(Inner) ear ache after diving and flying shortly after. Safe to fly again?

[Agat]

Hi!

I went diving last Tuesday (1 week ago) and did two dives. The first one went well, however, during the second one, the entire group swam through an overhead environment. It was my first time cave diving and my buddy and I had a dive master assigned to us for the duration of the dive. All of a sudden, I felt a huge pressure in my right ear so I tried to forcefully equalise as I was not able to get out of the cave for quite some time. The ear hurt a little bit till for the rest of the dive.

I got some drops for ear pain after I got back to the island as the ear continued to hurt a little (no doctor nor pharmacy on the small island so I just rested and did not go into the water). The following Monday (6 days after), I took a flight to another island, and my ear hurt a lot during the flight, I could not equalise and got extremely dizzy and disoriented. Consequently, after we landed I went to a doctor who said my outer and middle ear are fine and without any blood/fluid etc. Ear continues to hurt though

What can it be? I am supposed to fly from the Philippines back to Europe in 8 days and I am quite scared to fly after the last experience. Did anybody experience something similar and would be able to provide some advice?

 

[Duke Dive Medicine]

Hi!

I went diving last Tuesday (1 week ago) and did two dives. The first one went well, however, during the second one, the entire group swam through a cave. It was my first time cave diving. All of a sudden, I felt a huge pressure in my right ear so I tried to forcefully equalise as I was not able to get out of the cave for quite some time. The ear hurt a little bit till for the rest of the dive.

I got some drops for ear pain after I got back to the island as the ear continued to hurt a little (no doctor nor pharmacy on the small island so I just rested and did not go into the water). The following Monday (6 days after), I took a flight to another island, and my ear hurt a lot during the flight, I could not equalise and got extremely dizzy and disoriented. Consequently, after we landed I went to a doctor who said my outer and middle ear are fine and without any blood/fluid etc. Ear continues to hurt though

What can it be? I am supposed to fly from the Philippines back to Europe in 8 days and I am quite scared to fly after the last experience. Did anybody experience something similar and would be able to provide some advice?

@Agat , from your description it sounds like you did suffer from middle ear barotrauma. Drops that you put into the external ear will not help that. Are you still having the severe dizziness and disorientation?

If you're still experiencing ear pain in the day or so before you have to fly, you may want to consider some over-the-counter decongestants prior to flying, of course following all instructions on the package and making decisions on medications based on your own personal condition, which you'll have to assess yourself. One potential pitfall of using medications is that they can wear off during the flight, so you'll have to be mindful of that if that's the route you choose.

You may get some feedback here about swimming through an overhead environment as a recreational diver so if it wasn't a true "cave" you may want to clarify that before the pack pounces, so to speak. Outside of the potential diving safety issues, the fact that you were in an overhead environment took away one of your options to resolve the ear issue, which was to ascend until the ear cleared.

This in turn may have led to the decision to forcefully perform a Valsalva maneuver. Going by your description, it seems like you got away with it with relatively little damage, but I would strongly recommend that you not do that again. Forcing a Valsalva maneuver can permanently damage the delicate structures in the inner ear.

Best regards,
DDM

 

[Agat]

@Agat , from your description it sounds like you did suffer from middle ear barotrauma. Drops that you put into the external ear will not help that. Are you still having the severe dizziness and disorientation?

If you're still experiencing ear pain in the day or so before you have to fly, you may want to consider some over-the-counter decongestants prior to flying, of course following all instructions on the package and making decisions on medications based on your own personal condition, which you'll have to assess yourself. One potential pitfall of using medications is that they can wear off during the flight, so you'll have to be mindful of that if that's the route you choose.

You may get some feedback here about swimming through an overhead environment as a recreational diver so if it wasn't a true "cave" you may want to clarify that before the pack pounces, so to speak. Outside of the potential diving safety issues, the fact that you were in an overhead environment took away one of your options to resolve the ear issue, which was to ascend until the ear cleared.

This in turn may have led to the decision to forcefully perform a Valsalva maneuver. Going by your description, it seems like you got away with it with relatively little damage, but I would strongly recommend that you not do that again. Forcing a Valsalva maneuver can permanently damage the delicate structures in the inner ear.

Best regards,
DDM

Hello,

Thank you for your reply!

I did get disoriented for maybe 2 to 3 seconds twice yesterday so nothing too intense. The only time where I was really disoriented was during the flight pretty much for the entire duration of the flight.

For context, I have AOW license, the first dive was to max 22 meteres without issues, the second one to max 17 meteres after one hour of surface time.

I will definitely get some more decongestants and possibly rebook my flight for a later date. I am going to see a otolaryngologist later today to ask for advice on the situation.

Thank you so much for your help!

All the best,
Agata

 

[blue steal]

Please keep us updated on things and what the otolaryngologist has to say

 

[Agat]

Hi!

I went diving last Tuesday (1 week ago) and did two dives. The first one went well, however, during the second one, the entire group swam through an overhead environment. It was my first time cave diving and I had a guide assigned to me. All of a sudden, I felt a huge pressure in my right ear so I tried to forcefully equalise as I was not able to get out of the cave for quite some time. The ear hurt a little bit till for the rest of the dive.

I got some drops for ear pain after I got back to the island as the ear continued to hurt a little (no doctor nor pharmacy on the small island so I just rested and did not go into the water). The following Monday (6 days after), I took a flight to another island, and my ear hurt a lot during the flight, I could not equalise and got extremely dizzy and disoriented. Consequently, after we landed I went to a doctor who said my outer and middle ear are fine and without any blood/fluid etc. Ear continues to hurt though

What can it be? I am supposed to fly from the Philippines back to Europe in 8 days and I am quite scared to fly after the last experience. Did anybody experience something similar and would be able to provide some advice?

Please keep us updated on things and what the otolaryngologist has to say

The otolaryngologist didn’t speak English well so unfortunately she wasn’t able to tell me more than just to wait.
The ear feels better but still a little “weird”. I hope the flight back home tomorrow will be ok with lots of decongestants.

Thanks for your input!

 

[GiraffeMarineSalvage]

Flying Philippines to Europe is pretty far to deal with how you describe feeling on your last flight, if decongestants don't solve the issue. Just like it's ok to thumb a dive if there's a problem or something doesn't feel right, it's equally ok to prioritize your ear health and rebook your flight if you feel that is the best option...
In a course I took with Performance Freediving International, Mucinex and Afrin were the two over-the-counter aids they recommended (although with that said, they may very well not be sufficient for your ear to properly equalize, and given there is clearly trauma/irritation without giving any medical advice since I am not a doctor, if it were me I would consider a mellow anti-inflammatory IF I tried to fly).
Only you can make the judgement call of making that flight as opposed to rebooking...