Reverse block

[mosquito]

I recently returned from a liveaboard.

On about my 8th dive, I felt dizzy and with some ear pressure on ascent. I had had no issues descending and was not on any sort of decongestants. I descended a bit and ascended super-slowly, and it seemed OK.

However, I continued having some problems, always on ascent, and never for more than a little bit of the ascent. Maybe 2 more times where I felt dizzy but ear pressure on about half of the remaining dives I did. I usually descended and kept trying until my ears felt OK, but at least twice I felt the pressure get worse and then suddenly "pop" and then it was fine. By the end of the trip I had (self-diagnosed) middle ear barotrauma and doctor-diagnosed swimmer's ear. Right now I'm taking decongestants for the bulge in the eardrum my doctor saw and drops for the swimmer's ear.

So 3 questions: how do I end up with reverse block without decongestants or problems equalizing on descent? Does the dizziness suggest inner ear involvement? Does anyone know an ENT in the Baltimore/Washington area who is diving aware, and does going to one make sense in my situation?

 

[Duke Dive Medicine]

Hi Mosquito,

It sounds like you suffered from some mild alternobaric vertigo, which happens when one ear equalizes before the other, typically on ascent. The ear that didn't clear had a higher pressure than the one that did; this resulted in different pressures being exerted on the vestibular apparatus, which can cause transient vertigo. The key word is transient; persistent vertigo after difficulty equalizing is more indicative of inner ear barotrauma.

Maybe you had a subclinical ear infection, or maybe there was some irritation in the Eustachian tube from repeated equalization over multiple diving days; it's difficult to tell exactly why you had more problems on ascent than on descent. Is this the first time you've experienced this? If so, it's probably an isolated event. If you continue to have problems, a visit to an ENT physician would be in order.

Best regards,
DDM

 

[Zeldah]

Hi Mosquito

If you contact DAN, they will give you a list of specialists in your area.

Good luck!