Major ear issues

[scubacindy888]

I felt absolutely terrible after sinus surgery to open up the sinuses and correct a deviated septum. I just sat around and cried for the first few days and felt like I wanted to die. It slowly started to get better but it took time. Eventually I was glad that I had it done. I am sorry that you have had such a miserable time, I hope they come up with a good solution for you soon.

Thanks I am 2 weeks out from the surgery and it really wasnt bad the first week or so...But now it feels like it is getting a sinus infection and the ears are still full and popping....I see a dentist today too for possible TMJ

 

[Duke Dive Medicine]

The thought process was that there may have been silent bubbles. Bali is really different in the way that that treat divers. Locals go to the chamber every 6 months for a "wash". They run the chamber twice a day every day and use it for a variety of reasons~ear issues, open wounds. brain injuries...

Silent bubbles, as in you had trouble equalizing so they treated you for decompression sickness symptoms that didn't exist? Sorry, just trying to make sure I understand.

 

[scubacindy888]

Silent bubbles, as in you had trouble equalizing so they treated you for decompression sickness symptoms that didn't exist? Sorry, just trying to make sure I understand.

Not just trouble clearing. Completely unable to clear. Pain , headaches etc...

 

[doctormike]

Hey, Cindi..

Wow, that's quite a story! Really hard to figure out what is going on here, sorry you have to go through this.

I don't do tuboplasties myself, still sort of experimental and not done routinely in kids (I'm a pediatric ENT doc).

You don't give any information about your profiles, but this really doesn't sound much like DCS. The devil is, of course, in the details. It sounds like your primary symptoms is a clogged sensation in your ears, right? It would be good to know the results of the ENT exam and audiogram when you were having those symptoms, to see if it correlated with objectively measurable Eustachian tube dysfunction. I can see how a chamber ride might improve symptoms of ET dysfunction just by changing ambient pressure and forcing equalization, but that wouldn't explain the relief of symptoms 3 days after the hyperbaric treatment. Also, the fact that your symptoms resolved with myringotomy (hole in the eardrum) pretty much nails the diagnosis as ET Dysfunction, and not DCS. Negative pressure is a fairly mild form of ETD.

It's also odd for a dive professional to suddenly have problems equalizing after many years of being able to do that. I guess you had a CT scan which is good to rule out any physical lesion pushing on the ETs. It's normal to feel nasal congestion after septal and sinus surgery, but that shouldn't really have any effect on the ear symptoms.

 

[Duke Dive Medicine]

This chamber treatment could have caused you considerable harm. Inability to equalize the ears is not an indication for hyperbaric oxygen therapy; in fact, it's a relative contraindication. It's fortunate that your injury wasn't aggravated further, though as Mike pointed out, sometimes gentle equalization can clear out accumulated fluid and help you feel better. I would strongly advise you not to do that again until your ENT surgeon clears you to dive.

Mike, sorry, I thought you did tuboplasties, didn't mean to mis-speak! Thanks for jumping in.

Best regards,
DDM

 

[scubacindy888]

Hey, Cindi..

Wow, that's quite a story! Really hard to figure out what is going on here, sorry you have to go through this.

I don't do tuboplasties myself, still sort of experimental and not done routinely in kids (I'm a pediatric ENT doc).

You don't give any information about your profiles, but this really doesn't sound much like DCS. The devil is, of course, in the details. It sounds like your primary symptoms is a clogged sensation in your ears, right? It would be good to know the results of the ENT exam and audiogram when you were having those symptoms, to see if it correlated with objectively measurable Eustachian tube dysfunction. I can see how a chamber ride might improve symptoms of ET dysfunction just by changing ambient pressure and forcing equalization, but that wouldn't explain the relief of symptoms 3 days after the hyperbaric treatment. Also, the fact that your symptoms resolved with myringotomy (hole in the eardrum) pretty much nails the diagnosis as ET Dysfunction, and not DCS. Negative pressure is a fairly mild form of ETD.

It's also odd for a dive professional to suddenly have problems equalizing after many years of being able to do that. I guess you had a CT scan which is good to rule out any physical lesion pushing on the ETs. It's normal to feel nasal congestion after septal and sinus surgery, but that shouldn't really have any effect on the ear symptoms.

Hi My dive profiles when it all started were nothing special. 60 feet max with OW students. It really went to **** after the flight and diving. I had one dive to around 130 feet. No quick ascents, nothing out of the ordinary. The primary symptom when it really went bad so completely unable to clear. So negative pressure. The perforating after 4 months of symptoms was instant relief. The have done several audiograms. Before they perforated there was some hearing loss, after it has come back pretty much. He said there were some tones I couldnt hear, but I am also 49, so maybe just being older. The chamber definitely relieved the symptoms by a lot....I wish I knew how/why/what caused them to go back to 100%. I feel like something is being missed if they corrected to 100% at one time...and i could feel them getting better and better over a several hour period. I am wondering if there is maybe some type of infection going on as well as the inflammation....

 

[scubacindy888]

This chamber treatment could have caused you considerable harm. Inability to equalize the ears is not an indication for hyperbaric oxygen therapy; in fact, it's a relative contraindication. It's fortunate that your injury wasn't aggravated further, though as Mike pointed out, sometimes gentle equalization can clear out accumulated fluid and help you feel better. I would strongly advise you not to do that again until your ENT surgeon clears you to dive.

Mike, sorry, I thought you did tuboplasties, didn't mean to mis-speak! Thanks for jumping in.

Best regards,
DDM

Dive doctor cleared me for the chamber and it did relieve the symptoms......I am wondering if there is an possible infection somewhere that may be causing this as well

 

[doctormike]

Hi My dive profiles when it all started were nothing special. 60 feet max with OW students. It really went to **** after the flight and diving.

Another piece of information that argues against DCS. I'm with DDM on the chamber rides...

The primary symptom when it really went bad so completely unable to clear. So negative pressure. The perforating after 4 months of symptoms was instant relief. The have done several audiograms. Before they perforated there was some hearing loss, after it has come back pretty much.

Yeah, the perforation (myringotomy) sounds like it just equalized your middle ear pressure. That's diagnostic and therapeutic. A myringotomy usually heals in about three days, putting in a grommet (tube) would keep the hole open and provide ventilation for months to years. Which might give your ears time to heal, but that would also put a stop to your diving while the tube was in. But the question is what is preventing your own ETs from doing the ventilation like they should. If there was no fluid in the ears (negative pressure usually means no significant fluid), then it's not an ear infection.

I am also 49, so maybe just being older.

HEY!! Watch that talk, young lady... If 49 is old, what does that make 54?

 

[scubacindy888]

Another piece of information that argues against DCS. I'm with DDM on the chamber rides...



Yeah, the perforation (myringotomy) sounds like it just equalized your middle ear pressure. That's diagnostic and therapeutic. A myringotomy usually heals in about three days, putting in a grommet (tube) would keep the hole open and provide ventilation for months to years. Which might give your ears time to heal, but that would also put a stop to your diving while the tube was in. But the question is what is preventing your own ETs from doing the ventilation like they should. If there was no fluid in the ears (negative pressure usually means no significant fluid), then it's not an ear infection.



HEY!! Watch that talk, young lady... If 49 is old, what does that make 54?

I asked the ENT I was seeing if we could pop a hole in the eardrum...he sad no. So I went to a different guy, told him what was going on and he suggested perforating. I didnt even know it was a thing. I was at the point where the pressure was so bad I was ready to go dive and blow the ear drums out if I could. So they were shut completely for about 4 months. I got sick as a dog after he perforated them . Fever, chills ...on my buddy's couch for three days. Dizzy...sweating bullets...

 

[scubacindy888]

I asked the ENT I was seeing if we could pop a hole in the eardrum...he sad no. So I went to a different guy, told him what was going on and he suggested perforating. I didnt even know it was a thing. I was at the point where the pressure was so bad I was ready to go dive and blow the ear drums out if I could. So they were shut completely for about 4 months. I got sick as a dog after he perforated them . Fever, chills ...on my buddy's couch for three days. Dizzy...sweating bullets...

I also asked him about a temporary tube in the ears as well so they could heal...he said no to that as well