Ears - over a long dive trip

My wife has trouble with her ears, myself not so much, but over dive trips where you're diving multiple times a day every day I am very conscious of avoiding any trauma, being careful on equalizing... however, it still seems, and maybe it's as I'm getting older that my ears are bothering me more and more no matter how careful I am, and my wife had to sit out a day of diving on our last trip to Belize, on the second day she could not equalize below 34-38 feet. We brought 'ear beer' with us for the first time and used it during the trip, my wife even was using it between dives, while I was using it at the end of the day. Just seems no matter what there is always some sort of ear issue rearing it's head over trips now with us, and we are doing longer and longer trips with more and more diving, heading toward some live-a-board diving sooner or later.

I noticed my wife was holding her nose a lot to equalize, I kind of suspect in doing this all of the time she is putting more pressure on her ears then if she was just equalizing without resulting to doing it that way. Am I correct or does it not matter?

Wondering what tips, tricks or what we could be doing differently to either avoid entirely any ear issues or even change what we are doing to ensure less problems. Not spring chickens anymore and it seems like we are getting to the point that ears are now becoming a factor holding our diving back in the future.

I am in the same camp here Mike, last few years I have had more ear issues than I can remember.

What I do now is have mini-breaks in my diving, 3 days max diving then a day off, gives me time to edit my photos and clean out my SD cards. Of course the day I don't dive whale sharks or hairy frogfish will be all over the place, but that is life. 17 years ago I was in the Maldives doing 5 dives a day, now I rarely do more than two, but I do like long dives and tend to go to places that have no limits on the dive time, another reason for shore diving on house reefs.

I think the key here is to equalize early, starting at about 3-5 feet, and continuing throughout the descent. Pinching the nose and blowing gently is how most clear their ears, but wiggling the jaws helps keep the Eustachian tube open too. Don't wait until you are at 15 feet to start, as by then you may already be in problems.

If you look at the old books by Hans Hass, he and Lotte (his wife, diving partner and photographic subject for many years) wore nose plugs inside their mask in their 1950s films (though it's hard to detect as they don't show in the top-side scenes). I have tried that and it allows hands-free ear clearing, and you can start earlier if you don't need to get your hands up to your mask. The newer stainless steel wire nose plugs easily fit under any mask, and still allow mask clearing (though it's a bit more difficult). Here is a nice discussion of Hans Hass and Lotte in a short film titled "Rapture of the Deep."

SeaRat

I've found that a combination of keeping the air conditioner in the room turned up as warm as I can stand it while still being able to sleep (to prevent waking up all stuffy), daily saline rinse first thing in the morning, and taking 12-hr Sudafed if my ears start to feel "crunchy" works for me. I keep close tabs on when I take the Sudafed and when it is supposed to wear off to prevent reverse blocks.

On a liveaboard 2 years ago, I lost a day and half of diving after employing none of these methods. Last year, on a liveaboard, the saline and A/C setting did most of the trick and one or two doses of Sudafed took care of the rest, with no dives lost.

Remember, ear beer or other similar remedies you put in your ear only serve to dry out the water trapped in there and prevent things like swimmer's ear. They don't have anything to do with helping you to equalize. For that, you need to work on your internal systems, namely sinuses and eustachian tubes, as well as employing proper clearing techniques while diving.

I'm not a doctor and a dive-familiar ENT doctor might have other advice, but this is what works for me.

If I dive several times a day for more than week, then I start to have problems equalizing. Block and reverse block are not fun.

Maybe it's not the best choice, but like Rand I used 12-hour Sudafed.

And like John I equalize gently, early and often.

And like Searcaigh, sometimes you just gotta take a break from diving.

Staying hydrated keeps the mucous thin and watery so that it can drain.

i used to have problems equilizing my left ear, now totally gone
i always put it down to my lack of experience and not diving enough, not during a trip but over time
one thing i changed after reading an article is, starting to equilize on the surface, and doing it very often while descending, i use the nose pinch at the begining then once at depth biting down and swallowing is enough, i also found that gently shaking your head from side to side and turning your head sideways and pointing the ear up, helps on a stuborn ear at the begining of the dive

now yesterday during the stress and rescue course while doing different exercises and having to surface and go back down about 5 times in a row it was starting to mess with my ears
i guess the best advice is to take as long as you need or take a break

Ugh ears! :depressed: I have been having more issues as I get older. I took a few years off of diving and now that I am back in it is like I have to learn it all over again.

What I try to do is practice equalizing while not diving. I have even gone so far as bought a second SeaCure mouth piece to practice with (not mounted on the reg). I can equalize just fine without a mouthpiece but once I put one in it becomes a real challenge. I have found that a SeaCure or Jax mouthpiece makes it alot easier for me. Also this past winter I did pool dives about once a month to practice in the water.

As others have noted, the descent should be very slow and equalizing before you start has helped me. Once you get too much pressure differential in the ETs they tend to shut down (for me at least).

I also do a daily sinus rinse, 12 hour Sudafed and even use Afrin before a dive.

I envy those that can drop like a rock with no issues!

Go see an ENT doc, especially one familiar with diving. Sudafed and Afrin might be ok for an occasional dive or weekend, but you already know it can't be a steady diet on a long trip. My ENT dive buddy puts me on a steroid spray like Nasonex starting a few weeks before a long trip. That and some of the other things mentioned have helped a lot.


iPhone. iTypo. iApologize.

Sudafed is fine for prolonged use as long as you don't have any underlying cardiac or hypertensive problems. In fact, pseudoephedrine is the "D" ingredient in the most popular OTC allergy medications. I use the 12 hour version to avoid reverse block and possible sleep issues but if you are having worsening symptoms the 24 hour formula may give you some added benefit by controlling congestion for a longer time. Pseudoephedrine is also a key component in methamphetamine. That's why you are required to show ID and sign to purchase it (in the US). And of course, there is also the oxtox controversy.

Afrin use however should be restricted to a maximum of 3 to 4 day use. It can cause rebound congestion after longer use. On occasion I will stretch this out for a few additional days if I need to and have had no problems so far but I can't recommend that for others. I have seen and treated several habitual users and it is a tough cycle to break once started.


As a study of one, pseudoephedrine makes a huge difference for me. I use it before each day of diving. If I feel it's getting more difficult to equalize, I add in Afrin. I have tried the steroid nasal sprays such as Nasonex but I do not tolerate them. BTW, a steroid spray just became available OTC, no script required, Nasacort Allergy

I have the same problem on my annual trip to the keys. Diving all day long for six days straight.
There is a difference between your ears just being sore and barotrauma. Listen to your ears (pun intended?). Take a day off if necessary.

Clear your ears early and often
Sudafed, or Mucinex D 12 hour in the morning, every morning, followed by swimmers ear drops at end of day.