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Did Sky Driving. Developed Runny Nose, Ear Pain, Heavy Feeling In Head. Prescribed Tylenol, Aleve, Mucinex

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Posted on Fri, 4 Oct 2013
Question: Hi,

[Day 1]I had cold and running nose and [Day 2] i did skydiving from 0000 feet, in the midair my ears started hurting very badly, after i landed my my left ear was fine but right ear still hurts, when i blow my nose i could thick blood in mucus, then i had to fly back home same day changing 2 flights which caused lot of pain in ears while take off and landing..[Day 5] today its 5th day after skydiving, my head still feels heavy and it feels like something is stuffed in there, it hurts when i shake my head (as its filled with fluid) and i have this constant pain in right temple, the pain is 6/10 not very severe but i feel pressure there.

[Day 4] i went to see a doctor, she examined me in less than 30 sec, did not understand anything regarding skydiving, and just asked me "are you here for cold or pain" so i said "pain due to cold after skydiving"
she examined my ear and said my ear have inflammation,infection and prescribed an antibiotic,Tylenol, aleve, mucinex, XXXXXXX pot. i still see thich blood in mucus when i blow my nose.

as of now i still have pain in my right temple , i feel like my head is stuffed with fluid, i am very worried as its been 5 days and still no improvements. i had light fever and body pains which i do not anymore, its just the head and nose that still troubles

Please please advice and help..

Also if you could suggest which doctor can i visit in new jersey area that would be great (who could understand avaition) as my yesterdays visiti to doctor was very unsatisfactory.
doctor
Answered by Dr. Sumit Bhatti (1 hour later)
Brief Answer:
Ear and Sinus Barotrauma, Decongestants

Detailed Answer:
Hi,

Thank you for your query.

1. Normally, skydiving does not lead to barotrauma. Since you had a cold and a runny nose while skydiving, you have ear and sinus barotrauma.

2. Ear barotrauma causes ear pain and sinus barotrauma may cause epistaxis (bleeding through the nose).

3. To relieve the blocked middle ear and the blocked sinuses you need to start decongestants in addition to the above medication.

4. As the symptoms still persist after 5 days, get an examination of the ear, nose and sinuses done. Some of the medications include oral decongestants (such a pseudoephedrine), local decongestant drops (such as xylometazoline), steroids and anti-inflammatory enzymes (such as chymotripsin, Disperzyme), cold compresses initially followed by hot fomentation around the ear and sinuses. Further management will depend upon any other findings such as ruptured ear drums or fluid trapped in the sinuses or behind an intact ear drum (bulging era drum).

5. If there is no response to medical treatment, nasal endoscopy and decongestion with local agents may be done. Following a Sinus CT, Balloon Sinuplasty is a newer option. Negative pressure or fluid build up in the middle ear may be drained by a myringotomy.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sumit Bhatti (2 days later)
its my 3rd day after doctors visit and i'm taking the above mentioned medication, i'm able to breathe perfectly fine and hearing is better, i do not see blood in mucus very often, right ear doesn't hurt anymore but still feels like something is clogged in there. i feel better than before but looks like this medication isn't helping my head as my head still feels the same heavy, like there is fluid inside and it hurts a little on the back of my head when i tilt or shake my head quickly, My vital signs are normal, no dizziness, no blurred vision, no fever as of now, no body pains, no nausea. But when i blow my nose hard i see dark brown clotted blood in mucus (not bright red as it was earlier) What does this mean
Do i have any XXXXXXX leaks in my head, if yes then what are the symptoms
and how bad is this, will i need a surgery? what are the methods of treatment?
My last 3 fingers on left foot gets little numb once or twice a day when i lie down.

Let me know if you need to know anything else. Please address all the queries

Also please suggest me a good doctor in my area (New Jersey USA)

Thanks
doctor
Answered by Dr. Sumit Bhatti (3 hours later)
Brief Answer:
Decongestants.No major problem.Any ENTdoc will do.

Detailed Answer:
Hi,

Thank you for writing back.

1. I don't see a decongestant in your current medication.

2. You seem to be feeling better. Dried blood clots in the mucus is a sign that the acute trauma has passed.

3. An Impedance AUdiogram (Tympanometry) and an ear drum examination will reveal why your right ear is still feeling clogged.

4. Without a Sinus CT, it is not possible to comment on your nasal sinuses.

5. You do not have any XXXXXXX leaks in the head. The nose has such a vast blood supply that it can bleed like a tap after injury. Hence blood stained mucus represents minor trauma and is not a cause for worry.

6. I have already mentioned the supportive medication and possible treatment methods in my earlier answer. A full trial of medical treatment is a must before any kind of surgery is considered.

7. The numbness in your foot is not related to this. Consult a Neurologist for this.

8. You may consult the nearest ENT doctor in New Jersey. Ear and Sinus Barotrauma is common during colds and your ENT doctor does not have to be an expert in aviation medicine to tackle this problem.

I hope that I have answered your query. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sumit Bhatti (2 days later)
Hello Dr. Bhati,

Thanks a lot for the reply, it was a relief after reading your reply.

I forgot to mention but doctor did prescribe me decongestant nasal spay and i have been using it since day 1 of visit.

I feel lot better from my last post, no blood in mucus anymore, no cold, hearing is perfect, no numbness. Though i will go for ear checkup as right ear still feels clogged (better than before)


But i still feel the same pressure inside my head and temples, head still feels heavy and it hurts when i shake my head or while jogging or while travelling in car or when i bend down, so i have to keep my head steady

Seems like its getting better but very very gradually.

So should i just wait and continue the medication and see if it gets better by time or should i go visit a doctor for head checkup?

I am planning to visit india next month, if my ear doesn't feel perfect by then i shall visit you for treatment :)

Once again thanks a lot for the reply it was very helpful.
doctor
Answered by Dr. Sumit Bhatti (13 minutes later)
Brief Answer:
You may wait for a few days for recovery.

Detailed Answer:
Hi,

Thank you for writing back.

1. Good to hear that you are feeling better.

2. Get the right ear checked. A Tympanometry (Impedance AUdiometry) will help track the recovery.

3. Further checkup of the pressure and pain in the head will require a plain Sinus CT. New multi-slice CT Scanners entail X-ray radiation equivalent to around 200 X-rays at a time. Hence you can continue treatment and wait a few days before investigating further. Your neurologist may include an MRI brain + spine to investigate the numbness in the foot if it is not related to any local injury while skydiving. In fact it is better to rule out any local injury to the foot by visiting an orthopedic specialist.

4. You are welcome to XXXXXXX me in India, hope you recover well, and try not to fly if you have a cold! : )

I hope that I have answered your query. If you have any further questions, I will be available to answer them.

Regards.
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Sumit Bhatti

Otolaryngologist / ENT Specialist

Practicing since :1991

Answered : 2685 Questions

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Did Sky Driving. Developed Runny Nose, Ear Pain, Heavy Feeling In Head. Prescribed Tylenol, Aleve, Mucinex

Brief Answer:
Ear and Sinus Barotrauma, Decongestants

Detailed Answer:
Hi,

Thank you for your query.

1. Normally, skydiving does not lead to barotrauma. Since you had a cold and a runny nose while skydiving, you have ear and sinus barotrauma.

2. Ear barotrauma causes ear pain and sinus barotrauma may cause epistaxis (bleeding through the nose).

3. To relieve the blocked middle ear and the blocked sinuses you need to start decongestants in addition to the above medication.

4. As the symptoms still persist after 5 days, get an examination of the ear, nose and sinuses done. Some of the medications include oral decongestants (such a pseudoephedrine), local decongestant drops (such as xylometazoline), steroids and anti-inflammatory enzymes (such as chymotripsin, Disperzyme), cold compresses initially followed by hot fomentation around the ear and sinuses. Further management will depend upon any other findings such as ruptured ear drums or fluid trapped in the sinuses or behind an intact ear drum (bulging era drum).

5. If there is no response to medical treatment, nasal endoscopy and decongestion with local agents may be done. Following a Sinus CT, Balloon Sinuplasty is a newer option. Negative pressure or fluid build up in the middle ear may be drained by a myringotomy.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Regards.