There are certain things in life that no one wants to hear, feel or experience in anyway what so ever. For a diver, ear problems can take you out in a heartbeat and equalization will become the bane of your existence. To this day I can't tell you exactly why I have so much trouble equalizing and Doctors seem as if they don't want the liability of telling me an exact cause. In turn I have scoured the internet researching everything I can find about middle ear barotrauma (MEBT).
Here is what I know for sure and some of the outcomes to my endless quest to solve my ear problems. I decided to see an ENT for some solid answers. After going through the misery of being poked on the insides of my arms with several needles coated in allergens to determine what I am allergic to, I learned that I am mostly allergic to grass (mother f#*king grass is everywhere) and cats (sh!t, I have three of them). Thank god for allergy medication.
I was just through my Open Water certification and halfway through my Advanced Diver certification when my ear problems were really kicking my a$$ and at their all time worst. Many trips to the doctors office had been made to get me to this point. Usually I left the Dr. office with a prescription for a course of prednisone, and the usual we can see a fluid build up and bubbles behind your ear drums, you have MEBT. One Dr. actually laughed at the way my ear canals dropped down at a sharp angle - this was the closest I ever got to a doctor telling me that I shouldn't continue diving because my ears were not anatomically correct.
What made me stop diving for an entire year was the feeling of a knife being shoved through one of my ears. I had been convinced to try vented ear plugs. I was pretty desperate, I had spent a boat load of money, had top of the line equipment and I was SO close to having that Advanced Diver card in my hand. I had some friendly competition pushing me to finish as well. My friend Zach, who I met while completing the Open Water certification course made everything look easy. Zach was crushing everything and the worst problem he suffered along our journey was an ear infection. Back to the vented ear plugs ... one ear plug vented and the other plug didn't. The one that didn't left me thinking that I most definitely ruptured my ear drum and was going to have permanent hearing loss. For months afterwords I could feel and hear my ear drum moving all the time with every minor thing I did from swallowing to blowing my nose.
Around this time I also had a hearing test that my ENT told me I needed to take. The results of which were not good. I was told my results landed right on the cusp of having a hearing deficiency. I was 30 years old and needing hearing aids for the rest of my life was not appealing.
For those of you in the back this is for you!! The difference between an ear infection and MEBT is about to be explained! Many of my friends tried to keep pushing me to dive and believe me I wanted to. I loved it. I made a huge investment into it and I still had goals I wanted to accomplish. None of my friends understood the difference between an ear infection and MEBT. If I had a dollar for everyone who told me to get swimmers ear drops or mix a vinegar solution for my ears it could have paid me back the cost of my gear!! Needless to say this only added to my mounting frustration.
MEBT is a tissue injury to the ear. It is secondary to pressure differences inside and outside of the ear. Swimmer's ear is an infection in the outer ear canal that runs from the outside of your ear to the ear drum.
Anatomy and Functions of the Ear
The human ear has three distinct sections:
External ear: This includes the ear itself and the ear canal to the eardrum.
Middle ear: This is an air-filled cavity between the eardrum and the inner ear. It has three components: the middle-ear cavity, the three ear bones (ossicles) and the mastoid process.
Inner ear: The inner ear is a sensory organ. It is part of the central nervous system, and it has two functions:
Auditory: The cochlea turns soundwaves into electrical impulses for the brain.
Balance, orientation and acceleration: The canals provide some of our control of balance and position and help detect acceleration.
There is actually a grading system for how severe a patients MEBT is. Take a look.
In contrast, this is swimmer's ear.
I highly encourage everyone to click on the links and read the information directly off of DAN's website.
So now that we know the difference between MEBT and Swimmer's Ear. How do you prevent MEBT?
You can try all of the normal suggestions, swallow, wiggle your jaw, chew gum, suck on candy, take decongestants, but if that doesn't allow your Eustachian tube to open and equalize the pressure then what!?!?
My only suggestion, my only saving grace is to descend slowly, at my own pace, on a line and not worrying about anyone else but me. My dive buddy can wait for me to get down to them. Of course I let my dive buddy know my situation well ahead of time. Communication is key. I'm like an inch worm going down. Descend a little, wait while I feel the pressure release and equalize. Go down a little more. Keep repeating.
There is one other possibility out there, but you're going to have to be agreeable to parting with some $$$. I've been too skeptical to try it, but I have to admit there are some diver's who swear by it. That is the IST Pro Ear Mask.
Watch here for a complete description of the mask.
If you can't equalize there is no shame in ending a dive. If you can't equalize and you keep getting pressure related ear injuries, you might be in a position where you have to make the decision give up diving. There is no shame in choosing your health over a sport. Chances are your friends will push you to keep trying, your doctors wont tell you what to do because they aren't your mom - you just have to make the best decision for you.
I'm currently at a cross roads where I'm trying to re-enter the SCUBA diving world. Unlike in the past I am armed with information and experience. I know not to push myself this time and I'm not afraid to put down my dive gear an walk away for the benefit of my own health.