Can't Get Below 4 or 5 Feet Deep?

[BetterLateThannever]

Help!!

I took my confined OW cert classes this weekend and couldn't make it through the last hour or so. When it came time to demonstrate buoyancy control in deep water I experienced sharp pain above my left eye and brow anytime I got deeper than 4ft.

My instructor suggested I may have some sinus thing going on and has scheduled me to finish up with her next class in 2 weeks. I have never had sinus problems as far as I know and am concerned that I may have the same problem next time.

Anyone out there had this experience and if so, how did you overcome it?

BLT

 

[Rick Murchison]

It sure sounds like a frontal sinus block. In most folks these things are pretty rare, and transient - you may not have it happen again in a long, long time. But - you should have an ENT check it out, 'cause if you do have a chronic problem you can create a long term problem by ignoring it. And you don't want that.
Rick (voice of experience)

 

[John Reinertson]

I agree with Rick. The most likely thing is failure to equalize the frontal sinus.

There a number of sinuses in the face. All of them connect one way or another to the nasal passages, and all have air spaces in them that compress with depth and the air spaces need to equalize pressure in the same way as your ears.

In that regard, the Middle ear (the area involoved in equalization) can be thought of as just another sinus.

Most of the time, sinus "block" results from the same things that cause trouble with ear equalization.
Generally, the causes are one or more of these three factors;

1. infection of the nasal passage tissues causes them to swell and narrow the opening (or ostium) into the sinuses.

2. Allergies or chemical irritants can cause the same swelling and difficulty .

3. there are also some people with abnormally narrow Ostia into their sinuses as something they were born with or as a result of previous trauma (broken noses, etc.) These unfortunate people have usually had long-term sinus problems, in some cases requiring surgery to correct.

Since this is your first such episode, the odds favor number one or number two. Since infections come and go and allergies vary in severity day-to-day, you may find yourself able to dive most days and only occasionally have problems.

I've had good luck having divers with #2 use Cortisone nose sprays. They are sold by prescription for treatment of nasal allergies, and don't usually have the "wearing-off" phenomenon associated with them. They also have no mental side effects, which some allergy or decongestant tablets can create.

If the pain keeps happening, don't force anything on that dive! Call the dive for that day and later talk to your doc about medications or treatment that may be needed.

Sudafed decongestant tablets are generally quite safe and many divers use them.

Allergy pills containing antihistamines may cause drowsiness in some individuals, so test yourself first on dry land, doing your favorite video game or anything that requires concentration and has a repeatable score to see if the medicine drops your score.

Hopefully, this was a transient viral infection or local irritation and will never trouble you again.

Keep your diving wet and painless,

John Reinertson

 

[BetterLateThannever]

Thanks for the responses. I did go to my doctor and explained the circumstances as I outlined above. She checked me out and said that I definitely had swollen passages as well as major post nasal drip. When I mentioned to her that I felt fine...no different than usual...she just laughed and explained that after forty years of living in this area "normal" for me was indeed being quite "stopped up". She prescribed 24 hour time released Claritin D as well as Nasonex and told me after a week or so I would be amazed at how much better I would feel. She also admonished me to wait at least 2 weeks before continuing my quest for OW certification.


To my amazement, I almost immediately discovered breathing through both nostrils at once. I really never noticed I wasn't before.

Go figure.

I plan to finish my confined water modules on the 19th of this month with my open water on the 27th and 28th. Keeping my fingers crossed.

Jim

 

[BetterLateThannever]

Rick and John, thanks for your responses. I thought you might want to know how it turned out.

I did like my doctor said; stayed out of the water for 2 weeks and took the Claritin D and Nasonex everyday. To my great relief I breezed through the deep water training session yesterday with no discomfort either descending or ascending.

Now it's on to open water next weekend.

Jim

 

[John Reinertson]

Glad things worked out well for you.

Welcome to the underwater world.. As one who gave up Backpacking and skiing after a couple back surgeries, welcome to the weightless world, where a totally diffferent ecosystem is a few feet away and just as exciting, if not more so, than the gravity-bound. The endless variety of life is indeed the ultimate inspiration for all of us to enjoy each day.

Sorry about getting philosophical. There are so few human beings privileged to see what we see underwater, that I get excited whenever someone discovers it.

Keep blowing bubbles.

John Reinertson

 

[keralucu]

I could be wrong, but I could swear I was told that you should not take Sudafed if you have blocked sinuses because of how it reacts when you're at depth. Did I misunderstand this?

Same with Lomatil if you have a bad stomach... Would appreciate it if someone could clarify.

Cheers

 

[John Reinertson]

Sudafed is a sympathomimetic that slightly increases anxiety level in some people and in theory could alter seizure risk slightly in persons pushing nitrox to the limits.

I personally recommend the nasal steroids, as they are free of systemic side effects, but Sudafed is safe enough that pilots and commercial divers are allowed to use it.

Lomotil (and to a lesser extent Imodium or loperamide)
is very mildly sedating and there is some theoretical risk that these would increase the effects of narcosis at depth.
These effects are minor and for most people the effects are less than that of Non-drowsy dramamine (meclizine)

I would probably not abort a dive trip personally if I had taken those. I would probably dive shallower and shorter and use a greater margin of safety on those dives, not only because the medications have some effect, but the illness itself increases the risk.
With these medications the risks are relatively small. Use the illness and medication as just two more factors when doing your pre-dive assessment.
Never be afraid to call a dive if it's not your day.

Dive safe and well
John Reinertson

 

[keralucu]

Thanks for that, Dr John - been wondering about it. It's good to know that there is an option to continue diving if you do happen to have a slightly blocked nose or minor tummy trouble - of course taking into consideration the whole dive and degree of "un-wellness". I was under the impression that if you had a blocked nose that was basically it for diving as Sudafeds were a no-no.... as for the other, I have seen the pic of Warhammer's *???* manoeuvre....