Ear Equalization Problems

Discussion in 'New Divers and Those Considering Diving' started by Amersboo, Jul 25, 2011.

  1. Amersboo

    Amersboo Guest

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    My husband and I are attempting to get our SSI Certification. We did our first pool training session today and went under 10 feet. I went down very slowly each time and the first time, I didn't equalize my ears very well. They hurt horribly the entire time I was under water. From that point on, they ached and hurt and I heard a lot of high pitched sounds, along with not being able to hear voices all that well. It has faded and now I have a dull ache in both ears. I've popped them quite a bit and that seemed to help some, but I don't like the dull ache going on.

    I told my instructor about this and she said to just put drops of hydrogen peroxide in each year. I told her that they hurt quite a bit.. but she didn't seem overly concerned. The thing is, I am concerned!! My ears hurt like hell right now and tomorrow we do pool training 2. I don't think I could really stand them hurting much more than they do now.

    The thing is, I had a physical before we did this and the doctor found nothing wrong with my ears. But truth be told, I've always had issues with my ears. I'm either dizzy or they feel full of wax/gunk. Should I do pool training session #2 tomorrow or postpone? :(

    Mind you, this is my first time attempting to dive... eep!
     
  2. Bubbletrubble

    Bubbletrubble Regular of the Pub

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    Your instructor is giving you poor advice.
    Hydrogen peroxide drops will do nothing to help with middle ear barotrauma, which is almost certainly what you have.
    In fact, such caustic drops might end up irritating the external auditory canal -- doing more harm than good.
    With your ears in their current condition, you should not be diving. Postpone the rest of your class.
    If you were to proceed with the class as scheduled, you could easily damage your ear structures even more...and then you might not be able to dive for months (or longer). Suffice it to say that your health is far more important than adhering to a silly class schedule.

    In the short-term, to help you deal with the pain/pressure in your ears, you can take NSAIDs (e.g., ibuprofen) for pain relief and possibly an OTC decongestant (e.g., pseudoephedrine, phenylephrine) to deal with the middle ear congestion.
    If your ears seem to be getting worse, I would recommend seeing your physician.

    Getting back to the cause of the ear pain...you probably injured your ears that first time you descended without equalizing sufficiently. From that point on, you were fighting a losing battle.
    I think some ear education is in order. Click on the link in my sig. Dr. Kay's lecture is a worthwhile watch.
    Poke around on his website and you'll find a webpage which describes the various ear equalization techniques. There are several. Try all of them. Find out what technique works best for you. As one datapoint, the standard pinch-the-nose-and-blow (Valsalva) method never worked that well for me. YMMV.

    A diver using proper ear equalization technique will never feel any ear pain. In fact, I only feel a slight pressure during descent. For a beginner, it can be helpful to hold onto something during the descent so that you can gain proficiency in ear equalization without the added task-loading of managing buoyancy.

    Hope this helps...
     
    Last edited: Jul 26, 2011
    1fast05 likes this.
  3. 1fast05

    1fast05 Angel Fish

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    Bubbletrubble said it all. As a hyperbaric tech and active diver I see people using improper techniques to equalize quite frequently. The Valsalva is one of the more "dangerous" techniques to use as it is easy to over-pressure your middle ear and cause issues such as you described. Also if you don't equalize often enough it is very easy to reach a pressure that pinches of the eustation tube and can prevent you from equalizing. The phrase "equalize early and often" is said/should be said a lot during your classes. As bubble pointed out you should postpone the dive and if the ear problems persist make an appointment with an ENT to make sure that no issues are present.
     
  4. snowdog

    snowdog Nassau Grouper

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    Keys to Ear Equalization:
    "Equalize early and often", avoid “Improper techniques”, get more Practice
    When all else fails, or as 1fast05 said, make an appointment with an ENT to make sure that no other issues are present.
     
  5. DivemasterDennis

    DivemasterDennis ScubaBoard Supporter ScubaBoard Supporter

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    I think quite a few people do not get equalization techniques properly. They may be overly concerned with ear squeeze, or over sensitive, and therefore "over equalize" with a counterproductive result. Here are some things to try when you dive next:

    1. Exhale through your nose
    2. wiggle your jaw
    3. tip your head from side to side, or if horizontal, roll from side to side
    4. swallow while doing #3
    5. Descend slowly
    6. If you feel excessive pressure, ascend a little until it abates, then commence the decent again
    7. My wife and I take a single sudafed little red pill 1 hour before diving and find that makes equalizing easier. Use only if other techniques don't work.
    6. As you dive more and relax more, equalizing in fact becomes easier.
    Don't push diving when ears give you pain. Pain and pressure are two different things. When I have pain, I know it and have to go shallow until I can clear.
    DivemasterDennis
     
  6. BabyDuck

    BabyDuck Surface Interval Member

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    there's an excellent thread somewhere with lots of different techniques. valsalva works for me, but i think one you could use as search is the frenzel technique. a friend of mine only has to sort of jut out his lower jaw. stop your class for now, i think bubbletrouble's on the right track with his advice, and read up on lots of different techniques. try them in the tub - it won't be the only stupid-looking thing you do in the name of diving!
     
  7. TSandM

    TSandM Missed and loved by many.

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    BubbleTrubble, as usual, has nailed it. DON'T try to dive again until the discomfort is gone! Middle ear barotrauma is generally just annoying, but you CAN do permanent damage to the structures of the inner ear, and end up with hearing loss or vertigo. The instructor who gave you the advice to use drops does not understand the difference between external otitis (infection of the outer ear canal) and barotrauma -- many divers are confused about this, but an instructor really ought to know better.

    Once your discomfort has resolved, you can play with the various equalization techniques (HERE is a site discussing some of them) on land, and see what works for you. Don't get in the water until you can reliable pressurize your ears on land -- nothing gets BETTER underwater.
     
  8. gypsyjim

    gypsyjim I have an alibi ScubaBoard Supporter

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  9. Amersboo

    Amersboo Guest

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    Thanks so much for the tips guys! I called the Scuba place and postponed until next week. I DID see a GP about my ears and she said that everything looked fine, other than a little water. But I don't want to risk it with the pain that I am having. It's still bugging me! With all that I am hearing - I don't want to damage anything. What a nightmare that would be! Thank you for the great tips on equalizing as I am descending.

    I think my biggest problem is that I'm completely new to buoyancy and I feel completely out of control. I'm sure everyone has been there - but it's tough to remember to equalize with everything else going on! I also feel that everyone is getting to the bottom much faster than I am. I DO have pretty bad allergies so I will look into the sudafed before diving. This should help clear those passages. There are times when I'm even on a plane and can't equalize my ears, so this might be a problem I have before each dive.

    I do find that rolling my head back and forth and swallowing at the same time sure does help! I'll remember to try these different techniques. I just hope diving gets a bit easier with time. I am VERY sensitive about my ears and this kind of makes me feel a bit down trot about the whole thing. I'm grateful to hear of other people who have experienced the same issues with equalization.

    Babyduck, I had to laugh when you said to try the techniques in the tub. Good idea!! Trust me, I couldn't feel like I look anymore stupid at this point. About 2 minutes into the pool training I was laying at the bottom of the pool due to not inflating the BC a bit to get neutral... so I'm flipping/flapping around at the bottom of the pool without remembering the inflator button. Every time I think about it I start cracking up!
     
  10. gypsyjim

    gypsyjim I have an alibi ScubaBoard Supporter

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    :rofl3: There may be divers who were so natural that they never had any buoyancy, or other issue, but I certainly have never dived with them! maybe a few who might have tried to make trhat claim, but.....:no:

    Even the most experienced diver has occasional "issues", that he/she hopes none of his buddies have witnessed. Every dive is a learning experience, and mistakes can be very good learning tools.

    Sunday I dived an entirely new gear configuration (at least for me), and there was not a minute of that dive I am proud of. But I did learn a thing or two. I say never be afraid to experiment, and learn, and use every single time in the water as a chance to improve your knowledge and skills.
     
  11. Bubbletrubble

    Bubbletrubble Regular of the Pub

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    Allergies are one thing. You can take an OTC antihistamine to prevent them from becoming an issue while diving or during air travel. I'm not so sure I would recommend taking a systemic decongestant, such as pseudoephedrine (Sudafed), to deal with recurring allergies, though. Sudafed does have some potentially serious side effects that you should be aware of before taking it on a dive trip.

    It's possible that you could have a certain amount of Eustachian tube dyfunction. An ENT might be able to figure out the root cause of the problem.

    Best of luck with everything...
     
  12. Amersboo

    Amersboo Guest

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    So you're guess is that I overcompensated for the fact that I didn't equalize and then this caused the inner ear pain I'm having now? It still burns and hurts like crazy... ugh. I'm very concerned about going back and doing pool training #2 because I feel like something is wrong with my ears. I did go to a regular general practitioner and she said nothing was wrong with my ears. Um... it sure FEELS wrong.
     
  13. Bubbletrubble

    Bubbletrubble Regular of the Pub

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    Ummm. Your general practitioner did the standard ear exam with otoscope. She should have been able to visualize your eardrum. Not sure whether she added insufflation (air puff applied with a little bulb to check movement of the eardrum) to the exam. Most likely, what she meant by saying "nothing was wrong with your ears" is that there were no perforations (tears) in your eardrums. I suspect she would have said something if there were an obvious effusion of some sort. That's good news. That still doesn't change the fact that you sustained middle ear barotrauma which is giving you the pain in both ears.

    It's pretty easy to deduce that your doctor has not had any training/experience working with scuba divers.

    Given your current condition, the best recommendation is not to dive until the ear heals, i.e., the pain disappears, ear feels normal, and you can equalize.
    If it feels wrong, it is wrong.
    Re-schedule the rest of your OW class for a date when your ears will have had time to heal. That's probably a week or two in the future...assuming that you didn't do any serious damage to middle/inner ear structures. Don't feel bad about re-scheduling. This happens all the time to basic OW students.
     
    Last edited: Jul 26, 2011
  14. TSandM

    TSandM Missed and loved by many.

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    Amersboo, if you are having persistent ear pain, go see an ENT doc. Ear pain can be referred from the throat or the temporomandibular joints, or even from the sinuses. And a GP may or may not be able to detect middle ear issues that would be picked up by an ENT with more tools.

    BTW, when it comes to buoyancy . . . spent some of your non-diving time reading the journal of my open water class that is linked in my sig line. I was NOT a natural at this sport, but I've gone on to become both tech and cave certified. If I can do it, anybody can!
     
    CamG likes this.
  15. Amersboo

    Amersboo Guest

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    Okay, this makes muuuuch more sense now. She didn't give my ears a puff of air of any kind, just took a look and said, "Oh, FINE! Off ya go...go diving or whatever you want to do." She definitely didn't have experience with scuba divers. It makes sense she wouldn't know about any sort of barotrauma going on. But it's still sort of un-nerving with a scuba instructor telling me to do the one thing that will infect my ears. AHHH!!

    I did put off session #2 for a week, per my instructors advice. I'll see if the pain has disappeared by Monday. It's a huge relief to hear it's not a big deal to put it off. If the pain isn't gone by Monday I won't think about doing it. Good thing you guys are here... huh? It's a lifesaver, so thanks for that. :)
     
  16. Bubbletrubble

    Bubbletrubble Regular of the Pub

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    I think one very important lesson to be learned from this scuba experience is: when it comes to your own safety and well-being, be assertive.
    This can be applied to your interactions with instructors, DMs, more experienced divers, doctors, boat captains, etc.
    Pain is your body's way of saying: "Stop doing that."
     
  17. daz88

    daz88 Barracuda

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    good call to postpone you next pool class, If you're having alergy issues, that will seriously effect your ability to to equalize. take your time and go slow..
     
  18. Amersboo

    Amersboo Guest

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    So true! Couldn't have put it better myself. I do have one more lurking question in my brain... is this normal for a first-time diver or is it pretty rare to have problems at just 10 feet? Something makes me think I might have something really wrong with my ears. They seem toooo touchy.
     
  19. Bubbletrubble

    Bubbletrubble Regular of the Pub

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    This kind of thing (middle ear barotrauma) occurs in basic OW students more often than people would think.
    Ask the other students in your class if their ears feel squishy/congested or hurt after class dives. I'm willing to bet that some of them (if they're being completely honest) will admit to at least some middle ear barotrauma.

    I get the impression that many scuba instructors only teach one method of ear equalization. Often times, that one method isn't taught very well.
    I think more time should be spent on the development of "ear awareness" during class sessions. Unfortunately, there's a rush to get students certified as quickly as possible. It's a shame. What ends up happening is that students get hurt and they give up the sport.
     
  20. TMHeimer

    TMHeimer Divemaster

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    Amersboo: "Pretty bad allergies'? This could be your only problem. If you're congested in any way equalization can be difficult. Good idea to see your doc. Sudafed? I believe data suggests that if it wears off during a dive you may experience reverse block if you congest up again. Being unable to ascend is of course way worse than unable to descend. Is your Dr. versed in scuba physiology? Assuming you overcome the other problems you have with buoyancy, inflating, etc., you should not have trouble equalizing according to the many methods listed above. The only time I ever have any problems is when I am not quite over a cold and figure I'll try a dive. Perhaps if you have the extreme allergies I had up until 15 years ago, you may only be able to dive at the times of year when they do not exist. But I'm no doctor.
     

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