How can type 1 inner ear decompression sickness be differentiated from combined hypothermia, overexertion, and exhaustion? normal dive, 47ft for 38min with an ascent rate of 58 ft/min. flooded drysuit in 38f water combined with 200 yd hike uphill with 80

Inner : Inner ear dcs is an extremely rare form of dcs and is not likely based on your dive profile. It is most commonly seen in deep dives with heliox mixtures (edmonds et al, diving and subaquatic medicine, 2002) and may be associated with changes of breathing gas at deep depths as a result of isobaric counterdiffusion (brubakk and neuman, physiology and medicine of diving, 2003), neither of which was present in your dive history. Additional history with regard to the onset of symptoms (during the dive, immediately after dive, delayed onset after dive) could help to differentiate iedcs from other etiologies. It would also be helpful to know whether the symtoms have improved or resolved, and if so, when. Physical examination would provide helpful information in making an accurate diagnosis. Iedcs can be associated with acute sensorineural hearing loss, vertigo and tinnitis (ringing in the ears). Inner ear barotrauma may present with many overlapping symptoms, so direct visualization of the ear drum and hearing tests would be mandatory before a diagnosis of iedcs can be made. Although i believe that iedcs is very unlikely in your case, the only way to be sure is to be examined by a qualified physician.

I : I have not practiced undersea and hyperbaric medicine for quite a while. But, is there any chance that the term "type i inner ear decompression" could be mixed up with "type i barotrauma " (which is middle ear trauma). This is the teed middle ear barotrauma classification system: type i: portions of the eardrum are red; the contours of the ear drum may or may not be distorted. Type ii: the whole eardrum is red with possible distortion. Type iii: the whole eardrum is red with with blood and fluid in the middle ear. Type iv: the eardrum is perforated. I am just trying to figure out how you would have gotten type i inner ear decompression from this dive profile.

Your : Your dive profile does not look like you are at risk for decompression illness, but the risk is increased in cold water dives, especially when compbined with the significant exertion you had. But the ears issues would manifest with some pain, and on visual exam there would be changes of the tympanic membrane. Contact dan for an hyperbaric program near you and let them check you out tomorrow if you still do not feel well. Go to an emergency room if your symptoms worsen. And as I am sure you know, plenty, plenty, plenty of fluids.