Unresolved Barotrauma - What to do Next?

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tech3324

Lionfish
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I just don't log dives
It's been exactly one month since I suffered a middle ear barotrauma on the last dive of a five day vacation. I made about 25 dives that week, never felt I had a problem equalizing, and came home with an ear that felt blocked with muffled hearing.

Went to the ENT doctor right away, had a hearing test to check for nerve damage (none), did two regimens of Prednisone, tried Pseudoephedrine, neti pot, but nothing has relieved the blocked feeling in the ear. The last communication from the doctor was just "give it more time". The ear pops and clicks as if about to clear but never does.

I have a dive trip scheduled in two weeks, but it's looking increasingly unlikely that this problem will be resolved by then. I'd appreciate any advice on what else I could do and how long a condition like this could last. Been diving 30+ years and this is my first ear problem. Thanks.



 
It is certainly not advisable to dive with unresolved barotrauma, but I have done it, and as long as I could equalize easily and stayed aggressively on top of it, the condition didn't worsen. That is NOT a recommendation from a doctor for doing it, though!
 
I injured the ear backing down a smaller section of cave after a sinkhole. I was trying to get a shot of a diver entering with the sunlight behind her. I succeeded, it was a good shot, but I went from about 15’ to 40’ without much clearing. I knew what I was doing, but didn’t realize just how much it would impact me! Silly me cleared without ascending. It took a bit of force and the ear cleared very sharply—it was a sharp pain in the ear and a ringing for a few seconds. After the dive, I felt like I had hurt the ear and I couldn’t hear out of it very clearly.

I’m not a doctor and don’t know much about ears, but I could still clear just fine so I went on another dive the next day.

It’s been a while but I recall that it hurt a bit for a few days but the pain went away, except for some sensitivity and the inability to hear very well, I was fine. I think I went diving again 3 weeks later on a shallow beach dive, and was ok, but the ear stayed bad and sensitive.

I think I was able to hear more clearly when I went diving about 3 weeks after that. I think this second dive was in deeper water, maybe another two day cave trip. After this, the ear got painful again and I really couldn’t hear out of it. It had me pretty worried for a week or two, I was having to tell people to stand on my left side so I could converse with them, and I worried I might have permanently damaged my hearing. But, I didn’t want to go to a doctor (after it taking almost a year to get three bills sorted out for a 4 hour stay in the ER, I’m determined to never go to a doctor unless absolutely necessary. I didn’t want to have any hassle over co pays or be fighting to get a payment paid by my insurance for a simple earache, when my research (google) shows most of them clear up on their own and overuse of antibiotics causes super bugs.) so I determined to go in a week if it didn’t get better. Well, a week went by and it wasn’t any worse, so I decided to wait another week.

That went on for atleast another week or two before it seemed like the ear was a little less painful, but I still couldn’t hear well. It gradually got better over the course of a week or two. This entire time, I was fighting the “stick-your-pinky-finger-in-your-ear-because-it-feels-like-there-is-something-just-stuck-in-there” impulse, and losing pretty badly. It’s like the impulse to lick really chapped lips, but there wasn’t any Blistex for my ears! Finally, one day my ear felt like there was something tickling it, I reached up and what came out on my finger but the biggest bit of wax I’d ever seen. It was perhaps the thickness of several sheets of paper, 3-4, and as big around as a pencil eraser. It was very dark red or brown, it surprised me really. Anyways, a few days later and I felt just fine. Hearing normally, and all that.

I waited another week to get in the water, and several dive trips later I’ve had no reoccurrence of the symptoms.

I’ve always been able to clear pretty well, even with a cold. I was able to clear relatively well with the ear symptoms, but I do notice the ear that was hurt doesn’t clear as easily now. I do wonder what I did to myself, and what sort of ramifications it could have in the long term, and I dive more cautiously now. I love the picture I got, but the 2 months of ear sensitivity and partial inability to hear was not worth it. It’s far from my best picture, and even the best picture I’ve gotten isn’t worth not being able to hear.

I have had a middle ear infection before, which also made it impossible to hear, but this didn’t feel the same way. That kept building to a sharper and sharper sort of pain that wouldn’t let me sleep, and I did get antibiotics which cleared it up very quickly. This was less jabbing pain, more sensitivity and a similar inability to hear. But, not quite the level of sensitivity I’ve felt with outer ear infections before.

I’m not a doctor and even if I was I wouldn’t advocate diving with a hearing issue. I would definitely advise seeing a doctor, and even more I’d advise getting an ENT to be your friend so you don’t have to worry about insurance issues. And, get DAN! And, be willing to call them!
 
Not a doctor, and you shouldn't take this as medical advice, but I'll share my experience with something very similar.

I was dry for three months earlier this year because of a similar (almost identical) problem. My last dive before the problems started was uneventful and I didn't have any issues clearing. A day or two later and I started experiencing the same problems you're describing. I went through three ENT's who all gave me the same "give it a few weeks" answer. I finally went to see an ENT that works with DAN and she was able to actually give me some answers. My symptoms lined up with ETD (Eustachian Tube Dysfunction), but rather than just guessing she scoped me and sure enough my left ET was pretty inflamed. That's what caused the fullness, pain, etc. She put me on Nasonex and Atrovent. It took a loooooonnnngggg time to heal. I was cleared to dive on April 2nd, but was still not even fully healed then. All said and done it took about 4 months. The eustachian tubes are somewhat of a sanctuary area so getting meds back to them is very difficult. It took about 4-6 weeks before I started responding to the nasal sprays. ETD is pretty common, but it can take a long time to heal.

If you aren't satisfied with the answers you're getting from your ENT, find another one. Contact DAN. They do have a referral list. I'll never go to another ENT again.

ETD
 
If you aren't satisfied with the answers you're getting from your ENT, find another one. Contact DAN. They do have a referral list. I'll never go to another ENT again.

I did try working with DAN on this, but find out to my surprise that their referral network consists of exactly one physician in all of California, and not near me.

But thanks everyone for all the great responses on this forum.

Just to update at three months since the original injury, there is no discomfort or pain in the ear but I am left with a sensation of muffled hearing. The ENT's only suggestion is to "
consider placing a tube through the ear drum to allow aeration of the middle ear space". Just wondering if anyone here has ever done that. My present course of action is to give it more time and don't dive yet.
 
I just got over that problem. It took alomst 3 weeks. I chewed a lot of gum. Took a lot of cough drops. ate a lot of spicy food but probably none of that helped and it was all the Prednisone. The day I was suppose to go out on a dive trip my hearing was still giving me problems. I went down and did a very shallow beach dive. zero discomfort and zero problems equalizing. I came up and my hearing was far worse then before but then in about a minute of poking and pulling on my ear, like magic, I could hear again. Did the 2 dives the next day to abut 60 feet with no problems except that it takes longer for the ear to clear after i hit the surface each time. That was yesterday. Today I feel fine. I am not saying you should do it-just relating my story. I would follow the ENTs advice. I understand it only takes a week or 2 to heal (I am not a doc so...)
 

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