genericusername
Registered
This is a long post. If you have experience diving with various earplug/ear-covering masks, and/or have discovered some secret workaround for eardrum perforation events, please read on. I really could use your advice. I'll underline the questions so it is easier to scan.
In the last 6 months, I perforated my left tympanic membrane (eardrum) twice. I'm looking for advice on how to best continue diving despite a high risk of having it happen again. All the authorities say that if your eardrum is actually blown, you need to stop diving until it heals completely. (That is certainly the conservative thing to do, though there may be options that will save your dive trip. I'll talk about these at the end.) However, it is less clear what to do if you have a history of blow outs.
Scuba-doc says that a history of tympanic membrane perforation is a "relative contraindication" for diving. In other words, a pretty good reason to quit. DAN is a tad less conservative. They have lots of advice on how to decrease risk of rupture; clear before you even get in the water, descend slowly & clear often and gently, when possible use a line to descend to help you go slowly, descend feet first, etc. All of these are good tips to try to avoid a blow out. But, is there a way to insure that no water gets into your middle ear if you do rupture during a dive? Given my history, I'm certain that, no matter how carefully I clear, it will happen again.
You might be asking, "What's the big deal if it ruptures?" That's what I used to think. The references say you might experience vertigo and have a chance of an ear infection. Let me tell you that this doesn't begin to capture the problem. The first time I had a blow out, it happened on surface after a night dive. Since it was at the end of the trip and there was only one more dive left, I simply did the conservative thing, and skipped the last dive. I had some muffled hearing, a little dizziness, and a some mild discomfort from a little water getting in my middle ear. The rupture healed over in a few days and the fluid eventually drained. I was all back to normal in a few weeks. The whole thing was not a big deal.
But this last time, just about a week ago in Hawaii, was much more dangerous. I was doing a shore dive at night. We swam a couple hundred yards at surface, then dropped. At only 10 or 15 feet, I cleared and felt air go out through my eardrum and then the water flood back in. I can only describe what I felt next as extreme vertigo. Like the last few seconds you're awake when going under general anesthesia, the world began to spin rapidly in three dimensions, everything went blurry, I lost track of up and down, and I was almost certainly going to vomit. I stayed calm. Inflating my b/c could rocket me upwards and I knew the bottom was sandy and only at about 10 feet away. Instead of trying to go up, I just waited until I hit the ground, which I did a few seconds later, shoulder first. I had a bunch of camera gear that I knew was slightly negative. I reached away from my body and dropped them. With my hands free, I tried to orient opposite the ground. Then I swam slowly, exhaling shallow breaths, until I hit surface. I inflated my b/c, pulled my mask, and called out for my buddy who I thought had not yet descended. There were a few other divers with us, and the top-side world was all swirling flashlights and darkness. Very off-putting and disorienting. I couldn't hear well but I could hear my buddy tell me he was coming. I lay on my back, keeping my head out of the water, and started blowing water out my ear by "clearing" with my nose pinched. I was certain that I was going to hurl. My buddy and I had a raft at surface for camera gear, which he took me to. I held on to that while he retrieved the cameras from the bottom and swam me, the gear, and the raft in. The whole time I worked on getting the water out of my middle ear. I blew water out, shook my head, blew again, tilted my head another way, blew again, etc. The dizziness started to subside. By the time we got back to shore, I could see straight, and walk my own gear out on the rocky shore. I never did hurl.
I tell this story because I hope it serves as a warning that this is not a minor injury. In many situations (e.g. on a wall or in blue water) this strategy wouldn't have worked. I couldnt read my gages so I could easily have swum down for a while thinking it was up. Or, had I been at any appreciable depth, I could have gone horizontal a great distance from my buddy before surfacing. I've done a lot of thinking about how I'd handle this in the future, but have realized that if I'm to continue to dive, I need to find a way to keep my ears dry. That way, if I blow my drum again, I can avoid the vertigo. Also, I tell this story because, none of the references I've seen tell you what to do if you do flood your middle ear. I had one ENT tell me not to blow air out on purpose, but if I hadn't pushed to get the water out right away, I'd have been in the ER for sure.
If your eardrum is already blown and you really want to dive, you can try to keep it dry by completely plugging the ear water tight. So long as it doesn't leak, you should be fine. It's risky, but doable. I do wonder what that would feel like in your other ear when you try to clear, and if the air you're pushing out through your eardrum would eventually pop most plugs. Anyway, this won't help me most of the time because you can't put a water tight seal on an ear with an intact eardrum. If it isn't obvious why you can't, DAN has a pretty good description on this page.
Vented earplugs like Doc's Proplugs say they can help. Reviews on this site and others suggest they may reduce the chance of a blow out by easing clearing, but they don't keep the ear dry. The vent lets water in your ear canal, right? Therefore, if you do blow a drum, your middle ear will still get wet with these plugs? They say the water will be warmer due to the reduced flow, therefore, the vertigo should be decreased. That simply doesn't comfort me very much. If you are a user of these plugs, am I correct in my understanding of how they work, and their limitations?
The only other option seems to be the ProEar masks. These silly contraptions keep your ears dry by enclosing them in little "masks" of their own. These spaces are connected to your mask so air can flow freely. Despite how silly they look, they seem like the solution. I've read reviews on this site and it seems the mask works, that you need to practice with it, that you can have some troubles creating too much pressure yourself, and that most people with trouble clearing seem to think it helps. But has anyone ever used a ProEar mask with a ruptured eardrum? How does that effect the system? Can you clear your good ear OK? Do you end up drizzling air from the bad ear's cup when you clear?
Then, has anyone every tried combining the vented Proplugs, with the ProEar mask? Would that provide more protection, or just screw both gadgets up? Are there any other options? Can I get a replacement eardrum?
If you've read all this, thanks for your interest. If you can offer informed advice, thanks even more.
In the last 6 months, I perforated my left tympanic membrane (eardrum) twice. I'm looking for advice on how to best continue diving despite a high risk of having it happen again. All the authorities say that if your eardrum is actually blown, you need to stop diving until it heals completely. (That is certainly the conservative thing to do, though there may be options that will save your dive trip. I'll talk about these at the end.) However, it is less clear what to do if you have a history of blow outs.
Scuba-doc says that a history of tympanic membrane perforation is a "relative contraindication" for diving. In other words, a pretty good reason to quit. DAN is a tad less conservative. They have lots of advice on how to decrease risk of rupture; clear before you even get in the water, descend slowly & clear often and gently, when possible use a line to descend to help you go slowly, descend feet first, etc. All of these are good tips to try to avoid a blow out. But, is there a way to insure that no water gets into your middle ear if you do rupture during a dive? Given my history, I'm certain that, no matter how carefully I clear, it will happen again.
You might be asking, "What's the big deal if it ruptures?" That's what I used to think. The references say you might experience vertigo and have a chance of an ear infection. Let me tell you that this doesn't begin to capture the problem. The first time I had a blow out, it happened on surface after a night dive. Since it was at the end of the trip and there was only one more dive left, I simply did the conservative thing, and skipped the last dive. I had some muffled hearing, a little dizziness, and a some mild discomfort from a little water getting in my middle ear. The rupture healed over in a few days and the fluid eventually drained. I was all back to normal in a few weeks. The whole thing was not a big deal.
But this last time, just about a week ago in Hawaii, was much more dangerous. I was doing a shore dive at night. We swam a couple hundred yards at surface, then dropped. At only 10 or 15 feet, I cleared and felt air go out through my eardrum and then the water flood back in. I can only describe what I felt next as extreme vertigo. Like the last few seconds you're awake when going under general anesthesia, the world began to spin rapidly in three dimensions, everything went blurry, I lost track of up and down, and I was almost certainly going to vomit. I stayed calm. Inflating my b/c could rocket me upwards and I knew the bottom was sandy and only at about 10 feet away. Instead of trying to go up, I just waited until I hit the ground, which I did a few seconds later, shoulder first. I had a bunch of camera gear that I knew was slightly negative. I reached away from my body and dropped them. With my hands free, I tried to orient opposite the ground. Then I swam slowly, exhaling shallow breaths, until I hit surface. I inflated my b/c, pulled my mask, and called out for my buddy who I thought had not yet descended. There were a few other divers with us, and the top-side world was all swirling flashlights and darkness. Very off-putting and disorienting. I couldn't hear well but I could hear my buddy tell me he was coming. I lay on my back, keeping my head out of the water, and started blowing water out my ear by "clearing" with my nose pinched. I was certain that I was going to hurl. My buddy and I had a raft at surface for camera gear, which he took me to. I held on to that while he retrieved the cameras from the bottom and swam me, the gear, and the raft in. The whole time I worked on getting the water out of my middle ear. I blew water out, shook my head, blew again, tilted my head another way, blew again, etc. The dizziness started to subside. By the time we got back to shore, I could see straight, and walk my own gear out on the rocky shore. I never did hurl.
I tell this story because I hope it serves as a warning that this is not a minor injury. In many situations (e.g. on a wall or in blue water) this strategy wouldn't have worked. I couldnt read my gages so I could easily have swum down for a while thinking it was up. Or, had I been at any appreciable depth, I could have gone horizontal a great distance from my buddy before surfacing. I've done a lot of thinking about how I'd handle this in the future, but have realized that if I'm to continue to dive, I need to find a way to keep my ears dry. That way, if I blow my drum again, I can avoid the vertigo. Also, I tell this story because, none of the references I've seen tell you what to do if you do flood your middle ear. I had one ENT tell me not to blow air out on purpose, but if I hadn't pushed to get the water out right away, I'd have been in the ER for sure.
If your eardrum is already blown and you really want to dive, you can try to keep it dry by completely plugging the ear water tight. So long as it doesn't leak, you should be fine. It's risky, but doable. I do wonder what that would feel like in your other ear when you try to clear, and if the air you're pushing out through your eardrum would eventually pop most plugs. Anyway, this won't help me most of the time because you can't put a water tight seal on an ear with an intact eardrum. If it isn't obvious why you can't, DAN has a pretty good description on this page.
Vented earplugs like Doc's Proplugs say they can help. Reviews on this site and others suggest they may reduce the chance of a blow out by easing clearing, but they don't keep the ear dry. The vent lets water in your ear canal, right? Therefore, if you do blow a drum, your middle ear will still get wet with these plugs? They say the water will be warmer due to the reduced flow, therefore, the vertigo should be decreased. That simply doesn't comfort me very much. If you are a user of these plugs, am I correct in my understanding of how they work, and their limitations?
The only other option seems to be the ProEar masks. These silly contraptions keep your ears dry by enclosing them in little "masks" of their own. These spaces are connected to your mask so air can flow freely. Despite how silly they look, they seem like the solution. I've read reviews on this site and it seems the mask works, that you need to practice with it, that you can have some troubles creating too much pressure yourself, and that most people with trouble clearing seem to think it helps. But has anyone ever used a ProEar mask with a ruptured eardrum? How does that effect the system? Can you clear your good ear OK? Do you end up drizzling air from the bad ear's cup when you clear?
Then, has anyone every tried combining the vented Proplugs, with the ProEar mask? Would that provide more protection, or just screw both gadgets up? Are there any other options? Can I get a replacement eardrum?
If you've read all this, thanks for your interest. If you can offer informed advice, thanks even more.
