Congestion And Disappointment

[uncfnp]

A Dr. can examine you until the cows come home but he has no practical way to determine how actually congested your sinus and ear passages are.

Not entirely accurate. True we can't magically see into the sinuses but a good provider uses both history and exam to develop a diagnoses and treament. We can check the ears for ETD and equalization, look at the nasal passages for inflammation, and turbinate edema. Its not always clear cut but a skilled provider can make a pretty good educated assessment and offer knowledgable advice.

really doesn't matter if he gives you the OK, or 'bans' you from diving. Only YOU, ultimately, can decide whether you ought to stay out of the water or not. Dr's are not magic and entirely too much faith is put in their pronouncements in matters like this.

This is true. Each individual must weigh the risk and reward. Providers at best can only give you the info and options so you can make an informed choice.

This includes DAN Docs. You call them, tell them you are congested, and unless they are an idiot they are going to tell you to stay out of the water. How are they going to determine over the phone what your functional level of congestion is?

Again true. Telephone triage is notoriously vague. They can only give general advice for vague issues.

Can't be done in any reasonable way. IMO, unless you are honestly ILL (more than a cold), seeing a physician for a cold is a waste of time and resources on all accounts.

Also true. For the general public. This was a diver with a specific issue that wanted advice. Very reasonable.

One of the problems of pushing it with congestion on board is reverse block.

No arguement here.

 

[Steve_C]

As noted if congested don't dive. Having said that if you can breath easily, do not feel sinus pressure, but just have some drainage I have dove on psuedophed a few times. Take it at least two hours before the dive. Only use 12 hour psuedophed. Make sure you tolerate it well. I have had sinus issues off and on for decades and my body is very used to it. Then I avoid deeper dives and make my assents and descents very slowly making sure I clear every few feet. (Normally I can do hot drops with no problem). If there is any pressure issues I will stop and even go up or down a bit until all is good. I have thumbed a number of dives and trips due to sinuses not clear enough. It happens.

Note that I am not a medical doctor. I take pesudophed as a precaution on a dive that I think I could do without it to insure the sinuses do not act up. If I think the dive requires pseudophed, then I don't do it.

AND ONLY TAKE ONE. I lent a couple to a congested sounding private guide once assuming he knew to take one. Found out later he took both and felt so wired he almost thumbed the first dive.

You might be one of those folks who has to be cautious with clearing. Descend slow. Never try to force it. Clear before you feel you need to clear. Go up some if need be.

 

[WrmBluH2O]

mattdust, congrats on your recent OW certification. Congrats and kudos too for being so smart to thumb your dive when you experienced "considerable pain" at 15 feet. Disappointing to choose to end the dive but very mature on your part. That's what good divers do.

You'll have to be very patient. I know that is frustrating to hear; it seems like what old people always say. lol But, you are young and smart. If you take care of your bod each and every time you go out, you'll have a lifetime of cool dive trips. It sucks as I know you are really excited about this trip. Please keep working with your doc, keep being self-aware about your body, and keep being honest with your buddy. We do this for fun; it's neither fun nor safe if you push through "even a little" pain.

Great post on your part! Wishing you many happy years of diving!!!

 

[wetb4igetinthewater]

I skimmed most of the responses. There's one more thing that isn't good about taking cold medicine. Sure it may clear you up when you start your dive, but what if it wears off during you dive? Then you have reverse block. And that can be quite problematic.

 

[Buliwyf]

Just go snorkeling instead.

I get nasty colds this time of the year due to the wind. Even on nice feeling warmer days. So I'm always sweating in a wool hat a week before any vacations.

 

[fmerkel]

Medications can be extremely useful but you have to know what you are doing. If you aren't willing to do the research, probably better to not use them and simply stay out of the water if you are having congestion issues.

Below are examples of divers with good intent but simply passing on the incomplete information and partial truths that divers give to one another without ever examining what that information is, why it came to be, or if it's actually even accurate. This is very common in the dive community.

There's one more thing that isn't good about taking cold medicine. Sure it may clear you up when you start your dive, but what if it wears off during you dive? Then you have reverse block. And that can be quite problematic.

I was taught never to take something to enable the dive to take place.The reason being is what would have happened if the Sudafed was effective allowing you to get to your target depth and then wore off as you are about to ascend?

2 common high profile examples:
Sudafed is a fine drug, but you have to know about it's central nervous system effects, it's vasoconstricitive properties, and like all drugs, it's particular effect on you.....OUT of the water, before you ever try it IN the water. It does not have much rebound when it wears off. It's useful for about 2 hours and should be taken 30-60" before splashing.

Note on 'so called' 12 hour extended release Sudafed - Normal dose on Sudafed is 60mg (2 x 30mg tablets). The extended release is 120mg (double dose). My personal experience is that the 'extended release' claims are complete crap. It's like drinking a quadruple double espresso....horrible stuff. I can barely function on land after that, but that's me. I have a BIG friend that gets along fine with it. I rarely take more than 1x 30mg tablet on a dive.

Afrin is another. Works fantastically for the nose and to a lesser extent for ear clearing. BUT when it wears off you'll be worse off than before when you get congestion rebound. If you take it again, the rebound when that wears off will be sooner, and even worse. Do that several days in a row and you end up in a world of hurt. It does last ~12 hours, so is pretty useful for a day of diving, maybe 2 if you understand what you are doing and push it a bit. It's useless for extended diving unless it's the last day or 2.

Rebound is when your condition gets WORSE when the drug wears off, which is not the same as returning to your previously compromised state prior to the medication dose. If you are taking medication to deal with congestion problems when diving you have to be quite clear what your problems are, what the medication does, how it does it, how long it lasts, and what is going to happen to you when it wears off, whether that is related directly to the medication, or to your previous state.

From DAN:
Taking medications when you dive.
DAN Takes a Look at Over-the-Counter Medications

 

[claymore]

It is also a possibility that you have a sinus infection. Your upper sinuses can be pluged but still be able to clear your ears but your upper sinuses will not equalize, not comfortable at all. I have had it happen a couple of times. I did not feel congested but when I tried diving and the front of my head felt like it was going to explode by the time I got to 15 feet. A couple of days later the major sinus infection reared its head.

 

[Jayfarmlaw]

I have used a combination of Zirtec or Claritan and a shot of Afrin in each nostril at breakfast before morning dives. It works fine for me with no issues and usually keeps be clear for most of the day.

That being said, I have never tried to dive with a bad cold or sinus issue (knocking on wood now). I think I would try....but be ready to thumb the dive or stay shallow.

Good luck,
Jay

 

[uncfnp]

Medications can be extremely useful but you have to know what you are doing. If you aren't willing to do the research, probably better to not use them and simply stay out of the water if you are having congestion issues.

Below are examples of divers with good intent but simply passing on the incomplete information and partial truths that divers give to one another without ever examining what that information is, why it came to be, or if it's actually even accurate. This is very common in the dive community.





2 common high profile examples:
Sudafed is a fine drug, but you have to know about it's central nervous system effects, it's vasoconstricitive properties, and like all drugs, it's particular effect on you.....OUT of the water, before you ever try it IN the water. It does not have much rebound when it wears off. It's useful for about 2 hours and should be taken 30-60" before splashing.

Note on 'so called' 12 hour extended release Sudafed - Normal dose on Sudafed is 60mg (2 x 30mg tablets). The extended release is 120mg (double dose). My personal experience is that the 'extended release' claims are complete crap. It's like drinking a quadruple double espresso....horrible stuff. I can barely function on land after that, but that's me. I have a BIG friend that gets along fine with it. I rarely take more than 1x 30mg tablet on a dive.

Afrin is another. Works fantastically for the nose and to a lesser extent for ear clearing. BUT when it wears off you'll be worse off than before when you get congestion rebound. If you take it again, the rebound when that wears off will be sooner, and even worse. Do that several days in a row and you end up in a world of hurt. It does last ~12 hours, so is pretty useful for a day of diving, maybe 2 if you understand what you are doing and push it a bit. It's useless for extended diving unless it's the last day or 2.

Rebound is when your condition gets WORSE when the drug wears off, which is not the same as returning to your previously compromised state prior to the medication dose. If you are taking medication to deal with congestion problems when diving you have to be quite clear what your problems are, what the medication does, how it does it, how long it lasts, and what is going to happen to you when it wears off, whether that is related directly to the medication, or to your previous state.

From DAN:
Taking medications when you dive.
DAN Takes a Look at Over-the-Counter Medications

Pseudoephedrine basically has two actions that can effect divers. First is the vasoconstriction that can cause a temporary elevation in blood pressure. This same vasoconstriction can reduce nasal congestion. But ultimately it is also a stimulant and this is where the CNS symptoms come into play. It can include nervousness, agitation, insomnia, excitability and even the occasional tachycardia or arrythmnia. It is the stimulant and seizure association that has caused concern with divers for increased susceptibility to oxygen toxicity. I think DAN has a study on this pending.

The 12 hour formula has a half life from 4 to 8 hours so more than adequate to cover the average diver. And of course no diver should take any new medication just before a dive. But there are few adults that hasn't taken a decongestant in one form or another. As I said, I have chronic congestion and a dose just prior to a day of diving was recommended to me by an ENT that was also a diver. I am 5'2" and 135 lbs and have no issues with this dose but of course everyone's response is unique and individual.

As for Afrin, rebound is only an issue with prolonged use. The bottle typically recommends no more then 3 to 4 days use but up to 5 should cause no issues and limiting the dose to just once a day before diving will also help avoid this problem.

 

[wetb4igetinthewater]

Medications can be extremely useful but you have to know what you are doing. If you aren't willing to do the research, probably better to not use them and simply stay out of the water if you are having congestion issues.

Below are examples of divers with good intent but simply passing on the incomplete information and partial truths that divers give to one another without ever examining what that information is, why it came to be, or if it's actually even accurate. This is very common in the dive community.

I wouldn't say incomplete, but more conservatism. From another DAN (Europe) article: DAN Europe - Drugs and diving

DECONGESTANTS
Sinus Congestion, Treatment. The drugs used to treat congestion are called sympathomimetic agents, and may stimulate the release of norepinephrine. This causes blood vessels in the nose to shrink, and it reduces any swelling there. The major side effect of these drugs is their ability to increase heart rate and blood pressure. These agents usually have a short duration of action - about four to six hours - and may wear off during a dive, causing a rebound effect and a reverse squeeze on ascent. Divers concerned about drugs with systemic side effects may choose topical nasal sprays to avoid the jitteriness and rapid heart rate seen with other sympathomimetics. Some of these sprays even have an extended action (8-12 hours). The drawback, however, is that these agents should not be used for more than three days at a time: tachyphylaxis (rapid drug resistance) occurs, requiring an increased amount of the drug to be effective. Saline mist sprays are another option for those concerned with drug side effects. They may be used as often as necessary and will not result in tachyphylaxis. Pseudoephedrine, a key ingredient in Sudafed, is a commonly used decongestant by divers. A recent study highlighted its effectiveness. The study compared pseudoephedrine to a placebo in its ability to prevent middle ear squeeze in novice divers. It concluded that a 60-milligram dose of pseudoephedrine administered 30 minutes before the dive was effective. This study was conducted to a depth of 40 feet / 12 meters, with objective data gathered only through otologic (ear) exams. Symptoms of side effects were collected in a questionnaire.
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So it gets complicated, and fast And if someone messes up, they have a problem. The OP is on vacation, not the best time to start examining the impacts. You and I live in an area where we can have the time to experiment and see what works. However, my policy with my students is, if they are sick, let's continue another day. No reason to push. Sure, it consumes more of my time, but I'm interested in helping people getting addicted to diving. People learn better when they are feeling well. They enjoy themselves more when they are feeling well.

Remember what the OP said originally:

I am a very new diver. ... I'm 14

Do you really want a 14 year old experimenting with cold medication while he is on vacation? Do you want a 14 year old reading the above links that you and I have provided to make a decision on what medications to take so that he can dive?

I don't. Which is why my response was simple.

OP, please skip the meds, enjoy snorkeling and other activities that others have suggested. You have so many years ahead of you for amazing diving experiences. When you get to be my age (old), you will have thousands of dives under your belt. I envy you a bit to be honest.

Kosta