Problems with ear clearing

4 years 5 months ago #26685 by kapenta
kapenta created the topic: Problems with ear clearing
I have just completed my dives to gain a SSI open water certificate but it has been a long drawn out process which I'll describe here in the hope that it may be of use to other novice divers. I am 62, in good physical condition - I got through the medical including Stress ECG and bronchial challenge with no problems and the surface water swim was no problem.

I completed the pool training with no problems but on the first open water dives I couldn't get below 5-7m, having trouble clearing my right ear and experiencing slight pain before giving up and returning to the surface. I was using the Valsalva method of equalising (exhaling with nose pinched shut). The instructors suggested I look up and try stretching my neck from side to side but nothing seemed to help.

"Old hands" and those divers who never have any ear problems will probably find it difficult to understand this problem. I have never had difficultly clearing my ears on planes or in lifts so it was very frustrating for me. Hanging on the mooring line. I could see the rest of the group waiting for me on the bottom, which seemed a long, long way below. I got a bit anxious so I tried "blowing" a bit harder with the Valsalva method - my left ear cleared but the right remained stubbornly closed. We tried going up a bit but it still wouldn't clear so I was forced to surface and abort the dive. [We had two instructors with our group, one remained with me all the time and the other was with the rest of the group].

The instructors suggested that I should try a nasal decongestant overnight and try again the following day but the next day was even worse and I could only get a couple of metres under the water before again experiencing pain in my right ear. [My wife sailed ahead with her open water dives and gained her certificate - but wanted me as her buddy!]

A few weeks later, I got an appointment with an Brisbane ENT specialist who had done some diving. He found nothing physically wrong with me. He suggested that I was using too much pressure with the Valsalva method and that I should use it much more gently, combined with other methods such as swallowing, jaw wriggling, etc. He suggested that the excessive pressure that I was using in Valsalva might even have blocked the Eustachian tubes, preventing equalisation.

With this advice, I returned to try the open water dives and was successful. I am sure that my ears do not clear as easily as in some people but a slow descent, with frequent ear clearing (using GENTLE Valsalva and then different methods if it does not work) has allowed me to get to depth with no recurrence of the earlier problems.

I just hope that this may help others who experience similar problems.

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4 years 5 months ago #298139 by AB
AB replied the topic: Problems with ear clearing
Peter,
Welcome to our underwater world and thank you for posting. Ear clearing is something which varies greatly in it's ease with different people, and many people will have problems on a regular basis. Eustachian tubes are quite delicate, so anything other than a gentle blow might cause swelling or even discharge into the tubes which can prevent equalising. Hard blowing can cause damage so must be avoided.

I come from a free diving background, where we have to equalise every few minutes and I found it beneficial to gently "pop" my ears just before my descent, then lots of small blows on descent. You should never wait til you experience pain. There have been days where, although I haven't felt blocked, I found it difficult to equalise. On these days a decision was required. One dive is not worth months off and permanent scarring on your eardrum.

I did succumb to peer pressure once and dived straight after an international flight where I did feel a bit congested. I made a very slow descent and had a comfortable dive on a wreck in Vila harbour, but when I ascended back to 10 metres I could not equalise and felt pain. I slowly made it to 5 metres where the pain was constant, and as my air ran low I had to surface. My mask was partly filled with mucous and blood, and I felt my dream of diving the Coolidge over the next week was dead. Luckily I recovered over the next couple of days and was able to dive, but it could have easily gone the other way.

I have used medication to allow me to dive, but this is very risky. When the nasal sprays wear off it often results in increased congestion which comes on fast. If this is during the dive, you are in trouble. Medications which work for some people can actually cause problems for others, so be careful of taking other people's recommendations.

The bottom line is that no dive is worth damaging your ears, and there should be no negative implications to you abandoning a dive if you feel your ears are at risk. It's great you have found a way to enable clearing and now some awesome experiences await!

Alan

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4 years 5 months ago #298141 by pgcarter
pgcarter replied the topic: Problems with ear clearing
This sort of thing can vary a lot over time. I have dived 30yrs plus and usually had no problems, however I have a few times had eustacian tube congestion that has gone on for weeks or even months, it can be allergy related it can be triggered by a transient virus.....in June this yr I dived in Fiji no problems, got back and caught a cold a week or so later.....heavy wet head cold, mild sore throat and then a mild cough that took about 4 weeks to throw off. Here we are early Sept and my left ear and tube is full and tight as a drum, no chance of clearing some of the time. It's been rare over the years but it does happen.I sometimes find the first dive can help push the junk out...if you can clear on the way down the expansion on the way up helps push the stuff out of your tubes.......
regards Phill

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4 years 5 months ago #298179 by ripstone
ripstone replied the topic: Problems with ear clearing
I am new here and am not a diver but am a person that has suffered unmercifully with ear issues for 8 years. I live in the USA and fortunately in Maryland. In the USA if you're going to be sick, do it in Maryland. Best hospital in the world is Johns Hopkins and I am lucky to have it near (within 3 hours). Doctors kept diagnosing me with sinus issues after an upper respiratory infection. I saw more than 12 ENT doctors prescribing many antibiotics, decongestants, steroids, etc. etc. I am sure many of you have been there. Finally went to Hopkins to top neurotologist in the country. All ENT doctors had me using saline nasal irrigation multiple times daily which was the cause of my problems. Dr. At Hopkins took one look and knew immediately I had a patulous eustachian tube. Basically the saline water I was irrigating my nasal cavity with was going into my ear via the eustachian tube. Hopkins could/would not attempt surgery for 6 weeks (eardrum obliterated) as the ear had to totally dry first. Here was their treatment and it did work but remember I had been irrigating for years therefore I had alot of damage to dry up. If you use this right after diving it should stop your problems before they start. They gave me an Otomed powder insufflator (google image Sheehy-House Powder Insufflator. available online 15.95 usd. They also gave me capsules just like capsules that you can pull apart in most medicine capsules. The capsules contained Boric acid powder (do not ingest). Here in the USA you can buy boric acid powder over the counter at most pharmacies but not in capsules. You open the capsule and place it in insufflator with open side of capsule toward tip that goes into ear. Squeeze the insufflator bulb 2 to 3 times. This will clear the ear of infection but also dry the ear. This works. Insufflator is reasonable reusable and boric acid powder is dirt cheap. You can always split any medical capsule and clean its contents out well (not with water of course) and fill that half capsule with medical grade boric acid. It works and if Johns Hopkins is prescribing it I would stake my life on it. If my instructions are not clear email me and I will try to put together a video. In searching online for years for answers to my problem I could not help but notice so many divers were having ear problems. Water is the ears worst enemy. I posted here but can't post something this long on every diving site around the world. I enjoy helping people as my occupation before retirement was mortuary. Saw more of what agony pain and suffering did than most people ever see so please pass this info along to other divers forums. If I am able to help someone then the length of this post was worth it.

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