Expert: Trace Malinowski - 6/7/2009

Question
I have ear pain, and based on your response to another person, it sounds like maybe baratruama injury.  But I would greatly appreciate your opinion even though I am seeing a doctor this week.  Sorry it is so long, but I feel it is important for you to know all the facts.

August of 2008 I did about 5 dives in 4 days.  Deepest was 80 feet.  Did not experience any problems.  4 months after that I felt water in my canals.  didn't bother me so I did nothing about it.  2 months ago I felt pain in my right ear with pressure (blowing nose or sneezing).  2 weeks after that went to both ears.  Saw my doctor and was told some infection and moisture.  prescribed antibiotic.  week later no changed, perscribed stronger antibiotic and pseudophed, along with a nasal spray.  Currently, most pain is gone, but it feels like something is going on inside ear canals.  No other symptons, other than congestion.  I have a cat and am allergic to cats, so almost always nase passage is congested.  not taking any meds for allergies.  It appears I can equalize. I feel my ears pop. I flew this past weekend with no problems.  The reason I am concerned is that I am supposed to go diving next week to Cozumel.  Just because I sometimes feel pain when I blow my nose or sneeze, does that necessarily mean I will feel pain when I descend in the water?  Since the pain is now mild does mean there is still an infection?  Does infection mean definitely no diving?  I am trying to make an appointment with an ENT before I leave but sure if that is possible.  Any thoughts?   I will also contact DAN on Monday for advice.  Thank you very much.

Steve

Answer
Steve, normally barotrauma injuries while scuba diving would be noticed immediately or very soon after diving. Having problems so many months later would probably be the result of a cause other than a diving related injury. Perhaps an infection or allergies as you mention? I have been diving in the past with ear pain when equalization was still possible. My ear pain was normally associated with congestion, but if my sinuses and ears could equalize I did dive. I was just extremely careful with rates of descents and ascents. Definitely consult DAN and your doctor. Professionally, I would caution you against diving and it is better to be safe than sorry. However, I know from experience that I've had pain when blowing my nose, but felt no pain while diving. If after talking to medical professionals, you decide to dive, be cautious and exceptionally gentle with valsalva clearing techniques, be aware that decongestants may wear off underwater, and be very careful of reverse squeezes upon ascent. Cave and wreck penetration or other dives requiring multi-level changes (especially saw tooth profiles) may be extremely problematic when congested. It is often easy to descend deep and return to shallow when congested, but more difficult to make several up and down depth changes. If you have an infection, it is best not to dive. Water tends to make ear infections worse because the ear is not properly able to defend itself from aggravating or invading sources when in a state of poor health. Hope this helps and good luck!