Ear problems on liveaboards.....need advice!

Greetings all,

I'm heading out on the Kona Aggressor II 8/1/09-8/8/09. I dive regularly on Oahu and I notice that after I scuba dive or free dive my ears "squeek" a little at night. What I mean is, if I'm sitting down and I try to just equalize my ears like I would underwater (just to check that there aren't any blockages or congestion) I hear a very noticeable squeeking. Now, my ears don't really hurt as much as it's a bit of an annoyance because it feels like there's just a tiny little bit of air that can't escape and seems to stay in my eustatian tubes. This is after only doing one day of 2 dives (sometimes 3 dives). Usually it goes away the following day after a good night's sleep but I'm worried about whether 5 dives a day for 5 1/2 days might do to my ears. I have never had ear problems in the past or any other medical issues that would keep me from diving.

I plan on diving my @$$ off on the Kona Aggressor and I'm wondering if anyone has had this problem - especially diving repetatively on a liveaboard. This will be my first ever liveaboard - so I am a rookie (but I have over 120 dives under my belt and consider myself up to the challenge).

If there is anyone who has had this issue, what did you do to get rid of it? Did it present a problem that caused you physical pain or discomfort? And did it cause you to miss dives?

Thanks and Aloha!

I haven't done a liveaboard trip, but I have done a couple trips to Bonaire. Lots of dives on consecutive days.

On a couple of occasions at home I think I've had the same kind of "stuffiness" that you describe. Both times it was related to being sick.

In the absence of any contraindications, you may want to experiment dosing with an over-the-counter decongestant.
The other thing you might want to do is to descend slowly and pre-pressurize (Valsalva technique) just prior to initiating descent. Also, avoid any saw-tooth profiles.
Have fun on your trip...

This squeeking noise is gone the next day, right? If so, you may have a slight edema from equalizing on your dives. You may be doing it a little too forcefully, or, more likely, too late, on descent. The edema may be indicated by squeeking or other watery noises in the ears, a feeling of fullness, muffled hearing, etc. after a dive or a dive day.

If you wait until you feel the pressure to equalize, you are already stressing your ears. I usually recommend doing a valsalva (or other equalization technique) on the surface before descent and on every breath while going down. It has been my experience that divers who anticipate the pressure proactively and use their favored technique before they feel the pressure in their ears (rather than dealing with it as a correction), are less likely to stress their ears enough to cause edema.

Having said this, it is only my experience working with lots of divers. I'm not a medical doctor or a specialist in ear care, so do seek professional advice if the problem worries you.

I recommend calling the DAN non-emergency number for advise and possibly consult an ENT Doc that specializes in dive medicine (DAN can give you a referral in your local area). I teach so I have multiple days of multiple dives often and occasionally the inner tissues just become irritated and swollen from so much equalizing. DAN recommended 12 hr Afrin nasal spray to help alleviate occasional mild equalizaion problems but not for long term usage. As stated by others in this post, consult the medical pros, equalize gently, early and often, avoid sawtooth profiles.

Enjoy your trip.

Thanks so much for the advice, keep it coming if you have more

Actually come to think of it, when I free dive I go repetatively down to 40 feet to shoot pictures and I make sure I ascend and descend slowly and in a controlled fashion. However, I do need to make sure I pay more attention to my equalization. I've been lucky not to suffer an injury but I suppose when you have alot of dives it doesn't necessarily mean you can't afford to still practice your basics. I'll have to try concentrating on earlier equalization on my next few dives and see if it helps. Thanks all and I can't wait for my trip......7 more weeks!!!! It might be the best trip I've ever taken!

I have done lots of liveaboard trips diving on consecutive days and used to have lots of ear problems when I first started diving 20 years ago, but over the years I have learned to manage those problems and I am really careful with my ears when I am diving! I have a bit of a routine now......about 30 minutes before the dive I'll take a sniff of olbus oil to make sure my sinuses are really clear. Then when I dive I try not to go down head first.......I equalise really gently....and definately avoid that saw tooth profile...once the dive is over I always wash my ears with bottled water....generally this routine keeps my ears fit and healthy......

That nocturnal squeaking is due to edema following the trauma of repeated equalizations. The most common aggravator is to continue to assess your capacity to equilabrate post dive, say through the evening, to reassure yourself that come the morning you'll be OK. Unfortunately this only makes things worse.
External ear drops don't help as this involves your eustachian tubes. In the absence of any contraindications, such as high blood pressure, you could take an anticongestant with you which should help alleviate the problem. Be careful with nasal sprays as you quickly develop tolerance if you over do it. Additionally, there can be a paradoxical response after a couple of days of increasing your nasal secretions and making things worse. If I use a nasal spray, it's only at night and if I'm symptomatic.
Safe diving!

I wear Doc's Pro plugs and that seems to take care of most issues.

They are diving ear plugs.

Repeated issues may call for an ENT visit before the dive. There are several long acting cortisone or equivalents that make clearing easy, but your ENT is the one you need to see to see if they are the right answer for you. I generally carry an injectable prescribed for me on live a boards that makes it impossible to get a head or ear blockage for about 10 days, and only administer it if necessary. I don't generally like to take steroids more than once a year, if that, but with my sinus problem history if the head locks up it's nice to have the option in hand when the boat sails. The down side to this is the need to learn how to give yourself a shot in the arse...:shocked2: and the knowledge that any injury will take several times longer than normal to fully heal.

Ditto HBO MD on the nasal spray. I was quite surprised to see that DAN suggests Afrin. My ENT really doesn't ever recommend it except to equalize airplanes. He has seen too many people get addicted. And from experience, as HBO MD said, after a few days of Afrin you end up stuffier than you were when you started.
I have had quite a few ear issues in my diving career and after my first liveaboard got a barotrauma and couldn't hear for quite some time. What really helped me was a hood of all things. Now, no matter what the water temp, I always wear a hood and I haven't had any issues since.