Wet Equalization Experiences & Techniques

[donmoore]

This thread is for people who are interested in learning and discussing wet equalization. Its been a little of a hush-hush topic :ban in the freediving community, but in keeping with the openness attitude of the db forum I though I would share my experience of an in-home experiment and let other share their's. I am not interested in setting records at the risk of going deaf in 10 years, so I would rather discuss it out in the open and learn from others. I love freediving, but health, family, job, and other things are more important.

After reading mostly vague statements about it for years and then seeing what Patrick Musimu did this summer and his comments that it would soon be used to increase the records in all depth disciplines, I decided to give it a try. Just an in-home experiment to see what would happen.

First I used Eric Fattah’s suggestion that the middle ears be filled with a sterile saline solution. Actually the only saline solution with the word sterile in it I could find on the internet that had a large enough volume to fool with was from veterinary supply places and it required a prescription from a vet to order it. This stuff was in sealed bottles with syringe rubber tops so it had to be drawn out by syringe and needle. Instead I opted for Contact Saline Solution from my local grocery. Is that what you meant Eric?

First I tried various ways to put it into me and equalize to push into the middle ears. Nothing worked well so I went on to Eric’s suggestion of filling a mask. The bottle of solution had a small opening to squirt into contact cases, I guess. With the mask on and while looking into a mirror I slipped the tip of the bottle underneath the top of the skirt on the mask and squeezed.

The nose pocket filled up first. When the fluid went above my eyes it was really hard to see. But the contact saline solution was the nicest fluid on my eyes I have ever had. It was very comfortable.

Then came the part of getting it in ears. Using a little anatomy knowledge and lot of experimenting I discovered what work for me. It was pretty simple. Head upright and suck the fluid into my nose and sinuses, then bend over so the head is inverted and equalize. Apparently the eustachian tubes are position flowing down when the head is vertical fluid from infections etc, will drain down out. With air, when the head in the inverted position, it is more difficult to open the tubes and push the air down into middle ears, but with fluid (which has gravity), it’s easier when the head is inverted.

After settling into this technique of suck then bend over and equalize, it only took about 5 times to empty the mask. With the nose pocketing being the lowest place on the mask I was able to suck the mask pretty much dry. It sure was nice to see again! It makes me nervous when I can’t see well.

At this point my ears felt full. There was a very small pain, kind of like when you over equalize by putting a small amount of continuous air pressure on the ear drums. I was surprised to be able to hear well. The movement of the eardrum is magnified several times by three bones as they take the eardrum movement to the cochlea. I assumed that if the middle ear was filled with fluid the extra density of the fluid on the inside of the eardrum would severely decrease the amount the eardrum could move, making hearing difficult. But that did not happen so either it doesn’t happen, or I had some air space left in the middle ears. I assume I would have had to dive to know for sure, but I had no problem hearing the wife’s and baby’s voices. Not sure if that was good or bad thing!

Then came the draining of middle ears. Again after trying several things I found a simple solution that worked for me. First let me say I can open my eustachian tubes when vertical and little when inverted so this solution my not work for everyone. But all I had to do was open my tubes when my head was upright and the solution flowed right out into my sinuses and out my nose. Fluid flowing over the sinuses was a little freaking, but manageable. This whole experiment sure cleared all the snot out of me!

I would guess this simple technique was able to drain 90% out of the middle ear. Things sounded slightly funny and my wife said my voice sounded funny for about the first 20 minutes.

So for a few negative things that have been said about wet equalization like: having to do it with sea water that has bacteria, at depth with pressure, and it takes hours or days to get out of your middle ears; I just don’t see these as real issues. From a practical stand point, it looks like both filling and removing can be done fairly easy.

Now here the not so good part. I had little pain develop about 2 hours afterwards that lasted through the night and is less, but still with me today. It wasn’t bad, but it is unnerving to not know why and what the long-term consequences are. I’m not worried about this one time experiment, because many people have had middle ears full of nasty infected body fluid and or blood, with no loss of hearing when it cleared up, so a one-time of saline solution is not a big deal. The consequences of doing several times a year is what I wonder about.

Right now I think the pain is from one of two things. First, and the worst, is the lining, small window to the fluid filled investibula, or something else in there is irritated by the saline solution. From all I have read on the subject I would assume it is usually damp in the middle ear from body fluid, but maybe there is a film or something that the saline solution washed off making the surfaces irritated?

The other thing that could have happened is since fluid doesn’t compress, I equalized too hard when pushing the fluid in and stressed the drums out. The pain wasn’t bad enough to stop me in anything I wanted to do yesterday afternoon. I went shopping with my wife, had dinner with friends, etc.. It also didn’t bother my sleep. It is just the fear of the first possible explanation that scares me.

Any advice, comments or experiences would be greatly appreciated.
don

 

[naiad]

I think it is most likely that since fluid doesn't compress, you put strain on the drums when you equalized.

It could also be that germs from the nose were forced into the ears, causing a minor infection.

I hope the pain gets better soon.

Lucia

 

[donmoore]

Naiada,
Thanks for the response. I guess the thread is not that popular. I think you were right about either stretching the drums or a small amount of bacteria from the sinuses. The pain persisted through a few more days until last night I did the old divers treatment of putting a 1/3rd each of rubbing alcohol, hydrogen peroxide, and vinegar in each outer ear. I can’t remember all the reasons why this formula is suppose to work, but I know it's suppose to dry the outer ear and its been proven to help draw infection from the middle ear through the ear drum as well as help heal the ear drum itself if needed. Each drum immediately felt better like it had been pushed out and when the fluid of the formula reached it from the outside, it helped to push it back to a neutral position.

The funny thing about the hearing was that I experienced no hearing loss, just a small pain and load noises really hurt. Soft noises were no problem to hear. There are two muscles that are suppose to contract and help the ear absorb less volume in load noise situations. Don’t know if and how they would be affected.

I did some more studying and found that the saline solution for contacts I used is sterile, but to make it sterile that have to add preservatives, which could effect the delicate mucus membrane of the inter ear and eustachian tubes. The next experiment I do I believe will be with Broncho Sterile Saline solution. The reason is apparently it is the only sterile saline solution with no preservatives available without a prescription. Their method (Blairex the major manufacturer) is to keep it sterile by containing it in an aerosol bottle. Not as cost effective as the contact solution, but maybe it will work with less irritation.

The possibility of the solution picking up germs from the sinuses on its way to middle ears is a real concern. I imagine the saline would help some, but antibiotics might be more effect, but I hate to take any antibiotics if it is not absolutely needed.

Another thing I learn, if I understand it correctly, is salt water, unlike some wet equalizers have suggested, is not similar in saline % as the body. Salt water saline percent is about 3.5% where the body is about 0.9%. That is 3.89 times higher! A solution higher than 0.9 is called hypertonic and a solution at 0.9 is called isotonic. Apparently a hypertonic solution (higher than 0.9%) can be used to reduce swelling in mucus membrane (lining of almost all air cavities in the body), because fluid tends to travel through the membrane to the higher salinity side to try and equal the salinity on both sides. An isotonic solution has very little fluid cross between membranes.

So what this leads me to believe is a hypertonic solution maybe useful in reducing swelling which the estuachian tubes are know to do, but plain old distilled or sterile water, as some have suggested, maybe just what you don’t want to use because it could cause swelling right where you don’t want it. For me I’m going to stick with isotonic (0.9%) for now which is what most broncho sterile saline solution is. From what I have read a high hypertonic solution can have unexpected results when used in air cavities of the body.
don

PS I hope someone finds this interesting.

 

[jome]

I find it very interesting, but just had nothing to add. I'm only replying because you seem to think no one cares

I've been meaning to do similar experimets my self, but didn't get around to it just yet...

How about just boiling some water and adding 0.9% salt in it? Perhaps not 100% sterile, but neither is your mask, mouth, sinuses etc...Still should be better than seawater.

I don't think a wet equalization technique will ever be so perfect, that it would be useful for recreational or frequent diving, because how every you perform it, the risk of infection is always very real. But it may be very beneficial in record attemt/personal best type of diving...And naturally FRC diving...

 

[watts]

Don thank you for for your experiment and findings with wet eqalization. I will probably try it myself now that it didnt kill you. :hmm . Maybe doing a good sinus and nasal wash prior to flooding the middle ear would prevent the risk of pushing junk up the tubes. Ear candles may help to dry the middle ear up some after aswell. How long did you keep them flooded?

Thanks Nathan Watts

 

[donmoore]

Jome,
I read a post of yours where you were thinking of it too. I also read where people do the very same method you mentioned of boiling water and adding salt for sinus washes. A 0.9% formula is 1 tsp of salt to 2 cups of water. They also recommend using non- iodized salt which as you know, most table salt is. Canning salt apparently is not iodized. I don’t know about Finland, but here all salt and most foods have to say what is in them so its easy to know if the salt is iodized.

I was thinking of washing out my mask next time with alcohol or something before hand.

Watts,
Some good ideas. I kept them flooded for about 15 minutes before trying to get it out. The fluid stayed in place with no effort until I opened my eustachian tubes. In fact I could even breath through my nose. The first time I opened them I was not in front of the mirror and all this fluid came running out. I wasn’t sure what happened but I had to grab a towel fast to keep from soaking myself and the floor. Then I went in front of the mirror.

After further research, although the eustachian tubes drain down when inverted, it appears they only slightly drain down. So I am not sure a straight inverted position is best for filling them. It might be easier and work better to just lay back. Like wise when draining it out, it looks like a slight head tilt forward would be the best.

I don’t know if it would ever be easy enough for recreational diving, but the most interesting thing to me is to-date is that it can be done on the surface with much cleaner water than ocean water and you can use a normal mask and dive with air in it. In fact a person probably could have gotten away with it in a meet before AIDA even changed the rules last year.

The only thing I left out in the procedure is I had to first break the seal at the top of the mask after each cycle to let air in to remove the vacuum.

I think the thing about not pushing too hard to fill the middle ears is important. With the Frenzel you can generate a large amount of pressure. With air it compresses some, but with fluid you can probably really push the ear drum out.
don

 

[Bill]

Don
Very interesting reading. I've always been curious about the size of air spaces in the head. Since you made 80-100 ml of solution disappear, they are at least twice as big as I thought. I've used a method similar to yours to put saline solution in my sinuses and ears before diving for the last year or two. I only used one shot because I felt that it would drain out when I stood up and be forced out during warm up dives. Next time I'll try more.
I tried flushing with sea water (2.8% here) but it made sinus clearing more difficult. For a solution, I just use sea water diluted with tap water to about 1%. Five minutes of microwave radiation and a filter should take care of most bugs, I hope.
Aloha
Bill

 

[donmoore]

Bill,
Glad to know at least a few people who seem to have sound judgment have tried it. Was being to think I was freak or something!

The space size is something I have wondered too. The middle ear space doesn’t seem very large on the diagrams. The sinuses seem larger. The fact I could still breath through the nose is interesting too, because it suggest that my sinuses where not totally filled. Also the fact that I was able to drain a large amount of fluid out afterwards suggest that I didn’t accomplish the draining of the mask by swallowing the fluid.

I do have a very low volume mask. It is a superochio with the top inside skirt cut out so it fits closer to the face and it has a prescription lense with bifocals attached to the inside of the mask lense that take up more room. In fact the bottom of the bifocals (the lense is extra thick there) actually just touch my checks - to give you an idea of how low of a volume it is.

Now since I know how to fill my mask up and I have a cooking measuring cup with ml’s on it, I should see just what the volume of my mask is.
don

 

[efattah]

If you learn the yogic technique of kechari mudra, you can close off your eustachian tube openings with your tongue, by sliding your tongue up the back of your nosepharynx. It takes about 8 weeks of daily practice for the frenum under the tongue to stretch enough to do that, but once you master it, you can feel the openings of each eustachian tube with your tongue, and close both or just one; in that sense you even have the power to equalize one ear and not the other, by blocking one opening and then doing frenzel. You can also plug one nostril by blocking the passage with your tongue in the nasopharynx. Using this method, you can frenzel by plugging only one nostril, and blocking the other with your tongue.

Once I mastered the technique I amazed friends by making air come rushing out of one nostril only, then the other, without using my hands at all.

Kechari mudra could be used to prevent the water from escaping the eustachian tubes, once they have been filled with water. Alternatively it could be used to prevent water from entering the eustachian tubes during flooding of the sinuses.

Unfortunately the anatomy of the nasopharynx makes it impossible to close the nostrils via the tongue, while keeping the eustachian tubes untouched. If this were possible, then kechari mudra would allow frenzel to be performed without using your hand to pinch your nose. Instead, in reality, if you block both nostrils with your tongue, the side of your tongue will cover each eustachian tube, making equalizing at that moment, impossible.

 

[cdavis]

Don, you can bank on the fact that lots of people read your posts with great interest, even if we don't intend to try what you are doing. Like Bill, I'm surprised at the apparently large volume Measuring your mask will tell us how much solution you used, a minimum estimate of total volume (assuming some solution wasn't spilled or swallowed). Any thoughts on how much volume is left or what the total volume of he sinuses and middle ear might be ?

Thanks

Connor

 

[Absolute]

Good thread Don.

Do you plan on diving while your sinsus are flooded? I would acutally like to try this but I think it would only help me for depts over 30m. At that point I do a mouth fill and freznel as BTV stops working. I would still like to try it though.

Eric, once again my friend you never fail to amaze me with the wacky but useful info.
Very cool.

 

[Longfins]

Don,

Take a look at the virtual sinus lab,

http://www.entnet.org/healthinfo/sinus/virtual_sinus_lab.cfm

(The links to specific sinuses are in the right-side column)

You'll see there's a lot of sinus volumes up there for fluid to go into.

Cheers,

Peter S.

 

[Lachlan]

Very interesting reading Don. I find this stuff very interesting so keep us updated on your findings and theories. Sounds like you have really done some research to keep the critics at bay.

Catchya, Lachlan

 

[donmoore]

Thanks for the input guys. Connor I will try and measure the volume of the mask this weekend. I am wondering what the volume of the sinuses and middle ears are just as much as everyone. I was hoping Eric would throw the answer out soon. Since he has done extensive measuring of his lung volumes and has an idea what the physical limits are of equalizing with different volumes, he must have an approximate of the volumes sinuses, middle ears, and Eustachian tubes are so he could use them in his calculations.

Absolute, the ultimate goal for me is to dive with the middle ears flooded. If it is possible to only partially fluid the sinus and still be able to add air in the mask on the descent and then an extra bonus would be to take it back out on the ascent, I would like to do that. But I don’t know how possible this is. More experimenting is needed. I believe you could keep the sinuses flooded by a raised soft palate when in upright our laid back positions. If it is impossible to equalize a mask well with fluid in the middle ears than I will be looking to add a lense or two to the mask so I can keep it full of fluid as well and still see partially clear.

Below is a graphic of the sinuses and the Eustachian tube openings which is labeled ET on the diagram.

My first priority is to find a way of flooding the middle ear that does not cause pain for days afterwards and hopefully no unfelt damage. After they are not hurting any more (almost there now) I will try again with the Broncho Sterile Saline solution. There is also another option I read in my wife’s Human Anatomy Physics book last night. Apparently there is a product that uses carbohydrates to keep fluid from transferring through mucus membranes. Carbohydrates are larger molecules that won’t go through the membrane.

If I can get this worked out then the next step is to dive, which could be very exciting. The dream of going straight down with both hands in front and not having to do anything to the ears, is almost beyond comprehension. Right now I am stuck at about 27 meters and that is on a very good day with the last equalization at about 24 meters. My progress is slow, plus there is the limiting factor that my lungs are only about 4.5 liters. They were 5, but have regressed. Breathold wise I don’t appear to be anywhere near my limit. I have even stopped at 22 meters and turn straight up, just so I could get some more air into the mouth to equalize a few more times, and then turn back down and swam further down and still felt no where near my breathhold limit at the top.

I am sure with more technique and experience I could increase my depth equalization ability on air, but what is my max with my limited lung volume and how many years will it take to get there.

Nice web site and graphics Peter!
don

 

[donmoore]

As I look at the above graphic and think about it, I think there are two issues in filling the middle ears. First you have to have fluid over the opening of the Eushtian tubes before trying to equalize. Second the air in the middle ear needs to come out. This may explain why I was able to push the fluid in while inverted, with head down. What is hard to see on the graphic is the Eustician tubes are going to the sides (forward and behind the graphic) of the head and a little up so they will drain fluid when the head is upright.

Maybe when inverted it allows the gravity of the fluid to go down and let air bubble up and out.

Anyone have a good 3-D graphic of Naspharynx, Eustachian tubes, and middle ears?
don

 

[Michael]

Don,

I have done some experimenting with wet equalization. First, let me say that I do not personally believe that the risk of infection is so great as to make the method impracticable. I have for years snorted salt water at the beach when I had a cold, and it has never caused me any problems.

So, I have experimented with a very simple method of wet equalization. I dove without a mask or nose clip, at around 30m I snorted water in my nose, and then frenzeled that water into my eustacian tubes, and continued the dive. It was simple, but it did feel uncomfortable to have the feeling of a head full of water. I also found that the eustacian tubes did not fill completely with water. So, I had to continue using small amounts of air.

I believe that wet equalization can be simple and effective and relatively safe.

 

[Longfins]

...but what is my max with my limited lung volume and how many years will it take to get there.
don

Don,

This is a little off topic, but to account for my own lung volume experience,

When I started freediving my ribcage is pretty much collapsed, and I know my VC was way below average. Stretching them were a bit difficult because the muscles between each rib are pretty short. I started using neck weight at the pool 2 years ago, starting with 5 lbs with a full pack (no suit), doing DWF and DNF. Today I'm using 9 lbs on a full pack, so I know my lung capacity has increased by 1.8L within the past 2.5 years because I have to fully pack my lungs to stay neutral in the pool. When my head start to sink I'll know it's time to add more lead. I like this method because it's an objective measurement of my total lung capacity on a given day.

So don't give up! It's harder in the beginning but it gets easier as your ribcage gets stretched. It took me a year to progress from 5->6 lbs, but only a few months to go from 8->9lbs.

Peter S.

 

[Panos Lianos]

Don,

I couldn’t help smiling when I read what you wrote. I’ve had a similar experience.

I haven’t actually done any serious dives using the wet equalization technique but I have done some playing around with it, mainly to help with my normal Frenzel technique.

Some years ago one of my ears wouldn’t equalize, probably because of some leftovers from a cold. It just wouldn’t. The Eustachian tube seemed to be blocked. I got some 0.9% sodium chloride solution from a pharmacy and did some sinus “washing” but it didn’t seem to help. What I did was to tilt my head back, close my soft palate and inject the solution in my nose. Keep the soft palate closed and breath through my mouth for about 20 seconds, then tilt forward and “blow” my nose.

This didn’t help “clean” the Eustachian tube very well so I decided to equalize “with” the solution to force some of it in the middle ear hoping this would clean the tube. Again tilt head back, inject the solution and equalize quickly. I obviously used excess force and pushed too much solution and after a while it started to hurt a lot. I couldn’t open my Eustachian tubes to let the solution out so you can imagine that I was VERY MAD and in pain. I laid down in bed and after a few hours the solution “trickled” out and the pain was not unbearable anymore. It was there but I could live with it. Also the tube of the problematic ear was clean and I could equalize again.

Ever since then, in the rare occasion that I can’t equalize in the sea (maybe once a season?) I get some sea water in my hand and put it under my nose and quickly tilt back to let it go down my nose, then bring head back (so the area in no longer flooded and equalize gently. This pushes some “drops” of sea water in the tubes and helps open them since they are “wet” and open easily. However this is not a nice sensation since you can feel some “burning”

So, not really related to 100% wet equalization but it’s the same mechanics and for some people it might help with the Frenzel.

 

[cdavis]

Wow, talk about different results from the same action. Very occansionally, I will equalize inverted but slightly over on my back. A little bit of salt water, a few drops, gets forced into my e-tubes. Immediately it is difficut to clear, the tubes feel gooy and the valves don't open very well. It takes a day or so to clear up. Why the difference?

Connor

 

[donmoore]

Panos,
Nice sharing. I think the excess force was the main cause for pain for me too.

In trying to find what kind of solution to use, I did several searches on the internet for “cleaning middle ears”, “cleansing middle ears”, etc. All I could find was veterinaries who did it to dogs and other animals. Veterinaries are unique in that they are not bound by the medical restrictions MD’s (liability, insurance, etc.) and are willing to try things without having to worry about establishment restrictions!

Connor,
In theory a hypertonic (higher than 0.9% saline solution) is suppose to draw fluid away from the mucus membrane, but one study I read where they used 4.5% saline solution in one group of asthmatics and 0.9% in another in their nebulizers found the 4.5% user to have more irritation which resulted in more congestion and difficulty breathing, so it appears a true 0.9% maybe better. If using salt water from the ocean it would be hypertonic and would also have who knows what other things in it.

Maybe this could shed some light on why they became more sticky for you.
don