Ear clearing and blood in phlegm

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I did a fairly routine and easy shore dive yesterday. Upon descent to a sandy bottom at 15 fsw, however, I couldn’t clear my left ear (first time ever that I couldn’t clear). There was a mild ache, but nothing sharp or unbearable. Rather, I would describe it as a discomfort. After holding my nose and blowing rather hard several times, I still couldn’t clear. I finally gave the thumbs up signal, and my buddies and I all went up.

It was an easy clear at the surface. We regrouped and redescended. This time I tried clearing right away and often and was able to clear all the way to the bottom.

We proceeded with the dive, and the rest of the dive was normal and uneventful. On the return trip, we stayed underwater and performed a routine, slow ascent from 12 fsw sandy bottom. Once at the surface, as a routine, I cleared my throat and split out some phlegm. But I immediately noticed that it was pinkish, indicative of phlegm mixed with some blood. I did it the second time to confirm, and again, there was a bit of blood. However, I felt fine, and so did my left ear (it also felt normal throughout the dive). I checked my left ear for blood; there was none. No feeling of vertigo, no loss or reduced hearing, nothing out of the ordinary.

After exit, I cleared my throat again and looked for blood. There was none. Whatever it was, it was gone. I felt fine despite the bloody phlegm, and I feel fine today. No residual ache, hearing from left ear (and right ear) is normal. Everything seems normal.

Questions:

1) Does anyone know if the blood in phlegm is related/caused by my inability and attempts to clear my left ear?

2) Any guesses on the cause of the blood in phlegm, whether or not it’s related to the ear clearing issue?
 
Blood in the phlegm could be due capillary rupture secondary to overly forceful attempts to clear. It could also be due to sinus squeeze. The tiny amount you are describing sounds more likely to be a capillary leak from equalizing.

Note that I can't make specific diagnoses over the internet, but only hazard a guess based on the hypothetical situation of a diver with difficulty equalizing subsequently having a small amount of pink-tinged phlegm.
 
Thank you both, Don and Lynn, for your quick responses. I watched the lecture video, Don. Good presentation. I need to start equalizing while still on the surface and just before beginning the descent, and then keep pressurizing continuously until I reach the bottom. Thanks again.
 

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