Help with my ears after diving

[Felipe Gomez]

Hello, I am Felipe. I am really new in this foro. I have diving since March from this year , recently I got my padi advanced certification. I am a Doctor and my life is very full of stress so when I dive I really feel how all that disappears. But I have a problem.

After a dive I feel my ears as It would be full of water inside , I got a check with a Otorrinolaringologist and he told me that I had median otitis with effusion , he said that it wasn’t too much for drain the liquid and it will be out for itself. But each time I dive I feel that and sometimes I feel as I can feel my breath and voice in one ear. As a Doctor I have tried to find the cause of my problem but I still don’t have a concrete answer, I read sometimes about Patolous Eustaquian Tube but I am not sure.

I am here because I want to know if somebody have experienced something like my problem? And how you fixed it?

Thanks for your comments

 

[Duke Dive Medicine]

Hello, I am Felipe. I am really new in this foro. I have diving since March from this year , recently I got my padi advanced certification. I am a Doctor and my life is very full of stress so when I dive I really feel how all that disappears. But I have a problem.

After a dive I feel my ears as It would be full of water inside , I got a check with a Otorrinolaringologist and he told me that I had median otitis with effusion , he said that it wasn’t too much for drain the liquid and it will be out for itself. But each time I dive I feel that and sometimes I feel as I can feel my breath and voice in one ear. As a Doctor I have tried to find the cause of my problem but I still don’t have a concrete answer, I read sometimes about Patolous Eustaquian Tube but I am not sure.

I am here because I want to know if somebody have experienced something like my problem? And how you fixed it?

Thanks for your comments

Hello Dr. Gomez, welcome to the forum! How are you equalizing your middle ears when you descend? Are you descending in a head up, or head down position?

Best regards,
DDM

 

[Felipe Gomez]

Thanks. With Valsalva, head down

 

[Pleinmont]

Hi Filipe, it sounds like we have similar experience (and experiences) of diving. I found that I was getting similar symptoms to yours, and in fact I got a couple of ear infections which were no fun at all.

It seems I was getting reverse blocks: I wasn’t equalising very well while descending, so that my eustacian tube would become a little inflamed and would become clogged with mucus.

Two things have really improved the situation for me.

Firstly, I saw a doctor with an ear nose and throat specialism and she suggested using a neti pot to clear my sinuses occasionally (I always use it before diving). It seems to help. While I was recovering from the ear infection she prescribed decongestants and anti-inflammatories. I also found it helped to wiggle my jaw from time to time.

Secondly, and most importantly, I have really concentrated on my equalisation technique. I am taking a breath for every metre I descend, and on each breath I use the valsalva manoeuvre. I also wiggle my jaw and tilt my head a lot.

At first I had been frightened of blowing too forcefully and damaging my ear drums, so that in fact I was not blowing hard enough to equalise. It has taken about 20 dives to get familiar with the technique. I usually go diving with a local dive shop team and they make a point of letting me start my descent before their other guests so that I don’t feel any pressure to rush my descent. That makes a big difference. I’m still quite slow at descending but I am getting a little quicker, and I no longer have any ear problems.

 

[Duke Dive Medicine]

Thanks. With Valsalva, head down

You are most welcome. Try descending in a head-up position, it's easier to equalize that way. Perform a Valsalva before you leave the surface, descend slowly and in control, and equalize early and often, even though it may not feel like you have to as @Pleinmont recommended above.

Here is a link to an article on barotrauma I wrote a few years back. The anatomy will be familiar to you but you may be interested in the pathophysiology.

Best regards,
DDM

 

[fmerkel]

Along with descending feet first, especially at the beginning of the dive, look UP, jut your chin our a bit, and tilt the ear the gives you more problems toward the surface more. This stretches the Eustachian Canal and makes it easier. Try it while just sitting there; tuck your chin in and down hard and look down. Now.....gently try to clear. Personally I can't clear at all in this position. Then slowly lift the head up while trying again. You should find it much easier at some point.

Early and often means; at the surface, and EVERY 2 FEET, down to about 20'-30'. It should be EASY. If it's hard, go back up until it's easy. NEVER force it, and DO NOT descend if you can't equalize.If you go 4-6 feet without clearing near the surface you've gone WAY too far already. Many people are behind the curve almost immediately. That top 0-30 feet go through serious pressure changes.

Those thing are techniques and critical to learn.
Depending on your personal body, anatomy, allergies, upper respiratory history, you may also need some medical support (antihistamines, nasal steroids, Sudafed).
Technique FIRST, medical support if that does not work.
I also strongly encourage nasal rinses. It can make a big difference.

 

[docsin]

Hi Dr Gomez, maybe I can help. My diving career began with my first three trips resulting in ear infections. I thought I might have to give up the newly found sport I loved. Fortunately, I went to an ENT physician who was also a diver. He said begin taking Mucinex D the day before you dive. Talk about a GAME CHANGER! That was over 10 years ago, and I have never had any problems with my ears since. Ability to equalize——massive improvement. Stuffy ears after diving every day for a week——-not a problem. Yes, you have to take the Mucinex D the whole trip though, so if there are any medical contraindications it’s a no go. I know there are some on this board that will poo poo the idea of taking ephedrine compounds. It’s a personal choice because it affects people differently, but I don’t get any racing heat rate and don’t suffer from hypertension, so it works for me. I have given this tip to soo many divers including senior dive instructors. I have progressed to NAUI Master Diver, and this is the best tip I have ever learned. Without it I would be a non diver. And I take my chances bringing it to Mexico, but never had a problem with it yet. Hope I helped

 

[docsin]

PS: I rinse my ears immediately after every dive with a squeeze of rubbing alcohol/vinegar mix I keep in my mask case.

 

[Jayfarmlaw]

I second the ear beer recommendation. Vinegar/alcohol has eliminated post dive ear issues and seems to help multi day dive issues as well. The store bought stuff has glycerin in it and I don't really like it so I just make my own. On vacation, I also take a 24 hour decongestant at breakfast for extra protection. If I detect any sinus issues at all, I will throw in a blast of nasal spray. Luckily, (knock on wood) I have never missed a dive due to ear issues, even though some descents are slower than others.

Good luck!
Jay

 

[caruso]

3 words. Vented Ear Plugs. Why deal with the problem with ear drops after the fact when you can prevent water intrusion in the first place?