Problem with ears [Archive]

Tip tank

18th Sep 2007, 08:07

:(
I have been having trouble popping my ears for a long time and have tried pretty much everything to sort it - medication, surgery, acupuncture, homeopathy, diet change etc....it is basically too much thick mucus in the eustachian tubes that is preventing me from equalising pressure. I don't want to try grommets or anything as it can damage your hearing but I am faced with the decision now that I might have to give it all up. I have seem specialists up an down the country and they have all just hit a brick wall.
I'm not that old but I love this job and borrowed heavily to get it. I have also just moved home (new mortgage) and changed types (bonded). It seems the pressurisation schedule of the new type is giving me problems - it was bad in the previous one but much worse now. It would be a difficult decision to just walk away and I'm not sure what else I could do to make a living. I am in my late 30s and really just did a number of random jobs prior to becoming involved in aviation. I do have a degree but it was a long time ago and I didn't really enjoy it anyway! I have a mortgage and due to a number of unfortunate decisions in my life I don't have a great deal of money, so if I give this up I will have to sell the house and move into rented accommodation while I try to replace my income. My company has loss of licence insurance but it isn't valid as I I haven't technically lost it.
Right now I am at a very low ebb and can't really see the way forward.
It would really cheer me up if there is anybody who has been in a similar position who has been able to go on and do something different outside of aviation. I really just need some success stories to brighten my day as I look through the job pages trying to decide what I can do!

Fly-by-Wife

18th Sep 2007, 16:45

Tip tank,

Rotten luck to have to consider ending your dream career due to ear trouble.

I had to change career in my early thirties, having been made redundant as a civil engineer (my degree was in civil engineering). I moved into IT, starting at the very bottom (I bought a PC and started learning about the hardware and O/S!), and moved onward and upward. I believe I am better off now than had I stayed in civil engineering.

OK - not moving from aviation, but a career change is still a change! Not that I specifically advocate moving to IT, of course.

You might find books like "What Next?" and "What colour is your parachute" useful for considering where your transferrable skills lie, and in what other areas you could re-use them. There are many more books like those - maybe you can find some in your local library to start with.

Good luck!

FBW

Loose rivets

18th Sep 2007, 18:08

I'm a pilot, not a doctor.

Okay, for a start, stop thinking the blackest thoughts. All of the consequences are secondary, you need to beat the problem.

I see that you have taken a lot of advice, but tell us about the surgery.

I'm not sure why you feel that grommets will permanently damage your hearing. I have known several pilots with grommets and they didn't seem to have any hearing problems, certainly they kept their Class I over many years. I would have thought this would have been better than the problems you envisage.

However, firstly, are you applying techniques in the correct manner, and with enough force?

Although the Eustation tube is effectively a non-return valve, it may still be possible to help yourself by sniffing on the way up. By sniffing, I mean really doing it so hard you have to apologise to your colleagues before you do it! This is the good way round as anything coming out of the tube is a plus.

On the way down, holding your nose and gently blowing is of course something you will have tried. Sometimes, it has to be done quite hard. If nothing is happening, then it doesn't matter how hard you blow, (use a bit of common sense on this one) it's just that this way round you will be pumping any goo in the undesirable direction.

I have said a lot about salt in the past, from saving limbs to astonishing results for folk with M.E. Salt water gargles are easy...until you try to get some of the water up the tube. I have even hung off a chair so that I'm upside down for best results. Best keep your first attempts at this procedure totally private.

I have worked for a lot of companies that do not accept a cold as being an excuse for time off, and the results were horrible. Once, after days of pain, I started the saline treatment with almost immediate results. This all came about by some observation that people that swam in the sea did not have the problems that others did. Not very good science, but it worked for me many times over 40 years of flying.

Martin1234

18th Sep 2007, 18:31

Try flying helicopters, which are more friendly to your eustachian tubes.

helimutt

18th Sep 2007, 19:41

Martin, Really? Where do you get that from? They can still climb and descend can't they?

Martin1234

18th Sep 2007, 20:39

Where do you get that from?

My own experience. Please note that I am comparing helicopters with medium and heavy fixed-wing aircraft with pressurized cabin. Also, the smaller helicopter the better. If it's due to the fact that smaller helicopters normally have less good performance I don't know. I just know that I don't feel the pressure difference in an R22 as I do on a medium or heavy fixed-wing. Also, some fixed-wing aircrafts are better than others. I rather fly a B737 than an MD80.

They can still climb and descend can't they?

Can they?

The Right Stuff

18th Sep 2007, 21:17

Apologies for hijacking your thread a little bit, but...
Loose Rivets; can you elaborate on your salt water remedy please? Are you just suggesting gargle salt water?
I'm struggling at present with seemingly incurable sinusitis (never had it before) going back almost nine months, and am interested in what you've said.
I've been tested for allergies with a negative result, just finished four weeks of antibiotics (can't remember the name, but they make you susceptible to sunburn:\) and no change, CT scan showed up as 'normal' but my head/ears/sinusus etc. are anything but 'normal' :{. Docs now out of ideas and have asked me to take antihistamines and come back in six weeks; and I thought we'd ruled out allergies:confused:.
Any advice or straws I can clutch on to much appreciated.

Loose rivets

18th Sep 2007, 23:53

A huge amount of research is being done to find out more about the ‘mechanisms' of inflamation. You would think that doctors would know all there is to know about such a common phenomenon, but it isn't the case.

The relationship between state of mind and control of inflamation is now fairly well established science, but hugely complex and still far from being understood. A broad spectrum of medical problems, are it seems, directly related to inflamation, but it should go without saying that having a sudden closure of these tubes or cavities needs expert monitoring. I'm making an assumption that chronic inflamation is what we are dealing with, but you must think laterally, and have it professionally monitored for other possibilities.

Why I take salt very seriously is a long story, but for now, check with your GP to see if there is any reason he can think of why you should not try saline remedies.

My own experience was when I walked away from a good job once, I just could never get well.

They were a great bunch of guys flying out of LGW and even the 1,000hours / pa didn't faze me, just the crews dropping like flies with colds giving the others more and more to do. Finally it was my turn to be ill, and 33 years later I can still hear crewing's reply-- to me saying that it was the first day my temp had come below 100. "Good. Can you fly tonight?" He replied, and he wasn't kidding.

Time and again I broke common-sense rules and flew too early after a bug, and one day I suddenly got a headache as we climbed. It got worse and worse until I was in agony. We fiddled the pressurization, and spent a lot of money on fuel flying low, but the pain was horrible, I thought the top of my head was coming off. When we got back I went sick saying that I had had enough, and that I was going to be completely well before going near an aircraft again.

At this stage I was nearing the end of another course of antibiotic.

A week of swimming etc., left me feeling fine, but the sinuses and ears were still sore when diving and the antibiotic was well past its active period. I tried breathing in steam with some old concoction that smelt like tar mixed in, but it wasn't till I tried getting salt water–about the same concentration as the sea–into my cavities that things changed. Doing it upside down was tedious and it @#$%^ hurt.

Slowly, I could almost hear the squelching noises as the pathways allowed minuscule amounts of the saline solution into the swollen areas. The more I could get in, the more it allowed in next time.

If it had just been one time, it would not be significant, but it has worked several times.

Loose rivets

19th Sep 2007, 00:04

http://www.pprune.org/forums/search.php?searchid=1867860

And these are not all. I haven't time to see if the tale about a great aunt is embedded in this list, but at a time when she was on the verge of losing her leg due to inflammation, after weeks of treatment, an Irish doctor in Colchester had the nurses bathe it several times a day with saline solution. It was fine in a week.

mutt

19th Sep 2007, 04:29

Couple of us here using saline nasel washes, idea came from colleague who has had 2 nasel operations due to mucus, he was started on a daily routine of saline, he either uses a babies feeder bottle to spray the mixture into his cavities, or he just heads to the beach. He has kept his medical without restrictions.

I find that i get fewer colds when using the washes.

Mutt

Loose rivets

19th Sep 2007, 05:25

‘Funny thing memory, your post has just made the clearest image of a test-tube like device, tapered at the nose end and with an air hole in the middle. Raise it, and take your finger off the hole. Handy little thing from Boots. Are they still around?

homonculus

19th Sep 2007, 09:27

A blocked eustacian tube, otherwise known as otitis media or 'glue ear' is very common and I doubt an ENT specialist will be stuck by it (forgive the pun). Decongestants work in some, and usually the problem is seen in children and improves at puberty, but if this doesnt apply in your case, the answer is grommets. This is the most minor of operations and can be done under local anaesthesia, although I would recommend general anaesthesia. Far from damaging your hearing, it will improve it. Leaving things as they are is not just a career problem - chronic otitis media can permanently damage your hearing.

I suggest you sit down with those ENT chappies and ask them to spell out the benefits and risks, get your grommets in, and carry on flying

Tip tank

19th Sep 2007, 12:55

Thanks for all the good advice, particulary Loose Rivets - the surgery has been to open up the nasal passages to allow more air in - idea being that it will help the tubes to drain more effectively. Not working though.

I do try saline washes - in fact I have a syringe I use to squirt warm salt water up my nose - it comes down the back of my throat and clears any gunge out but I can't seem to find a way to get it into the ends of my eustachain tubes? I can can occasionally hear the "squelching" you talk about as if it is trying to get in. I have tried hanging upside down while doing it (I wish I could have taken a photograph of myself) but it didn't seem to make much difference. If you could offer a bit of additional advice on technique it would really be appreciated....I can feel the benefits on my nose so I can see how it would help my ears too...

Not seen the device you mention but there is this: it is called a Neti pot

http://www.healingdaily.com/exercise/neti-pot.htm

I have tried this too although I use a plastic container that came with a steam iron I bought - it is designed to top up the iron but does the job!

The Right Stuff - sounds like you are having the same probs as me! Have you tried Nasonex - a steroid nasal spray you can but over the counter - long term use can help. I also inhale steam, take decongestants and also have tried expectorants - they thin the mucus so may help it drain a little. Also tried cutting out dairy which can help in some people and might have helped a little in me. You need to be careful with the medication though - the CAA frown on a lot of stuff so better check. Feel free to PM me if you like....

gingernut

19th Sep 2007, 20:37

TT, what exactly are the differences between your previous job&your current position?

Are your symptoms seasonal?

What have you tried so far? What havn't you tried? (Lots of threads about ear pressurisation problems on here recently).

SAS-A321

20th Sep 2007, 10:22

Interesting thread, as I also have some problems with my right ear. I have been to many doctors and they don't seem to take my problem serious!

Do you experience a loss of hearing and tinnitus, due to your problems?

Can someone give me a approx. mix of water and salt? I guess if you put too much salt in the water it will become to thick?

Bob the Doc

20th Sep 2007, 10:27

It sounds on the face of it that grommets is the way forward. It should cure the pressure issues that you have and give the chronic otitis a chance to clear up. You also get to keep your job!

Choppers obviously do climb and descend but usually not to the height that FW a/c do. Given that most a/c are pressurised to 8000 feet, as long as you do not go that high in your RW a/c then you should in theory get fewer problems with pressure changes. As they are not usually aircondiitoned, you also get fewer problems due to the drying effect, both of the aircon itself and the fact that high altitude air (whether pressurised or not) is very dry.

Bob

Tip tank

20th Sep 2007, 22:38

Hmmmm, good advice all. I understand from my ENT consultant there are different types of grommet - all the same size but some are designed to stay in longer than others.

When kids get glue ear, they fit temporary ones which are designed to fall out after a few months once it has cleared up. The hole normally heals up. I suppose this might work and give my tubes a chance to breath. The longer term ones are the same size but have "flanges" to keep them in. They call them "t-tubes" due to their shape. They also eventually fall out but leave behind a bigger hole which often doesn't heal. Then you end up with a perforation and loss of hearing. Repeatedly re-inserting short term grommets can also cause scarring and loss of hearing so I'm not sue what to do.

Bob the doc - do you think it is likely that a few months of grommet use would offer a permannent solution?

SAS-A321 - I use one teaspoon of salt to one pint of warm water...it tastes roughly the same as sea water

Loose rivets

21st Sep 2007, 03:09

It sounds as though you have given it your best efforts. Don't give up, and make sure that the strength is similar to the UK sea areas.

I have to say that I don't know the salt ratio of typical sea water, but Wiki says http://en.wikipedia.org/wiki/Sea_water

At home in Essex, it never seemed particularly strong, but here in the Bay of Mexico this summer it really did sting my eyes and the little'uns seemed to get red eyes, so it was pretty strong.

The issue of Iodized salt was discussed on this forum a while back, I would guess that it would be better for your problem, but there may be other issues. Take professional advise.

hoggsnortrupert

21st Sep 2007, 22:31

Tip tank:
I AM NOT A DOCTOR!
On reading your thread I identify with your symptoms in their intirety.
I have been diagnosed with mild RHINITUS(if thats spelt correct)
To get to this point I had quite a journey.
Up until 95 I had never experienced sinus.
Since then it has caused me considerable missery until recent time.
I spent bad money on a ENT that could not find anything, and this caused me to think all sorts of things, can be a rather dark place!
In desperation I went to another ENT(Incidentally a prodigy of the first)
He immediately shoved a small cable and camera up my nostrils! not as bad as you think.
He prescribed me BUTACORT 100 AQUEOUS nasal spray.
I use this night and morning, every day.
Told me to bye this product called "Nasal Rinse"
Basically it is a soft plastic bottle with a screwable cap/nozzle.
I was instructed to use a teaspoon off each 50/50 salt and baking soda, with luke warm boiled water, I have been doing this for about two years now, and use this procedure night and morning.
Try squirting it up a nostril gently, slightly sniff at the same time until you feel it run down the back of your throat, and exit out the back of the roof of your mouth.
It will take a week or so, and after doing this you will notice sometime later when you lower your head, your nose will run freely, ( have tissue's handy)
Also I have found that if I work about the house in a dusty enviroment( I am a joiner/cabinet maker by trade I am always doing something) I use a GOOD RUBBER FACE FITTING DUST MASK, if I don't I will suffer terribly with sinus issues, you have to remember to WASH the filter after use.
Dissposable paper dust masks just do not work, they are as useless as T-t's on a bull.
My advice to you is this:
Take some time off/ use personal/ family/ issues if you feel it is awkward to go sick.
But take the time, see a good ENT, suffer the hose up the nose (if you haven't already)
I stay out of Public Chlorine pools, they stuff me up quicker than anything.
As a from of fittnes I use to enjoy the gym, and swimming lengths, now I just Cycle, and use the gym.
I realise that not knowing what is going on with ones self when the experts can't Identify ( Well a good guy did more for me in five minutes than his master did over five F---ing years) the problem and it affects the way you live, to me it was becoming increasingly depressing, this effects everything else you use to do, want to do, and need to do.
Spend the money see another ENT if he has not done as mine did for me.
Realise I say all this from MY EXPERIENCE with I IDENTIFY STRONGLY WITH YOURS.
In saying this it is possible your diagnosis could be different to mine.
Let me know how you get on, but don't throw in the towel ::ok::ok:
Chr's
H/Snort:

Loose rivets

22nd Sep 2007, 00:17

That's interesting, but the only comment I would make about the above is, when all this concoction is loaded into your head, you have to hold your nose and blow -- not sniff.

That you will cough and splutter at first is a given, but you have to pressurize the stuff into the tubes and cavities. No one said it was going to be easy.:\

hoggsnortrupert

22nd Sep 2007, 01:16

Loose Rivets:
Quote:
That's interesting, but the only comment I would make about the above is, when all this concoction is loaded into your head, you have to hold your nose and blow -- not sniff.
Please: Are you saying throw this concoction up your nose, then hold and blow??
It does make sense, but wouldn't it cause OVER PRESSURISATION of the Sinus?:suspect:
Chr's
H/Snort.

Loose rivets

22nd Sep 2007, 07:44

Well, if you notice any cranial leakage Stop Blowing!!

Seriously though, you certainly do not want to trap any significant pressure and be left with a residual sinus headache. Often these are caused by day to day changes in atmospheric pressure, so quite a small diff can be tedious if it is locked in.

Let pain be your guide, as the physios say. But whatever you do it would be doubtful that you would achieve the pressure diff of totally blocked sinuses at a typical cabin altitude round 35,000 feet. On the above mentioned flight, I had no lasting injury, and there was no bleeding despite spending 2 hours in the cruise in severe pain. we landed in Tunis and I had no pain at all for a blissful 30 mins. On the way home we were worried about fuel and pushed up a bit higher. It totally disabled me.

I was also concerned that it would suddenly equalize and leave me with a huge pressure diff while on the ground;at least as it was, I knew the pain would stop on landing.

So, I'm suggesting that you listen for the little squelching noises and use them as an indicator of when to stop. Proceed slowly, you only need a tiny fraction of the mixture to start to work its way in. If all's well, be a bit more adventurous next time.

Tip tank

22nd Sep 2007, 08:55

So, I'm very encouraged by all this - but I'm still a little uncertain about how to proceed.

Loose rivets

I can get the saline solution up into my nose and it runs down my throat and I can even get it into one nostril and have it run out of the other by tipping my head sideways, but I can't think how to get it up into my sinus cavities too.

Is it just a case of lying on your back and pouring the stuff up your nose? I read somewhere that you can feel the liquid filling up your cavities but all I can feel is it running out....I think I'm doing something wrong?

Fly-by-Wife

22nd Sep 2007, 10:22

Is it just a case of lying on your back and pouring the stuff up your nose?

Oh to be a fly on the wall!! :)

You sure you're not on candid camera?

FBW

Loose rivets

22nd Sep 2007, 16:40

Yep, I hang with my head upside down off the end of the bed. Not a pretty sight.

I guess being able to control the spluttering will be proportional to how much time one has spent swimming under water.

Unlike the above poster, I find swimming in a chlorinated pool very good for clear nasal breathing, but I do react to some chemicals, so it's just a matter of luck how you react I guess.

The Right Stuff

22nd Sep 2007, 20:31

Evening all, interesting stuff, makes me feel a bit better knowing I'm not the only one suffering. The last ENT 'specialist' I saw on Monday following a CT scan, acted like I was wasting his time. The CT scan showed no more inflammation in my sinuses than 'normal'. :confused: What's normal?

I've had the camera up the nose twice; almost as painful and unpleasant as flying with my sinusus blocked.

My job involves three or four flights a day in a B200, not up front unfortunately, then spending a couple of hours on the ground before flying again.

The last flight I tried was an OPC, about an hour in total, and was okay for 40mins or so but then I got a bad headache, lots of sinus pain and it actually felt like my head was distorting to a rugby ball shape. Sort of pressure feeling corner to corner. We landed soon after, and I went into shock. Not happy.

I've just stopped eating dairy to see if that helps, and I think it is a little; four days in now, and the last two days I feel a little better. I'm on the antihistamines too, so maybe its those.

I've got some Nasonex, but it doesn't seem very effective. I was on Betnesol drops before, and that settled things within a few days when unbearable back in June. I found them quite unpleasant to take too, and I couldn't really tell how many drops I was putting in each nostril. In the end I decided the tipping my head upside down off the edge of the sofa twice a day gave me more headaches just when I didn't need it (i.e. having got up with a bad head, then going to bed with a thumping head again). Things seem to be settling down, and I haven't had a really bad day for a while now.

I do wonder whether I still have some virus on me; this all started with an ear infection which cleared after antibiotics, but the sticky ears feeling never cleared. I could always clear the pressure in my ears, but it was a real struggle sometimes. My eustacion tubes are really 'clunky'; they thump and clunk and I clear them, whereas they always used to clear with just a light click. From time to time I'm still going hot and cold, and have real wobbly moments. Two days ago I had no energy whatsoever, I was just flattened, felt utterly lousy.

Anyone else suffering with sinusitis or rhinitis showing these virus type symptoms?

Sorry, I've gone on a bit. Hope you're not :zzz:

FLCH

22nd Sep 2007, 22:52

Add me to the list too, After 20 years in jetliners I seem to get a serious sinus infection at this time of year every year, after reading Loose's post about state of mind and sinus problems, I realize that I'm due for a check-ride and a Class one physical pretty much in the same month. I don't know if they are related, but seems to make sense, I too use a saline solution and it does help me breathe better. BTW exercise seems to move the stuff around and out too. Very interesting reading...

hoggsnortrupert

23rd Sep 2007, 02:24

Wot would we do without some brevity:
Jokes aside, for me and only speaking for myself, as I SENSE from what I read that others could well suffer from depression as I did, due to Sinus.
I say this because for years since 95, I would suffer, it affected me in every way, in the cockpit (sick and tired of always taking Panadol-Nurophen-sydomol-voltaren) just to be able to work, then doing all the correct things like seeing a specialist, and being told only mild Rhinitis! F----me I don't ever want to suffer a serious form!:ugh::ugh:
When I use the word depression, it is in the sense that you wonder if you are loosing it! I certainly began to doubt myself solely due to the way I was feeling.
Especially as my rotation was always from one Hemisphere to the other, season to season! then to a hot dry climate in the desert, then back again in reverse order.
I would get shi--y, my attitude would suffer, my family would suffer when I came home after 5 weeks.
It just became difficult to cope,( good days to bad days) one starts out good ends up bad, starts out bad ends up good.
I am not a Doctor, and am not (completely) mad, but this ENT guy I saw,(THE GOOD B'STARD) HE SET ME FREE, I have a life again, and I have started flying again and I am enjoying it, and I intend to do it even better than before, I still love it, where as it had got to the point of resentment as "my lover" was F---ing me up.
And I don't have shares in the pharmaceutical ( Spelt wrong) companies any longer.
It has been three years since I THREW MY TOYS OUT OF THE COT, I knew I was not well enough to fly,( Nothing wrong mild rhinitus:ugh::ugh:) as long as I do as I have indicated in the previous post, I don't have an issue with it any longer.
This is just me, we are all different and I would hate to put anyone wrong, but if this helps anyone then I've done a bit more for my fellow man.
Chr's
H/Snort:ok:

Tip tank

23rd Sep 2007, 07:50

The sinus problems can actually be fairly easily rectified - it is the ears that are the problem.

You can go for what they call FESS - facial endoscopic sinus surgery. It involves burning away excess flesh from the passageways so that when they get inflamed, there is still enough room for the air to get in and out. It can help the ears too by helping mucus drain but from what I have heard it doesn't really. Once the gunk is in the eustachian tubes it is hard to get out.

I too have found that exercise can help - I understand it is because working out causes the body to release adrenalin - this kind of "fight or flight" response helps open up the tubes a bit as the body tries to get more air in. I have been told that decongestant tablets work in a similar way.

Also you can try expectorants - they work in a different way - they thin the mucus instead - normally designed to help chesty coughs etc. but seem to help some people (not me though). Best check, but the CAA seem to be OK with "non drowsy" expectorants.

Drinking lots of water helps a bit - I have read similar things on this site too - it helps thin the mucus.