Ear Equalization Issue preventing cert: advice?

[mechnohonu]

Hi everyone -

I am one dive away from my PADI open water cert due to a persistent ear equalization issue that has caused me to have to abort many dives. I know there's a lot of advice on this forum already about equalization issues and I've looked at and tried everything I can find, but to no avail. I was hoping to get some help.

Over a year ago I had two terrible ear infections, and have not been able to equalize consistently since. I often can't get below 6 feet on a dive. Sudafed has helped at times. Other times I have descended with no issues and gotten a reverse block later in the dive. I can't freedive below 10 feet since I use up my entire breath hold just trying to equalize. On my last dive (Open Water #4) I descended with no trouble. My instructor had me perform a CESA about 10 minutes into the dive, and then I had to descend again to complete the last skills. On the 2nd descent I couldn't get below 6 feet, even though 10 minutes earlier I equalized with no trouble.

Starting last May I saw an ENT who did tests and said my ears look normal and I shouldn't be having trouble. Since last May I have been trying the following:

• practice equalizing at my desk (10-50 times a day) to train the eustachian tubes. In May I couldn't perform a Valsalva, now I can perform a Valsalva with relatively few issues (but I prefer to use other methods underwater since it takes a huge amount of force for me to Valsalva underwater). I have no trouble equalizing in air anymore
• practice freediving to train ears under pressure (again, can't get below 10 feet and that often hurts)
• try Sudafed before a dive (seems to help) -- I have not tried Afrin yet but I got some to try tomorrow

Unfortunately now my instructor says I may not ever be able to dive again, and won't let me re-do my last dive (the only skill I didn't complete was underwater compass navigation) until I can easily freedive to 25 feet. I was supposed to do my scientific diving training next month and it has been nearly 10 months of this frustration thus far.

If anyone has any advice or suggestions as to where to go from here, I would really appreciate it. I'm really sad at the thought of giving up diving and really want to find a way to work through this issue.

 

[MargaritaMike]

First and foremost I AM NOT A DOCTOR! I have had some difficulty over the years of equalizing my right ear. I always do, but I have to start early and often. Back in November I had a deviated septum corrected and spoke with my ENT about the clearing issue. During the septoplasty operation, he inserted balloons into my Eustachian Tubes and inflated them for "some" period of time. I wasn't awake but I THINK is was a couple of minutes. He then deflated and removed the balloons after the tubes had been well opened. I haven't been diving yet due to other issues, but I can clear by just swallowing above ground. It's wonderful.

I don't know if this is something that your ENT can/will do, OR if it will help. I'm just putting it out there.

Good Luck -

 

[northernone]

One particular point. There's nothing in an OW course specifying the student must breath hold dive to 25ft. Withholding certification is not appropriate behaviour. Refusing to train you is their right, but you can easily transfer to another instructor who would be more patient with your equalization and would take the time to let you descent comfortably.

My only advice is slow down. If a descent takes 20 minutes of slow undulating gradual equalization, so be it. You may not be a freediver, but with scuba equipment, you can go gently and allow your body to adjust. If you've managed a handful of dives already, it seems apparent you can equalize. And if the doctor cleared you medically, there's no reason not to tranfer your training to someone else who is willing to work with you.

Regards,
Cameron

 

[fmerkel]

You simply cannot freedive at a slow comfortable pace. What agency are you dealing with that requires you to freedive to 25' to be certified? That is not a requirement for PADI or NAUI.
If I had to do that I'd have flunked out during my certification and I have 1500 dive now. I DO ABSOLUTELY have to use medication, and a very controlled, slow descent to dive without pain or damage. It's amazing the number of people that I dive with that express appreciation for this when I tell them I need to do this of cannot dive. They also have clearing issues and frequently feel pressured to dive their ears harder than they are comfortable.

I do, and have used nasal steroids for almost 20 years. I do saline nasal rinses daily. I've had 2 sinus operations. Afrin can help. Sudafed can help. If you have allergies there are medications for that. You CAN use them together if necessary. They are useful but not a total answer to the problems.
You absolutely need to clear about every 2' on the way down. If you push it > you'll damage something.

I'd say, fire the instructor and find someone with a bit more understanding. +1 to what Cameron wrote while I was writing.

 

[KevinNM]

If you are forcefully equalizing you are doing it wrong and are liable to injure yourself. Start more shallow, it shouldn’t require forcing it. If it isn’t clearing easily then get shallower. And you may find some days are days you shouldn’t dive. But if you can easily clear on the surface you should generally be able to clear as you descend.

 

[Damselfish]

I second what is said about this freediving requirement - where is that coming from? If you're having trouble, fast is not the way to help you equalize.

I have problems sometimes, especially when I'm doing many dives a day over multiple days. My ears get crankier as a dive trip goes on. Over the years I've found a bunch of things that help me.

- The thing that helped me most was using Doc's Pro Plugs (the vented version appropriate for scuba.) Some people swear by these, and some (possibly who don't need them and haven't tried them) think they're a bad idea. Part of the problem there may be that it's not 100% clear how or why they work. I don't really care, since they work great for me, and I wouldn't be able to dive as much without them.

- I do use Sudafed, but I stick with the 12 hour version. The 4-6 hour version is apt to run out at the wrong time. And I stick with the real stuff for diving, not the PE junk. I also take an advil in the morning and sometimes again before afternoon dives, to help with any inflammation. I used to wait until I started to have problems to start taking anything, but I find it much better to always take stuff from the beginning and stay ahead of the game. I don't use Sudafed to get around having a cold/real congestion. I've heard of people doing it, but for me at least I think that doesn't really work and isn't a good idea.

- I avoid unnecessary ups and downs, larger ones especially will aggravate my ears (besides not being a great dive profile anyway.) A CESA immediately followed by another descent would make my ears unhappy too. Training dives tend to do more of this than regular dives, but if you find an instructor that will work with you maybe you can minimize that. (Attempting to "train my ears under pressure by freediving" would definitely do me more harm than good.)

- When jumping off a boat or dock, I put a little air in my BC to avoid any initial bounce where you go under and pop back up. Even on a negative entry I might, I can dump that air fast enough if I need to. (Though, I prefer to avoid hurried negative entries period.)

- If my ears tell me to give them a rest, I do.

 

[Marie13]

Flonase nasel spray may help.

 

[mechnohonu]

THANK YOU everyone for your responses! I really appreciate it!

You simply cannot freedive at a slow comfortable pace. What agency are you dealing with that requires you to freedive to 25' to be certified? That is not a requirement for PADI or NAUI.

It is a PADI open water cert but the instructor is not being understanding to my equalization issues and doesn't want me to come back until I've fixed them via freediving. I am going to look for another instructor tomorrow.

- I avoid unnecessary ups and downs, larger ones especially will aggravate my ears (besides not being a great dive profile anyway.) A CESA immediately followed by another descent would make my ears unhappy too. Training dives tend to do more of this than regular dives, but if you find an instructor that will work with you maybe you can minimize that. (Attempting to "train my ears under pressure by freediving" would definitely do me more harm than good.)

This is really good to know -- I've been confused about this particular dive for several weeks now as to why I couldn't equalize after the CESA. Hopefully with a new instructor I can do all my remaining underwater skills (well, there's only one) before the CESA so I don't have to re-descend immediately.

Thank you all for all the other tips as well. I'll check out the vented earplugs as well as the nasal sprays and saline rinses as I haven't tried any of those. I appreciate all the help, it's nice to not be told that I should give up diving when I've barely started!

 

[fmerkel]

The sinuses, Eustachian canal, and inner ear are delicate membranes. With ANY trauma they may rapidly swell up closing off passages that may have been open moments before. Forceful or any kind of poor equalization can easily produce this trauma.

I've seen instructors lock up when they are taking students through CESA. Remember, the body was not designed to dive. It's a foreign environment and we are fortunate to have equipment and adaptations that allow us to get away with it.

If you thought you did a dive with no problems, then got reverse block > you had problems. You should be almost totally concentrating on your clearing issues to start. (Obviously you have to have enough dive presence to do that safely). You should start clearing on the surface, and EVERY 2' ON THE WAY DOWN! You should never feel any more than the most minimal pressure. It should not be hard, NEVER forceful. If you can't easily clear, ascend a few feet, and gently try again. People like you need to go slow, have excellent technique, and may very well need medication support.

ALLOW NO ONE TO HURRY OR FORCE YOU....EVER.
If you simply cannot clear, abort and hope for a better outcome another day.

I had a buddy that had consistent ear problems. When I talked to him he insisted he cleared fine. I finally had him do a shore entry in waist deep water, clearing at the surface, as soon as his head got under, and again when he trimmed out on the bottom. They he slowly proceeded to depth clearing every 2' of depth gained. Funny thing, ear problem went away.

 

[EastEndDiver]

Possibly look for another ENT maybe the one you used is not familiar with diving here is DAN's (Diver Alert Network) number they can recommend an ENT that is familiar with diving it is also a good idea to join DAN.

DAN #
1-919-684-2948