how to assess diving safety for someone with ear conditions

[captnkuk]

Hi,
a good friend of mine would like to try diving but he has had ear difficulties since birth; partial deafness and needs hearing aid (external only), regular ear infections etc.
loves snorkeling but never tried to dive due to fear of whether pressure and equalizing might not work for his ears and that he could cause himself extra damage.

Is there any way to be able to check this - e.g. using a hyperbaric chamber or any other way to assess?

Alternatively, are there any suggestions how to minimise the risk of ear infections while diving?

...trying to find ways how to help him to experience this amazing world of diving but avoiding risks of doing additional harm.

Thanks

 

[34109411]

find a doctor specializing in "fit to dive" exam.

 

[BoltSnap]

See a Doc, probably an ENT, who has training in diving medicine.

 

[Oldbear]

I have been diagnosed with Ménière's disease this past year and it scared the $h!t out me not knowing if my dive career was over or not. My (VA) medical team did all out diagnoses and test, then came up with a treatment. My first dive back in the water was on a WII shipwreck in Truk Lagoon. Long story short, my dive went well, my Truk trip went well and I have been teaching & diving full time. I keep my medical team up to date.

A lot of people think that ear issues automatically excludes them from dive. Most of the time it is just learning how to clear their ear. But they should see their medical team and ask for a Dive knowledgable one. If they don’t have one on their medical team find one and schedule an exam. They can determine if a medical condition would rule out diving or not.

 

[Germie]

My friend has for 1 ear a hearring aid and also had as a child a lot of problems with his ears. Before I did a trydive with him, he went to a doctor to ask about his ears as he told me he was not able to clear his ears, but he also did not had problems in a plane or so. The doctor did not find anything with eardrum or not being able to clear his ears, so we have tried to dive.
If you cannot clear your ears, you will feel it at 2m depth, and then normally nothing has been damaged. So we just started to try and went on the trydive to 3m. Not deeper, but this had to do with his problem that he wanted to get to surface every time. He was no natural in diving.
Now he has done around 70 dives, I have taken him to 42m depth, he has done several solodives already, so yes, he can dive. But 1 ear is still sometimes a problem. He is very sensitive for running ears. And then he has to stay out of the water for 1 week or so till it is over again. He went back to the doctor, but they did not find anything. Sometimes he cannot clear his ears, and always we have to go down very slow. If he cannot clear ears, then he goes out and on holiday he tries it the next dive again.
We use eardrops with tea tree oil before the dive (are sold for divers), rins with clear water after a dive (not too cold water) and at home a mix of alcohol, and vinegar. And of course always just in case he has some drops with antibiotics if there is a real problem. But with the easy over the counter eardrops most times all goes fine. Last year in Indonesia we did 14 days of diving, he 3 dives a day (I 4 or 5), and his ears did hold it. 1 day he thought he had some wet things coming out of his ear, so skipped the first dive, but tried the second again and then in the evening the ear was ok again with the over the counter eardrops. So the antiobitcs were not needed.

So if we go diving, we need to have a divecenter that does not make a problem if someone cannot clear ears and go out again. Sadly there are not a lot of divecenters that don't destroy other divers dives then. My friend can go out on his own, there is no guide needed.
Also we need to have a divecenter that has no problems with 1 diver getting down very slow on boatdives. (rest can go, he will follow later).
To find these divecenters is the worst thing about 'bad ears' for diving. A lot are hurrying too much. Diving on your own don't give these problems. We dive for 99% of our dives without use of a divecenter, but I know a lot of divers only dive with guides.

So if your friend is cleared by a doctor to go diving, do it very very slow. Never accept rushing by an instructor or guide. And rinse ears after diving. For me clean fresh water is enough, but if I don't do that, I also get ear infections in some waters if I don't rinse after a dive (here in summer, a lot of people get the otitis externa when water is around 20 degrees, or in some caves) and I have ears that can clear almost always even if I have a cold, cough and a fever together, so normally don't have problems with ears.

And for people with ears that don't clear easy, negative entries are not a good idea of course.

 

[Duke Dive Medicine]

Hi,
a good friend of mine would like to try diving but he has had ear difficulties since birth; partial deafness and needs hearing aid (external only), regular ear infections etc.
loves snorkeling but never tried to dive due to fear of whether pressure and equalizing might not work for his ears and that he could cause himself extra damage.

Is there any way to be able to check this - e.g. using a hyperbaric chamber or any other way to assess?

Alternatively, are there any suggestions how to minimise the risk of ear infections while diving?

...trying to find ways how to help him to experience this amazing world of diving but avoiding risks of doing additional harm.

Thanks

Does your friend have an otologist or ear/nose/throat physician who he sees regularly for this? If so, then that physician should be able to determine if your friend can equalize his ears and speak to anything about his ear anatomy that could be problematic with diving.

Best regards,
DDM

 

[captnkuk]

Does your friend have an otologist or ear/nose/throat physician who he sees regularly for this? If so, then that physician should be able to determine if your friend can equalize his ears and speak to anything about his ear anatomy that could be problematic with diving.

Best regards,
DDM

Yes, he's used to working with ORL doctors all the time; the problem, they are all "classically trained" and noone here has a clue about diving. He has no issues equalizing on a plane etc. But is worried about diving just due to so many problems he's had with ears in his life...
It doesn't seem to be any anatomical issue or reason not to.

 

[captnkuk]

My friend has for 1 ear a hearring aid and also had as a child a lot of problems with his ears. Before I did a trydive with him, he went to a doctor to ask about his ears as he told me he was not able to clear his ears, but he also did not had problems in a plane or so. The doctor did not find anything with eardrum or not being able to clear his ears, so we have tried to dive.
If you cannot clear your ears, you will feel it at 2m depth, and then normally nothing has been damaged. So we just started to try and went on the trydive to 3m. Not deeper, but this had to do with his problem that he wanted to get to surface every time. He was no natural in diving.
Now he has done around 70 dives, I have taken him to 42m depth, he has done several solodives already, so yes, he can dive. But 1 ear is still sometimes a problem. He is very sensitive for running ears. And then he has to stay out of the water for 1 week or so till it is over again. He went back to the doctor, but they did not find anything. Sometimes he cannot clear his ears, and always we have to go down very slow. If he cannot clear ears, then he goes out and on holiday he tries it the next dive again.
We use eardrops with tea tree oil before the dive (are sold for divers), rins with clear water after a dive (not too cold water) and at home a mix of alcohol, and vinegar. And of course always just in case he has some drops with antibiotics if there is a real problem. But with the easy over the counter eardrops most times all goes fine. Last year in Indonesia we did 14 days of diving, he 3 dives a day (I 4 or 5), and his ears did hold it. 1 day he thought he had some wet things coming out of his ear, so skipped the first dive, but tried the second again and then in the evening the ear was ok again with the over the counter eardrops. So the antiobitcs were not needed.

So if we go diving, we need to have a divecenter that does not make a problem if someone cannot clear ears and go out again. Sadly there are not a lot of divecenters that don't destroy other divers dives then. My friend can go out on his own, there is no guide needed.
Also we need to have a divecenter that has no problems with 1 diver getting down very slow on boatdives. (rest can go, he will follow later).
To find these divecenters is the worst thing about 'bad ears' for diving. A lot are hurrying too much. Diving on your own don't give these problems. We dive for 99% of our dives without use of a divecenter, but I know a lot of divers only dive with guides.

So if your friend is cleared by a doctor to go diving, do it very very slow. Never accept rushing by an instructor or guide. And rinse ears after diving. For me clean fresh water is enough, but if I don't do that, I also get ear infections in some waters if I don't rinse after a dive (here in summer, a lot of people get the otitis externa when water is around 20 degrees, or in some caves) and I have ears that can clear almost always even if I have a cold, cough and a fever together, so normally don't have problems with ears.

And for people with ears that don't clear easy, negative entries are not a good idea of course.

This is AMAZING response, thank you for writing it so precisely. I like the suggestion with 3m trial, taking it slow, using tea tree oil etc. All what you said is fantastic and I think we should heed your advice and see how it goes. Thank you so much!

 

[Germie]

It is not pure tea trea oil, it is specially made for ears, called 'Audiol Swim':

Audine Audiol®Swim - Natuurlijke Oorspray - 10ml | bol

Audine Audiol®Swim - Natuurlijke Oorspray - 10ml. Audiol®Swim oorsprayWaterafstotend, gaat irritatie van zout- en zwembadwater tegen, voorkomt jeuk en...

www.bol.com

A good instructor will tell people on a trydive that if the ears start hurting and clearing ears does not work, then they cannot go deeper, otherwise they will damage their ears. Also will a good instructor tell people to start clearing ears as soon as they are under water. And also will help to remember the person on a trydive.
I feel my ears already at 1m depth without clearing, so let an instructor tell your friend that clearing must be done directly when getting under. And never hurry.