Right Ear Has Bled on Two Consecutive Dive Outings

[Buoy_A]

On August 9th I did a single dive to about 90ft max depth (probably about 50ft avg depth); total dive time was about 1 hour. That was a Thursday. On Saturday morning I felt a wetness in my right ear that I thought was from a shower one hour earlier. The wetness persisted throughout the day and I finally verified it was blood later that day w. a cotton swab. I had blood coming out of my ear for the next two weeks. Not enough to actually exit the ear, but clearly visible amount. It finally stopped.

Fast forward to this past Sunday. I did two dives, with deepest being about 110 ft. On Monday morning I used a cotton swab to check my right ear. More blood. I came home that afternoon and there was more blood. Checked this morning and it looks like it stopped. Fingers crossed.

Symptoms included bleeding, very little to no pain, a tiny bit of vertigo around Aug 13th, and no hearing loss (although I already suffer from hearing loss due to tinnitus). After checking the internet, I’d guess I’m suffering from Barotitis Media (middle ear barotrauma).

I do want to see a doctor. My question is should I go to URGENT CARE and see a doctor who can give me immediate attention and medicine or should I go to a ENT and wait for an appt opening? I’m going to be flying in early November and I’d like to get this addressed sooner rather than later, but not sure an URGENT CARE doctor is going to be as precise as an ENT. Thoughts?

 

[dlofting]

I'd suggest getting any available doctor to examine your ear to see if the eardrum is damaged and/or rule out an infection. You can follow up with an ENT if necessary.

 

[uncfnp]

First of all, no more diving until this has been resolved.

I would plan to start with a visit to your PCP or an Urgent Care unless you can get in with your ENT sooner then is typical around here. Either should be able to take a look at the canal and eardrum unless it is blocked with blood. They will look for drainage, swelling, injury, fluid, infection or a ruptured eardrum. Blood in the canal can only come from the canal itself or from a hole in your eardrum. Then they can get you started on the appropriate treatment with plans for followup at an ENT.

But most of all, no more diving!

 

[Buoy_A]

Well I appreciate both replies. They prompted me to go to an URGENT CARE physician. Actually turns out it was a Physician's Assistant, and I was lucky to have gotten him. He's been in the Navy 25 years and is very familiar with divers and has examined MANY of their ears.

After looking in my affected ear, he kind of scratched his head; said "your ear looks perfectly fine". Then he asked me to hold my nose while pressurizing my ears as he looked through his scope. He said my tympanic membrane looks and performs perfectly good without any evidence of damage including puncture, redness, or fluid buildup. He said he did see evidence of a dried dark substance at the bottom of my canal. He hypothesized that there are small blood vessels in the ear canal that somehow might have burst because of diving. But he was confident that I did not suffer any serious ear injury and he cleared my to fly and dive immediately. So that makes me feel a whole lot better. Whatever it is, it doesn't seem to be serious. Thanks again for the replies!

 

[gert7to3]

You know, sitting around after having some obvious out of the ordinary bleeding issue with one of your sensory organs is not a good idea. I suggest seeing a specialist immediately which likely entails a referral. Be sure to explain to the appointment desk people that you have had a bleed form your ear. They will get you in ASAP, their schedules are set up for this.

 

[Doctorfish]

I agree with gert, bleeding from small blood vessels in the outer ear canal to me sounds implausible. I would go see an ENT before diving again.

It may be a minor issue but you don't want to put your hearing at risk.

 

[Protondecay123]

I agree with gert, bleeding from small blood vessels in the outer ear canal to me sounds implausible. I would go see an ENT before diving again.

It may be a minor issue but you don't want to put your hearing at risk.

That takes some internet audacity to criticize and basically refute another medical professional's opinion without even seeing the patient.

 

[caruso]

That takes some internet audacity to criticize and basically refute another medical professional's opinion without even seeing the patient.

They're simply suggesting a second opinion from a specialist.

Docs get it wrong all the time. I can't even tell you how many times I see a patient in my practice who has been seen in urgent care or the ER, or sometimes by a private practice primary care physician, and is still symptomatic weeks later because they've been completely misdiagnosed and given the wrong treatment.

If you read my post and thing I'm targeting my criticism more at urgent care and ER docs, it's because I am. They miss a lot and there are good reasons for it.

 

[Doctorfish]

I'm in the business as well. I was suggesting that the PA's diagnosis was a very unusual one and I would get an opinion from a specialist, rather than relying on a generalist when a sensory organ is at stake. Bleeding from the ear is not a trivial symptom.

 

[tursiops]

You know, sitting around after having some obvious out of the ordinary bleeding issue with one of your sensory organs is not a good idea. I suggest seeing a specialist immediately which likely entails a referral. Be sure to explain to the appointment desk people that you have had a bleed form your ear. They will get you in ASAP, their schedules are set up for this.

I agree with gert, bleeding from small blood vessels in the outer ear canal to me sounds implausible. I would go see an ENT before diving again.

It may be a minor issue but you don't want to put your hearing at risk.

That takes some internet audacity to criticize and basically refute another medical professional's opinion without even seeing the patient.

I'm in the business as well. I was suggesting that the PA's diagnosis was a very unusual one and I would get an opinion from a specialist, rather than relying on a generalist when a sensory organ is at stake. Bleeding from the ear is not a trivial symptom.

It's the Internet. But sometimes the advice is quite good.