CCRs and "Minor" Diving Disorders

Ant Slegg

Having just completed a Boris Mod 1 course in Stoney Cove (a fresh water, flooded quarry in Leicestershire, England) I find myself suffering from an ear infection. This is odd because in all my years of diving (about 15) I've never had such a problem.

This may be just my luck running out but I was wondering if swimming around for extended periods (70 to 90 minutes) with one part of my ear exposed to water that is hardly clean and the other side exposed to a gas mix with a 1.2bar ppO2, and a warm gas mix at that has somehow increased the possibility of an infection taking hold? (i.e. warmth + moisture + high O2 = perfect breeding ground for invisible litte monsters - I'm not a micro-biologist as you can probably tell).

Taking into account that the other student's ears were completely blocked by the morning of day 5 with only the instructor being OK and an entirely unscientific poll of 2 out of 3 would seem to indicate that there's a potential for problems that may not be as life threatening as DCI but could put an end to diving.

Has anyone else suffered similar problems for the first time when on SCR/CCR or have an opinion on this?

I'm usually pretty careful with my ears anyway but if anyone takes any extra precautions I'd be interested in hearing them.


Ant S

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Ant' S
Learning to dive since 1990...

diverklondike

Ant,

I had a similar set of problems several months ago after 5 days of cave diving in Florida. It took lots of strong antibiotics to clear up the infection. Based on that I know religiously put drops in both ears after each day of diving that are designed to eliminate any water that may be in my ear as well as kill any nasty germs that are lurking about. They drops are designed to prevent what here in the US they call it swimmers ear.

Here is some further information...

http://www.entnet.org/healthinfo/ears/swimmers.cfm

Dive Safe...

Mark

MattDuke

Hi!

I've never been on a warm water diving holiday before, (Just fitted dives in around normal family holidays before) but in July I will do my first Red Sea liveaboard. (If only to stop my students looking at me in dismay when I list my diving experience: England, Wales, Scotland, Norway, Ireland, Orkney, Northern France, you notice the lack of Reefs!)

I've not had problems on temperate liveaboards, but doing 4 dives a day in Egypt would possibly increase the risk of ear infection.

So my question, what solutions do you guys use in your lug holes apres plongee?

That useful link suggests 50/50 alchohol/Vinegar Is that the best then?

Thanks for any useful replies!

M.

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Born 1975
Started Diving 1984
Started CCR Diving 2006.
Stopped CCR Diving 2006.


CCR isn't for everyone, but it was a lot of fun trying.

Sutty

I can't "reccomend" it medically, but based on some reading around I made up some 4% acetic acid in 70% isopropanol. The idea is to dry out the ears and restore the usual slight acidity in the ear canal which discourages bacterial growth. I try to use it at least twice a day on a liveaboard and have had no problems if I do. Previously I ended up on antibiotic drops for "swimmers ear" (otitis externa) on most trips to the Red Sea. Interestingly I understand that the bugs responsible are usually from your skin rather than from the water.

If you forget to clear regularly after finishing a dive at high inspired O2% then you can get the "oxygen ear" effect mentioned in another thread, which would then make you more liable to get middle ear infection due to the bug-nourishing fluid in the middle ear. This could be why you have got it after changing to a CCR.

Any other difficulties with equalising can also cause fluid to seep into the middel ear from the tissues and cause similar pre-disposition to infection, so make sure you equalise early. It is also important not to poke anything in your ears or rub the ear canal, especially if there are salt crystals around - this can break down the normal wax layer which helps keep the bugs off.

Neil

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Never forget that life is a finite resource.

nmanfield

I had the joy of swimmers ear once - on my CCR TMX course in the Phillipines. It started in one ear then went to both but I carried on with the course anyway I used all sorts of anti-biotics, drops, oil and vinegar and nothing worked. On the last day I got swim-ear's bast**d cousin, red-eye. If anyone has had this they know how painful this is - you are VERY sensitive to light and you eye puffs up and drips - so much so I had to go to quarantine at the airport before I was allowed on the flight. There is one cure for both and it is works (certainly for me) incredibly quickly. You can use it both for eyes and ears. It is got on prescription in the UK and can be bought over the counter in Egypt. I never go on dive holdiay without it now. It's called SOFRADEX and another variant is TOBRADEX. Magic stuff

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Tub 'O Lard

bgpartri

From my experience, there are two places where I get ear infections. The first is fresh water diving like caving, and the second is resort swimming pools.

So if I'm doing fresh water diving I use ear drops every day or two.

And I never put my head under water in a resort pool.

I've never had an infection since.

I didn't use ear drops in the Great Lakes last year and didn't have a problem. I wonder if I was just lucky.

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dive2dive2000

When diving fresh water i use Doc"s Pro Plugs as well as ear drops. You may have also had a reverse squeese from your middle ear that will occur after the dive. When diving high O2 your body accumulates that mix in your inner air, When you surface it will metabalise and create a void or reverse squeese, heance air infection a day or two later. it happens at such a slow rate that you will not feel any pain untill it is too late. The fix is to equalise after the dive for a couple of hrs. there are threads here on this I am sure one of the mods could post the links to them.

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Safe Diving,
Martin

Genesis

I made up my own "ear beer" from equal parts of isopropyl alcohol, vinegar and peroxide.

I don't tend to have problems in salt water, but cave diving is another matter. For some reason the fresh water gets me often enough that I came up with that solution - it works.

As long as I use it after diving... no problems......

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Gill Envy

couldn't tell from your post if you are having trouble with outer or middle ear. Hopefully someone can be more definitive than I, but it seems that there is more of a need to be vigilant about inner ear equalization on CCR than you needed to be on OC, mainly because you don't have a regulator that is matching ambient pressure. I too, after 12 years of diving had not had much issue with my ears accept from one bad middle ear infection in egypt, until i stared CCR diving.

I've found that on CCR, it's easy to end up swimming around with negative pressure in your inner ear for prolonged periods and to get used to it...the idea that this can cause mucus/fluid to exude from surrounding tissue and into the inner ear cavity seems like the most viable explanation. It seems quite plausable that this added fluid makes for a prime environment for bacteria to grow.

I've been having problems with my middle ear since diving CCR, mostly that my ears are crunchy and my hearing a bit muffled for as much a week post dive. (At least i have an excuse for not being able to hear my wife as well ) the suggestions that folks gave me on my post were to add a little extra air in the counterlungs to avoid bottomming out on the loop volume and to equalize more frequently on the descent. We'll see on this weekends dives if this resolves the issue for me. hope that helps!

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Gill Envy

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rewrites

Hi Ant

Two possibilities here - the first, Gillenvy alluded to in his post:

1 Counterlung induced pressure imbalance in the ears - most Rebreather designs have counterlungs which are lower than the ears when in normal swimming position. This creates a slight, but physiologically significant, pressure difference which forces air/gas to push outward on the eardrum. This can also lead to mucus/infection being forced through the Eustachian tubes into the middle ear.

2 Middle Ear Oygen Absorption Syndrome - high po2 gas breathed during a typical scr/ccr dive is retained in the middle ear and Eustachian tube. Once on the surface, the surrounding tissues continue to absorb the o2 content, however this space is not being replaced by nitrogen, hence a pressure differential can potentially build-up between both sides of the ear drum. The net cause is a gradual increase in pain in the affected ear(s). Worst case scenario is a complete tympanic rupture. It is advisable to equalise often when on the surface after a dive if you feel you might be susceptible to this.

After all that, it could just be a 'standard' ear infection, but would seem strange that you have never previously incurred this with your diving.

The above is paraphrased from articles within Mastering Rebreathers by Jeffrey E. Bozanic

Hope you get it sorted.

PH