Minor Ear Infection - ABX to dive time 33 hours??

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I know you will probably tell me to call DAN or don't dive... BUT I'm hoping that maybe I can still save my dive!

Scheduled to max depth of 13 feet, my husband got me a gift certificate to go diving in a local aquarium for Christmas. Of course I got a cold last weekend, took a ton of vitamins and zinc to fend it off and was feeling fully recovered. Then yesterday I noticed that my ear felt clogged. Thought it was temporary, had some minor pain last night and tried some home remedies. This morning it still felt clogged but not painful so I went to urgent care. Doc confirmed ear infection, augmentin for 7 days. I told him that I was supposed to go diving tomorrow and did he think it was possible for the abx to clear it up enough to equalize tomorrow. He said I'd probably feel a lot better 24 hours out. He said the eardrum wasn't bulging or too severe, but that it had been enough to warrant the prescription.

I've tried equalizing today and unlike yesterday seem to be able to do it (yesterday I felt like I was going to pass out and couldn't get my ear to pop at all).

I will have 3 doses of ABX in me by my dive tomorrow, I am hoping that 33 hours of ABX is enough to save my dive. No refunds and I have to tell them if I have a substitute diver for them by the end of today.
So my husband might possibly be taking the dive that he bought for me!

Anyone successfully dive after a day of ABX without difficulties?

 

[uncfnp]

Before I give my two cents let's see if @doctormike is available.

 

[scubadada]

I can't second guess the physician you saw, but, most all "middle ear infections" in adults are not infected, but are sterile fluid collections following a viral infection, with poor drainage.

Personally, I would not have taken antibiotics, but would have taken a decongestant, pseudoephedrine, and see how I did. If I could equalize, I would dive.

In general, you should follow the advice of the treating physician. A call to DAN could not hurt. If you choose to dive and can't equalize, you'll have to abort.

Best of luck, Craig

 

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Thanks Craig! I am actually taking sudafed with that hope too. I average about one ear infection per year and I've had the whole range from taking prednisone because my eardrum was about to explode to this one, which feels pretty minor.

I just hate to cancel this dive when it's so shallow it's essentially a pool dive. If I were doing a regular dive, I would probably cancel but given the circumstances of max depth, I can't imagine that it's going to be that big of a deal. I'll probably be between 12 and 8' deep most of the time.

 

[victorzamora]

Thanks Craig! I am actually taking sudafed with that hope too. I average about one ear infection per year and I've had the whole range from taking prednisone because my eardrum was about to explode to this one, which feels pretty minor.

I just hate to cancel this dive when it's so shallow it's essentially a pool dive. If I were doing a regular dive, I would probably cancel but given the circumstances of max depth, I can't imagine that it's going to be that big of a deal. I'll probably be between 12 and 8' deep most of the time.

Make VERY sure it's Pseudoephedrine (Sudafed) and not Phenylephrine (Sudafed PE, aka Satan's work). Phenylephrine has proven itself incredibly useless to me in my life-long struggle against sinus and allergy issues.

 

[doctormike]

Hi!

The bottom line is that if you can't equalize, you can't dive, no matter what is going on. A few thoughts...

1) True middle ear infection (acute otitis media, with yellow pus behind the eardrum) is extremely rare in adults. The majority of the time that this diagnosis is given, it is inaccurate. This isn't to sound arrogant, I'm certainly not one to criticize other doctors that I don't know. It's just that if you aren't a pediatrician or an ENT doc, you just don't see a lot of ears.

2) Antibiotics don't really clear middle ear effusion and problems with equalizing, even in cases of actual acute otitis media. So I wouldn't count on that to help you dive. You need to be able to equalize, end of story... sorry!

3) Might be a good idea to see an ENT doc if you haven't seen one yet. If you let me know where you are writing from, I may be able to give you a local referral...

Best,

Mike

 

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Make VERY sure it's Pseudoephedrine (Sudafed) and not Phenylephrine (Sudafed PE, aka Satan's work). Phenylephrine has proven itself incredibly useless to me in my life-long struggle against sinus and allergy issues.

Oh I am with you! I know to use the good stuff, that phenylephrine is garbage. When I went to the pharmacy we joked that it has been five months since I picked up any Sudafed there, so I must be slacking on my meth cooking. Walter White has taken all my turf!

 

[button]

Hi!

The bottom line is that if you can't equalize, you can't dive, no matter what is going on. A few thoughts...

1) True middle ear infection (acute otitis media, with yellow pus behind the eardrum) is extremely rare in adults. The majority of the time that this diagnosis is given, it is inaccurate. This isn't to sound arrogant, I'm certainly not one to criticize other doctors that I don't know. It's just that if you aren't a pediatrician or an ENT doc, you just don't see a lot of ears.

2) Antibiotics don't really clear middle ear effusion and problems with equalizing, even in cases of actual acute otitis media. So I wouldn't count on that to help you dive. You need to be able to equalize, end of story... sorry!

3) Might be a good idea to see an ENT doc if you haven't seen one yet. If you let me know where you are writing from, I may be able to give you a local referral...

Best,

Mike

Thanks Mike! I live in Maryland on the Eastern Shore... middle of nowhere. I saw an ENT a few years ago before I started diving since I seemed to have these recurrent "ear infections" - partially because I wanted to start diving. He said the only way I could tell if I'd be able to do it is to try. If I'm feeling a little stuffy before a dive I usually take a Sudafed and so far haven't had any problems.

What do you think as far as the depth goes? It just seems like something so shallow would require minimal equalizing... I usually start equalizing on descent probably 6-8 feet.

 

[doctormike]

Well, the problem is that the biggest proportional pressure change is in shallow water...! Seriously, it's not like anyone can "clear" you to dive to 10 or 15 feet. You just need to be able to equalize. If you push through without being able to do that, you are at risk of causing permanent ear injury.

I don't know any of these docs, but here's a list of ear specialists within 100 miles of your area. Maybe someplace to start!

John P Carey, MD
Baltimore, MD 21287-0006

David J. Eisenman, MD
Baltimore, MD 21201-1619

Clarence W Gehris, Jr, MD
Lutherville, MD 21093-6275

Michael J. Jacobson, MD
Williamsburg, VA 23185-8905

Carla M Lawson, MD
Bel Air, MD 21014-4360

Josep Maeso Riera, MD
Terrassa, Barcelona 08221

Avron Marcus, MD
Glen Burnie, MD 21061

David V. Martini, MD
Elkton, MD 21921

Robert C O'Reilly, MD
Wilmington, DE 19803-3607

Kanaiyalal J. Patel, MD
Greenbelt, MD 20770-2027

Barry S Tatar, MD
Elkridge, MD 21075-6438

Michael T Teixido, MD
Wilmington, DE 19808-5400

Aaron Wood, MD
Baltimore, MD 21204

 

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Well, the problem is that the biggest proportional pressure change is in shallow water...! Seriously, it's not like anyone can "clear" you to dive to 10 or 15 feet. You just need to be able to equalize. If you push through without being able to do that, you are at risk of causing permanent ear injury.

I don't know any of these docs, but here's a list of ear specialists within 100 miles of your area. Maybe someplace to start!

The pressure change within the first 33 feet is the first thing that I thought of... but then I thought that this is only first third of that 33 feet. I guess I will equalize early & often, not force it and ascend if it doesn't work out. Or maybe just snorkel on the top, ha!

Thanks for the doc recommendations - I'm assuming that these are ENTs with knowledge on our diving issues?