Ear trauma

[Absolute]

Hello everyone. Sorry for the long absence but I need a little help here. So on Saturday I put on the scuba tank to clean the bottom of the sailboat in the marina. 2m max for 20 min or so. going up and down wiping off the slime on the bottom of the boat.

Sunday am 0245. Both of my ears hurt so bad that I cannot sleep, eat, hardly walk fast. I spend the rest of the day suffering, temp over 100f, and lots of pain, lots of pressure buildup in the inner ear, hard to hear.

Monday I get to the doctor, antibiotics and heavy pain killers, monday afternoon both ears start popping on thier own little by little with a light brownish fluid leaking out, more like water not blood. Now my ears have been draining for about 10 hours, hearing has improved, pain decreaced, seems to be getting better.

Definatly a double ear infection but why. I have cleaned the bottom a hundred times before and never this. Mabey there was some toxic stuff that came off the bottom and floated into my ears. I usually don't use the tank so I was going up and down alot. Maybe I stressed them out repetition wise. My ears are used to deep depths but not shallow ones with little to no eqing.

Question is: fluid draining from the ears=what. broken ear durm? How else can fluid escape the innner ear?. I expect to wait at least 2 months before doing anything but will I be able to dive again? saying that makes me cringe.... Freediving that is. Everytime I use the tank something goes wrong.

Thanks for the help and advice,
Jay

 

[spaghetti]

Jay I've had my share of ear pain and ear doctors in the last years, so I made up a "culture" on this subject. But what I've learned is that every case is so specific that only a specialized MD can give you the answers.
My impression from your story: ear infection occuring before the dive, cavities full of mucus and made narrow by mucus, thus trapping air inside. Results: air being compressed, trauma. Just an idea though.
Welcome back on this board

 

[naiad]

Did the doctor examine your ears and tell you if the eardrum was burst or not?

 

[Absolute]

He had a look but did not say anything about it being broken. No fluid was leaking out at the time and I was in so much pain I did not bother to ask him. It was like my head was being squeezed in a vice and then someone was hitting the vice with a hammer.

Now the pain is not as much but the fluid is still coming out.

 

[wet]

Guessing: (I'm not a doc)

Ear wax contains dry skin flakes, (50-80%)

The brown fluid was water & ear wax (dry skin flakes, cerumen (grease)), which got mixed during diving submersion. You didn't get all the water out of your ears when you finished scraping the boat. The trapped water/wax stayed in the ear canal, the numerous skin flakes in ear wax absorbed water, which enlarged the wax "ball" putting pressure against tubular walls of the ear canal (pain). This "ball" got heated by the sub-dermal blood vessels around the ear canal (inflammation) while you were sleeping, when heated the earwax partially disintegrated and became fluid.

This alone is an indication of wax build-up and water entrapment, but does not indicate (nor contraindicate) a torn eardrum (aka perforated tympanum). A torn eardrum would reduce pressure differential while submerged, and not in itself be painful, but also would allow contaminants into the middle ear cavity, possibly causing infection later (not within a couple hours).

To me seems like you should have equalized every time you submerged, due to stress on the eardrums at 1.5m depth or more.

The greatest differentiation of atmospheric pressure is between the air just above the surface and the water just below a few feet.

Did you not equalize because of already existing pain or sensitivity in the ears or fever? (per Spaghetti's message, pre-existing ear infection & mucus)

Excluding the outside rubbery ear that we see (pinnae), the ear is 3 parts: the external ear canal, [which ends at ear drum], the air-filled middle ear and the inner ear.

 

[wet]

Ear wax

Ear wax contains Cerumen (waterproof) & Squametes (water absorbing).

Cerumen is the oil, Squametes are the dead skin flakes.

The greasiness of ear wax is determined genetically.

East Asians typically have "dry" or hard ear wax - 20% cerumen,
Europeans & Africans have "wet" or greasy ear wax - 50% cerumen.

Cerumen is produced in the outer one half of the ear canal, the tunnel leading from the hole in the external ear to the eardrum. The ear canal is about one and one-half inches in length. The skin of the outer one half does not have sweat glands but instead has glands that make cerumen.

Skin in the ear canal is identical to external skin in all other respects,
however external skin, due to friction (clothing, swimming, movement) and drying, sheds squametes (skin flakes) regularly, while ear canal skin has no friction so the cerumen acts as a migratory agent, pushing dead skin outward from the ear.

 

[Absolute]

Thanks for the ear wax lesson. I did not know that. I had just cleaned my ears mabey a few days prior. I am still leaning tward contaminated sea water. I think some one was pumping over the side and the stuff collected on the bottom of my boat. Living on Guam has it's drawbacks, one of those being there is no ENT doctor on island so you have to self diagnose. From what I can come up with is OTTIS MEDIA. Infection of the middle ear. What I can't conclude on is if fluid is draining (which is normal for the infection) does that mean the tempanic membrane has a hole in it? Thanks for your help on the ear wax. that stuff can build up fast.

 

[Charles Engles]

Dear Absolute in Guam,


I suspect that your recent cleaning of your ears washed off and out some of the protective and hydrophobic cerumen, which would be a normal consequence of ear cleaning. I suspect that you then were unlucky enough to inocculate both ears with some nastiness while cleaning the bottom of the boat. I highly doubt that you ruptured your eardrums. Your description sounds like you have a serious case of bilateral otitis externa. I suspect that the fluid draining is serous fluid (plasma) from the inflammation of the delicate and highly sensitive skin lining the ear canal. It may possibly be blood tinged.

My long distance recommendation is to continue antibiotics. Stay out of the water. Once the pain and swelling and drainage have gone, then your local doctor or an ENT doctor can best visualize your eardrums and answer the question of perforation or not. Typically, a middle ear infection is more common to rupture the eardrum than an external otitis. I think that you're stuck above the water line for at least 10-14 days.......


Good luck, Charles Engles

 

[Absolute]

Thanks Charles, I like the sound of that. What do you think about a drop or two of olive oil in the ear before diving. Would that help things move around a little better.

Thanks again.
Jay

 

[Charles Engles]

Dear Absolute,


Olive oil in the ear canals??? Interesting. I've never heard of it, but I've led a sheltered life. It could theoretically work. A real ENT could provide a better opinion.

IMHO, you should get over this spell; get your ears inspected and if all is well, then resume your dive routine. To prevent such events in the future, the usual accepted approach is instillation of isopropyl alcohol ( two or three drops in each ear ) or a weak solution of boric acid (I think that is right). Those solutions (available at the local pharmacy even on Guam) promote drainage of the residual water in the ear canal and also promote a dryer ear canal environment, which is less hospitable to bacterial and fungal nasties.

I suspect that if it weren't for the unfortunate combination of slightly reduced natural ear wax plus the likely high dose of foul water innoculating both ears over a long period of time, that you shouldn't have any problems when you resume your usual dive activities (understanding from you posts that this event is unusual for you ).

Regards, Charles Engles

 

[wet]

Thanks for the ear wax lesson. I did not know that. I had just cleaned my ears mabey a few days prior. I am still leaning tward contaminated sea water. I think some one was pumping over the side and the stuff collected on the bottom of my boat. Living on Guam has it's drawbacks, one of those being there is no ENT doctor on island so you have to self diagnose. From what I can come up with is OTTIS MEDIA. Infection of the middle ear. What I can't conclude on is if fluid is draining (which is normal for the infection) does that mean the tempanic membrane has a hole in it? Thanks for your help on the ear wax. that stuff can build up fast.

How did you clean your ear canals? dry Q-tip? warm water/shampoo via shower? ear syringe-plunger? The Q-tip removes the outermost wax, but pushes the innermost wax towards the eardrum where there are no cerumen glands, so it tends to get stuck there. The other two methods are better, but water must be removed afterwards. (And the shampoo method shouldn't be used too often)

I haven't seen any indication of middle ear infection specifically, but won't rule it out. Has your hearing changed significantly? Difference in hi or low frequency perception? Does it sound like you are underwater? If none of these, then I still lean on the ear wax idea.

I would expect infection fluid to be filled with white blood cells aka pus.

You were only under water for about 20 minutes total? Or did you make numerous 20 minute dives?

Did you notice any other skin infections anywhere else? Itchiness? Eye soreness?

(again, I'm not a doc)
DDeden

 

[Absolute]

to clean out my ears I flush them out with warm water in a syringe, then carefully use the chinese ear picker. It is basically the same thing doctors use(like a super small version of an ice cream scooper) just a little smaller and not metal which makes it easier on the canals. It usually does a good job. Rarely I'll go to the doc and have him clean em but I have before. In regards to hearing, i can't even hear the keyboard tapping away as i type right now, and when I am eating......forget it....hells angels could roll by and I wouldn't miss a bite. Well mabey not that bad but you know.

My ears continue to cry themselves away with a brownish until i touch it with the tissue yellowish fluid that is kind of sticky and fogs up the screen on my cell. At one point in the day today I was feeling great, no pressure, no soreness to touch, I could even hear well so I tried it. Pinched my nose and gave them the ever so slight and gentel freznel. My nose bulged as a shock absorber. rofl It sounded like the grand fanalie fireworks show on the 4th of july. pop pop gurgle gurgle fiz no bang and no pain but no stop. no fullness, no ok that's enough. I was exhaling out my ears. So there busted and so amd I. At least I could have gone down with a good story but cleaning the bottom of a dirty boat in a dirty marina with a scuba tank on to beat all is just a little depressing to me. But I have to stay focused, eat right drink lots of water, vist the doc :crutch and get em better. I guess this is a good time to practice dry statics.:inlove

 

[naiad]

At least I could have gone down with a good story but cleaning the bottom of a dirty boat in a dirty marina with a scuba tank on to beat all is just a little depressing to me.

I know the feeling - it is always worse to hurt yourself doing something you don't like. rofl :waterwork

I have had many ear infections in the past, and they are very painful. The only thing that has worked is antibiotics. Definitely see the doctor about it.

Hope you feel better soon

Lucia

 

[wet]

From my own understanding/experience, the water plunger is not followed by an ear picker. The water plunger is used for greasy ear wax (European, African), while the Chinese ear picker scoop is used on hard/dry ear wax (East Asian, Native American).

Here's an example of Hard wax removal, similar to others I've read, written by an Asian lady medical student: (anon.)

"One of the best times I had with my mother while growing up was not of her giving me hugs and kisses. In fact, the most vivid memories of my childhood are the times when my mother spent time at least once a week to clean my earwax. Sounds disgusting but I really loved putting my head on my mom’s lap while she prodded with a metal ear-digger for my solid wax. And I absolutely love the feeling of the digger scraping my ear canal to relieve the itch. Although I’m not pretty sure how orgasm feels like, I’m quite certain it is almost similar to the one I experience every time I clean my ear".

The relative lack of cerumen produces an ear wax which is solid and powdery with a different sensation than the sticky greasy ear wax. (Of course there is variability due to genetics and environment).

That being said, are you saying that you have both ear drums punctured? That when you tried equalizing, air traveled through the eustacian tubes through the middle ears and out through the external ears, both left and right?

Have you had many ear infections in the last 10 years or since you began regular diving?
How long have you been using the Chinese ear picker? Have you had ear infections since you started using it?

 

[Absolute]

It seems I will live through this as condition improve day to day. Still hurts like a bugga sometimes, but the new sounds are amazing. The shower water on your head, eating a cookie, the boat splashing through the water etc, all completly different and amazing. I reccomend that everyone preforate both drums just for the audio experience. LOL. No don't do it. Hearing underwater noises is much better. I can't wait for that. Anyone have any experience using docs pro plugs?

 

[kmo]

I perforated an eardrum and got the proplugs. I only used them in the shower while I healed though, I decided against risking surfing or diving with them in.

Edit - They did a good job of keeping my ear dry, and I think that they'd help in your case for avoiding any more moisture getting stuck in there while you shower.

 

[Absolute]

Well, It's been a year since the double ear infection. After a lot of pain, 3 doctors, and not hearing squat for 2 weeks, I survived. Recovery was slow, and eq ing was challenging at times, but the up side is now my eq ing is way better than pre ear infection. I have always been able to dive hands free but only for the first 15 to 20 dives. Now I can dive all day hands free and eq down to 25 to 30m no problem. So what I thought was the end of my diving has turned out to be a blessing in disguise. I guess the swelling and increased pressure on my Eustachian tubes stretched them out making it easier. I don't know.