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Preventing Ear Barotrauma


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#1 DS256

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Posted 26 February 2019 - 05:17 AM

On my last dive trip, I was diagnosed with ear barotrauma. The symptoms were that several hours after the dive, both ears started to hurt and I developed a head ache. The doctor who diagnosed me put me on antibiotics, advil and Sudafed. I experience the same problem on a trip the year before and think I was misdiagnosed by the nurse on the small island we were diving on.

 

Now, on reflection, I think I missed a condition I had that contributed to this. Over the last last several years, I've developed a perpetual post nasal drip down the back on my mouth and throat. I chose not to treat this with medication. In hind sight, this condition likely contributed to my barotrauma. Unfortunately, neither myself nor my doctor caught the association with potential ear problems.

 

I have an appointment with an ENT coming up but here in Toronto Canada. DAN has not been able to provide me a reference to any specialist with dive medicine qualifications in my area.

 

I thought I'd ask here if anyone else has experienced this and have found a good prevention regiment. I understand from the doctor who diagnosed me there are steps that can be taken such as taking Sudafed starting the week before diving. The first is I've got myself on the medication for post nasal drip.

 

Thanks in advance for any insights. Hoping this does not mean the end of my diving days.


Edited by DS256, 26 February 2019 - 05:19 AM.


#2 TimG

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Posted 26 February 2019 - 10:09 AM

What are you taking for the post nasal drip? The plague of my life!

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#3 DS256

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Posted 26 February 2019 - 02:01 PM

TimG, my doctor prescribed Avamys fluticasone fuorate nasal spray from GSK. I've only been on it for about a week and it seems to help but I still have the condition.

 

However, unless I'm wrong, it seems you are able to dive with post nasal drip without any problems. I was hoping it was the root of my problem.



#4 TimG

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Posted 26 February 2019 - 04:05 PM

Thanks for that, Paul. Yeah, happily it doesn't stop me diving and no problems with ear equalisation etc. But, mercy, I do seem to have it all the time. Yuk!


Tim
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#5 dreifish

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Posted 28 February 2019 - 01:30 AM

Best prevention for baurotrama is to pay attention to equalization when descending, especially near the surface. Focus on that when you initially start the dive rather than fiddling with a camera. Descend slowly, equalize often. 

 

Some thing during the dive when you're taking photos.. pay more attention to any changes in depth you might be making while absorbed in the camera. 

 

I can't count the number of times I've followed a subject to get the shot (especially on video!) and ended up making large depth changes without equalizing. It wrecks havoc on your ears :(



#6 DS256

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Posted 28 February 2019 - 12:20 PM

Thanks DREIFISH. Yes, that is part of my plan. To equalize often starting on the boat. I also plan to do it while ascending.



#7 dubi

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Posted 01 April 2019 - 12:06 PM

 

I can't count the number of times I've followed a subject to get the shot (especially on video!) and ended up making large depth changes without equalizing. It wrecks havoc on your ears :(

 

This is a biggie.  I end up with a sawtooth profile and my ears are killing me after a week of diving!



#8 DS256

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Posted 02 April 2019 - 05:08 AM

Thanks all. As I suspected most of the problem is self inflicted. 

 

Since this a relatively new problem for me in the last couple of years, I'm wondering if anyone has had an ENT eliminate any other possibilities? I've heard of people being diagnosed with conditions requiring surgery to correct.



#9 subsea

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Posted 24 June 2019 - 06:15 AM

I have found that keeping sinuses clear by flushing with saline prior to diving is a big help for equalization issues. 

 

A visit to an ENT will help.



#10 SwiftFF5

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Posted 25 June 2019 - 03:31 AM

What I tell our new divers (and try to do myself) is to equalize every time I take a breath while descending and again while ascending.  I have always had some trouble equalizing, and this has helped me a lot, along with descending very slowly and deliberately. 

 

If I am going to be making many repetitive dives in a row, I may also take Sudafed (the real stuff that you have sign for at the pharmacy, not the "over the counter" stuff), and/or may spray a little Afrin decongestant in my ears (not the nose as you would normally).  The Afrin in the ears trick helps very quickly, and was something that a Harbor Patrol diver told me about quite a few years ago. Of course, those are not approved uses for either medication, use at your own risk, I am not medically certified to give you advice, etc. etc.


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#11 davehicks

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Posted 25 June 2019 - 01:52 PM

Ear issues after a week of diving are extremely common for many people. There are a few things that you can do.  I have the post nasal drip thing also...

 

1) Take a decongestant of some sort.  I use Zyrtec (Cetirizine) a non-prescription 24 release pill.  It's mostly for allergies (I don't have any) but it does a good job of drying things up.  I take it every night before bed for best results in the morning.  It is safe to use 365 days a year for most people.

 

2) Use drops to clean ears and remove water after each day of diving or after every dive if your problems are severe.  Many people use a home made mix of alcohol / vinegar in a 50/50 mix.

 

3) Some people I know (dive pros) swear by mineral oil drops in the ear before every dive.  This likely prevent water from being trapped in the ears and cleans out bacteria.

 

4) Be diligent about slow descents and gentle ear clearing as you drop.  No violent pressure should be needed.  If you feel the urge to push harder then descend even slower.

 

5) New divers are often over-weighted and drop like cannon balls.  See number 4, you should descend slowly and under total control of your decent rate.


Edited by davehicks, 25 June 2019 - 06:23 PM.

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#12 ChrisRoss

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Posted 25 June 2019 - 06:06 PM

For ear hygiene using something to dry out your ears is very worthwhile - basically trying to prevent ear infections coming on - I use Aqua-ear available over the counter in Australia it's a blend of isopropyl alchohol and and glacial acetic acid (no water) in a little squeeze bottle.  It's disinfectant and also absorbs water helping dry out the ears.  Saline nasal sprays can also help.  I found getting advice on diving rather difficult from medical practitioners that don't have any dive experience.  Luckily I can most clear my ears extremely easily just by swallowing as I descend so can't help much with advice on how to do so.