Clearing sinus squeeze

[tomcat]

Hey All,

Lately I have been having a problem with sinus squeezes. It happens right between the eyes in the sinus cavity just as I make my descent from the surface. Often, it is so painful that I need to stop my descent and work on clearing it before I can go an inch lower.

Is there a "sure-fire" way of clearing sinus squeezes? What I have been doing so far is holding my nose and blowing real hard and adjusting my facial muscles so that air is forced up into my sinus.

This works to some extent although it is not fool-proof and the result seems to be that I get a bloody mask :Þ

If anyone has a better way, please let me know.

I have no idea why I get sinus squeezes as my nose is typically clear before the dive and I have no problems breathing through it. Decongestants don't seem to help me very much.

tomcat

 

[BillP]

Hi tomcat:

It sounds like you've approached the problem well, so I don't know how much help I can be. I don't know of a "sure-fire" way of clearing sinuses. Unlike the eustachion tubes to the ears the openings to the sinuses are relatively fixed and unaffected by the various clearing maneuvers. The passages to the sinuses are either open or they're not. They could be blocked by swollen mucous membranes, mucus, debris, or just unfortunate anatomy.

There are several things divers with trouble clearing can try. If you smoke, quit. You say that decongestants don't help very much, but what have you used? Flushing the nose with a saline nasal spray (eg Ocean) before a dive might help with clearing. Oral decongestants like long acting pseudoephedrine (eg 12-Hour Sudafed) or long lasting decongestant nasal sprays like oxymetazoline (eg Afrin) can help with equalization, but introduce potential problems of their own. (See other threads on this board.) Some people think that the expectorant guaifenesin (eg plain old Robitussin with no other letters like "DM" or "CF") thins mucus and should help with equalization.

If none of the above helps a diver with trouble clearing their sinuses, they might have a medical condition like infection or allergies that need treatment or they might just have unfortunate anatomy. If simple fixes don't work the diver should probably be evaluated by an ENT physician. Chronic sinus infections can be treated with antibiotics. Non-sedating allergy pills are available to help those suffering from allergies. There are also prescription steroid nasal sprays that might help reduce swelling and ease equalization. And if the diver has an anatomical problem, there are procedures to improve the anatomy.

HTH,

Bill

 

[Rick Murchison]

The only thing I can add to what the Doc's already said is that if you are routinely enduring pain to the extent that you are causing bleeding in your sinuses you need to re-evaluate what you're doing, or you *will* end up with a chronic sinus infection - and believe me, you do not want it.
Rick (the voice of experience)

 

[tomcat]

Thanks Bill and Rick for the reply.

Bill, I have been using clarinase as it is non-drowsy and seems to be pretty potent + long acting. I take 2 throughout the day just to make sure that I don't get reverse blocks due to the stuff wearing off. I guess having my nose passage to the throat being clear (I can breathe perfectly fine through my nose) doesn't mean that my sinus isn't blocked huh?

As for the bleeding Rick, gee, that sounds serious. I don't have very much bleeding although it is noticeably in my mask (probably a drop or two in total?). I thought it was pretty common for people to get bloodied noses.

During my OW, my buddy couldn't equalise his nose and he came up with a bloodied nose. His ears hurt like hell apparently but not his sinus.

Thanks for the advice and I'll see how things go this season.

tomcat

 

[John Reinertson]

The above information is indeed correct and to the poiny.
The only other medication not mentioned (and that has been helpful to several of my diving/flying patients) is use of cortisone nose sprays.. There are several brands available by Rx from your doctor-- Nasacort AQ, Flonase,Nasonex, and others.

They will not solve all cases of this problem, but my patients are batting around .600 so far, so it's worth exploring.

They take several days to a week to get full effect and then take a week or so for the benefits to fade, so there's not much worry about them wearing off in the middle of a dive.

Your doc can help you decide if they're right for you.. Others have had good luck.

Bloodless diving is best!
John