Diagnosing My Tinnitus & Partial Hearing Loss
I've been very lucky to have been blessed with two healthy, if a little oversized, ears.
My hearing has always been sharp and medical check-ups have declared them to be in great shape to scuba dive and free-dive.
Despite my fortune in the ear department I have been plagued with difficulty equalising underwater since I first tried to dive below the surface.
Ever since breezing through PADI's Open Water theory at the age of 14 - only to be let down by inability to equalise in the pool - I have struggled to equalise sufficiently to descend. I have never had issues when flying or in other facets of life.
Despite this shortcoming I've remained an avid snorkeler from an early age and I am, of course, absolutely ocean-mad.
My First Successful Dives
In 2017, following surgery on a deviated septum, I tried my luck at another PADI Open Water course and was ultimately able to successfully equalise and descend beyond 30m as part of the Advanced Open Water course. Over the next couple of years I racked up over 50 dives and absolutely loved it.
Scuba diving was one thing - it provided me with ample time for my ears to acclimatise to the pressure and adjust. Through a combination of jaw-wiggling, swallowing and blowing gently through my nose I would always get there, even if it was painstakingly slow and more than a little embarrassing when with a big dive group!
My Free-Diving Aspirations
Free-diving, however, was the thing I'd always dreamed of. Moving three-dimensionally in another world without the burden of scuba equipment, what's not to love!?
Conscious of my temperamental ears, I made sure to get professional free-diving advice, take it very easy and NEVER push through any pain, pressure or discomfort. Taking this approach and getting out in the ocean regularly I managed to get down to depths of around 10m, taking the descent slowly and typically remaining horizontal in the water.
I had assumed that this approach would protect me from causing any damage to my ears, unfortunately I was proven wrong.
My First Ear Incident
In 2019, whilst volunteering with MWSRP in the Maldives, I'd been comfortably free-diving for 2 weeks when I set off alongside a juvenile male whale shark.
The plan was to get ahead of the gentle giant before diving to let it pass over my head.
I managed to overtake the shark thanks to some swift front-crawl and dive down into the deep blue. I felt no pain or pressure on the descent but had underestimated how much oxygen I'd used to out-swim the biggest fish in the sea. As a result I had to immediately resurface, long before the shark even caught up!
When I returned to the research vessel shortly afterward I noticed that my ear was ringing and felt blocked. There was no pain, no discomfort (at any point) but fast-forward two-and-a-half years and that sensation remains. I was diagnosed with tinnitus and partial hearing long loss in my right ear.
Looking back on the incident, the only thing that was different about that dive was the fact that my heart rate was up and my breath short prior to diving. But I didn't come close to blacking out and surfaced with air to spare.
Diving with Care
Since that day I vowed to take even more caution to protect my "good (left) ear". I love music and the partial hearing loss in the right ear impacted my ability to enjoy it fully, leaving it up to the left. I also treasured the sound of silence in my left ear, something the tinnitus again took from my right.
I continued to scuba dive, taking all the time in the world to equalise each time and took a formal free-diving course to further reduce risk.
Being relaxed under water and in decent physical shape I was able to excel at breath-holding (I notched up a distance of 67m at my second attempt at dynamic free-diving). I still struggled to equalise but didn't force anything and was quite happy typically sticking to 5m and under, which is plenty to take some great photos and meet some cool marine critters.
My Second Ear Incident
All was well until June 2021 - almost exactly 2 years after my first incident in the Maldives - when I was enjoying the beauty of the Ningaloo Reef in Western Australia.
Scouting manta rays from the beach, I came across three that were barrel feeding about 100m off-shore. I excitedly swam out to grab some footage, only for my GoPro to fail when I got there.
Eager not to miss the moment, I swam full-tilt back to the beach, ran along to fetch my Fuji and dashed back out without hesitation.
Without diving deeper than 4m and without a hint of pain, pressure or difficulty equalising I proceeded to spend the next 15-20 minutes in the company of the beautiful rays.
When I got back to the beach I was horrified to notice the familiar blocked ear sensation and persistent ringing in my left ear.
Given the similarity in sensation and circumstance to the incident of 2019 I conceded that both symptoms would likely remain indefinitely and the damage was done. Sadly, six months and a few specialist appointments later that certainly seems to be the case.
I did free-dive to similar depths the following day, assuming that the damage was done and that was that. However, this led to two days of more severe symptoms - I woke with an inability to balance and struggled walk without swaying and stumbling.
Note: I was in the middle of nowhere without access to medical assistance but if you experience similar symptoms please get to a specialist as soon as you can!
On my return to Sydney I saw an ENT Specialist on a couple of occasions and had an MRI on the ear to confirm there was no lasting, physical damage.
The conclusion was that any damage done had since healed and I had experienced a perilymph fistula, which caused the days of imbalance. The assumption was that the tinnitus was another symptom of this and would remain for life. Fortunately I didn't suffer the same extent of hearing loss as I did in my right ear previously.
No More Diving
The most devastating advice that culminated from this was that, heartbreakingly, I never dive again. This suggestion was based on the fact that the damage could have been more severe in both case. It could have permanently impacted my balance and caused more severe hearing loss.
Consequently, given that it's already happened twice, it's liable to happen again and could cause even more issues.
Naturally, keen to preserve my health, I have followed this advice but I'm still at a loss as to why it happened and wonder whether I can better understand the cause, protect myself against it and maybe, just maybe return to diving.
Throughout both incidents I experienced no pain whatsoever, nor did I push through pressure or discomfort.
The one constant, that exclusively applies to these two instances in my years of diving, is that both involved a descent after an intense spell of cardiovascular activity.
In the months that followed the most recent damage I found my ears becoming foggy and my hearing muffled after short spells of exercise. This is something I have always experienced but it was previously infrequent and typically only as a result of very intense cardio. The sensation is known as Eustachian Tube Dysfunction and is, according to my ENT Specialist, a result of the muscles in your ear pulling the Eustachian tubes open.
Given that I've often experienced Eustachian Tube Dysfunction when exercising and the fact that both incidents came after a spell of intense cardio, my theory is that there must be a link between the two.
If the Eustachian tubes have already been prized open prior to descent I may not feel the normal build up of pressure that forces me to take the time to equalise - leading to a false sensation of equilibrium that exposes the inner/middle ear to damage. Whether that's remotely accurate, too simple or way off the mark I'm unsure but there must be some correlation.
My ENT Specialist was convinced that there was no reason to think there would be any link between the exertion prior and the damage caused but I can't see beyond it.
I'm also aware of research that suggests that tiny hairs within the ear can become flattened and cause tinnitus when starved of oxygen when diving. Again, it would make sense that the risk of this happening is increased after cardiovascular exercise?
Can You Help?
I am, of course, not a medical professional but I am extremely eager to understand what happened to me and why. In an ideal world, I'd love to work towards a return to diving and, if possible, even explore potential ways to fix/alleviate symptoms.
Whether a diver, someone who suffers from similar symptoms, a medical student or a qualified specialist I would absolutely love to hear from you!
Drop me a message or comment below, thanks in advance!