would of course be a good thing, but not absolutely necessary. The bottom line is that there is a bell curve for everything, and some people really have to struggle to equalize. Whether or not you take up diving is something that only you can decide - as long as you don't have any absolute contraindication, which you might explore with the ENT doctor.

You also need to realize that there are certain diving situations where your ENT limitations (assuming that you can't fix them by training and/or medical management) can be very dangerous (e.g. deep diving, technical diving, overhead environments, etc...). This is especially the case if you will be using up an unpredictable amount of your gas to equalize - it makes it difficult for both you and your buddy to plan a reasonable dive.

But don't give up (it doesn't sound like you are about to!).... The sinus problems may well be addressable by medical or even surgical means. There is less likelihood of a quick ENT fix for problems with Eustachian tube dysfunction, but you may be able to improve your ability to equalize your ears with practice and training (see the video).

Good luck, keep us posted! If you tell me where you are writing from, I may be able to give you a local recommendation...

Mike

 

[Dive Junky]

First of all be sure to see an ENT doc that is familiar with diving. I have actually had to explain to one ENT doc what happens to our ears when we dive. ?????

Your ear issues sound so familiar. I battled the same issues for years. The single, biggest aid for me has been to start equalizing my ears a day or two before diving, especially the morning of. My right ear clears at the drop of a hat but my left one isn't as easy.

 

[jl_va_21]

yeah I find that a couple days of practice is helpful too. I have actually seen that video before - it is very informative. My ears are good enough that if they never improve, I'll still keep diving, but the point about needing to limit the types of dives I do is certainly valid. I'm just wanting to improve it so that I can get more out of my dives... and let my dive buddies get more out of their's.

Sounds like I should try the DAN referral doctor and see where it leads. I tend to be congested often so maybe a trip to an allergy doctor might be helpful too. I really never went to doctors at all before diving, now I want every edge I can get towards making some great dives.

 

[jl_va_21]

UPDATE:

I've been to a couple doctors now so I thought I'd pass along some more info to see what further tips you all may have.

First, I went to an allergist. Not much to report here, I'm not allergic to anything. They said I just seem to have something call vasomotor rhinitis... a fancy word for what we already know... I get congested easily and often.

Second, I finally saw the ENT. I went the one that DAN suggested despite the extra drive. He seemed a little rushed, but also quite knowlegable. He said before he even looked that my voice sounded like someone with sinus problems (should I be offended - hehe). Once he looked, he was sure. He mentioned a deviated septum but didn't seem to concerned by that. He also noticed polyps though and said that those could certainly cause the type of problems I'm having. He mentioned at one point that he was somewhat surprised that I could dive at all. I guess I've been beating the odds

Anyway he prescribed 12 days of Prednisone (sp?) to reduce imflamation of the polyps and then Nasacort to help clear sinus/nasal congestion. I'm supposed to go back in 4 weeks for a xray/ct scan thing of my sinuses and for a follow up checkup.

I'm hoping the drugs help, but others so far have not had a huge impact. I'm got a couple dive trips coming up in their early part of summer, so if any further procedure is needed, I'll probably try to postpone until after my trips so as not to jeopardize them if I recover slowly or something.

On a side note, I also got a fitting set for doc's proplugs (vented of course). I'll likely order a set of those for a quick test in a local quarry once things warm up a bit.

 

[doctormike]

UPDATE:

He also noticed polyps though and said that those could certainly cause the type of problems I'm having. He mentioned at one point that he was somewhat surprised that I could dive at all. I guess I've been beating the odds

Anyway he prescribed 12 days of Prednisone (sp?) to reduce imflamation of the polyps and then Nasacort to help clear sinus/nasal congestion. I'm supposed to go back in 4 weeks for a xray/ct scan thing of my sinuses and for a follow up checkup.

I'm hoping the drugs help, but others so far have not had a huge impact. I'm got a couple dive trips coming up in their early part of summer, so if any further procedure is needed, I'll probably try to postpone until after my trips so as not to jeopardize them if I recover slowly or something.

Thanks for the update..! It sounds as if you might have some nasal problems that might be optimized (medically or surgically) which evenutally might help you with diving as well as your topside symptoms...

Keep us posted, good luck!

Mike

 

[snorkelcorey]

"Hi, every body. I'm writing this post because I have a few questions. I saw the ENT DR. yesterday, in Moncton, NB. But now, I live in Oxford, NS. She looked in my ears and said that the tube that is in my right has to be removed and replaced. She got me to sign a permission paper, saying that she has permission to put new tubes in to both ears, my right and my left ear. And earlier today, I got the call from her office. Her Secratary said that another person canceled his/her appointed surgery slated the same day as mine.She told me that she's only offering that opening to me. I told her that I was thinking of going to Ontario that same day. But, I relented and said, ok, I'll have those tubes put in. But now, I'm thinking of cancelling that surgery. What would happen if I called the day before I get those tubes put in my ears, and told her secratary that I'm not geting those tubes put in my ears at the last minute? Would I get get a real bad ear infection? And, I'm wondering if I should cancel that surgery. Should I cancel it?" SnorkelCorey

 

[don Francisco]

Can't tell you anything for or against, especially because the Doc had the benefit of an examination, and the expertise to render a qualified opinion.

But one thing I can say is that I'm surgery averse, and a strong believer in getting second opinions before I consider any kind of invasive treatment for anything. Also, getting treatment that you're unconfortable about is a good way to set yourself up for after the fact regrets.

If you feel pressured, or not sure if it's really needed, put off the surgery, get a qualified second opinion, and then if surgery turns out to be the right treatment, at least you'll be more comfortable about getting it.

 

[jl_va_21]

Thanks for the update..! It sounds as if you might have some nasal problems that might be optimized (medically or surgically) which evenutally might help you with diving as well as your topside symptoms...

Keep us posted, good luck!

Mike

Doctormike -

So here is the latest (complete with CT scan - as captured on my cell phone). Tell me what you see (if you can make it out) and I'll tell you what the Doc here said.