did I hurt my ears

[Crowley]

I am not a DR and I am not giving medical advice but I have had this problem numerous times myself without the pain. I’m not entirely sure of the mechanics and no DR that I have been to can tell me what is going on. But for me it takes as long as a week for it to go away. It’s like a pressure build up in my inner ear, but it feels like there is water in there. I have found that if it happens and I make another dive and I use an assent line and ascend very very slowly it will relieve the problem. It happens to me just by moving my head in the wrong direction while diving but there is never any pain. Any more I can feel it coming and I can stop it by moving my head. But in general you want to avoid dive profiles that involve a lot of up and down and don’t do goofy things like somersaults.

Water Monkey - you need to go and see a hyperbaric physician and get your skull x-rayed or MRId - this should not be happening. Up and down all the time is never good but a goofy somersault is great fun and should not cause problems. It is likely you have a malformed Eustachian tube or some other problem with your middle ear. The Eustachian tube changes shape as a person progresses from infant to child and in some cases it doesn't happen. I dived with a lady not long ago who had very similar problems. The "water in your ear" sensation is a squeeze, with the aforementioned blood and spinal fluid getting stuck in there. Assuming your equalisation technique is correct, you have a physiological problem which needs to be addressed.

Cheers

C.

 

[Hank49]

I It has now been four days since my dive and I am worried that perhaps I perforated my eardrums? I am not in pain, but my hearing is that 'underwater' feeling, like water stuck in my ears (but no sloshing).

Any suggestions as to what to do, besides seeing an ENT which I plan to do ASAP? Am I at risk of damaging my hearing?

And what's worse, I loved the experience, and I want to dive again, but I'm worried that this will happen again. Is there anything I can do?

My son just perforated his eardrum. He did it by jumping off a bridge...for fun....and landed wrong slapping the side of his head on the water, forcing air into his ear, pressurizing it and "pop". It's real obvious. When he came home he said, "Dad, listen", and he did a Valsalva and I could hear air coming out of his ear. He feels pain but it's not intolerable. Ibuprofin seems to work well enough.
Saw a doctor about it...(an American guy I met who plays a mean blues guitar...but that's another story) and he put him on an antibiotic and got some drops with antibiotic. He actually looked some info up on the internet to make sure certain drops wouldn't irritate the middle ear.
Unless it tore loose on the perimeter and wasn't just a split, it should heal within a couple weeks. Right now he can't hear a thing out of it. I'll update this in a week or so.
I'm hoping for the best. He's also my spearing and dive buddy.

 

[offthewall1]

You address many issues in your email.

1. You had trouble equalizing
2. You used decongestents before your dive
3. You had blood in your mask
4. You have the feeling of water in your ear
5. Your hearing seems to be impaired

Lets deal with each issue...
1. If you're having trouble equalizing during descent - there is a problem. The dive should be aborted and the problem solved before returning to diving. This is over and done... but I think you've learned a lesson...
2. Under absolutely no circumstance should decongestents be used prior to scuba diving. I'm tired of the stupidity behind this concept. Decongestent use can have very bad consequences for divers on many levels.
3. Blood in your mask. This was most likely caused by forceful equalization - blowing to hard while attempting to equalize. If the blood was red and minimal, this is quite normal for people who shouldn't be diving. It often happens when people try overly hard to clear while having a cold, allergies or other issue with the sinuses.
4.The feeling of water in your ear is most likely water that has become trapped in the middle ear. By itself it is not dangerous. You can usually dry it up with the use of simple 70% rubbing alchohol. Lay on your side, put a couple of drops in and equalize your ear slowly. You should feel your ear feel full and leave it that way for about 60 seconds. Then roll over on your other side and allow the solution to drain from your ear. This can dry the ear as well as kill bacteria that may be forming in the ear. Water in your ear.. depending upon the cleanliness of it can also lead to possible ear infections. If you're having pain with the feeling of water, you'll need to see an ENT for antibiotics... usually in liquid form (drops in the infected ear.)
5. Impaired hearing can simply be from the fluid or you may have done more serious damage to the middle or inner ear. If it is just water (and you're in no pain) I suggest trying the 70% alchohol to dry it up. Your hearing may then return to normal. If accompanied by pain or if after the feeling of water goes away - you still have impaired hearing...GO SEE the ENT.

The real question is getting to the bottom of why you had so much trouble equalizing in the first place. If you know you were sick or bothered by allergies it may be as simple as that.

If you've struggled with frequent common colds or allergies for a long time, you may have other issues going on which need to be addressed. These can range from narrow eustacian tubes to polyps in your sinus cavities to a deviated septum to other more serious problems. Only an ENT can assist you in figuring out your problem... and it helps if the ENT has dive medicine knowledge. Try calling DAN (Divers Alert Network) for a referral in your area.

Good Luck!

 

[TSandM]

1. If you're having trouble equalizing during descent - there is a problem. The dive should be aborted and the problem solved before returning to diving. This is over and done... but I think you've learned a lesson...

Quite true.

2. Under absolutely no circumstance should decongestents be used prior to scuba diving. I'm tired of the stupidity behind this concept. Decongestent use can have very bad consequences for divers on many levels.

Quoted from the DAN website:

If your doctor agrees, you may use decongestants and nasal sprays prior to diving to reduce swelling in the nasal and ear passages. Take them one to two hours before descent. They should last from eight to 12 hours so you don't need to take a second dose before a repetitive dive. Nasal sprays should be taken thirty minutes before descent and usually last twelve hours. Take caution when using over-the-counter nasal sprays. Repeated use can cause a rebound reaction with worsening of congestion and possible reverse block on ascent.

In normal, healthy divers breathing air, occasional use of pseudoephedrine at the recommended dose is probably safe.

There are certainly risks involved with using these medications, and people need to know what they are, but making the blanket statement that diving while using them is unsafe and indefensible is definitely overcalling it. I say that as an MD.

3. Blood in your mask. This was most likely caused by forceful equalization - blowing to hard while attempting to equalize. If the blood was red and minimal, this is quite normal for people who shouldn't be diving. It often happens when people try overly hard to clear while having a cold, allergies or other issue with the sinuses.

Forceful equalization is certainly ONE cause of blood in the mask. Sinus squeeze is another very common one. Forceful equalization is a common error in new divers, and I don't think it equates to "people who shouldn't be diving".

4.The feeling of water in your ear is most likely water that has become trapped in the middle ear. By itself it is not dangerous. You can usually dry it up with the use of simple 70% rubbing alchohol. Lay on your side, put a couple of drops in and equalize your ear slowly. You should feel your ear feel full and leave it that way for about 60 seconds. Then roll over on your other side and allow the solution to drain from your ear. This can dry the ear as well as kill bacteria that may be forming in the ear. Water in your ear.. depending upon the cleanliness of it can also lead to possible ear infections. If you're having pain with the feeling of water, you'll need to see an ENT for antibiotics... usually in liquid form (drops in the infected ear.)

First off, water doesn't accumulate in the middle ear, unless you have a perforated eardrum. Water can remain in the external auditory canal. Alcohol can help dry it up, or the very gentle insertion of a Q-tip can absorb the water. Most people can get it out simply by tilting the head and manipulating the external ear. Pure alcohol is to be avoided as a repeated practice, as it overly dries the skin of the external auditory canal.

But I believe far more common than retained water in the external canal, is the accumulation of edema fluid in the middle ear from inadequate or delayed equalization. It SOUNDS like water in the ear -- muffled hearing, and possibly crackling or bubbling sounds with swallowing or yawning. But it's in the middle ear, where alcohol can't touch it. This takes time to resolve, which may be shortened by the use of decongestants or antiinflammatory agents. It's a VERY common issue for new divers.

5. Impaired hearing can simply be from the fluid or you may have done more serious damage to the middle or inner ear. If it is just water (and you're in no pain) I suggest trying the 70% alchohol to dry it up. Your hearing may then return to normal. If accompanied by pain or if after the feeling of water goes away - you still have impaired hearing...GO SEE the ENT.

Persistently decreased hearing should definitely be evaluated, and significant ear pain as well. However, muffled hearing that doesn't resolve with alcohol may simply be middle ear barotrauma, and if not associated with balance problems and especially if the diver was aware of some late or difficult equalization, it's reasonable to wait a couple of days and try conservative therapy.

 

[lavachickie]

I'm not a doctor. And I'm a new diver. So my two cents is probably not even worth that.

I've had similar issues. When first hitting the water in pool sessions, I didn't identify any problems in equalizing (I felt pressure, but it would resolve with the usual swallowing, wiggling, etc. and without holding my nose/forcing air.). I did, however, notice a signifigant reduction in hearing--a "muffled" sense--after exiting the pool. It would take some time to clear up -- a few days. But it would always incrementally improve.

During a week long dive trip, I had the same issues. It didn't seem to compound each day, so I didn't worry too much. I did note a few times when I had an issue equilizing and the pressure edged toward discomfort, so I'd come back up a few feet and try again and all was good. We dove between 20 and 90 feet 2-3 times a day all week.

I do take antihistamines and nasal sprays before diving. I have consistent low grade environmental allergies, and this seems like good insurance for me.

It's getting better, and seems to be less of a problem each time, and resolves more quickly. My goal is to "work with it" unless I experience signifigant discomfort or pain. I do use alcohol drops after getting out of the water. Many divers have told me, "Yeah, that happened to me when I first started diving, too."

I can't say for sure what your issue is; the plan to visit an ENT is a good one. But just know that it's possible it's just your ears getting used to handling the pressure changes. I'm not sure why so many divers would experience this at first and then it go away after weeks/months/years of experience, other than the body getting used to it.

 

[Water Monkey]

Water Monkey - you need to go and see a hyperbaric physician and get your skull x-rayed or MRId C.

Are tying to say that I should have my head examined?

Maybe my wife is right, she tells me that frequently.

 

[tuj]

Well I really appreciate all the great responses. I see the ENT later in a few days (as soon as I could get an appt). I still have weird hearing; sometimes it clears up, and then usually after I sleep, one ear has degraded hearing, which usually starts to go away as I spend time upright, but never completely clears. I hear various popping in both ears throughout the day. I've tried all sorts of things from decongestants to an ear wax removal bulb and nothing really helps. Occasionally I'll get some mucus in the back of my throat that contains blood. But I have no pain in my ears or sinuses.

Once again, I *am* going to an ENT, I just can't get in yet.

I have a history of allergies, and I know that one of my sinuses is smaller than the other; this is from an x-ray an ENT did on me probably 10 years ago when I was having allergy problems. My allergies are generally controlled fine with OTC medicine (chlorpheniramine maleate and phenylephrine; no nasal sprays). I emphasize that on the day of the dive my breathing felt especially clear, although I understand this is not necessarily indicative of the condition of all of my sinus passages.

The dive was a heads-up 40' decent in open water using a line. The instructor indicated to grab the line downwards in 1m increments, equalizing each time, and returning 1m up if there was pain. I indicated ear pain a couple times and each time the instructor had me ascend about 1m and the pain alleviated, although I would say there was some mild pain throughout the entire dive. During the dive prep, there were no plans to abort the dive if one felt pain; the plan was always to ascend 1m, re-equalize, and try again to descend 1m. I have no idea if this is correct instruction or not. I was warned that people with sinus troubles should be cautious or not dive at all; and I recognize that I accepted that risk.

Are there people who just can't dive, no matter what? I would be willing to accept surgery to fix any problems with my sinus passages. I'd really like to dive again, I just don't know if I'll ever be able to.

 

[boulderjohn]

The dive was a heads-up 40' decent in open water using a line. The instructor indicated to grab the line downwards in 1m increments, equalizing each time, and returning 1m up if there was pain. I indicated ear pain a couple times and each time the instructor had me ascend about 1m and the pain alleviated, although I would say there was some mild pain throughout the entire dive. During the dive prep, there were no plans to abort the dive if one felt pain; the plan was always to ascend 1m, re-equalize, and try again to descend 1m.

Please read both sections of my reply--they go together.

If there was some mild pain throughout the dive, then you did not follow instructions. If your ears are properly equalized, there will be no pain.

If you cannot equalize, you cannot equalize, and in that case, you cannot dive. If you cannot dive, then the dive is over for you, and you will have to return to the surface.

There was probably no talk about that because it is an extremely rare occurrence. In fact, I have never seen a situation in the OW in which the diver could not eventually equalize. If you have kept at it instead of living with the mild pain you indicated, the instru tor would have had to make a decision about calling the dive, but you apparently went ahead despite the mild pain you mentioned. Your instructor can only tell if you are having pain if you tell him.

As for calling a dive, here is the golden rule for calling a dive: Anyone can call a dive for any reason at any time.

I was warned that people with sinus troubles should be cautious or not dive at all; and I recognize that I accepted that risk.

Are there people who just can't dive, no matter what? I would be willing to accept surgery to fix any problems with my sinus passages. I'd really like to dive again, I just don't know if I'll ever be able to.

Please couple what I am about to say with what I said before.

I was a person who was told that because of my chronic sinus issues that I might not be able to dive. An instructor told me that. It took me forever to get down on my OW training divers, and it was often a struggle when I was first diving.

I did exactly what you did--exactly what I told you above not do do--and I got exactly the same results you did.

I learned to work on my equalizing techniques frequently before diving, as in while just sitting around watching TV, and eventually my ears got used to it and started equalizing much more easily. I am now an instructor who spends a good deal of time under water. My ears clear so easily now that I rarely have to think about it. It is not because I am doing anything different--it is because my ears have grown accustomed to it.

And my sinus problems have pretty much disappeared.

 

[Herk_Man]

My wife during certification had a problem and surfaced too quickly. Had a lot of blood coming from one ear. Went to ENT next day and he said he was not sure whether she had ruptured her eardrum or burst a vessel in her outer ear close to the eardrum. She had very similar symptoms to you.

Doc put her on some steroid ear drops and an antibiotic. She was back in the water diving in a month. She still has a little bit of a funny feeling in her ear but it seems to be going away over time.

Personally, given the "full" feeling in her ear and some perceived hearing loss, I think she ruptured her eardrum and she thinks so too. Luckily, eardrums heal if you give them an opportunity to do so and they don't end your diving experience permanently.

Good luck!

 

[Hank49]

Update on my son's perforated eardrum. Been a week since visiting the doctor and seeing the hole. As of today, he blows his nose (forgetting to keep that kind of expansion of the membrane to a minimum) and he now hears what to him seems like a normal equalization sound.
It's only been 12 days or so since his accident. I thought the healing would be much slower than this. I think we'll do a single tank 80 air dive to 250 feet tomorrow just to test it out and see if it's really healed.