When reading an article by Marty McCafferty in the Fall 2017 edition of Alert Diver, a situation was discussed that we felt would be good to share. The article, entitled An Unexpected Earplug dealt with the effect of excess earwax on an otherwise healthy diver. 

In this article, an experienced diver with over 150 lifetime dives suddenly became ill after an otherwise uneventful dive except for some trouble clearing his right ear. He was given oxygen and transferred to the hospital. On the ride there, the vertigo and nausea he was experiencing lessened and by the time he reached the hospital he was able to sit up, his hearing however, continued to be muffled. After a number of tests, the doctor examined the divers ears. The left ear was normal, but the right ear had impacted cerumen (earwax) blocking the ear canal. Once the wax was removed, the eardrum was slightly reddened and his hearing returned to normal.
So, what happened?
In a nutshell, the earwax created plug which prevented the diver from fully equalizing his ears. This can happen to anyone! The body naturally produces earwax as a protection for the eardrum. However, some people produce more than others and this can lead to a buildup. During a dive, the excess wax is pushed toward the eardrum. This puts pressure on the eardrum and stops the ears from properly clearing. When an ear is not properly cleared it can cause vertigo, nausea, and other ear trauma. 
In the above scenario, the diver's symptoms probably resolved because the air found a small hole through the wax which allowed his ears to equalize.
This uncomfortable situation can be prevented! Irrigating the ears before diving will help to remove any excess wax which will prevent a plug from happening. Ear Irrigating kits are available over the counter at your local pharmacy. 
CAUTION: DO NOT OVERUSE!!! Irrigating too often can cause the ears to produce more wax and lead to the very problems we just discussed trying to prevent. 

Sometimes life gets in the way of our plans and we are forced to change plans last minute whether we want to or not. Surgery is one of those things that can definitely change a diver's plans. When considering whether or not it is safe to dive after a surgery will depend on many factors. While some factors are specific to the surgery, many factors are generic and can be a good starting spot for you and your doctor to discuss when making this decision.

• The first thing is to make sure the incision area has healed completely and is fully closed to minimize risk of infection. This includes internal stitches and incisions
• If the surgery entailed adding air into body cavities, time must be given to allow the body to absorb the excess air so it does not cause expansion injury.
• Side effects of the surgery should be considered when looking at returning to diving. Some surgeries cause the patient to experience side effects such as heartburn, weight loss, and difficulty lifting/performing physical tasks. If the side effects of the surgery would cause a big problem if they occurred during a dive, it may be not worth the risk to your health.
• SCUBA is a physically demanding sport. You would need to be cleared for full activity including lifting heavy weights (dive equipment, dive weights, tank and regulator, etc) full range of motion (bending, twisting, lifting, carrying, climbing) and tolerance for exercise (kicking/swimming, carrying, walking, lifting)
• A general timeline is about 6-12 months after a surgery is when a person who is in good health can expect to return to the world of diving.

None of this is substitute for the advice of a medical professional. DAN recommends that you see a physician who specializes in dive medicine before returning to diving following a surgery. A list of providers who specialize in dive medicine on their website or by calling DAN.