Yep I did it, middle ear Barotrauma first day of Raja Ampat liveaboard

[fluff_astrid]

Yep, I am that person, the person who managed to get barotrauma on the d*rn checkout dive on the first day of a long-awaited Raja Ampat liveaboard. Based on one I experienced many years ago, the pain I had mid dive followed by a stuffy (but still able to to hear) ear leads me to believe it’s a middle ear barotrauma.

anything I can do to speed the absorption of the fluid in my middle ear? BTW, I’m absolutely hating on myself for not calling the dive when I had trouble equalizing on the surface (not congestion, so figured it’d be ok in water, especially since I dive two weeks ago without issue), and I know all the prevention rules—so know that I’m totally “I’m toldjasoing” myself. And I’m prepared to write off the rest of the trip if I have to.

I don’t have access to pseudoepinephire but do have Afrin, Advil, and...time to jealously watch everyone else dive :/

 

[UFOrb]

I feel for you...so sorry to hear that (no pun intended).
I did something similar on a trip to N Sulawesi last year and sat out several days before I felt my ear was ok enough to dive again. I wasn't on a liveaboard though so sucked less I guess!

I hope you can at least do some snorkelling and manage to get some more dives in on your trip.

Sorry, I'm not able to offer any medical advice.

Cheers,
Rob

 

[fmerkel]

See if anyone on board has oral steroids (Prednisone). That's your best bet > Take 40mg/day x 3-4 days then start backing off 5-10mg/day (taper down) until finished.

(Just because they have it doesn't mean they will let you have it. I do bring Pred on dives, and I have given other divers some but I'm pretty leery of doing it, and we have to have a long talk first. It's not an entirely benign med.)

NOTE - If you do Pred, be careful/aware of emotional swings with this. They can go from feeling fabulous to being downright grouchy. Don't let feeling fantastic sway you into diving before you are physically ready, which could take days to the entire dive time. Depends on how bad it is, how your body reacts, and how quickly you can start treating it.

Someone on a dive liveaboard is going to have a good supply of pseudofed.Ask around.
Assume you know how to use that and Afrin.

 

[CptTightPants21]

Bummer. See if there is a doctor or a medic on board--someone who could sign a paper saying don't dive. Have ship/doctor document symptoms and keep records. Depending on credit card or insurance that was used it is possible you may be able to get some type of reimbursement.

 

[Duke Dive Medicine]

Yep, I am that person, the person who managed to get barotrauma on the d*rn checkout dive on the first day of a long-awaited Raja Ampat liveaboard. Based on one I experienced many years ago, the pain I had mid dive followed by a stuffy (but still able to to hear) ear leads me to believe it’s a middle ear barotrauma.

anything I can do to speed the absorption of the fluid in my middle ear? BTW, I’m absolutely hating on myself for not calling the dive when I had trouble equalizing on the surface (not congestion, so figured it’d be ok in water, especially since I dive two weeks ago without issue), and I know all the prevention rules—so know that I’m totally “I’m toldjasoing” myself. And I’m prepared to write off the rest of the trip if I have to.

I don’t have access to pseudoepinephire but do have Afrin, Advil, and...time to jealously watch everyone else dive :/

@fluff_astrid , so sorry this happened. I'm glad to hear that you don't intend to dive if you can't equalize your ears. That said, there may be a way to rescue the trip. Caveat: it's up to you to check medication side effects and interactions and ensure that you are not sensitive to any medication, and your mileage may vary. Oxymetazoline (Afrin, others) *may* be useful if you can get it far enough back to touch the proximal ends of the Eustachian tubes, which are in the nasopharynx (the area of the back of the throat that's behind the nose). You need to be careful with nose sprays because they can have a rebound effect if you stop them after having used them for a few days. Also, depending on when they're administered and how long they last for you, they can wear off at depth, which could result in reverse barotrauma when you ascend. Over-the-counter non-steroidal anti-inflammatory medication like ibuprofen may be beneficial as well.

Try GENTLE Valsalva (pinch and blow) maneuvers on the surface. This can gently pressurize the middle ear spaces, and when the air comes back out, it may bring fluid with it, which can clear out the middle ears. If you can't clear your ears on the surface, there's no way you'll be able to in the water. If your ears will clear on the surface with a gentle Valsalva, it may be reasonable to attempt to dive again. Pre-load your ears before descent; that is, perform a gentle Valsalva before you leave the surface, then pause frequently to Valsalva on descent even though it doesn't feel like you have to. Don't wait until it feels like you have to clear your ears. If you feel that, this means that the middle ear has already begun to compress, which can seal off the proximal ends of the Eustachian tubes and make it more difficult to equalize. At any point, if you can't equalize, abort the dive.

I recommend you use caution with prescription steroids like prednisone. They can have strong side effects and, depending on your individual medical history, can do more harm than good. If they're available on board AND you can get on the phone with a physician who can recommend them after interviewing you, it may be reasonable to try them.

Best regards,
DDM

 

[fluff_astrid]

Hey folks! So sorry for the delay in following up, connectivity was a bit shot. Thanks to advice from you all (and others on the boat), I sat out a day of three dives and did a variety of things, in absence of an onboard medic:

- A spray of Afrin once (just that day)
- Ibuprofen every 4 hours
- Wore a face mask in the air conned interior of the boat to maintain humidity
- TONS of water

After a day’s break, believe it or not, everything was feeling much better. I was able to hear (yay!) and I could clear it — it was a “sticky” clear but a clear nonetheless. It’s possible I mistook pain + severe water logging for a middle ear barotrauma. I decided to try one of the easier dives the next day and mentioned to the DM that I’d abort if there were issues...and there were none!

7 days later and my ears did just fine on multiple dives after that one episode. I stayed on top of it with an ear beer mix after each and every dive; gentle clearing throughout the day on the surface; Advil at night and midday; saline nasal spray and tons of water to keep things moist; sleeping with my head propped up on pillows to encourage Eustachian tube draining as well; sleeping with a face mask to keep my nasal passages moist. I also didn’t use the Afrin again after the one use, because I was frightened of making it worse with rebound effects.

I’m certainly lucky, and so happy the whole trip wasn’t a wash

 

[outofofficebrb]

Glad you are okay and that it worked out. I hope the diving was fabulous and it made up for all the worry and discomfort!

 

[Twoblues]

Do you have meclizine available?

Yep, I am that person, the person who managed to get barotrauma on the d*rn checkout dive on the first day of a long-awaited Raja Ampat liveaboard. Based on one I experienced many years ago, the pain I had mid dive followed by a stuffy (but still able to to hear) ear leads me to believe it’s a middle ear barotrauma.

anything I can do to speed the absorption of the fluid in my middle ear? BTW, I’m absolutely hating on myself for not calling the dive when I had trouble equalizing on the surface (not congestion, so figured it’d be ok in water, especially since I dive two weeks ago without issue), and I know all the prevention rules—so know that I’m totally “I’m toldjasoing” myself. And I’m prepared to write off the rest of the trip if I have to.

I don’t have access to pseudoepinephire but do have Afrin, Advil, and...time to jealously watch everyone else dive :/

 

[Twoblues]

Yep, I am that person, the person who managed to get barotrauma on the d*rn checkout dive on the first day of a long-awaited Raja Ampat liveaboard. Based on one I experienced many years ago, the pain I had mid dive followed by a stuffy (but still able to to hear) ear leads me to believe it’s a middle ear barotrauma.

anything I can do to speed the absorption of the fluid in my middle ear? BTW, I’m absolutely hating on myself for not calling the dive when I had trouble equalizing on the surface (not congestion, so figured it’d be ok in water, especially since I dive two weeks ago without issue), and I know all the prevention rules—so know that I’m totally “I’m toldjasoing” myself. And I’m prepared to write off the rest of the trip if I have to.

I don’t have access to pseudoepinephire but do have Afrin, Advil, and...time to jealously watch everyone else dive :/

Sorry, didn't look for the date. My bad!