I got bent and went to the chamber, but was I really bent?

[LubaScuba]

PS How do you feel now?

 

[luvspoodles]

Barotrauma induced infection is relatively rare but it does happen because the injury produced exudate in the middle ear serves as a good opportunity for the ever present bacterias to start the invasion. I believe antiinflamatory drugs were not the proper choice as majority of those drugs might promote bleeding in already fragile ear. The proper initial treatment would involve rest, lot of yawning (not 'valsalving'!) and eventually some decongestants (for example: Pseudoephedrine 60mg 3 times daily). When pain started to develop, potent broad spectrum antibiotics should have been introduced and in the case of severe pain a myringotomy (surgical incision of the eardrum) should have been performed. Flying was not the best idea because considerable rest of the both injured and infected ear was very much needed. The sudden pop and pain relief can mean the ear drum perforation which is commonly seen in acute otitis media. Even though middle ear barotrauma and even consequent infection most often does not produce vestibular (inner ear) symptoms it is possible to feel dizzy due to some inner ear involvement but also due to the general toxemic syndrome from a bad infection. One thing is certain: there can not be any bubble which jumps from your ear to your elbow. It seems that the more vivid the bubble-thoughts are the less likely there is some bubble present at all...bent divers usually live in denial. (this of course is just one naive observation and not the rule to exclude the DCI) Onset of elbow pain during the flight even though it sounds very DCS-ish was most likely something else as it happens quite a while after your last dive (still possible though) and eventual onset of pain would much more likely happen already on the first flight. Onset of pain in another arm after chamber treatment is almost certainly non bubble related (well, i hope they used O2 table). Something else was more than likely responsible for that aching like for example general toxemic syndrome from infection, dehydration, trauma, hyperventilation....
Your further fitness to dive depends mainly on how good your ear infection heals and of course how strong was the negative psychological impact of the whole misadventure. Keep the spirit! The likelihood that there was some DCS in the whole story seems to be remote but you could have the hole in your right eardrum which might need some time or even surgery before you go diving again.

Dear LubaScuba,
Thank you very much for this excellent post. It is helpful to get information on this ear barotrauma and infection, as it undoubtedly effected my sanity during this time. In Mexico, I did not get any information from the doctor. I probably would have gotten information at the chamber that I went to in America, but I was on Vicodan, and therefore do not remember much that the doctor told me, although he was a truly knowledgeable man. I am still awaiting a call back from him. Please forgive me for asking this, as I have been told that asking questions in the middle of my thread is "confusing and frustrating for the readers," but can you please share what general toxemic syndrome is? Up until yesterday, I was feeling achy all over, and now that I have finished the Cipro and have gotten back to work I feel much better. I suppose that the achiness was very "flulike." Also, can you please tell me about the hole in my right eardrum. I am still very confused about what exactly occured in my ear, and I didn't know that it involved a hole.

 

[luvspoodles]

PS How do you feel now?

LubaScuba,
Thank you for asking. My ears do still have a feeling of fullness, however the excruciating pain has left. I still have throbbing pains from time to time, and it hurts more in the morning and evening. It is also very strange when I "clear." It is amazing how much one can ignore the warnings given during diving instruction. It has only become clear since it has happened to me. Hopefully there will be some new divers that will gain some knowledge through reading this thread. I will go diving again. I simply cannot stay away from something that has given me a huge boost in self-confidence, and has added such dimension to my life. Again, thank you for your very, very informative post, and for linking the barotrauma, infection, and DCS (or lack thereof) in such a meaningful way.

 

[DandyDon]

My ears do still have a feeling of fullness, however the excruciating pain has left.

The ear part of all this certainly sounds a lot like the disabling ear infection I had a couple of months ago. Not fun at all!

I got to go diving last month, and did not forget my after dive ear alcohol!

Good luck on your recovery...! :rose: Something I've missed along the way here, have you seen an Ear doctor back home...?

 

[LubaScuba]

Dear Luvspoodles,
From your story i assumed that your ear drum ruptured (on the second flight), which frequently happens during the purulent middle ear infection (the sudden relief of pain with pop is quite indicative, but it might mean that Eustachian tube suddenly opened as well) but it is not a major concern and the eardrum hole usually heals spontaneously after infection ceased. The remaining pain and fullness indicates that battle is not over and ENT specialist evaluation is more than necessary. As for 'general toxemic syndrome' i meant the usual unwellness in the whole body because of the 'toxins' released in the circulation from the local infection. That is the most likely reason why you feel achy all over the body. Do not question yourself too much, equalizing problems can happen to anybody and infection was not your choice neither. As a diving doc i've seen lot of diving professionals up to course directors with middle ear barotraumas. I wish you fast recovery and please, keep us updated.