Recognizing signs and symptoms.

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Diving Dutch

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Messages
34
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1
Location
The Aleutians, USA
# of dives
200 - 499
The plan was to dive the length of a dock, entering at one end, descending to the bottom (45’), and swimming along the pilings to the other end of the dock. This was a cold water dive (39F water, 41F outside), with four divers, including myself diving dry. I was the least experienced of the group, with 30 drysuit dives.

The entry and descent was smooth. With about 30’ visibility, I descended near one of the pilings. All seemed to be going as usual on the descent. The group stayed together and I was clearing my ears as normal. At about 37’, all hell for me broke loose. I heard a roar in my left ear, and remembered thinking that this can’t be good.

I started to look around, and a second later, the whole world seemed to teeter to one side. Trying not to lose a grip on reality, I grabbed the one thing I knew that should be stable – the piling. The piling kept moving horizontal, then back to vertical. My partner moved next to me, and I gave him the “crazy in the ears and need to surface” signal. He stayed by me close while I hung on to the piling with all fours and rode the vertigo-coaster. I’m assuming this is what’s called vertigo, although I’ve never experienced this before. It’s not like the type of dizziness that comes from, say, rolling down a hill, then trying to stand up. Whatever it was, it was not fun.

I slowly ascended, for what seemed like an eternity, to 15’ and stopped for 3. At that point, my dizzy spell was over, but I still felt like crap. After surfacing, I felt nauseous and my ear hurt. At about 30 minutes after the dive, BP, pulse, resp. all a little high, and 02 sats low. Probably just anxiety. Good news, no ear drainage.

Checkup at the clinic revealed no perforated eardrum.

I am posting my experience for two reasons:

1) What went wrong? I thought I was descending at a safe rate. I thought I was equalizing effectively and often enough. I do remember experiencing a little pressure in my left ear prior to the last attempt to equalize. Maybe what’s a usual descent for me is not safe? Also, in all fairness to the readers, I usually dive from shore, and follow the contour of the bottom down, stopping when needed. What can I do different to prevent this from happening again?
2) I want to give a big High-Five to this Board. I came across this one posting a while back about someone experiencing vertigo underwater. I’m not sure what brought it on, but he described the same signs and symptoms as me. Armed with that knowledge, I could recognize what was going on, try to stay focus, and act on the problem – not react. This was whole incident was very disconcerting, but understanding the case and effect of something, and knowing that it can happen, helped me to keep my wits and make a safe water exit.
 
Not sure if the post was one of mine but I experienced a very similar issue in the middle of my navigation dive for AOW. I have also had several similar experiences since then, all in cold water and I am pretty sure I have almost fully eliminated the issue by doing a few things.

First if it does happen again under water, pull back your hood on both sides if you can to allow the cold water to get to both ears, that has worked for me and has allowed the vertigo to clear up after less than 30 seconds some times.

1. I took a soldering iron and burned holes in the top and where my ears are on my hood. I think that most of the issues that I have had with this are due to Caloric Vertigo, or vertigo induced by a difference in the temperature from one ear to the other. I think what often happens is that if you are wearing a hood, it traps water or air over one ear (that one stays warm), and then the hood shifts for whatever reason and the other ear gets a fresh blast of cold water which is why I put the holes to allow water to move in and out of my ear so that although it is colder, the temperatures are balanced.

2. You can try Docs Proplugs to slow the Caloric effect, I had ok luck with them but found them uncomfortable even after trying a few sizes.

3. If I think that I may have even a slight sinus issue that day I will take a Sudafed an hour before the dive. I will only do this if I feel that I am on the verge of having a sinus issue, if I am having a sinus issue which is clearly noticable I will call the dive.

Hope these suggestions help and good luck!

Ben

ps. You may want to ask a MOD to move this to the diving medicine forum and you may get a better response.
 
Diving Dutch:
Blah blah blah blah blah

I started to look around, and a second later, the whole world seemed to teeter to one side. Trying not to lose a grip on reality, I grabbed the one thing I knew that should be stable – the piling. The piling kept moving horizontal, then back to vertical.

Blah blah blah blah blah

Good news, no ear drainage.

Checkup at the clinic revealed no perforated eardrum.

Blah blah blah blah blah

You were looking at the wrong part of your ear, IMO. It's your inner ear which likely was the problem, perhaps a low level infection if you didn't experience vertigo standing up. This is just based on my own experience having had an inner ear infection. Sitting down - no problemo, standing up - like being in a fun house at a carnival.
 
When I had the problem I went to go see an ENT 2 days later. The ENT was recomended by my LDS owner because he is a diver and a lot of the divers who have issues at the shop go to him. The ENT did numerous test on my ears and declared that there was nothing wrong with them.

Seeing a doctor though is a good idea.
 
I had the very same problem in Thailand this last year and when I came back I saw an Ear Specialist and in turns out I had a low-level Ear Barotrauma...
I had vertigo underwater, and nausea on the boat. The stupid thing I did was continue to dive and I won't make that mistake again.
 
Dang, and I wanted to dive today (one week since the incident). Unfortunately, the closest ENT specialist is 800 air miles away - that appointment will have to wait.
If I decide to go, I think I'll try a couple of things that TTSkipper suggested. I have a snug hood and wear my goggles on the outside of the hood, so I get a very good seal. When the dive is over, my hair is slightly damp. My thought is that I normally don't get much water in my ears, and on this particular dive, I did. Maybe because I jumped off the pier (10' drop) for my water entry, it shifted my hood and allowed water in? Grasping at straws? In denial that I may have an infection?
FYI, I did see a Nurse Practitioner and he didn't "think" I had an infection. But then again, it's the middle and inner ear we are talking about.
 
Diving Dutch,

When I was first reading your post, I immediately thought of caloric vertigo. However, in my experience, caloric vertigo ceases pretty much as soon as the temperatures of both ears are the same again. Since your ear actually hurt even after you ended your dive, my guess would be that you might have sustained some mild ear barotrauma. If that is the case, the hood vents will not help (although they may reduce the risk of getting caloric vertigo in the future.)

But I am NOT a medical professional, so please don't regard my comments as authority but merely food for thought about your experience.


Dive safe!
 
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