Pain after pool dives?

[Togalive]

So last weekend I finished up my pool dives for my OW certification, and everything went absolutely perfect, up until about 20 minutes from the end of the exercises. It was at this point that I began to feel some serious pain over my right eye, and in my right eye as well, my left eye and everywhere else was completely unaffected. The area was definitely very sensitive to the pressure from my mask, so I began to exhale periodically through my nose to relieve the pressure on the area. As far as equalization goes, we were only in 6ft of water, and I only ever felt the need to equalize if my head was within the bottom foot of the pool. I have been fighting a sinuse infection, and im on Amoxicillin for it at the moment, prior to the dive I also was on Zyrtec and Sudafed. By the time we finished the Amox. had worn off, but I didnt take notice of it during the lesson, so I suspect that had something to do with it. However I never felt any aching leading up the the initial pain, it was very sudden in its onset.

So, now 3 days later, the pain has lessened from where it was before (I couldnt sleep that night it hurt bad enough whenever I tried to close my eyes), but I still have an aching above my right eye, and at times, some specific points that hurt quite a bit within that area.

Is this from a reverse squeeze from some trapped air in my sinuses? (I didnt think I could even get one as serious as this in 6ft of water) If so, or even if not, do any of you medical guys have any suggestions on treating it? I have since bumped my sinuse medication up to Omnicef in hopes of knocking this thing out (no congestion when on medication btw), but I have 4 certification open water dives this weekend, and I really am hoping this pain im feeling wont become a huge issue.

Thankyou

P.S: I just wanted to make it clear that I did not have a "headache" after my pool dives. It was a very localized pain, and still is. However by about 10pm that night, I did have some pretty noticeable redness both above my right eye, and below it (I could actually see the outline of the sinuses below my eye, not above though that area was still sensitive to touch). I had no redness in the eye itself. And again, this came on within 10 minutes, and after having been in the water for 4 hours leading up to it.

[kittles]

If you have sinus issues (temporary due to sickness) that requires Zyrtec/Sudafed then you shouldn't really be diving until it's cleared up..

You can get a reverse squeeze in that depth of water which could have been exacerbated by your current illness/medications.

Personally I would pause your training till it clears and get stuck back in. Why risk the added complications which, since you're worrying about them, will take your mind off the job at hand.

[a22shady]

While any issue can be a possible seriuos one, My g/f will occasionally get this same pain, as well as an occasional headache. She has been checked out and everythign is good. we gather it could be to a few differnt things. Not breathing correctly, as fast breathing will will build up more co2 which can result in this, or dehydration. or even just didn't equalize properlly or mask might have been to tight.

[annieols]

Just out of curiosity, did your instructor know you were sick and on medication? Did you have the ok from a dr to be in the water?

I would not let a student with a sinus infection who was still currently on medication even get close to the pool. It can cause serious damage (and pain, as you know) even in the shallow end. I would have explained that if you just wait a few days till the cold is gone you'll be fine; if you dive and exacerbate the sinus probs it could be weeks till you can dive again!

Not diving with a cold is covered in the ow manual, and the manual. Also, there is a question on the medical release that if youre on prescription meds you need a note from a dr...

be careful, and take your time before you get in the water again!

happy diving

[Jim Lapenta]

The effects from my reverse block 2 years ago only lasted 3 WEEKS! If your instructor knew of this condition he/she had no business allowing you in the pool. IF the antibiotics and ANY residual effects from this are not COMPLETELY gone by the time your checkouts come up stay out of the friggin water! You're risking serious and perhaps permanent injury for what? A piece of plastic that lets you dive on your own? Seeing some fish? Not worth it. As a result of my experience I no longer dive on meds if I see anything other than an occaisional allergy flare up. Even then I may call the dive if it's bad enough that it causes real congestion. The pain, numbness, tingling, lost sleep, and fear were valuable lessons. If you choose to listen to those who think it's no big deal. Get their phone number and address. That's where you should send your medical bills.

And amoxicillin does not "wear off" it keeps working for up to a week or more after you take the last one. That is because the infection can last that long. At what point in your classroom work was diving and colds covered? Should have been in several places.

[sansky]

Did you equalize your mask? Even though you were only in 6 ft. of water, everyone is different in equalization depths. If you had no sinus medical issue, it could have been a mask squeeze. If you had been on a real dive in deeper water, it could have been much worse - blood in the eyes and major bruising around the eyes. Be sure when you equalize to also put air into your mask afterwards.

[Togalive]

I appreciate all the well-thought replies, and I'm considering trying to find a way to delay my OW cert dives. I made it pretty clear to my father (were doing out cert. together) that I did not want to dive on medication, but once he spoke to our instructor, and one of our local doctors' assistants who's husband dives, he was told that diving on medication was "fine" and that "if people didnt dive on medication, most people wouldnt be able to dive." so I guess that lulled me into a false sense of security once the doctor prescribed for me to take Zyrtec each dive day, and Sudafed a few times daily on those days. I will be sure to pay very close attention to where I am medically before this weekend, hopefully everything clears up now that Im on Omnicef instead of Amox.


So in short, the instructor knew I was sick (not coughing, not a cold, just sinus), but he made a point of making sure I wasnt congested the night before, and during our dives. I had an ok from the doctor to be diving provided I was on the Sudafed and Zyrtec prior to the dive.

As far as regarding the Amox. wearing off, I am on my second "10 day" prescription, taking it 3 times daily. There is a noticeable difference between 20 minutes after I take it, and 4 hours later when congestion starts to settle in again, so that is the "wearing off" I was referring to, and it is that reason that I am moving to an Omnicef regiment now.

I guess overall I was surprised at just how much could happen in 6ft of water, in a pool, but I have made it clear now to my father that I will not be doing my certification dives this weekend unless I have ZERO congestion and all the pain above my eye has gone away. I still trust my instructor, and I think that my having been on medication when he "checked" me for being congested could have lulled him into a false sense of security (he knew I was on meds for it) about the situation just as my father telling me it was ok, if not the norm, did. Either way, I blame no one but myself, but you can bet I wont be making the same mistake again. Thanks again for all the help, I'll keep you posted on how things progress involving my OW cert dives.

I guess my only remaining questions are these. Come this weekend, if I do not have any congestion (while off meds), and if there is no pain above my eye, do you think it would be safe for me to go in the water? Also, just for the technical sake of the matter, what would I classify this as? A reverse squeeze in my sinus cavity?

EDIT:
@ Sansky:
I did equalize my mask and ears whenever I felt a squeeze, and it was relieved each time, so that was part of what caught me off guard with this pain. I also made a point to exhale gently through my nose periodically after I felt the pain to help relieve the pressure of my mask on that part of my face, which provided temporary relief.

[annieols]

i am appalled that a dr would reccommend that you actually take these kind of medications while diving- it is absolutely insane!

when you have a cold and take medication it allows all the passages in your body to open up which allows air to flow freely from your lungs to your sinuses and ear airspaces. when that medication wears off, the eustacian tubes can fill back up with fluids. If this happens while you are underwater, you now have compressed air trapped in your sinuses and ears which will expand as you ascend. if those tubes are badly congested, that air has no where to go and can end up blowing out you ear drum. In extreme cases this drum damage can end your diving career, FOREVER!!!

please dont let your dad and instructor pressure you into diving while sick- you are on an array of medications and are (it seems) suffering from serious sinus problems... I hope you make the informed decison to postpone your diving, and that you dad steps up to support you in this decision.

If you do decide to dive I hope it works out well for you- but remember just cause it does this time doesnt mean it will next time... be careful!!!!!

[Jim Lapenta]

That doc is a quack and an ass. Have your dad and instructor read this thread. And just how did the instructor make sure you were not congested- x-ray, MRI, Cat scan? And this "one of our local doctors' assistants who's husband dives". Is that like "my cousin who read a book on surgery said it's ok for uncle bubba's friend at work to take out his own appendix". Sure seems like it. You are surrounded by fools. I would be afraid, very afraid.

[Togalive]

That doc is a quack and an ass. Have your dad and instructor read this thread. And just how did the instructor make sure you were not congested- x-ray, MRI, Cat scan? And this "one of our local doctors' assistants who's husband dives". Is that like "my cousin who read a book on surgery said it's ok for uncle bubba's friend at work to take out his own appendix". Sure seems like it. You are surrounded by fools. I would be afraid, very afraid.

Mainly he listened to me breathing, and said that I didnt sound congested, which in his defense, I didnt. But looking back it probably was not the most scientific of approaches to the subject. As far the doctors assistant, she is a licensed Physicians Assistant, so one step down from an M.D, but I understand your point.


@annieols

I will make a point of making as informed a decision as possible come friday, and thanks to everyone who replied with such great information, that process has been made considerably easier, and the possible repercussions of my decisions much clearer.

[Cruisin Home]

You need a new Doc. You need to see a real ENT and get a CT scan. You most likely have an infection and a blockage of your frontal sinus (just above your eye). Antibiotics dont wear off in hours like you suggest this is just your false placebo like perception. The fact you are on a second course suggests that you have an intractable, drug resistant problem. Likely need a course of steroids (also dangerous) to dilate your sinus membranes and allow the "puss" (to drain from your sinus.

And if you pay attention to your training you will see that the biggest pressure changes are in the first 10 feet so yes, pool diving can produce issues if you have trapped air spaces in your body.

Not too impressed with your instructor either. Safety is paramount. There is always another day to dive. If you are going to survive in this hobby you must learn that either you will someday take a stupid risk instead of abandoning a dive.

[TSandM]

Man, there's a lot of rhetoric and some plain misinformation in this thread.

I concur that the pain you describe sounds like a frontal sinus that couldn't equalize. Whether it was a reverse block or just sinus squeeze would depend on whether the symptoms began with descent, or only upon ascent. If it occurred on descent, you could easily have filled the sinus with edema fluid and blood, and this will take significant time to resolve.

Many sinus issues are not bacterial infections. The track record of antibiotics in acute baterial sinusitis is poor, and courses of two to four weeks are often required to see any significant improvement. I agree that a CT scan will give a lot of information about the amount of fluid in the sinus cavity, but CT is overkill for the majority of uncomplicated sinus issues.

Saying that a physician is a quack for recommending that a diver use antihistamines or even OTC decongestants is really not called for. Non-drowsy antihistamines are often recommended for people with seasonal allergic symptoms, and I have seen any number of people here who have been instructed to use decongestants, if a good medical evaluation shows that they are likely to have problems equalizing due to anatomic issues.

To the OP -- I'm not sure your antibiotics are doing you a great deal of good, and I don't think there is any particular reason to believe that the Omnicef will work much better than the amoxacillin, given the bacteriology of sinus infections. But if you are asymptomatic by the time your dives are scheduled, I don't see any reason not to try to do them. Monitor your symptoms, and abort if you redevelop pain. At that point, I would highly recommend an evaluation by a diving-savvy ENT doc.

[Togalive]

Once again, I really appreciate all the knowledgeable replies, its a great help :)

So just an update for you guys. I have began to irrigate my sinuses twice a day with luke-warm saline solution and a kit designed for it (by the way, if you havent done it, it is quite possibly the weirdest sensation I have ever felt) so hopefully that will help to some degree. I also have a doctors appointment with a different doctor, so we will see what he says, personally Im hoping he will pursue a more aggressive treatment given the circumstances. Based on what he says, I'll either have to call the dives for this weekend, or possibly not if he actually gets to take a look up in there and says its ok. But right now its looking like theres no diving this weekend for me :/

[Cruisin Home]

You are correct TS&M that the track record of anitbiotics in sinus infections are poor. they are often repeatedly over prescribed, mostly by GPs. I would retract my statement somewhat and say that if this is an isolated incident that a CT would then not be prudent. However if this is a recurring chronic problem then a CT is most definitely the correct approach. Even great ENTs don't have 3D xray vision. These problems, originating in the osteo meatal complex are primarily mechanical in nature, and permanent relief is usually only achieved with surgery (I am a living testament to this, new person/diver after surgery). Sinus meds have their place but unfortunately are overused resulting in "rebound" effect thus creating a horrible dependence on the medication.

I did not mention the word quack, I suggested he see a specialist instead of a general practicioner, which I believe you suggested as well.

Togalive: If this is a recurrent problem you should see an ENT and disucss getting an image and the options of surgery. Saline rinse, in my opinion, is the best thing that anyone can do on a daily basis for your sinus. I do it every morning in the shower as recommended by my ENT and close friend Dr. Peter Catalano, pioneer of the now famous minimally invasive balloon sinusplasty procedure.

[TSandM]

Crusin' Home, you didn't use the word quack, but someone else did. And I agree with your last post completely.

[Cruisin Home]

Thanks

[Togalive]

So another update for you guys. I went to the doctor this morning and actually got to see a different doctor who himself dives. After explaining everything, he said "well, I wouldn't think it was irrational if you did try to do your certification dives this weekend" and he made sure that I knew to immediately let my instructor know if I began to feel any pain whatsoever on my way down. Also, he reccomended that even just as a precaution, for me to take a 12 hour sudophed an hour before the dive. I spoke to my instructor, and he agreed with the doctor, so it appears that the dives are a go for this weekend. I will post up how they go, I feel confident that I should be fine, but if I feel ANYTHING I will call my dive without a second thought...

[shakeybrainsurgeon]

The potential downside of diving with a sinus condition requiring several meds, several trips to doctors, and producing severe pain after a pool dives is: bad

The downside to delaying these dives until you are completely well is....???? Loss of money? Angry dad? Fear of looking wimpy? Irritated instructor? What??????

All of life is a risk/benefit analysis, but the scales seemed staggeringly tipped in this case to waiting things out.

I'm not getting the point of this discussion at all. It's like another thread where the OP had visual obscuration, skin rashes and extremity tingling after every series of prolonged or repeated dives and people were discussing whether she should get a workup and whether insurance would pay for it. If it walks like a duck, etc... that poster had DCS and was (and remains, I think) in denial. This OP has a serious sinus problem and anyone who suggests he do an elective certifying dive until the issue is resolved should take lessons in how ducks walk and quack.

When people go to multiple experts and seek multiple opinions, they are not usually seeking the truth, they are seeking to validate what they want. They will go to doctors until they find one that tells them what they want to hear and voila, that will be the "smart" one.

This is a recreational sport. These are elective training dives, not a lunar landing, and this is a temporary and acute illness, not some chronic hayfever.

True, people dive on meds all the time, but with chronic illnesses like hayfever, the sufferer usually has years of experience regarding the severity of symptoms, response to meds, times and conditions which worsen the illness, etc. Inexperienced divers with acute, unpredictable illnesses are another matter entirely.

Experts can legitmately question whether the medical profession is too onerous in preventing people with medical conditions from enjoying the sport, conditions like asthma, diabetes, COPD, epilepsy, MS, parkinsonism, etc. But I would hope that suggesting that an elective set of dives be postponed for an acute sinusitis, especially when the diver has had serious symptoms at only six feet in a swimming pool, would not be all that controversial.:confused:

[farsidefan1]

The sinus flooding helped my wife get rid of a sinus infection that had lasted for yrs (flareups). Glad you are dealing with an experienced doc now. My wife loves her "neddy pot" I think that is what she calls it.

[Togalive]

@shakeybrainsurgeon
While I value your position, just like all the helpful posts put up here, I have only gone to the doctor I went to today so I could ask him specifically whether or not I should stay out of the water based on previous sinus issues, and the pain I felt. In his opinion, I need a CAT scan of my sinuses (good call to those who suggested it!) As it is looking more like I have Chronic Sinusitis opposed to a simple sinus infection, as I have been battling them for quite awhile now. However financially a cat scan is completely undoable for my family at this time. My goal was to get an official diagnosis from a doctor who is also a diver, from which I could weigh the risks and make a decision, and I got just that. My condition has vastly improved from a few days ago, in both terms of congestion (sinus irrigation and stronger meds seems to be helping a lot), and also the residual pain. I realize there is still a risk in my diving this weekend, but I feel well enough to dive (no more congestion), and I am prepared to call the dive if I get any pain or trouble equalizing. In the end, just to make sure I was not tricking myself into thinking anything, I left the decision entirely up to my instructor whome I trust, and he believes that as long as I stop and tell him if I feel any pain, there is little reason to not do the dive.

@Farsidefan1
Its good to hear I'm not the only one shooting water up one nostril and watching it come out the other! I am using a squeeze bottle with a nozzle, but only because I couldn't find a Neti Pot.

P.S: just another update, as stated before, any sinus congestion is gone as of this time and all that's left is slight drainage in the back of my throat. As I type this I am breathing free and easy through the very nostril that was completely clogged before :) I hope to get a CAT scan in a month or so, but between college and everything else, there isn't a penny left to satisfy such a big pricetag.

[shakeybrainsurgeon]

The doctor wanted a CT, you said no, so he said OK to diving anyway? So the doctor is making a decision on inadequate data?

Obviously, you must have no health insurance, or inadequate insurance, since a sinus CT scan in this case should be covered and, as far as imaging tests go, is not that expensive (to an insurer, that is). Or are there copayment issues?

If you have no coverage, or poor coverage, and are strapped for cash, all the more reason NOT to risk your health and get into more potential problems (see risk/benefit analysis above).

But adults are free to make their own choices and accept their own risks. Once my patients make a decision like this, even if it goes against my judgement, I never berate them for it. It's their bodies, not mine, their money, not mine, and I respect that.

Good luck and good diving. I hope and pray all goes well. :)

[Togalive]

Just as far as the doctor goes, he said "in the long run, it would be a good idea to get a CT to see what might be up as far as the long term", and as i said before, he very clearly told us that he thought i would be fine diving this weekend as long as i turned back in the event i experience any pain. I would just like to make it very clear to you that I did not refuse his advice on a CT, I'm not even the one who makes the final decision. With an $8,000 deductible for my family's health insurance, there is no chance of getting something like a CT done, unless somehow I come up with the money on my own, and as an incoming college student who has to pay for every last penny of my education (Davis is 29,000 a year mind you), that is virtually impossible in anything short of a few months, but believe me, I am going to try. I hope, even though as a medical professional and you are on the other side of the fence, that you understand just
how frustrating this is for me, I am using the conditions/limitations I have been given as best I can to satisfy the timetable I have been put on.

[shakeybrainsurgeon]

Good luck, have fun and let us know what happens.

[Togalive]

Well I'm home, and happy to say that I am in one piece! We did our first 3/4 "units" of the certification open water dives today, and while I was pretty worried at first, once I got out into the water and relaxed a bit, everything went off without a hitch! My mask (swapped one rental out for one with more "padding" between forehead and the lens in hopes of relieving pressure) actually cause more issues than anything else. But in the end, I did feel some slight pressure (nothing compared to before) after the first dive to 15', but I considered it a distraction and my body trying to adjust, so I went on with the course, and I can honestly say that I was more comfortable down around 25 feet on our final dives of the day than I was in the shallower dives. I've still got one more "unit" and another 2 full tanks to use up tomorrow, so I suppose im not out of the woods yet, but with any luck everything should go just fine (knock on wood) :)

Thanks again for all the support and great advice, I really appreciate it! :)

P.S: How about those thermoclines! The water on the surface was 84, and once we got below the thermocline on our 25 ft dives it easily dropped to around 65! Still, it was an awesome day!

[TSandM]

Glad to hear it went well! Hope you don't wake up congested tomorrow.

[Togalive]

Glad to hear it went well! Hope you don't wake up congested tomorrow.

You and me both! But I'll be sure to post up how it goes!

Happy Diving,
Toga

[shakeybrainsurgeon]

Great news:)