Nose bleed after two deep dives

[Duke Dive Medicine]

I use Afrin occasionally, and it can dry me out. If your nasal passages were dry, that could account for the bleeding but with the clots, I tend to agree with the forceful equalization.

Have you tried saline rinse? I use the neti bottle almost every day but especially in the morning before diving.

I don't know how forceful equalization could result in bleeding from the sinuses or nasal mucosa. Maybe local trauma if you squeeze your nose too hard, but squeezing harder doesn't help you equalize.

Best regards,
DDM

 

[Bratface]

Thanks for your reply that should be directed to the original poster.

 

[fmerkel]

Ear equalization has nothing to do with sinus equalization....nothing.
You CANNOT force the sinus to clear. You WAIT and HOPE they do. If you proceed and they have not cleared you will learn of this oversight later......guaranteed.

I'm a 'sinus cripple', have absolutely crappy sinus and have since I started diving. My first week of diving I was introduced to reverse sinus block. Then I got to enjoy sinus pressurization fun on the plane flight home.

A trip to the ENT > got on nasal steroids > Hey! I'm good, for about 10 years. Then I started to go downhill again. Totally lost my sense of smell and taste (anosmia). Had sinus surgery which did no good for the anosmia but my sinus clearing improved a LOT. This lasted about 7 years and started to get really bad again (polyps and other pathology, it's ugly and complicated).

I need to descend to about 10-15 feet and hang out there for several minutes. You CANNOT force the sinuses to clear. You can only wait and hope.
NOTE-at no time did I ever have trouble clearing my ears......none. Well, no more than the average active diver, a few times a year. Never lost a dive because of it.

Now I'm on my 2nd sinus surgery and things have improved a lot again. I'm hoping this round will last until I'm done diving.

 

[dberry]

@fmerkel I really feel for you; your sinus problems sound like a life-long struggle. I've only experienced true sinus agony only once (on a airplane with a head-cold), and that was more than enough. But for those of us who occasionally honk out blood clots after a dive without feeling sinus pain (on descent or ascent), is it reasonable to rule out sinus blockage as the source of the bleeding? It seems to me that if the pressure differential from sinus blockage is enough to break blood vessels, it would surely cause severe sinus pain. It's not that I want to ignore the blood clots, but they'd be a lot less of a concern if the cause really is just me squeezing the honker too vigorously (which is what the ENT hypothesized.)

 

[fmerkel]

I think people with fragile vessels prone to breakage and easy nose bleeds may be more common than my problem. I seldom have frank blood. I get blood tinged pink-orange mucus on a bad day. I'm very sensitive to the slightest pressure and stop immediately until it goes away. I never even get close to pain. In my case pain is damage. I can't afford more damage.

I'm not sure people with my kind of issue get far in the sport if they start out the way I am now. My start (OW1 and first dive vacation) was rough but the early treatment lasted long enough to get well entrenched into the sport. As a Respiratory Therapist that has spent the last 20 years researching clearing issues of all sorts I've found ways to deal with it. It may sound a bit dramatic, but the reality of my average dive is a very easy relaxed descent. I almost exclusively shore dive. On a normal dive I try to minimize up and down profiles. I finish with a very easy ascent and a long safety stop. People with ear clearing issues like to dive with me.