Middle Ear fluid, post-barotrauma

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peeweediver

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I am posting this update because folks on this site have been helpful, especially, Dr. Mike. Memorial Day weekend, over 13 weeks ago, I pushed too hard to descend through congestion while teaching OW class and gave myself a nice ear barotrauma. Yes, very dumb on my part. Barotrauma led to infection (maybe), antibiotics did not resolve problem and the ear drum ruptured 15 days later. No diving since.
Status: Ear drum has completely healed but fluid remains in the middle ear. I flunked the Tympanogram, but I am able to get air into the middle ear by jaw movement, swallowing and valsalva method. The ENT thinks that the middle ear has fluid but not totally full. Her prescription: "At this point your ear drum is well healed and you can equalize by getting air into the middle ear. I hereby clear you to TRY diving. Descend slowly and stop at any discomfort".
Though I appreciate the clearance, she is not a diver. However, why would I seek a second opinion to tell me NOT to dive? I went to the pool last night, slowly descended to 10 feet, put my head down on the pool floor and had no problem. Next, Cocos Island in 3 weeks...a huge difference. ENT has prescribed antibiotics if rupture happens again, and a few other things to keep me clear as can be. Fingers crossed and I will abort at the first sign of discomfort. Undersea Hunter boat has a kayak, so that might be my trip...and hiking on the island.
Thanks to all for your help. Lesson, as you age (over 60 now) or any age, pushing your ear drums is just not worth it...even for students. Also, DAN docs have been helpful and repeated the same theme...if your ear drum is healed and you can equalize, go ahead and try. Nobody is thrilled that fluid remains this long, but...*&it happens.

Rob
 
Did you try a short course of oral steroids?
Immediately after a middle ear barotrauma the fluid in the ear is sterile. Physicians frequently give antibiotics at this stage because they are used to middle ear infections presenting similar symptoms. At this stage it is neither effective or appropriate. Short course steroids are far more helpful to reduce the swelling and enhance healing, but are unfortunately often not used.
If you DO have an infection you DO NOT want to use steroids.

At this point you don't have an infection, you do have damage, and you have subsequent inflammation and swelling. Think about it like you sprained the hell out of your middle ear. It won't just heal up in a couple weeks. Could take months.

I'd ask about a short course of high dose steroids now. If that's helpful then discuss using about 5mg/day while diving. It can be of significant help with almost no side effects or repercussions at that dose for the duration of a dive vacation.
 
Last edited:
fmerkel:

You, my ENT and I are on the same page. I already did a 5 day stint of oral steroids early on and another 5-day two weeks ago. Now, she wants me to start again 2 days before diving on this trip and continue for 5 days at 30 mg, 2 more days at 20 and then taper completely for 2 days at 10. That will cover all diving days.
Hard to know if it was a bacterial infection because 2 different antibiotics did not seem that effective. Could have been viral or just a bad barotrauma posing as an infection.
I'll also be using nasal spray 5 days on 5 days off starting before the trip, oral decongestant and my friend the neti pot. My ENT said that if all this doesn't work, it wasn't meant to be on this trip.
Thanks for your advice. I've read your other posts on this site and they are always helpful!!

Rob
 
Glad you can equalize in the pool! You are in good hands, and it sounds like you have a good attitude. Go slow and make sure that you can clear before trying anything...

Mike
 
Sounds like you have a physician that's on top of this and giving you the best shot possible for success. :cheers:
As Mike says, go slow, pay attention.....but I doubt if you need that advice. :)
 
Advice from you and Dr. Mike is very welcome. You two have helped a bunch of folks on this site. I'll do a quick update after Cocos. Fingers crossed.
 
Posting to let my two good advisers on this thread, Dr. Mike and fmerkel, know that I just returned from Cocos Island having successfully completed 20 dives without a single ear issue. My "bad" ear did not cause any trouble and my other ear just needed a few ascents back up a few feet and swallow to clear then descent. I did take a few afternoons off to not push anything. The trip was beyond awesome and you two did provide some confidence for my first try.
Thanks to you both and I'm a very happy camper...diver.

Rob
 
That's really rewarding to hear. Glad to contribute, and happy the trip was good.
 
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