Who's your favorite ear doctor

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kr2y5
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Who's your favorite ear doctor

Post by kr2y5 » Sun Dec 13, 2015 3:19 pm

in the Seattle area?

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fmerkel
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Re: Who's your favorite ear doctor

Post by fmerkel » Mon Dec 14, 2015 7:53 am

Ed Kay. Not sure if he's still practicing.
What's up with the ears?
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kr2y5
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Re: Who's your favorite ear doctor

Post by kr2y5 » Mon Dec 14, 2015 12:52 pm

Thanks, Fritz. What's wrong: left ear "locks up" and does not equalize, usual techniques ineffective (right ear works like a swiss watch). Sudafed (proper), saline sprays, nasonex all ineffective. Left has always been worse, but the problems with it very much intensified in the past 1-2 months. No obvious symptoms (pain, swelling, congestion) otherwise. I will pay Ed a visit.

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fmerkel
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Re: Who's your favorite ear doctor

Post by fmerkel » Mon Dec 14, 2015 1:37 pm

Figured you had probably been working on it awhile. In general you optimize technique. There are more ways and variations than most people think. Strongly recommend you watch this whole video if you have not found it already.
http://staff.washington.edu/ekay/ > Streaming Video in AVI and Flash Formats. "The Diver's Ear - Under Pressure"
I'd also read: PREVENTION OF MIDDLE EAR BAROTRAUMA down below the video.

After technique is maximized you then look at anatomy to see if there are correctable problems. Then you move on to medication support. Sometimes it take a bit of all of the above to get to your goal.
FWIW I 'clear' OK but have really lousy sinuses. Been dealing with them for 20 years of diving and they continue to get worse. Anyone diving with me does not drop fast. I tend to shore dive almost exclusively to control descents. I move s...l...o...w...l...y to ~10-15' where I get 'stuck' for a couple minutes letting the sinuses equalize before I continue slowly down. Any pressure AT ALL and I stop until it passes. Pain is WAY too far along for the body to deal with effectively.

"Early and Often" means every 2' all the way to 20', then you can back off a bit. If the ear locks, go up and start over, even slower. Never....ever....ever push it. Look UP, thrust the chin OUT, tilt the bad ear UP, then try again.
Practice on land. It becomes harder in the water with masks, hoods, and mouthpieces compromising things. I clear easily on land hands free but cannot do it hardly at all in the water.

Got any known upper airway allergy issues, hay-fever kind of stuff? Those problems tend to intensify as we get older > the over reaction of the immune system gets more aggressive, creating hell for the afflicted.
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kr2y5
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Re: Who's your favorite ear doctor

Post by kr2y5 » Mon Dec 14, 2015 2:41 pm

Thanks. I also suspect some sort of undiagnosed allergy/inflammation, although I do not feel at all congested. I don't have any symptoms distinct from what I've had over the past 5 years, and it doesn't seem like I'm doing anything differently. I moved to PNW a year ago, and I've started diving 10 times more than ever before, but I had no problems whatsoever last winter. No flu, cold, or diagnosed allergy in ears, nose, or sinuses within the past year.

Learning all the alternative techniques sounds like a good idea, maybe expanding my repertoire will make things easier. I equalize continuously, but that's limited by the rate, at which I manage to swallow. I can only equalize when I blow and swallow simultaneously, it's hard for me to do that fast (sometimes my throat is dry and there's nothing to swallow). At some point, I used to be able to equalize just by swallowing alone without even trying to deliberately develop that ability, but that's just randomly come and gone.

I've probably been impatient and pushed a bit too fast after experiencing the first problems, maybe that just exacerbated whatever problem I initially had and made it semi-permanent.

What's confusing is that the problem does not seem to be in an obvious way related to relative pressure changes. First 10-20 feet are generally fine. I go slow and try to maintain positive pressure. At some point, maybe 30 feet, it appears that no matter how slow I go, the ear just becomes basically unresponsive. Not always, but often. I don't go as far as pain, and do back off upon feeling any pressure. Ascending 10 feet doesn't immediately help. Even if it does, as soon as I descent another 2 feet, the left ear is just as unresponsive as it was.

Things tend to resolve eventually usually within minutes, comfort returns, but continued descent does not seem to become any easier after that with time or depth, so descent is slow. I think I can always maintain a b it of positive pressure in the right ear, whereas the left ear just barely catches up, so I can't really stay much ahead of pressure changes.

Sounds in the left ear also differ from the right one. Right is just gentle puffs, even if I occasionally push it too far and have to back off. Left, when it get stuck and later unblocks, is usually a slurping, siphon-like sound, varying from high-to-low pitch, that lasts for about a second or two. Probably there's plenty of accumulated mucus in it. Sometimes, when blocked and trying to equalize, I hear a split second high-pitch chirping sound that I can only compare to a glitch in digital audio playback, if that makes sense.

Thanks a lot, again, for your comments. I'm going to take a break from diving until this is cleared, but will definitely apply all the good advice on the next dive. Maybe I should dive with you again, it seems like I could learn a trick or two :)

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enchantmentdivi
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Re: Who's your favorite ear doctor

Post by enchantmentdivi » Mon Dec 14, 2015 4:40 pm

fmerkel wrote:Ed Kay. Not sure if he's still practicing.
What's up with the ears?


He is retired. :(
Jenn

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fmerkel
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Re: Who's your favorite ear doctor

Post by fmerkel » Mon Dec 14, 2015 5:02 pm

Ah, thought so. I'll get in touch and see if he's got a referral.
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RVbldr
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Re: Who's your favorite ear doctor

Post by RVbldr » Mon Dec 14, 2015 7:20 pm

I saw Doc Kay a year ago; he retired since? That's a bummer, he was the go-to doc for diving physicals.

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fmerkel
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Re: Who's your favorite ear doctor

Post by fmerkel » Fri Dec 18, 2015 3:31 pm

I received the following information from Doc Kay:

[There are three doctors who have a good knowledge of diving medicine in Seattle. One is James R Holm MD at Virginia Mason (206-583-6543) and Jim is probably the most knowledgeable of the three. Another is an occupational medicine doctor in the Tukwila/South Center area (Betsy McKendry, MD ) and the other is in my old office in Bellevue (Rich Montminy MD). These last two work in occupational medicine and as such are used to seeing working divers, but they have a good background in diving medicine and usually can handle diving medicine related problems.]

A experienced diving friend just saw Dr. Holm at VM for a persistent/difficult ear issue. Still need to get together with her and see exactly how that went.
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kr2y5
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Re: Who's your favorite ear doctor

Post by kr2y5 » Fri Dec 18, 2015 4:27 pm

Thanks, Fritz!

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Gdog
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Re: Who's your favorite ear doctor

Post by Gdog » Fri Dec 18, 2015 7:09 pm

fmerkel wrote:I received the following information from Doc Kay:

[There are three doctors who have a good knowledge of diving medicine in Seattle. One is James R Holm MD at Virginia Mason (206-583-6543) and Jim is probably the most knowledgeable of the three. Another is an occupational medicine doctor in the Tukwila/South Center area (Betsy McKendry, MD ) and the other is in my old office in Bellevue (Rich Montminy MD). These last two work in occupational medicine and as such are used to seeing working divers, but they have a good background in diving medicine and usually can handle diving medicine related problems.]

A experienced diving friend just saw Dr. Holm at VM for a persistent/difficult ear issue. Still need to get together with her and see exactly how that went.

Great post!!

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