Ear trouble days later

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I have allergy issues that can, if combined with dehydration, do what you're describing.

For me, ibuprofen, pseudoephedrine (the real stuff, like they make meth from), and lots of water clear it out.

For whatever reason, the fake pseudoephedrine doesn't work for me. Ibuprofen reduces the swelling in my Eustachian tubes. Water liquifies the mucus so it drains.

The water is probably most critical.
 
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Ditto Doctorfish. The alcohol in the external ear canal will do nothing for middle ear issues and is more likely to cause problems than to help what you have going on right now. You probably suffered a middle ear barotrauma, and the fluid you're feeling is probably extravasated intravascular fluid. Tincture of time is the best fix for this. A VERY mild Valsalva (pinch and blow) maneuver may help clear some of fluid out, but don't get carried away. Of course diving is not advisable right now.

Best regards,
DDM
 
This same point of confusion comes up frequently. Middle ear problems and outer ear problems are completely different conditions, caused by different things and managed differently. However, they can both cause ear pain, hearing loss and can be caused by diving.

Here is a blog post that I wrote on this topic, maybe it will be helpful to you.

A few points, in no particular order:

1) As DDM pointed out, alcohol in the ear canal has no effect on middle ear barotrauma.

2) Most random doctors who are not ENT docs (or pediatricians) will have very little experience examining the ears. I understand that your access to specialty care may be limited, but if you go to some sort of walk-in clinic, are told that your ear is "a little red", and are given a prescription for antibiotics and ear drops, then you probably don't have an accurate diagnosis.

3) While a poorly ventilated ear (i.e. after barotrauma) may cause pain with commercial air travel, it is pretty unlikely that any permanent damage will be done, assuming that there is no inner ear DCS.

4) Valsalva maneuver (pinch nose and blow) pushes air up into the middle ear, so commonly used on descent. The Toynbee maneuver (pinch nose and swallow) is better for a reverse block, since you are trying to vent an overpressurized middle ear outwards. There are actually a number of different techniques to try (both during diving and afterwards in case of barotrauma), see this link for details.

5) One way to differentiate middle and outer ear problems is to grab your ear and wiggle it (or open and close your jaw). If that makes the pain worse, it's more likely to be an outer ear problem.

6) Treatment for outer ear problems involves someone with experience cleaning out the debris, preferably with a microscope and suction, followed by dry ear precautions and topical antibiotic/steroid drops.

7) if you can't equalize, you shouldn't dive. Don't push it.

Good luck! Sorry you have to go through this...
 
Thank you so much to everyone who replied!

At this point I’m guessing it’s the middle war barotrauma, reasoning is as follows:

When I came up my ear initially felt slightly less full/hearing was less muffled, as time went on and I kept attempting valsalva things got worse. I’m guessing that irritated things more causing more fluid to build in middle ear.

Second, pulling bottom of ear and wiggling jaw doesn’t cause pain (though oddly when I burp that moment of pressure causes pain).

Im guessing this can lead to middle ear infection. I was able to get ahold of antibiotic ear drops yesterday but have not used them and given this is likely middle ear I probably won’t. I also have Zithromax, which it seems is a viable option should a mid ear infection develop.

Does anyone have an idea as to how long this will last? I assume the longer fluid sits there the higher likelihood of infection developing. Lastly, other than getting more antibiotics is there anything a doctor can do (knowing I’m in Thailand for 6 more days and communication is going to be a problem)

Thanks!
 
Thank you so much to everyone who replied!

At this point I’m guessing it’s the middle war barotrauma, reasoning is as follows:

When I came up my ear initially felt slightly less full/hearing was less muffled, as time went on and I kept attempting valsalva things got worse. I’m guessing that irritated things more causing more fluid to build in middle ear.

Second, pulling bottom of ear and wiggling jaw doesn’t cause pain (though oddly when I burp that moment of pressure causes pain).

Im guessing this can lead to middle ear infection. I was able to get ahold of antibiotic ear drops yesterday but have not used them and given this is likely middle ear I probably won’t. I also have Zithromax, which it seems is a viable option should a mid ear infection develop.

Does anyone have an idea as to how long this will last? I assume the longer fluid sits there the higher likelihood of infection developing. Lastly, other than getting more antibiotics is there anything a doctor can do (knowing I’m in Thailand for 6 more days and communication is going to be a problem)

Thanks!

Hi, Ben....

Middle ear barotrauma is a sterile effusion (fluid). True middle ear infection (pus behind the eardrum) is extremely uncommon in adults, and not generally considered to be a complication of barotrauma. There is little role for oral antibiotics in cases of middle ear fluid, and certainly no role for ear drops (as you correctly stated!).

Antibiotics do not hasten the resolution of a middle ear problem. There is also little evidence that decongestants and antihistamines help much, and topical nasal sprays (Afrin or nasal steroids like Flonase) do not affect the Eustachian tube at all. Oral steroids have some effect on improving Eustachian tube congestion, and are occasionally used to help the fluid resolve...

Try doing those exercises, hopefully your ear will open up soon!

Mike
 
Wanted to post a follow up in order to close loop in case this info can be helpful to anyone else at a later date.

Went to doc (ENT) at GFs request since I need to get on airplane tomorrow.

Middle ear barotrauma was the diagnosis (good job guys!), nothing wrong in outer ear. Fluid build up in ear is from my body due to trauma, not external (seawater). He gave me a nasal corticosteroid spray and Sudafed and told me to use Afrin (decongestant) before takeoff and landing. Apparently it can take up to 2 weeks for body to resorb fluid in middle ear.

Since I’m sure many people have to fly within 2 weeks of diving I wanted to pass along this info: In more extreme cases than mine you can have your eardrum pushed out slightly by the fluid. He had me perform a valsalva while looking in my ear to watch if the ear drum pushed out slightly with the added pressure from valsalva, which it did. I could hear that normal crackling sound when I performed the valsalva which I think was the eardrum pushing outwards. If that hadn’t happened because the eardrum was already pushed out from pressure of fluid, then getting on an airplane could be a bad idea (nowhere for fluid to expand to). The meds he gave me are to open up as much space as possible for when I get on the plane.

Any pain can be managed by ibuprofen and likelihood of infection is minimal. Oh and he said don’t do the valsalva to try to clear it, you can pop ears other ways on flight (gum, yawn, jaw wiggles, etc)

Hope this can be helpful to someone!
 
I'm going to bet you have an ear infection. If you want to test this, put some 70% rubbing alcohol in your ear. If you drop to the floor in sharp pain, then you most likely have an ear infection. If you don't feel any pain, then the alcohol will help clear the water out of the ear.

Of course, you could also go to a doctor/clinic and avoid the whole pain thing.

I'm scouring all the threads on ear issues. It's been 11 days since my last dive and I still have considerable ringing in my right ear and feels clogged with considerable reduced hearing. It just doesn't seem to be getting any better. I don't recall any significant equalization problems during our dives. My right year tends to get a bit stuffy, but always clears up in a few cays.

Feeling like I had water in my ear during our trip I put some swimmers ear in my right ear and the pain was ridiculous...I was dropping the F bomb and acted like a lunatic for a minute. I've never hadn't that happen before and haven't heard about that until I read your post.

I've had discharge from my ear while sleeping. Went to my doc...who is a pretty experienced diver....and he said there's no infection but looks like there may be a perforation, lots of gunk that also needs to be removed. I'm headed to an ENT.

Funny thing....when he gave me the ENT referral he also gave me a DVD of his trip to Raja Ampat last month. He said, "Enjoy this, unless you can't dive anymore...then I'm just being mean." :wink:
 
I'm scouring all the threads on ear issues. It's been 11 days since my last dive and I still have considerable ringing in my right ear and feels clogged with considerable reduced hearing. It just doesn't seem to be getting any better. I don't recall any significant equalization problems during our dives. My right year tends to get a bit stuffy, but always clears up in a few cays.

Feeling like I had water in my ear during our trip I put some swimmers ear in my right ear and the pain was ridiculous...I was dropping the F bomb and acted like a lunatic for a minute. I've never hadn't that happen before and haven't heard about that until I read your post.

I've had discharge from my ear while sleeping. Went to my doc...who is a pretty experienced diver....and he said there's no infection but looks like there may be a perforation, lots of gunk that also needs to be removed. I'm headed to an ENT.

Funny thing....when he gave me the ENT referral he also gave me a DVD of his trip to Raja Ampat last month. He said, "Enjoy this, unless you can't dive anymore...then I'm just being mean." :wink:

Please let us know what the ENT says.
 
Please let us know what the ENT says.

Saw the ENT today. He looked in with a microscope. Did a hearing test and a tympanogram. Tympanogram was flatline. Hearing test showed considerable hearing loss in the right/problem ear. But I have a bit of hearing loss in left ear too...I chalk that up to Tinnitus that I've had for 15 years now.

So he said I probably ruptured my ear drum. So weird because I don't recall that happening at all. I should have had pain, experienced vertigo or dizziness, right??? None of that happened.

So he put me on steiroids and Flonase. I see him again in 10 days. I asked, "I'll be able to dive again, right?" And he said that was the plan. I mentioned the Curacao trip in January and he said I should be good to go. :yeahbaby:

So I need to try something different next time I dive, so this doesn't happen again. I'll descend as slow as humanly possible equalizing as I go. I'll start equalizing the day before. I'll drink a hot beverage before I dive. Any other suggestions??? Ear plugs? Hood?
 
Saw the ENT today. He looked in with a microscope. Did a hearing test and a tympanogram. Tympanogram was flatline. Hearing test showed considerable hearing loss in the right/problem ear. But I have a bit of hearing loss in left ear too...I chalk that up to Tinnitus that I've had for 15 years now.

So he said I probably ruptured my ear drum. So weird because I don't recall that happening at all. I should have had pain, experienced vertigo or dizziness, right??? None of that happened.

So he put me on steiroids and Flonase. I see him again in 10 days. I asked, "I'll be able to dive again, right?" And he said that was the plan. I mentioned the Curacao trip in January and he said I should be good to go. :yeahbaby:

So I need to try something different next time I dive, so this doesn't happen again. I'll descend as slow as humanly possible equalizing as I go. I'll start equalizing the day before. I'll drink a hot beverage before I dive. Any other suggestions??? Ear plugs? Hood?


Did he say what the discharge was due to?

You might try Doc's proplugs - the vented ones. I don't see how they work, but some folks swear by them. Doc's Proplugs - Proplugs

Can I go to Curacao, too??
 
https://www.shearwater.com/products/peregrine/

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