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Thread: Problem decending on my 2nd dive

 


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    ScubaKeith001's Avatar
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    Problem decending on my 2nd dive

    Weirdest thing happened to me last Saturday when I was diving.

    My first dive was about 45ft for about 25 minutes. Everything was fine going down and coming back up.

    I was on the surface for about 10-15 minutes before my second dive took place. When I went down the second time to about 15 ft my left side of my head and eye was getting squeezed really bad and I had to accend. It was the worse pain I have felt before. I equalized fine going down but had to accend right away. Not sure why that happened but it ruinied the dive that day. This has never happened in the past and know I wonder if it will happend again and ruin my diving adventures???

    HELP PLEASE!! ADVISE??

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    Hard to say, but it sounds like maybe a sinus block?

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    This sounds like a sinus squeeze. The openings to the sinuses are different from the Eustachian tube, which is the passage through which air goes to equalize your ears. So it is quite possible to be able to equalize the ears, but not the sinuses.

    Whether this will recur depends a great deal on the reason why it happened in the first place. If you had a bit of a cold, or allergy symptoms, you may have had swelling of the lining of your nose and of the sinus openings, which would predispose you to having trouble equalizing those spaces. You can also have things like polyps that grow (common in people with chronic allergies) that can partially block the openings.

    What I would do, if I were you, is wait a few days or a week before diving again. Make sure you have no symptoms of congestion or allergies. If you again experience squeeze, make an appointment for an evaluation by a good, diving-savvy ENT doc.
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    Impression: sinus squeeze

    Likely cause: pre-existing minor sinus "stuffiness" due to cold or allergy. Initial descent caused some minor barotrauma to the sinuses resulting in inflammation that blocked off one or more sinuses -- hence, the acute pain during the second descent.

    Recommended action: abort dive, ascend to surface, and quit diving for the day (or at least until sinus congestion abates).

    Future prevention: address the primary problem (cold or allergy). If you have a cold, safest course of action is not to dive. If you have allergies, take some sort of antihistamine.

    For future reference, if you think you might be stuffed up (even just a little bit) before a dive, it might be helpful to consider taking some form of decongestant. A long-acting form of pseudoephedrine is a possible choice. Another is the NeilMed saline nasal irrigation system (a.k.a., Neti-Pot). The saline seems to work as a mild decongestant on the nasal passages which may help open up your sinuses a little.

    I find that when I'm "just a little stuffy" in the sinuses, up-and-down type profiles can be very painful. It feels like someone is driving an icepick into my forehead above the eye. That's why I try to conduct methodical/slow initial descents where ear-clearing can easily keep up with increasing ambient pressure.

    FYI, secondary to a sinus squeeze, it's possible to get a bloody discharge in the nose-pocket of your mask upon ascent to the surface. That "gunk" represents all of the stuff inside the squeezed sinus pocket that decided to come out once the ambient pressure decreased. Most times, the bloody discharge won't be painful at all. Just something to be aware of when it comes to sinus squeeze so that you and your buddy don't freak out.

    Since you've conducted 25-50 dives so far and this is your first incident of sinus squeeze, I'm inclined to think that this event was probably not caused by a polyps or other abnormal anatomical issue. If you start experiencing these kinds of sinus squeezes in the absence of any sinus stuffiness/cold/allergy more frequently in the future, however, then it would be worthwhile to see an ENT for evaluation.
    Ear Equalization problems? Check out Dr. Kay's Ear Lecture for Divers.

    What would you do? ScubaBoard has a "What if...?" series geared for beginner divers.

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    Probably not related and I don't know w/o checking computer or tables. But a 15 minute SI sounds kinda short.

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    Quote Originally Posted by cocoajoe View Post
    Probably not related and I don't know w/o checking computer or tables. But a 15 minute SI sounds kinda short.
    First dive was only 45' for 25 minutes so he where well within any limits. 50' allows 80mins dive.

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    I have more of a problem on really shallow dives with squeezes and I never do on deep dives. I believe I have read that the pressure change in the first 20 feet is pretty rough on the ears/sinus.

    B.

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    Quote Originally Posted by Booyakasha View Post
    I have more of a problem on really shallow dives with squeezes and I never do on deep dives. I believe I have read that the pressure change in the first 20 feet is pretty rough on the ears/sinus.

    B.
    The deeper you go, the less squeeze for each foot you go. The Padi OW manual will explain the details. But you are correct yes.

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    Quote Originally Posted by Booyakasha View Post
    I have more of a problem on really shallow dives with squeezes and I never do on deep dives. I believe I have read that the pressure change in the first 20 feet is pretty rough on the ears/sinus.
    Ears and sinuses are being affected not directly by the pressure but rather by the change in volume. That change in volume depends on absolute pressure, and that pressure changes the faster closer to the surface, so yes, the first 33'/10 m tend to have the most significant effect.

    In this range, many divers, especially relatively new ones, underestimate how often they need to equalize. I've posted this thought once or twice in the past:

    Quote Originally Posted by bleeb View Post
    When they ride an elevator, most people will feel like equalizing if they go up or down 50 floors. This pressure change is approximately equal to 8"/20 cm of water. The greater the pressure backlog in your ears, the more difficult equalizing becomes. It may be difficult or impractical to equalize every few inches, but this should tell you that waiting more than a couple of feet greatly increases the chances of trouble.
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    As others have correctly identified, you are describing sinus squeeze, even though your ears cleared, your sinuses have not.
    I have been suffering the same problem on my second dives quite often over the last few years but I do not abort my dives.
    The method I use to get over this does have some risk of reverse pressure in your sinuses when you surface later so only do this if you are prepared to take the consequences of a possible ruptured sinus.
    When I start to feel the pain I stop descending and move shallower until the pain lessens, then I equalize as hard as necessary to get pressure into the sinuses, once that is achieved I can then descend as deep as I want, the blockage has reduced.
    This has been working for me and I have not had to abort a dive or had a reverse pressure sinus rupture on ascent.
    I am not recommending anyone else try this, this is just how I get over the problem and I have had to do it sometimes every day for weeks. I have had to do this on probably less than a hundred occasions over 40+ years and several thousand dives but it works for me.

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