Recently DAN member Craig Taylor provided some comments on our Facebook page regarding a diving incident he experienced that left him with permanent hearing loss. Craig has kindly agreed to share his story on our blog.
Location of Incident: Honiara, Solomon Islands
Dives Undertaken
On Day 1, Craig took part in two dives, both easy shore entries with a max depth at 45m, easy deco with no current. On Day 2, the first dive was to 48m. “I left the bottom at 100 bar, switched to gas at 19m, deco obligations cleared at 53 minutes but stayed nearly an extra 20 minutes longer at 3m.”
After a 4-hour surface interval Craig undertook the second dive, which was planned to be to 50m. The dive was to the USS John Penn Stern and was a little deeper than expected at 56m. The ascent went well with no apparent issues.
Then the trouble started
“On boarding the boat, I found conversation hard to understand. There was a full feeling and a tinny echo in my right ear. I told no one. I thought I might have picked up a germ on the morning dive. I had antibiotics at the hotel so I thought I’d be fine by the next day. At dinner things were no better.”
The next morning Craig awoke totally deaf to external sounds.
“There was a sound of a lightly boiling jug and a mind piercing ringing inside my ear. At breakfast I explained my situation, but I still covered it up well. We travelled to Tulagi, site of the USS Aaron Ward, where I had one hour to ponder my next move. I decided to dive. My ears were clear all the way down, not the slightest twinge. I spent 18 mins at a max depth of 59m. We ascended to complete our obligations with extra time, headed off to Tulagi for lunch, had a 4.5-hour surface interval and completed two more dives that afternoon.”
On Wednesday evening, with only one day left of diving, Craig rang home and asked his wife to schedule a doctor’s appointment on his return.
“There was no change to my condition on the last day. However, the guys looked at me strangely when I asked if they could hear the thunder in an apparently storm free sky. The dives went well. The plane trip home was a little painful, even though I could equalise easily. At this point I was pretty sure I had a serious problem.”
Back home and straight to the doctor
At Craig’s doctor’s appointment, his family doctor admits that he is out of his depth. He is prescribed stronger antibiotics. The next morning the reality of Craig’s problem sinks in.
I finally called DAN
“I really do have a problem. I contacted the DAN DES Hotline and spoke with a diving doctor. Without hesitation he tells me to rest and advises one of the team will be in touch shortly. It doesn’t sound good.
“Within the hour, (on Sunday morning), John Lippmann (DAN AP Executive Director) calls. I will get a referral in the morning for an Ear, Nose and Throat (ENT) Specialist. DAN would find one with some dive knowledge. I receive a call on Monday morning at 9.30am from John. He has already contacted Prince of Wales Hyperbaric Unit. Unfortunately, they don’t think there is much they can do at this time and advise that I be referred to an ENT specialist. John has also short listed me at two ENT specialists in Sydney where a normal waiting time can be up to two months. I get an appointment on Thursday.
“The first part of the consultation questions my experience, dive profile, unusual signs during the dive. The tuning fork test sort of confirms what we already know. Then I undergo a full-on hearing test. My wife sits in, the technician goes to work on my good left ear, where things are normal. She then switches to my right side: Nothing.
“At the end of the test I know the result but my wife looks at the technician and asks, “Is everything good?” The results confirm that I have profound and permanent hearing loss in the right inner ear possibly due to Vestibular Barotrauma. I’m told I should question whether I keep diving as the last thing we want is the same thing happening to my left ear.
“I visited the Prince of Wales Hyperbaric Unit and was advised by Professor Michael Bennett that I had a rare type of injury as a result of using air at 50%, one often associated with the use of Trimix. The chances of it happening again would have to be very small, though not impossible. Had we got there earlier a trial in the chamber may have been an option.”
A changed life
“The word ‘deaf’ does not describe what’s going on. I have an incessant squeal in my head that appears to come from my bad ear. Shopping centres, restaurants, work, and the compressor all amplify the squeal. Conversation is virtually impossible in some places. They say it should settle down over time.”
“My family seem to be adapting: poking fun and laughing when I look the wrong way to talk to them, or when I occasionally put the phone to my bad ear.
“Work is tough as a construction supervisor, factory noise is much more intense with one ear, I find I don’t involve myself in general conversation as much as I did previously. I just get the job done. There is also the feeling of being down a little, withdrawal effects I suppose from not diving for a month. I stay in touch with the crew, visit the dive shop. Not diving is just not the same.”
Why did it happen?
“The dives I completed were not any different to the 50 or so dives I’ve completed beyond 40m, or the 150 or so deco dives I’ve undertaken in recent years. Safe gases were used, analysed, switched at the right depth, algorithms followed and extra time at 3m always undertaken. Yet this still happened.”
Lessons Learnt
“Quite simply the moral of my story is that I should have stopped diving immediately. I should have expressed my serious concerns to my buddies and not toughed it out. I definitely should have contacted DAN upon surfacing when I knew there was a problem; as should any diver who surfaces with ‘something’ that’s just not right.”
“When I finally called DAN, the response was fast, the advice right. DAN’s knowledge and contacts in the medical world are second to none; even my GP could not believe how fast things moved.”
Comment by DAN AP’s John Lippmann
This case highlights the importance of seeking specialist diving medical advice as soon as symptoms develop. Although it can sometimes be very difficult to differentiate between inner ear barotrauma, decompression illness, and certain other disorders, a specialist can make a provisional diagnosis and advise the best course of action based on the likely problems and the severity of the symptoms. Sometimes permanent injury may be unavoidable but on other occasions, quick action can minimise the likelihood of permanent hearing or balance problems.
In this case the diagnosis differed between various doctors (which is not unusual with inner ear disorders) but the end result was the same due to the delays and possibly the continued diving. Craig is a passionate diver and has decided to continue diving. He needs to be really careful not to damage his good ear. He is well aware of this and has chosen to dive cautiously to minimise the risk.
Note: All divers can call a DAN Hotline for advice, however, DAN can only co-ordinate an Emergency Evacuation and cover the associated costs for an evacuation and treatment for current DAN Members within the limits of their coverage.
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An update from Craig:
Since the incident Craig returned to diving and was diving as much as possible, often a couple of times a week. However, Craig is still adapting to life without hearing in his right ear and misses music the most. Craig is currently fighting health issues that will keep him out of the water for a while, but we wish him the very best that he recovers well and is able to get back in the water as quickly as possible.
DAN Insider 
Just an inquiry RE: cause being “using air at 50%, one often associated with the use of trimix”. What exactly is the hypothesis here? Isobaric counterdiffusion?
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