Water refusing to emancipate itself from my ears

[Tess]

About two weeks ago (May 22), after a dive, I ended up with water in both ears - though a bit more in my left than in my right. It wasn't too bad, just kind of annoying. It got really annoying when I was unable to do anything to get said water out! :angry: I still haven't been able to. I dove again just this Wednesday, and more water got in my ears... then some of it left, but there's still definitely water in there, and I really am not sure what to do about it or if I even should do anything about it. Repeated attempts to get the water out just seem to irritate my ear and make it more uncomfortable. If I leave it, I hardly notice it, though it's definitely there (I can tell by that occasional tickly sloshy feeling...). My main concern is that it might be hazardous to me in some way if I just leave it. Is there anyone here who can offer some advice for removing this water? Should I even still bother?

Things I've tried:

• Violent head flinging
  Turning my head up, putting water in the affected ear with one of these unsettling devices, waiting a few moments, and turning my head to the opposite side to drain it
  Applying alcohol to a cotton swab and sticking it in my ear
  Smacking my head several times
  Sleeping for a whole night on my left side
  Creating suction in the ear with my palm
  Hanging upside down
  Firmly but politely asking the water to leave

Things I haven't tried:

• Leeches
  Lobotomy
  Actually seeing a real doctor

[Norris]

I have had this happen to me and you really want to be careful about not trying to hard to get it out. This can lead to irratating your ear canal and if it swells due to being harassed it will even be more difficult to get out.
If I am not mistaken, if water stays in the ear for prolonged periods of time you do raise the risk for ear infection. This still happens every once in a while to me, and now I just leave it and try my best to ignore it, and it has always worked itself out.
Your mileage may vary and I will let some of our medical members answer.

[renoun]

I routinely use ear beer, a 50/50 blend of rubbing alcohol and white vinegar in a small squeeze bottle, after diving. You can also purchase commercial products like Swim-EAR which are usually alcohol and glycerin. If you are certain that your the water is in your outer ear, your eardrum is intact, and you don't have an infection any alcohol solution may aid in drying your ear. If you are in doubt you should probably see your health care provider.

[LCF]

It is actually quite unusual to have water in the outer ear that you can't get out by simple means. It really only happens if your ears are heavily clogged with wax. Having someone take a quick look will rapidly resolve that question.

Much more common, though, is the sensation that there is water in the ears -- fullness, often associated with crackling or popping noises when you swallow or move your jaw. This IS fluid in the ear, but it isn't in the outer ear where you can get rid of it. It is due to not being quick enough to equalize your ears on descents. The vacuum that builds up in the middle ear before you equalize draws fluid out of the surrounding tissue, and that fluid can be persistent, especially if the failure to equalize was sufficiently prolonged to cause ruptured capillaries and some bleeding. There is no proven way to accelerate the absorption and elimination of this fluid, although people have recommended decongestants like Sudafed, and even chewing gum (works the Eustachian tube opening).

Here is a very good video on the diver's ear (probably the best I've found on the internet): http://staff.washington.edu/ekay/ And here is an essay I wrote about ear problems: http://www.divematrix.com/showthread.ph ... ght=otitis

I really think that not enough attention is paid during open water classes, to explaining these things to students.

[spatman]

I had a similar thing happen to me last fall. Hope this thread helps:

http://www.nwdiveclub.com/viewtopic.php?f=4&t=19299

[fmerkel]

+10 on what Lynn said.

If you've got wax in there holding it in then that evil looking bulb + wax loosening liquid is in order if you don't want to see a health care provider. They will help get it out but it may take multiple applications over several days.

But, if you can't get it out with the means already applied I think it may be in your middle ear. If so, DO NOT DIVE ANYMORE UNTIL COMPLETELY RESOLVED!!! You WILL screw your ears up, potentially permanently.

If you really don't know for SURE whether it's inner or outer, then you probably shouldn't dive until you've figured that out, watched Dr. Kay's video on ear clearing, practiced it on dry land a bunch, and then are very very careful on your next dives.

More folks screw up their ears diving than any other kind of diving 'accident'.

You are new to NWDC. For reference LCF is a physician and I'm a Respiratory Therapist. I have OK ears but lousy sinuses so I've made an extensive study of the issue.

[olalladiver]

+1 Yup. agreed. And if it's any consolation, and speaking as a realtively new diver myself, I'd say it gets easier to prevent it becoming a problem... As buoyancy becomes easier and more natural, it's easier to control the rate of your descent and it also allows you to concentrate on keeping well equalized as you're going down and coming up. For me anyway, once I feel too great of a pressure gradient, I'm already swimming upstream (easy to get blocks, etc) and it's a LOT harder to equalize out than if I did a fair job of keeping them well equalized during descent/ascent. So I'd add to keep that in mind.

I have had some moderate success with alcohol for drying out, but mostly, gentle prevention is better than mopping up the mess afterwords...

It's why your dive instructor probably emphasized making slow/gentle tweaks to your buoyance, too.

Good luck, and if it doesn't resolve in short order it's better to have it checked out and hold off a bit on the diving and always better to be safe than sorry...

[Joshua Smith]

And another +10 for what Lynne said. I had this problem frequently when I was first diving. As I gained experience and learned how to properly equalize, the problem went away.

[lamont]

+20, first year of diving i had this a bunch.

if you get to the point where you feel significant pressure on your ears when you're descending, and then you valsalva somewhat hard and it "pops" that is usually enough to give you middle ear barotrauma -- which leads to squishy water-in-ears feelings and gurgling clearing of ears, etc.

once you feel significant pressure on your ears you need to ascend a little bit before trying to clear your ears. or better, you need to be staying ahead of it and clearing your ears consistently as you're descending.

when it happens, i usually find that ibuprofen helps me, but that might be placebo

[johndo88]

If so, DO NOT DIVE ANYMORE UNTIL COMPLETELY RESOLVED!!! You WILL screw your ears up, potentially permanently.

Listen to this advice!!! Ears can get screwed up with little or no effort. Trust me on this! PM me if you want example.

[fmerkel]

The 'clear early and often' advice generally doesn't get any specifics.
Clear on the surface. Actually clear in the shower and clear a number of times on the way to the dive site just to practice.
The clear on EVERY breath of descent or EVERY 2 feet down to about 30 feet. If you've gone over 6 feet, have not cleared and don't have open pipes for Eustachian Tubes you are getting close to doing damage BY clearing as lamont indicates above.

As you get deeper the relative amount of pressure increase goes down so clearing becomes a bit less necessary. Remember, 33 feet of descent equals the pressure of our ENTIRE surface atmosphere. It take very little water to create a lot of pressure.

[GearHead]

+1 on that!
Since I started equalizing on the surface and every couple feet of descent, I haven't had any issues. If you're feeling pressure (squeeze) on your ears, it may already be too difficult to equalize. Move your head up a couple feet and try again, gently.

There is a phenomenon where if you try the Valsalva maneuver (pinch nose & blow) too hard, you may damage your inner ear. It's much better to slow down, ascend a bit if necessary and equalize gently.

[fmerkel]

Yes, I know a guy that did that, a Dr. no less. He should have known better.
He took out his round window in his inner ear, thus suffering some permanent hearing loss.

I have to notice that among the older divers in our club there is a lot of 'Huh?' at our meetings. I think if folks are not careful they can accumulate a lot of minor damage over the years that accumulates.

[H20doctor]

well its funny that this has come up because i also have been having problems after diving, i think i have barotrauma.. I called dan today and spoke with someone, and he said this is prob what is going on..
My symptoms:
I can dive , i can clear my ears no problem, i feel fine during my dives, at all depths from 115 feet to 15 feet.. I have no ear pain at all during my dives... here is what happens after i get out of the water...
On dry land i get really dizzy after the dive, not so much vertigo, but i feel dizzy.. my right ear starts to sing , like there is a glass wind chime in it, tinkling .. this last for about 24 hrs.. and then reduces to a tenitious ring.. As of now i have about 20 % hearing loss in my right ear like its clogged or something... So im off to the doctor here in a few days to see whats in my ear ...

[fmerkel]

I hear something like that and I think, 'he believes he is clearing fine. I think he is clearing inadequately, possibly too late and too forcefully."
Those are delicate tissues. Like any tissue they can respond to trauma with swelling. Even more trauma causes exudation and bleeding. The more the swelling, the harder the clearing. The harder the clearing, the more likely the trauma.
As you see, it can easily become a vicious cycle. If you go into the water compromised because you just HAVE to dive you are already setting yourself up for more problems. Diving may be pretty important to you but think what your hearing is worth, especially in the long haul.

Some people think you should never use medication 'crutches' to dive. I think it's FAR FAR better to use GOOD TECHNIQUE FIRST, then if that proves inadequate resort to a staged use of appropriate medications. Some are over the counter, some you need an RX. Which ones or which combo needs to be individualized.

FWIW, I personally have been using RX nasal steroids since I started diving and ended up with reverse block, which was also the beginning of my education. That has helped a lot. On occasion I use Afrin, and once in awhile pseudofed at half dose. Papaya enzyme (health food stores) sucked liberally before a dive acts as a mild anti-inflammatory and may help with essentially no risk at all.

[H20doctor]

I hear something like that and I think, 'he believes he is clearing fine. I think he is clearing inadequately, possibly too late and too forcefully."
Those are delicate tissues. Like any tissue they can respond to trauma with swelling. Even more trauma causes exudation and bleeding. The more the swelling, the harder the clearing. The harder the clearing, the more likely the trauma.
As you see, it can easily become a vicious cycle. If you go into the water compromised because you just HAVE to dive you are already setting yourself up for more problems. Diving may be pretty important to you but think what your hearing is worth, especially in the long haul.

Some people think you should never use medication 'crutches' to dive. I think it's FAR FAR better to use GOOD TECHNIQUE FIRST, then if that proves inadequate resort to a staged use of appropriate medications. Some are over the counter, some you need an RX. Which ones or which combo needs to be individualized.

FWIW, I personally have been using RX nasal steroids since I started diving and ended up with reverse block, which was also the beginning of my education. That has helped a lot. On occasion I use Afrin, and once in awhile pseudofed at half dose. Papaya enzyme (health food stores) sucked liberally before a dive acts as a mild anti-inflammatory and may help with essentially no risk at all.

Huh? .. Ive been diving since 2001.. Do you think I cant equalize my ears correctly? I'm a bit confused

[Joshua Smith]

I hear something like that and I think, 'he believes he is clearing fine. I think he is clearing inadequately, possibly too late and too forcefully."
Those are delicate tissues. Like any tissue they can respond to trauma with swelling. Even more trauma causes exudation and bleeding. The more the swelling, the harder the clearing. The harder the clearing, the more likely the trauma.
As you see, it can easily become a vicious cycle. If you go into the water compromised because you just HAVE to dive you are already setting yourself up for more problems. Diving may be pretty important to you but think what your hearing is worth, especially in the long haul.

Some people think you should never use medication 'crutches' to dive. I think it's FAR FAR better to use GOOD TECHNIQUE FIRST, then if that proves inadequate resort to a staged use of appropriate medications. Some are over the counter, some you need an RX. Which ones or which combo needs to be individualized.

FWIW, I personally have been using RX nasal steroids since I started diving and ended up with reverse block, which was also the beginning of my education. That has helped a lot. On occasion I use Afrin, and once in awhile pseudofed at half dose. Papaya enzyme (health food stores) sucked liberally before a dive acts as a mild anti-inflammatory and may help with essentially no risk at all.

Huh? .. Ive been diving since 2001.. Over 3'000 dives.. Do you think I can't clear my ears.. ? Safely..

Well, maybe. He's offering good advice, in a nice way. No need to take offense.

[H20doctor]

I hear something like that and I think, 'he believes he is clearing fine. I think he is clearing inadequately, possibly too late and too forcefully."
Those are delicate tissues. Like any tissue they can respond to trauma with swelling. Even more trauma causes exudation and bleeding. The more the swelling, the harder the clearing. The harder the clearing, the more likely the trauma.
As you see, it can easily become a vicious cycle. If you go into the water compromised because you just HAVE to dive you are already setting yourself up for more problems. Diving may be pretty important to you but think what your hearing is worth, especially in the long haul.

Some people think you should never use medication 'crutches' to dive. I think it's FAR FAR better to use GOOD TECHNIQUE FIRST, then if that proves inadequate resort to a staged use of appropriate medications. Some are over the counter, some you need an RX. Which ones or which combo needs to be individualized.

FWIW, I personally have been using RX nasal steroids since I started diving and ended up with reverse block, which was also the beginning of my education. That has helped a lot. On occasion I use Afrin, and once in awhile pseudofed at half dose. Papaya enzyme (health food stores) sucked liberally before a dive acts as a mild anti-inflammatory and may help with essentially no risk at all.

Huh? .. Ive been diving since 2001.. Over 3'000 dives.. Do you think I can't clear my ears.. ? Safely..

Well, maybe. He's offering good advice, in a nice way. No need to take offense.

I dont get it josh..

[ljjames]

Hey! I know Fritz in person and he would NEVER be intentionally offensive. He responded to your post cause he gives a damn.

Even experienced divers have issues from time to time... Distractions of new buddies, scooters, or even just a random head cold that wasn't quite presenting itself before the dive.

I understand where he's coming from, in the course of my diving career I have talked loads of experienced divers who don't clear 'early and often' and have had any number of ear issues. I had one reverse block about 20 years ago and its made me incredibly gun-shy which is why i spend this past weekend thinking about diving and not diving. Stupid head-cold. <grrr> I also use some of the "better diving through chemistry" as Fritz describes, but not when i have a full blown head cold

In the event that none of this is at all correlative to your experience, try not to take it personally, it might be useful for someone else.

There are a few other possibilities that could explain your issues but barotrauma is the one with the least stripes.

How is your ear today?

[fmerkel]

I know you are a very experienced diver. You have way more dives than I do. But you stated you are having problems that sound like you are having barotrauma, even DAN said so.... why?
I gave you what I think is the most likely scenario, but that's playing Dr. over the internet with no chance to go over a whole host of variables that could be critically important. For example, you may be having changes in your allergies. That spontaneously happens to people as they get older with no apparent provocation. It's annoying, believe me, been there, am there. This may mean more chronic swelling so what used to be a fine clearing technique no longer works as well. There could be other medical issues. It's impossible to tell in from on line chats. I'm not as shy as some folks about throwing out a medical opinion, but it is an opinion based on inadequate information. We both need to be clear on that. Anyone seeking medical advice off the internet needs to be very clear there are serious limitations in the exchange.

I USED to be able to do deep water drops. NOW I ALWAYS do a very slow descent. If possible I prefer shore, drop in chest deep water, descend......slowly.....to about 12-15 feet where I get 'stuck' for a couple minutes while my sinuses equalize. Once that's OK I can resume the dive. There is no way to push those descents without pain and damage, as in blood traces after the dive. Anyone diving with me gets told that. Either my back or my sinuses are going to take me out of this sport. It's kind of a turtle race in time to determine which.

That's a way of saying things could be going on with your body that make you need to re-think how you dive or if you may now need drug support you may not have required before. Things change. If it's bad/chronic enough I'd certainly consider seeing Ed Kay or someone with diving ENT experience. You really don't want to mess up your ears.

I don't know if you remember me. We met at Deception about 2-3 years ago I think, and I believe one other time. It was a short exchange so it may not have stuck.

[Tess]

Hi everyone! Thanks so much for all the responses!

It definitely sounds like I got some barotrauma in my middle ear. I'm going to schedule a doctor's appointment as soon as I can, and keep diving to a minimum. I actually did have brief hearing loss after my first out of class dive (in other words, when this problem started) but I'd forgotten about it because the hearing loss just felt like I was super congested or something, and I waited for it to clear up and was fine. I was indeed equalizing when I already felt a squeeze, and sometimes would have to force it out! Eek! I was taught to equalize early and often, and told to move up a few feet before equalizing if I felt some pain, but I never felt pain so I thought it was still okay. I'll be more careful now for sure!

[fmerkel]

It is VERY VERY easy to be so task loaded when you are first diving you not only don't notice your ears but you don't notice pain until it gets bad, bad as in way beyond appropriate to clear and barotrauma damage is being done even before you clear. The body is reacting to the pressure trying to blow your eardrums in by filling the middle ear with fluid > exudate and blood.
You should be clearing when you barely perceive pressure.

DO NOT DIVE AT ALL, REPEAT, AT ALL, until ALL evidence of the barotrauma is completely gone and you can clear easily on shore.
RULE NOT TO BE BROKEN - If you can't clear on land, you sure as hell won't be able to clear underwater. Never break that rule.

If you don't have any pain, or any evidence of secondary infection you don't need a Dr. appointment, unless you want it. Your call.
Generally these things clear up on their own without issue, middle ear infection being the main one. You'll know if you have it...it hurts. At that point you'll really WANT to see a Dr. and get some antibiotics.

You can facilitate remission with a few days of over the counter pseudofed and Afrin used as directed. This will help open up the passages so things can drain better. Healing will take it's own course. 2-4 weeks depending on severity of the injury and how quickly and well it normalizes, assuming no infection.
Essentially, think of it as a blood blister in your middle ear space. The 'gunk' is preventing things that should be vibrating easily from doing so and muffling your hearing.

Note - many regular Dr. don't know squat about diving issues. That's not knocking the profession. My best friend is a family physician, a good one, but he doesn't know anything about diving I haven't taught him. You show up with a raging middle ear infection from the barotrauma....now that is something they know how to deal with. Little kids get middle ear infections all the time. They have lousy/floppy Eustachian tubes. Frequently non-infected barotrauma is treated as an infection because they don't know what it is and they don't know what else to do with it.

[LCF]

I think it's common to tell people to equalize before they feel pain -- the problem is that you can have quite a bit of pressure differential build up before it hurts, and certainly enough to have fluid accumulate in the middle ear. I'm currently dealing with a bit of it myself, having done a dive with a different dry suit, where the inlet valve was in a different place. Just the time it took to hit the spot on the suit where I expected the valve to me, realize it wasn't there, and move to the right spot was enough to get a little fluid buildup in my right ear, since it happened several times.

The key is to equalize before you feel ANYTHING -- even pressurize your ears on the surface before you begin your descent at all. The problem is that you have to have quite a bit of presence of mind to do that, and novice divers are usually processing such an information overload that they just can't get there.

I'm not sure you need to see a doctor, unless your ear is frankly hurting. If it's just a bit of crackling and a mild stuffy feeling, it's likely to be mild and resolve. If you have significant hearing loss, or develop pain in the ear, then you definitely need to be checked.

(This advice given subject to exactly the same caveat as Fritz's . . . )

[Tess]

I seem to be able to clear all right, even though I do feel as though there is some fluid in my ears. Should I still refrain entirely from diving?

[fmerkel]

The serious problem is if you indeed DO have barotrauma. Think of it as a 'sprained middle ear'. It's injured. Just like simple walking, a normal activity, makes a sprained ankle hurt, until barotrauma is completely healed the tissues are compromised and more susceptible to injury. Diving is most decidedly not a 'normal' ear activity. It's more akin to unrestricted combat.

How long since you've last dived?
When did the muffled feeling go away?
How long have you been able to clear?
Have you tried one of those kits to help get wax out of the ear?
If you can't tell where the water/fluid is, how am I supposed to know?

You see the problems....

It's possible you have a blob of wax with water trapped behind it bugging you. That happened to me once, but I knew what it was, knew it was not critical, and was able to keep diving until I could get a wax removal kit and work it out days later. That is one thing a regular physician with a scope can tell in a minute. A lot of people simply cannot tell if the fluid is outside or inside their eardrum, and it makes a HUGE difference.

It's statistically more likely you have unresolved barotrauma. As I indicated that can take up to a month to clear if you don't have any complications. That's a pretty strong incentive to not do that again, eh.