How to overcome ear fear

[Mike126]

Over the past few years I've been dealing with equalization issues in my right ear. While I can equalize just fine out of the water, when I dive I really struggle with equalizing. This year I am determined to work on overcoming this. I've been working on my technique which is a jaw stretch/yawn to open my ETs and then a Valsalva maneuver to equalize.

After thinking about what causes my issues in the water, I'm think part of it may be due to having a regulator in my mouth. This prevents me from being able to stretch/yawn to get my ETs open. Next month I plan on working with an instructor using a full face mask to see if that helps.

When I first started diving in the 80's I never had any problems. But over the past several years it seems I either get too anxious, dry mouth, or just can't seem to get my muscles working right.

Any suggestions on how to overcome ear fear?

Thanks!

 

[PsyWulf]

*Not a medical opinion*
Personally,I find exercising equalization beforehand helps quite a bit to stretch it out and get the fear sorted before it becomes a problem

Would need more details though,when in the dive are you struggling to equalize? I've found that if i'm in very cold water after repeated ascending and descending moves my left ear becomes problematic. Taking out the reg and going through the motions might help you if it's a problem with having the regulator in your mouth. Another trick to also try is tilting your head to individually stretch the tube whilst equalizing

 

[Mike126]

I do exercise EQ before and I even do it regularly on days when I don't dive. I've tried taking the reg out and tilting. I seem to have better luck wearing a hood which is probably keeping the water near my ears warmer. I've tried the Doc Proplugs with limited success. My next course of action, besides continuing to practice regularly, is to try the ProEar mask (covers the ears) and a full face mask. My thought with the FFM is that I will not be as restricted with my jaw movements as I am with a reg. In the past I have worked on things in the pool and have had no issues. When I took a dry suit class in the pool I could go inverted and change depth with no issue equalizing. Granted the depth in the pool was only about 12 feet.

My ENT has not found any obvious physical issues but that is not to say that my right ET may be smaller in size or obstructed somehow. I have not had an MRI. I do have a deviated septum on the right but I'm not sure how that would affect my EQ abilities on the ears.

 

[tbone1004]

not a doctor.

pre-equalizing is your friend. There is a huge pressure increase in the first 10ft and it is very rapid. If you equalize at the surface and over pressurize the air spaces a little bit, it gives them a head start when you make your descent.

FFM is likely to hurt your ability to open your jaw fully btw, but on a normal regulator, just hold the reg with your hand and you should be able to your mouth just as much as you could on land. On a FFM if you need to block off your nose, you have to push the mask up and into your nose to engage the blocks, and you can't always open your mouth all the way without breaking the seals.

Take some NSAID's a couple hours before you dive. I do this before every dive to help limit and inflammation that is likely to occur from going up and down, especially when I'm with students, and MAKE SURE that you are getting your ear canals fully flooded. As soon as I am fully submerged, I will roll to each side to make sure both of them have water going all the way up to my ear drum. It is distinctly unpleasant in cold water, so you may want to wait a minute at 10ft or so until you have warm water around your hood, but if you don't, your external ear canals will get inflamed and that can cause all sorts of lovely problems at the surface.

so, take some NSAID's.
pre-equalize and over equalize a little bit-same motion but you should hear your ear drums push out
Make sure your canals are fully flooded before finish your descent.
Hold the reg in your mouth if you need to move your jaw around
report back

 

[Bubblesong]

I have my finger and thumb pressing my nose closed as soon as my face hits the water, other three fingers up against the mask to hold in place. Then positive pressure to nose, not blowing hard, gentle positive pressure puffs at nose, right away. I am trying to keep Eustacion tube from closing in first place. If I descend and wait to feel the pressure on my ears, it is already too late.

 

[doctormike]

All good advice.

Here's a list of alternative techniques: Prevention of Middle Ear Barotrauma

I wouldn't think that a FFM would be very helpful - I have never used one myself, but take tbone's advice on that.

Sometimes it just takes trying different things until you find out what works best for your particular anatomy. Good that you are under the care of and ENT doc..!

 

[Mike126]

Hey guys all good advice.

TBone - Interesting about what you said regarding the FFM. For me, I use the jaw stretch/yawn to open the ETs and then pinch and perform a Valsalva. I'm also looking at a newer OTS mask that is oral-nasal but also has a soft nose piece that you can pinch your nose rather than pushing EQ blocks. Also, I'll try your advice on flooding my ears. I already re-pressurize and sometimes take Advil prior to diving. I always use Afrin about 30 minutes prior to open things up some.

Geez I'm becoming overly high maintenance! .

 

[tbone1004]

I usually take about 800mg of aleve or ibuprofen prior to any big dive and any time I'm doing a lot of shallow water work because of the up and downs with students.

Again, not a doctor, so hopefully one will comment, but I probably wouldn't take Afrin prior to diving... It appears to be a vasoconstrictor and that's not exactly what I want my body doing prior to going diving....

If you still pinch to equalize, then a traditional FFM is definitely not where you want to go as equalizing on those things can be a joyful experience if you don't have good tubes. I'd stay with a normal half mask and just use your other hand to hold the reg. You'll eventually learn to do it one handed where the palm of your hand supports the regulator to keep it from falling out and your fingers can pinch off your nose. Practice on land where the reg is a lot heaver in your mouth and you'll get used to it pretty quick.

 

[doctormike]

I always say that there were three great medical innovations of the 20th century: Insulin, Penicillin and Afrin. But Afrin should be used with care, and NEVER for more than three days (or you get addicted). No problem with the vasoconstrictive effect unless you have cardiac issues, but it really does nothing for the ears, it's more for the nose.

If your nose is very congested you might have a hard time doing a Valsalva, but it's more of a protective agent for sinus squeeze rather than ear squeeze. Also, when Afrin wears off, sometimes you are more congested. I wouldn't recommend it as a regular pre-dive medication. If you have such bad sinus issues that you can't equalize those spaces, you might be better off getting a CT and considering a sinus procedure... not the same as ears.

 

[tbone1004]

^what he said

Mucinex D is also my friend whenever I have congestion issues and I need to dive anyway. Was told by a couple of diving physicians that it's fine to use