Barotrauma

[gblades2]

I was diving in Egypt last week for 5 days finishing with the Thistlegorm on the Friday. On the Saturday at some point during the day I had a feeling as if my right ear was slightly blocked with wax or water.

I mistakenly tried cleaning my ears and although I was very carefull I think part of my ear was a bit sensative and I might have scratched it.

I went to the doctors today and she said that she could not see an infection but the ear was blocked with 'debris' and she could not see the ear drum because of it. I have an anti-inflamatory/bacterial spray to use.

I though a barotrauma was when you don't clear your ears when you decend. During the diving I did not have any problems clearing my ears and did not have any discomfort or pain in my ears.

Is it possibly to get a minor barotrauma from repeated regular dives without experiencing ear pain or discomfort or is the doctor just saying what the most likly cause is going from their past experience (not being a dive doctor)?

[Hyperbaric]

<font color='#0000FF'>It is possible for stuff to ooze out from the middle ear through a burst eardrum caused by barotrauma, but if your drum had burst as a result of pressure, you would certainly have known about it at the time.

I'm not aware of anyone having had enough barotrauma to cause a burst eardrum without them being acutely conscious of it... but there is often an exception to the rule somewhere.

Get your doc to check again when the debris has cleared to visually check your eardrum for damage. If it doesn't get any better with the medication, ask your doc for an ENT referral.

[Phill]

Agree with Stuart, but an alternative that I've come across was an insect bite in the ear canal, origonal symptoms were like yours, follow up action was like yours (self ear cleaning) result was an ear full of debris with no visible drum (plus slight deep ear pain when the jaw was wobbled) - when finally cleared out (over a week) only visible sign was a small red spot immediately adjacent to the drum - hence the final diagnosis. Antiseptic drops rapidly cleared this.

[chrisch]

Barotrauma occurs when there is a pressure difference - so the ascent part of the dive is the most dangerous as the pressure is causing swelling. &nbsp;In the descent the pressure is squeezing.

It is possible to bruise the ear if you are over vigorous with the equalising. &nbsp;This is very common and sounds like what you have done. &nbsp;It feels like there is something inside the ear.

I would still get it looked at again - its free on the NHS (some things are good here in the UK!!) so why not??

Try to develop other ways of equalising rather than valsalva (nose pinch &amp; blow) as this is a bad way to equalise. &nbsp;Also make sure the ascent is slow at all times. &nbsp;Both of these have DCI benefits too..

Chris

[gblades2]

I never use the valsalva method for equalising my ears as I am fortunate enough to be able to do it by directly activating the relevant muscle.
All my ascents were slow during the week and mostly 6-10M/min.
On the last day the ascents were particularly slow because of the crowded shot line and my computer did not go above 3M/min on the ascent.

I have made a scale of the feeling of pressure in the ear as you descent.

1. Minor pressure difference such as &nbsp;ascending in a lift. May not be detectable by some people.
2. Airplane starting to descend and you feel the pressure after a couple of seconds.
3. Airplane starting to descend and you wait 5 seconds or so before clearing you ears and you hear a slight pop as you clear your ears.
4. Can feel a larger pressure difference beginning to become slightly uncomfortable.
5. Pressure difference beginning to cause pain.
6. Pain in the ears.
7. Severe pain/burst ear drum.

I would say my descents were 2-3 on the scale.

[Mdemon]

Why is the nose pinch clearing bad and what are the alternatives?

[skener]

the nose pinching increases the possibility of blood shunting across the heart of a person with a pfo ( a small hole in the heart)

[skener]

other techniques for clearing the ears are frenzel- throat lift and use tongue as a piston, toynbee- nose pinching and swallowing, edmonds-combined with valsalva and jaw thrust i think

[chrisch]

Valsalva

The nose pinch or valsalva method causes a pressure change in the heart between the right and left atrium. &nbsp;If you have a hole between these vessels this causes bubbles to move from one side to the other. &nbsp;This hole is a Patent Foramen Ovale (PFO) and about 30 percent of us have it.

If bubbles are present this can shift them into the arterial system where they can give arterial gas embolism (AGE) which can be very nasty if it is in the brain or spinal column.

There are a lot of ifs here so it is more of a hypothetical risk than a problem. &nbsp;The key thing is to avoid equalising by this method at the end of a dive, for example if you accidentaly descend due to other divers pulling the shot line down as they ascend while you safety stop or deco.

To avoid this get in the habit of using a jaw wiggle or swallowing with the tongue pressed against the top of the mouth.

As gblades does this then no hassle - good for you.

I got interested in this as my partner is a migraine sufferer - a sign of possible PFO. &nbsp;I had dived for ten years before that without having heard of this. &nbsp;I am embarassed to admit having equalised at the dive end just as described above in the past.

I have now sort of got to where I can equalise without valsalva - sometimes I still have to resort to it on the descent. &nbsp;However I am aware of the danger and so make more effort to maintain good depth control on the stops - which is just good diving really after all.

Better safe than sorry and at no cost or loss of pleasure...

Chris.

[Dr Stevil]

I'd reckon you've hurt your ear by trying to remove the blockage, some medical person once told me &quot;never put anything in your ear that's smaller than your elbow&quot; ie don't stick fingers or Q-tips in there poking around, folk generally make the problem worse by this kind of &quot;self-help&quot;

The blockage would probably have been just regular ear wax and you'd have been better off putting a couple of drops of olive oil in there (nightly) to soften it and it'd come out naturally. To prevent ear infections you can use dilute vinegar (say 1:5 or 1:10) this will create a localized acidic environment not generally favourable to the bacteria. &nbsp;
You might want to think about what's in the spay you use. Active ingredients like Triclorsan are still (currently) in favour but widespread overuse of some other antibiotic/anti-bacterial compounds has merely bred resistant populations, stuff like Dettol can actually be quite to the liking of bugs, anything with cyclohexamide in it (eg Savlon) should be effective
For anti-inflammatory use you're just as well off with paracetemol or aspirin.
HTH
Steve