Strange incident with ear. Don't know what to think of it.

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drohn

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Hello fellow scubaritas and scubañeros,

I am currently on a dive holiday (abroad) where I just got declared unfit to dive, so I have a lot of time to kill and why not ask you if anybody of you ever have had the same experience that I just had. Because it is somewhat odd. This post is probably more about venting, but in both senses.

I had been diving for a few days prior without any complications. I was feeling great. But yesterday was strange. It was a guided NDL dive, nothing fancy. Nothing out of the ordinary during descend or at depth. We also checked my profile afterwards - all good. But. When we ascended, at around 30 feet, I felt a slight pressure in my left ear, plus squeeking noises. I did not exactly know what to make of it yet, when we slowly ascended just a few feet further and I suddenly felt a super intense, sharp pain in my left ear. I knew something was off with my equalization and I initiated a descend, but it did not happen: I heared a loud popping noise from my left ear. Like really loud, as if someone fired a firearm right next to me. I knew this was not good. But at the same time, the pain and noises vanished at once. I actually felt relieved. No dizziness, no nothing. Safety stop, out of the water. I took my hood off and told my buddy to have a look at my ear. He said that there was blood in it.

I was frustrated because I knew the possible implications. Other than that, I was feeling fine. No dizziness, no loss of hearing, no pain - nothing. Also, nothing was coming out of my ear, the bleeding had stopped. It was not even clogged. But we went off to see a doctor.

It was a general physician in a clinic and I told her my story and asked her to have a look at (in) my ear. She did (with "that device"), and said that there was blood in it and that I had teared my ear drum.

It sounded somewhat strange to me, because she made the impression to me that she was judging mainly by the blood in the ear. I asked her if she could clean it a bit, which she refrained from, because she did not want to touch anything in there. Which I can understand.

Anyhow, tearing of ear drum is the diagnosis. And I am behaving accordingly. But it is just so odd, because I am feeling great. No pain, my ear feels good, I hear perfectly well, nothing comes, or came, out of my ear, the blood dried up quickly - just as if nothing happened. I slept well. I don't have, or had, a cold or anything. Zero.

I feel like I should get a second opinion by a professional ENT/dive doc. Is it possible that I somehow trapped air in my ear canal which lead to a reverse blockade and the bubble "exploded" on ascend? Is that a known thing? It's just weird.

And no, I won't do anything stupid without further medical consultation in person.

/venting off :wink: :(
 
Definitely see an ENT as soon as possible. I have no ide what happened except possible a reverse squeeze. I had that happen on a night dive when ascending but the only problem was vertigo. No lasting ear problems. Good luck and get it checked out.
 
Hello fellow scubaritas and scubañeros,

I am currently on a dive holiday (abroad) where I just got declared unfit to dive, so I have a lot of time to kill and why not ask you if anybody of you ever have had the same experience that I just had. Because it is somewhat odd. This post is probably more about venting, but in both senses.

I had been diving for a few days prior without any complications. I was feeling great. But yesterday was strange. It was a guided NDL dive, nothing fancy. Nothing out of the ordinary during descend or at depth. We also checked my profile afterwards - all good. But. When we ascended, at around 30 feet, I felt a slight pressure in my left ear, plus squeeking noises. I did not exactly know what to make of it yet, when we slowly ascended just a few feet further and I suddenly felt a super intense, sharp pain in my left ear. I knew something was off with my equalization and I initiated a descend, but it did not happen: I heared a loud popping noise from my left ear. Like really loud, as if someone fired a firearm right next to me. I knew this was not good. But at the same time, the pain and noises vanished at once. I actually felt relieved. No dizziness, no nothing. Safety stop, out of the water. I took my hood off and told my buddy to have a look at my ear. He said that there was blood in it.

I was frustrated because I knew the possible implications. Other than that, I was feeling fine. No dizziness, no loss of hearing, no pain - nothing. Also, nothing was coming out of my ear, the bleeding had stopped. It was not even clogged. But we went off to see a doctor.

It was a general physician in a clinic and I told her my story and asked her to have a look at (in) my ear. She did (with "that device"), and said that there was blood in it and that I had teared my ear drum.

It sounded somewhat strange to me, because she made the impression to me that she was judging mainly by the blood in the ear. I asked her if she could clean it a bit, which she refrained from, because she did not want to touch anything in there. Which I can understand.

Anyhow, tearing of ear drum is the diagnosis. And I am behaving accordingly. But it is just so odd, because I am feeling great. No pain, my ear feels good, I hear perfectly well, nothing comes, or came, out of my ear, the blood dried up quickly - just as if nothing happened. I slept well. I don't have, or had, a cold or anything. Zero.

I feel like I should get a second opinion by a professional ENT/dive doc. Is it possible that I somehow trapped air in my ear canal which lead to a reverse blockade and the bubble "exploded" on ascend? Is that a known thing? It's just weird.

And no, I won't do anything stupid without further medical consultation in person.

/venting off :wink: :(
Concur with what @DanBMW said. This is a textbook description of reverse block (squeeze) of the middle ear with eardrum rupture. The weird part that you're describing (no pain and your hearing seems fine) is normal in this situation and is actually a reassuring sign that there's no other damage. The 'weird' part, if there is one, is the fact that it happened in the first place. Reverse block of the middle ear is uncommon. Air usually exits the middle ear via the Eustachian tube much more easily than it enters. Did you use any decongestants or nasal sprays prior to diving? If so, how long before the dive did you use them?

To your question about your hood, that seems unlikely. If your hood was that tightly sealed on your ear you'd have felt it on the way down.

A visit to an ENT for a thorough ear exam, including an audiogram, would be a good idea.

Best regards,
DDM
 
Did you try ascending a little to take pressure and then try descending again or just push through? I always value DDMs advice and am relieved (for you) he believes things will likely heal nicely. Sorry to hear about this and I hope there are shore excursions to fill your time. 😊
 
Did you try ascending a little to take pressure and then try descending again or just push through? I always value DDMs advice and am relieved (for you) he believes things will likely heal nicely. Sorry to hear about this and I hope there are shore excursions to fill your time. 😊
Thanks for the kind words. Your recommendation is perfect for a middle ear block of descent. In a reverse block, ascending could be harmful. FWIW one thing I heard from a friend/former colleague is that a slow, controlled head-down ascent can sometimes be of benefit in a reverse middle ear block situation. I saw her do it successfully with a commercial diving student in a deck decompression chamber.

Best regards,
DDM
 
Alright, so. I just come back from the ENT ward, after consulting with DAN a little.
My ear drum is not perforated. It has been put under a lot of stress obviously , but the damage of the ear is superficial. But just enough to start some bleeding. Like a scratch. I guess I was really lucky. ENT was able to clean the ear now, since everything had dried up, and that was nasty. And a lot of stuff inside my ear. Multiple inspections. Tests of hearing. All fine.

And no, I don't take medications or such... And all the other dives before were perfectly fine. I just have no idea. Will keep an eye on it.

But all the mucus made me think.. I can only think of a bubble of compressed air on the outer side of my ear drum (don't know how it is called), which hurt when it expanded and eventually bursted in a bang, adding to the damage... But I should have felt that on descend already?

Anyhow. I am feeling fine and relieved. But no diving for me until an ENT says that everything is healed up.

And yes, in a reverse squeeze situation, when people say ascend slowly, it means *really sloth like slowly*, *if at all*. That I know now.
 
Alright, so. I just come back from the ENT ward, after consulting with DAN a little.
My ear drum is not perforated. It has been put under a lot of stress obviously , but the damage of the ear is superficial. But just enough to start some bleeding. Like a scratch. I guess I was really lucky. ENT was able to clean the ear now, since everything had dried up, and that was nasty. And a lot of stuff inside my ear. Multiple inspections. Tests of hearing. All fine.

And no, I don't take medications or such... And all the other dives before were perfectly fine. I just have no idea. Will keep an eye on it.

But all the mucus made me think.. I can only think of a bubble of compressed air on the outer side of my ear drum (don't know how it is called), which hurt when it expanded and eventually bursted in a bang, adding to the damage... But I should have felt that on descend already?

Anyhow. I am feeling fine and relieved. But no diving for me until an ENT says that everything is healed up.

And yes, in a reverse squeeze situation, when people say ascend slowly, it means *really sloth like slowly*, *if at all*. That I know now.
Interesting findings from the ENT. Re the idea of the bubble in the external ear canal bursting and causing enough damage to result in bleeding, I can say with a reasonable degree of certainty that that is not what happened. Given your description, more likely is that you had a small perforation that has already begun healing, or it just wasn't visible through an otoscope, which sometimes does happen. The description of increasing pain with ascent followed by a pop and instantaneous relief of pain with visible blood in the external ear canal is textbook for eardrum rupture. If there wasn't blood in the external ear canal I'd say it was possible that the ear just equalized all at once through the Eustachian tube but the presence of blood is the clincher for me. If it was enough blood for your buddy to notice it externally after you removed your hood, I wonder if you already had a middle ear barotrauma from a recent previous dive. Regardless, the treatment of not diving until everything heals up is reasonable. Recommend you follow up with an ENT when you return home.

Best regards,
DDM
 
Definitely see an ENT as soon as possible. I have no ide what happened except possible a reverse squeeze. I had that happen on a night dive when ascending but the only problem was vertigo. No lasting ear problems. Good luck and get it checked out.

eardrum trauma. yup
 
I'm glad that it's healing with no further damage. I suffered a barotrauma in one ear in the late 80's and it left me with tinnitus in that ear... . A hearing aid helps.
 
https://www.shearwater.com/products/swift/

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