Mid ear barotrauma related to mild congestion?

[chrisal]

Hello,

This is my first post but I've been lurking for a few weeks – I’ve watched the streaming video on diver’s ear and read quite a few posts on the subject. Anyway the reason for posting is because I think I suffered a mid ear barotrauma during my OW course and I would like people’s advice on continuing my diving adventure…

Let me start by saying I have no shortage of doctors in the Family, in addition to various Uncles/Aunts and family friends both my Mum and Dad are (recently retired) GP’s and my Farther-in-Law is a practicing GP. I am the first in my family to try scuba diving and I don’t think any of them are vastly experienced in diving related problems.

I took the OW course on a spur of the moment decision whilst on holiday in the Maldives and everything went well apart from a mild but persistent ear complaint after my second open water dive. After the very first dive I came up and felt fine but I felt I had water in my right ear for a couple of hours after the dive - like you sometimes get after a swim or shower – this went away and all the time I felt fine – no pain or dizziness or loss of balance so I thought nothing of it.
During my second dive (on reflection) I maybe descended slightly too fast and had to try a little too hard to equalize but I managed it OK. When we surfaced I had a small amount of blood in my mask which the instructor said is not necessarily uncommon – Naturally the wife was more concerned than me as I occasionally suffer from the odd spot of blood in my nose. I had the same feeling as after my first dive but this time it stayed on until after we returned home.

About a week later I had my Farther-In-Law take a look at both ears and he said the right one was quite swollen but I would have to make an appointment with my registered GP to see if I needed a prescription. Before the appointment the condition cleared up and my hearing returned to normal. I went to see her anyway and she had a quick look in both ears and both nostrils and said they were healthy and normal. Apart from this condition, I also seem to suffer from very mild congestion a lot of the time – I never really noticed this until my wife said that I was usually a bit “snotty all the time” after we returned from the trip. I mentioned this to the GP and she gave me a prescription of steroid nasal spray called flixonase sp?.

I’ve subsequently tried the flixonase but stopped taking it because it didn’t seem to be having any effect after a couple of weeks and it actually seemed to make my nose bleed a bit.

I can always equalize/pressurize fine but I do notice a slightly different sensation in my right ear when doing this – It feels like my left ear stays inflated longer than the right one.

I have a pool session booked and another trip to the Maldives to (hopefully) complete my advanced open water. I’m hoping I’ll be fine after the pool session and I’m obviously anxious that I don’t have any more problems during the trip.
Several opinions from the various doctors seem to point to a mild allergy to dust mites or cats which would account for the persistent feeling of ‘stuffyness’. I usually wake up with one ‘blocked’ nostril which clears quickly after I get up. My wife also tells me that I snore quite a lot during the night – could this be causing the congestion and not an allergy…..?

Am I going to be ok diving in the long term? Or am I setting myself up for more problems in the future? I obviously intend to talk to the Doctors in the family more about this – do you have any advice I can give them to help diagnosis or treatment (if required). I’m still not sure if the congestion issue is mild, not a problem or severe enough to make it problem during dives.

Thanks for in advance and sorry about the lengthy first post…!

 

[gert7to3]

You would do well to see an ear, nose & throat specialist. You may want to call DAN and see if they could point you to someone in your area.

You may want to reconsider your equalization methods. If you are really forcing air, it could be damaging. Try descending and ascending much, much, much more slowly. Wiggle your jaw, swallow or yawn to equalize, rather than pinching your nose and blowing away.

While you are always taught not to use decongestants prior to diving, limited use may be warranted. Be very sparing with this as constant use can cause issues with dependecy and rebound effects. Also, many of the popular OTC decongestants (Sudafed) have pseudoepherine as the active ingredient. This could aggravate pre-existing hypertensive (blood pressure) issues.

One alternative would be to use the decongestant after your dive. Especially if your ears feel stuffy.

Lortadane (Claritin) an allergy relief product can have a soothing effect on your sinus cavities, helping you to equalize, but not over medicating. This is similiar to the Floxinase you were prescribed.

Again, see an ear specialist and check everything I have said with that specialist.

 

[pennypue]

Wow, that sounds pretty much JUST like me!!!

But good news. I've been getting better and better at it. I have pretty small eustachian tubes and just a little too much pressure when equalizing they swell. My left ear is the slowest too. My hearing can be a bit messed up for a while too.

Two things I've found to help me.
1) Using different equalization techniques. My favorite DM/Instructor Javier from Blue XT Sea, showed me how to massage just below my ear, behind my jaw line while descending. This works VERY well FOR ME. Something else might work for you.
2) After diving I like to take an anti-inflammatory.

I get nose bleeds easily. Even if just blowing my nose. I've heard of some people getting blood vessels cauterized (burnt). Not sure if it bothers me that much!! And I'm also allergic (according to my allergist, VERY) to dust mites.

Good news. It hasn't bothered me. And it's gotten better the more I learn to manage my tiny eustachian tubes. (the only thing little on me, so it's hard to hate them )

a)See the ENT, make sure there isn't anything else happening in there.
b)Practice more ways to equalize.
c)Dive every chance you get.

 

[Lightning Fish]

First, I'm not a doctor, this info is what my dive-doc gave me.

Flonase (I am assuming this is what you were prescribed or is floxinase another brand?), is a steroidal spray that opens up the nasal passage allowing the mucus to flow. It has to be taken for several days before it works. It doesn't have any rebound effect like pseudophedrine (sp? - sudafed) does but can dry out your nose with prolonged use.

In your OW you should have been taught to equalize early and often. If you don't, a negative pressure builds up in your ear. There is fluid in your ear in little chambers, this negative pressure will 'suck' the fluid out. Equalize properly, early, and often, and the fluid should be okay. It can take a few hours to several weeks for the fluid to return to the chambers in your ear. When you move your jaw around your ears may crackle. As far as I know, no amount of medication will speed up the fluid returning to the chambers.

Your best bet, as advised above, go see a dive-doc or ENT with dive knowledge.

Cheers,
Bill.