Equalizing Issues

[Ev]

I just got my Open Water certification, so I'm very inexperienced. I was having trouble equalizing one of my ears, even at the 20-30 foot depths I stayed at for my first dives. I eventually got down to the bottom at 30 feet without pain by taking the descents really slow, but now even a week after my last dive that ear feels kind of... not quite right, like it still needs equalizing. When squeeze my nose and blow it pops very easily, feels fine for a while then kind of stuffed up again. I don't know if I'm describing this exactly right or not, as I'm new to these sensations. Is this part of the normal process of getting used to diving, or do I have cause for concern? Should I worry about future dives?--I'm about to go to the Caribbean, hoping to do more diving. Any input or advice would be most welcome.

[Kourtjestr]

I'm basically fresh off my c-card, too, so I can't answer everything, but I have one question / tip. Were you wearing a fairly thick hood while diving? And if so, did you try pulling the hood away from your face to make an air gap to help equalize? I found that this helped immensely the one time I had issues in my class with it.

[DivemasterDennis]

Residual ear problems or even "sensations" are not normal a week after diving. I suggest several things that you should think about as you prepare for your Caribbean trip. First, Read my blog on not thinking too much. You may have over compensated in you equalizing. When you do need to equalize, there are options- swallow, tip your head from side to side, breath out through your nose once or twice, and doing VERY GENTLY the nose pinch light blow maneuver. Next, if you were in cold water you will find that equalization is harder than it will be in warm water, and it is true that for some people, wearing a hood can make equalizing more of an issue. Don't obsess about your ears, but don't ignore them either. By "don't obsess" I mean don't focus all your attention on your ears and constantly evaluate if they "feel right." Your ears will tell you if they don't feel right. Enjoy the view on your Caribbean dives. Don't be surprised if you don't formally equalize at all, or very little. But do what you must to be comfortable. A slow, upright vertical position during descent can also make equalizing easier. Have a great time on your dive trip/. Stop worrying about equalization- you will almost certainly have no problem. But if you do, try the things listed here.
DivemasterDennis

[eponym]

I just got my Open Water certification, so I'm very inexperienced. I was having trouble equalizing one of my ears, even at the 20-30 foot depths I stayed at for my first dives. I eventually got down to the bottom at 30 feet without pain by taking the descents really slow, but now even a week after my last dive that ear feels kind of... not quite right, like it still needs equalizing. When squeeze my nose and blow it pops very easily, feels fine for a while then kind of stuffed up again. I don't know if I'm describing this exactly right or not, as I'm new to these sensations. Is this part of the normal process of getting used to diving, or do I have cause for concern? Should I worry about future dives?--I'm about to go to the Caribbean, hoping to do more diving. Any input or advice would be most welcome.

If one ear is slow to equalize, as you say, try this:

While head-up in the water, tilt your head to the side as far as you can to put the slow ear up and do a Valsalva (pinch nose and blow gently).

My right ear was initially slow to equalize and I found this helped. And I know what you mean about the "stuffed up again" feeling. That could be from minor barotrauma (light bruising due to not equalizing soon enough) or just water in the outer canal, but a week of it? Try searching the Medical sub-forums here on SB, also for the term "ear beer."

Here are some threads I've followed and bookmarked over the years. They might have applicable info:
Constant Ear Equalizing Problems
Alcohol-Vinegar Earwash Expiration?
My ear is ringing
Earproblem prevention
Ear Problem
Ear care after diving the springs?

Hope this helps,
Bryan

PS. Here is a good overview of barotrauma.

PPS. You can ask a moderator to move this thread to the Diving Medicine forum if you like.

[RonFrank]

Unfortunately you have some minor ear damage. This likely will not keep you from diving but it may feel off for a while and it might become a problem if you do more damage.

Clearing at the surface, or practicing, is a good thing. Clear early, clear often and if you are experiencing pain go back up until your cleared. If you can not clear skip the dive if you must. If you really blow out you ears, or you get reverse block, things can become uncomfortable.

Over clearing is also a common problem. If you are at say 30' and there is no pain but things don't feel quite right don't worry. Keep descending and clearing often GENTLY. If you get to 60' and no pain but things don't feel right it's just something you will get used too. Believe me, if you can't clear and keep going down you will feel pain.

If you feel pain, Stop, go back up, and attempt to clear. if you end up at the surface and still can't clear it may be time to call it quits for the day. I always clear before I start to gear up. If I can not clear on the surface it's not going to get better at depth. Once you do minor damage they may feel off for a couple months. This is a time to be gentle and cautious. One new diver blew an eardrum, did not know where up was, was going into the muck (vs going up), and had to be rescued. Ears can be a real PITA.

Good Luck

[Ev]

What's odd is now my ears, especially the one that bothered me most while diving, clear really easily, almost too easily. That is, if I pinch my nose and blow, even gently, I hear what I assume is the air passing from my sinuses into my inner ear, sounds like a squeak. Then I get some clicking sounds when I swallow for awhile. Is that over clearing or what's supposed to happen? Should I skip diving next week? or try a dive and just be real careful about equalizing?

[RonFrank]

I think you ears are mildly hurt, but they sound like they are working well. If you can clear now that is a good sign. Just be gentle with them as I described. My ears sometimes make strange popping noises, or squawking sounds when diving. As divers we put odd demands on our ears, but I have been diving a long time and it's all good as long as they don't hurt. I have not had any ear issues for a long time.

[Bubbletrubble]

Congratulations on earning your OW certification!

It's very common for beginner divers to have ear issues during/after class. Reasons for this include: improper equalization technique, distractions during class, and poor buoyancy control. (A small percentage of the population have ear anatomy that hinders middle ear equalization. In such cases, an ENT should be consulted.) Basic OW instructors should spend more time teaching students ear equalization techniques and educating them about ear anatomy. The pinch-the-nose-and-blow Valsalva method is generally the only method taught. Unfortunately, that particular method isn't always the best technique for everyone. I recommend that you watch Dr. Edmond Kay's video entitled "The Diver's Ear Under Pressure," read his tutorial on "The Prevention of Middle Ear Barotrauma," and then try out every ear equalization technique he describes. Of the 7 methods he lists, the Roydhouse maneuver has worked best for me. You need to find out what technique works best for you. You'll be surprised how much easier and more enjoyable diving becomes when you aren't dealing with ear pain.

As for your current situation...
It's impossible to say with certainty what is wrong without a good ear exam (preferably by an ENT), but what you describe seems to be consistent with minor middle ear barotrauma (barotitis media). Sometimes such an injury will involve a small perforation of the eardrum. If that occurs, you really shouldn't be diving at all. Sometimes a significant amount of fluid can build up behind the eardrum. In such cases where a physician suspects infection, you might be prescribed antibiotics.
With any ear barotrauma, it's prudent not to put yourself in situations where your ears are subjected to dramatic ambient pressure changes (flying, diving, etc.).
Treatment-wise, over-the-counter systemic decongestants might give you some relief. Pseudoephedrine (Sudafed) is a common med in this class.
If your condition isn't getting any better after a few days (or is getting worse), schedule an appointment with a medical professional.

Hope this helps...

[Ev]

I think you ears are mildly hurt, but they sound like they are working well. If you can clear now that is a good sign. Just be gentle with them as I described. My ears sometimes make strange popping noises, or squawking sounds when diving. As divers we put odd demands on our ears, but I have been diving a long time and it's all good as long as they don't hurt. I have not had any ear issues for a long time.

Thanks for the advice, Ron. I will try a very careful dive this coming week in Belize and see how that goes. I only have 1 day off when I'm there anyway.

[Ev]

I wish I had time for a visit to an ENT. The fact that I'm not in any pain, even when flying encourages me to try a dive, since I'm going to be in a great diving area anyway. I plan to see a doctor as soon as I get back as I have more travels coming up to more great diving areas.