Sinus infection, best treatment? Fiji is calling!

[sleepr]

Ok my flight leaves for Fiji in 18 days and I am in the process of fighting of my very first sinus infection. I probably picked it up sometime in the last little while on my daily swims at the pool. I'm sure it was aggravated by the diving class I signed up for off the springboards. Anyway, on Thursday the 27th I started a round of amoxicillin as well as Nasonex to help clear this up. I have also bumped my saline nasal rinses up to 3-4 times a day as opposed to the 2, I was doing previous. As you can imagine my concern is being healthy for my trip so I have not been in the pool since Mon of last week (when symptoms began), and have decided to skip my pool scuba session this evening as well. In order to ensure full recovery in time what else should I be doing besides rest and plenty of fluids to ensure a full recovery in time? Is it advisable to skip my 1/2 hr weight workouts and cardio sessions as well for the upcoming week. How long should I stay out of the pool?
Advice from any others appreciated, I do have a follow up with my doctor on the 10th of Feb, 1 week before Fiji flight.

[doctormike]

Ok my flight leaves for Fiji in 18 days and I am in the process of fighting of my very first sinus infection. I probably picked it up sometime in the last little while on my daily swims at the pool. I'm sure it was aggravated by the diving class I signed up for off the springboards. Anyway, on Thursday the 27th I started a round of amoxicillin as well as Nasonex to help clear this up. I have also bumped my saline nasal rinses up to 3-4 times a day as opposed to the 2, I was doing previous. As you can imagine my concern is being healthy for my trip so I have not been in the pool since Mon of last week (when symtoms began), and have decided to skip my pool scuba session this evening as well. In order to ensure full recovery in time what else should I be doing besides rest and plenty of fluids to ensure a full recovery in time? Is it advisable to skip my 1/2 hr weight workouts and cardio sessions as well for the upcoming week. How long should I stay out of the pool?
Advice from any others appreciated, I do have a follow up with my doctor on the 10th of Feb, 1 week before Fiji flight.

Hi, Slepr..

Thanks for writing...!

It sounds like you are doing a lot of good things to hasten your recovery. While we can't give you specific advice about treatment, the bottom line is that your ability to dive will be pretty much based on your ability to equalize. There is a lot of variability with this, and there is no medical test to predict it, you just have to try it and see.

What usually makes sense - once you are feeling better - is to try equalizing in a pool with a free dive. If you can vent your sinuses (as well as your ears) in the first 10 feet or so of the water column, you should be able to keep doing that as you descend. Of course, be prepared to scrub any dive when you can't equalize. The sinuses are more prone to a reverse block than the ears, so go slow and be safe.

Remember, equalize early and often, follow up with your doctor, and keep us posted!

Best,

Mike

[scubamarketing]

I speak only from personal experience, I am not a doctor. I get a sinus infection almost every spring. I used to take amoxicillin, but several years back my doctor moved me to azithromiacn (sp?), they called it a Z-Pack. it worked much more quickly than amoxicillin. Maybe something for next time.

[Skydiver1]

I speak only from personal experience, I am not a doctor. I get a sinus infection almost every spring. I used to take amoxicillin, but several years back my doctor moved me to azithromiacn (sp?), they called it a Z-Pack. it worked much more quickly than amoxicillin. Maybe something for next time.

Neither am I a doctor. Sinus infections can be tricky as there is poor vascular supply to the area, making distribution of the drug to the site of required action more difficult.

Amoxicillin is a broad spectrum penicillin antibiotic commonly used, as are cephalosporin antibiotics.

Erythromycin and clarithromycin are popular "narrow-spectrum" macrolides antibiotics used. ENT specialists seem to prefer Clarithromycin for sinus infection treatment.

Clarithromycin has better sinus fluid penetration than azithromycin (sinus fluid concentration of 2.47 mg/L versus 0.65 mg/L in this study Sinus fluid penetration of oral clarithromycin and... [Am J Rhinol. 2007 Sep-Oct] - PubMed result).

Azithromycin is great for Chalmydia amongst other things though

[UnderSeaBumbleBee]

I started this thread a few years ago. I along with several others swear by it. When I get an infection I rinse about 5 times during the day and anytime I wake up at night until I am better. With aggressive rinsing, you should feel dramatically better in a just a few days. It used to take me weeks to recover even with meds

Shooting salt water up my nose everyday & feeling good! Anybody else doing this?

[scubamarketing]

Thanks for the pointer on Clarithromycin, if this head cold evolves into a sinus infection, I'll be sure to ask for it

[pholife]

I am in a similar situation to the original person who started this dialogue.
I have about a week and a half until I should be beginning my DM internship, I will be diving nearly everyday for the next
several months at the least in Cambodia.
Last week I came down with a sinus infection, I am not prone to sinus issues. I live in Ho Chi Minh City in Viet Nam, its
very polluted here but fortunately we have very cheap and easy pharmacies.
As I have been battling this with some small anti-biotics for about a week, vitamin c, water, green tea, panadol.

Today I came up on this post, I immediately went to the pharmacy and bought Clarithromycin, I was told to take 500mg
three times daily for two days.

I also purchased a nasal spray, I think its Saline Solution, but it does not flood my sinus as I read I should do.

Any advice would be great on how to clear this up quicky, I can stay at home away from the pollution if being inside is
beneficial.

Thanks

Greg

[Duke Dive Medicine]

We recommend following the package directions when using a sinus rinse. Excessive rinsing (e.g. five times per day) will wash off not only the excess discharge but also the protective layer of mucus, which will leave the sinus tissues more vulnerable.

Re your workouts: you may want to dial them down or stop them while you're ill. Also, you may want to stay out of the pool until you're cleared up, especially if you think that's where the infection came from.

Long-acting OTC nasal sprays like oxymetazoline can be helpful in some cases. This is NOT a recommendation, but if you choose to use one, again, follow the package directions and do not use them for more than three days in a row or you risk a paradoxic effect where the sinuses end up more obstructed than they were in the first place. Also, be mindful of the timing. If a diver mis-times the use of nasal spray, the effects may wear off at depth and precipitate a reverse sinus block like Mike mentioned above.

Best regards,
DDM

[sleepr]

Hi Greg, as mentioned above you'll want the sinus rinse kits as opposed to just a saline spray, I use the sqeeze bottle neilmed kits mentioned in the thread bumblebee mentioned.

I did make my trip ok to Fiji thank goodness but it did require a 6 hour wait in the local emergency room to get a presciption written for the Clarithromycin mentioned above. My infection had flared up again and there was no doctors office open the night before my flight left for LAX. I waited till 4 am and just made the check in desk 15 min before cutoff. I ended up sleeping 24 hours straight in LA before catching our flight to Fiji.