New anxiety after ear pain incident

[Nelumbo]

Hi,

I was in Croatia in September and on my first dive I felt a horrible, sharp pain into my left ear which left me unable to descend. Called it off, tried again the next day and the next, no luck - same sharp pain. The club was all ex-military, and I could feel I was annoying them by wanting to go slowly
I had it checked a few weeks later with a diving specialist ENT doctor, who couldn't find anything wrong with me. For him it was likely to be a temporary infection or inflammation as I had some pain while snorkelling too.
It felt so frustrating as my husband was able to dive, especially as I've never had ear issues before.

I used to dive regularly - every two weeks at least, but hadn't dived in three years (COVID and other practical reasons). I had no anxiety on that first dive, just happiness to be back in the water.

Since then I feel anxiety when I think about going diving again. I was on a small boat (not diving related) last week and that triggered a bout of anxiety. Even thinking about diving is making me anxious. All I can think of is - what if I'm not able to dive again? What if the pain comes back? What if I am never able to dive with my husband again (we very much enjoy it as a couple activity)?

What's wrong with me? I'm not particularly stressed by nature and I have no idea of how to react to this.
Should I do some pool training? Go on a trip but take it very slowly? Try yoga or other management techniques?

Thanks for the help.
Nelumbo

 

[Boarderguy]

Give it a few more weeks. If there's pain the is a reason for it. My wife ruptured her ear drum (small tear) and it took 3 months before she could descend without pain. 3 weeks after she got hurt and had be cleared by a doc she couldn't even snorkel below the surface. 4-5 weeks and she had the same issue. We gave it a full 3 months and on her first test dive she was good. Take it easy and remember to clear your ears often even when not diving.

 

[Duke Dive Medicine]

Hi,

I was in Croatia in September and on my first dive I felt a horrible, sharp pain into my left ear which left me unable to descend. Called it off, tried again the next day and the next, no luck - same sharp pain. The club was all ex-military, and I could feel I was annoying them by wanting to go slowly
I had it checked a few weeks later with a diving specialist ENT doctor, who couldn't find anything wrong with me. For him it was likely to be a temporary infection or inflammation as I had some pain while snorkelling too.
It felt so frustrating as my husband was able to dive, especially as I've never had ear issues before.

I used to dive regularly - every two weeks at least, but hadn't dived in three years (COVID and other practical reasons). I had no anxiety on that first dive, just happiness to be back in the water.

Since then I feel anxiety when I think about going diving again. I was on a small boat (not diving related) last week and that triggered a bout of anxiety. Even thinking about diving is making me anxious. All I can think of is - what if I'm not able to dive again? What if the pain comes back? What if I am never able to dive with my husband again (we very much enjoy it as a couple activity)?

What's wrong with me? I'm not particularly stressed by nature and I have no idea of how to react to this.
Should I do some pool training? Go on a trip but take it very slowly? Try yoga or other management techniques?

Thanks for the help.
Nelumbo

First of all, kudos for stopping yourself before you were injured. You did the right thing, regardless of what those around you might have been saying or thinking.

Anxiety in the context of fear of the unknown is perfectly understandable. From your description, it sounds like you may have experienced middle ear barotrauma, which is the most common injury in diving. That probably led to some inflammation, which can take a few weeks to clear up.

You might consider starting by trying a VERY gentle Valsalva maneuver (pinch the nose and blow) on the surface. You can try this anywhere. The important thing is to NOT force it. If you can feel both ears clear with little to no effort, then it may be reasonable to attempt a dive in calm water, taking your time and staying ahead of the descent, that is, equalizing your ears on descent before you feel like you need to. If you get behind in your equalizing, the anatomy of the Eustachian tube (the passage from your middle ears to your throat) works against you - the Eustachian tube collapses, which in turn makes it more difficult to equalize and can set up a vicious cycle.

Here is a link to a web page of our own @doctormike that explains things very well. Mike, incidentally, I started this search by Googling "doctormike ears" and got something about the world's hottest doctor, who has his own Youtube Channel. You may need to show him who's boss ;-)

Here's general one on barotrauma from the ScubaBoard knowledge base: Info - Barotrauma: The Ins and Outs of the Pops and Cracks

Best regards,
DDM

 

[doctormike]

First of all, kudos for stopping yourself before you were injured. You did the right thing, regardless of what those around you might have been saying or thinking.

Anxiety in the context of fear of the unknown is perfectly understandable. From your description, it sounds like you may have experienced middle ear barotrauma, which is the most common injury in diving. That probably led to some inflammation, which can take a few weeks to clear up.

You might consider starting by trying a VERY gentle Valsalva maneuver (pinch the nose and blow) on the surface. You can try this anywhere. The important thing is to NOT force it. If you can feel both ears clear with little to no effort, then it may be reasonable to attempt a dive in calm water, taking your time and staying ahead of the descent, that is, equalizing your ears on descent before you feel like you need to. If you get behind in your equalizing, the anatomy of the Eustachian tube (the passage from your middle ears to your throat) works against you - the Eustachian tube collapses, which in turn makes it more difficult to equalize and can set up a vicious cycle.

Here is a link to a web page of our own @doctormike that explains things very well. Mike, incidentally, I started this search by Googling "doctormike ears" and got something about the world's hottest doctor, who has his own Youtube Channel. You may need to show him who's boss ;-)

Here's general one on barotrauma from the ScubaBoard knowledge base: Info - Barotrauma: The Ins and Outs of the Pops and Cracks

Best regards,
DDM

As always, @Duke Dive Medicine is correct about everything. Generally this is a problem with technique, not anatomy. Or, it could be a temporary thing related to an upper respiratory tract infection. Take a look at those links he posted. I actually just had an article published on this in X-ray magazine, if you want to look at that as well.

I used to get that Doctor Mike's DMs all the time, since I had the twitter account before he did. He's social media royalty - 4.4 million followers on Instagram. But hey, I would like to see HIM clean the earwax out of a struggling 2 year old.

Eh, he can probably do that too...