Certain persons (whether pilots or passengers) have difficulty balancing the air loads on the eardrum while descending. This is particularly troublesome if a head cold or throat inflammation keeps the eustachian tube from opening properly (Fig. 1-7). If this trouble occurs during descent, the person should try swallowing, yawning, or holding the nose and mouth shut and forcibly exhaling. If no relief occurs, it may be best to climb back up a few thousand feet to relieve the pressure on the outer drum. Then a descent should be made, using these same measures. A more gradual descent may be tried, and it may be necessary to go through several climbs and descents to "stair step" down. If a nasal inhaler is available, it may afford some relief. If trouble persists several hours after landing, an Aviation Medical Examiner should be consulted.