Got OW Certification but have blocked tubes now!

[DandyDon]

...after a day's worth of nitrogen saturation, I still need a couple Dramamine and lots of booze to bring me down so I can sleep.

Dramamine is another brand name that now has different chemicals, I think. The orginal one: "Dimenhydrinate (marketed under brand names Dramamine and Gravol) is an over-the-counter drug used to prevent motion sickness, (emesis). It is closely related to diphenhydramine HCl, or Benadryl." may give some antihistamine benefit directly to the ear tubes as well as help prevent boat sickness.

Better diving through chemicals!

There used to be a DuPont TV ad "Better Living Thru Chemistry" when I was a kid, before chemical abuse become so well known.

 

[Mossman]

Dramamine is another brand name that now has different chemicals, I think. The orginal one: "Dimenhydrinate (marketed under brand names Dramamine and Gravol) is an over-the-counter drug used to prevent motion sickness, (emesis). It is closely related to diphenhydramine HCl, or Benadryl." may give some antihistamine benefit directly to the ear tubes as well as help prevent boat sickness.

Only the original formulation for me, thank you. I just puke up the non-drowsy formulations. The patch made me nauseous as well, and it never could survive a dive. On the way back from Cocos during a storm, I broke out the electroshock therapy wrist band, but that turns out to be a form of torture. It's just as easy, and far less painful, to distract oneself by plucking out one's toenails or teeth.

There used to be a DuPont TV ad "Better Living Thru Chemistry" when I was a kid, before chemical abuse become so well known.

I'm surprised they had TV back then. Are you sure it wasn't a radio ad?

 

[BRANDY]

I have same prob from time to time. I use afrin spray. I tilt my head back,sqirt a little in each side(when you use it this way its gonna sqirt out a stream,its meant to be used upright) and when I feel it start to drip in my throat,pinch nose, tilt head back to normal and try to equalize. This forces a little medicine in tubes and is the best way ive found to clear.

 

[wanadive]

Thanks eveyone for all the great information!
Hopefully I will be able to retify this ear issue and continue diving!

Have a good day all!!!

 

[TSandM]

Just a bit of caution . . .

First off, Afrin is not a benign medication. It is a powerful vasoconstrictor, and has a well-recognized rebound phenomenon, meaning that when it wears off, the tissue that was shrunk by its effects swells worse than before. The user is then tempted to redose, and this can lead to a vicious circle of increasing usage and worsening symptoms known as rhinitis medicamentosa, and can require steroids and a period of significant discomfort to get the patient off the medication.

Second, use of pseudoephedrine has been linked to an increased risk of oxygen toxicity seizures, so Sudafed should be used with caution by those breathing Nitrox, especially if you were trained to go to the higher ppO2s (eg. 1.6).

Third, the majority (not all, but most) of ear problems are technique problems, and are due to not equalizing early enough and often enough. This is one of the reasons why new divers are so prone to ear problems -- They're too task-loaded during descent to remember to clear their ears frequently.

If you have been diving and have decreased hearing or ear pain that is persistent for more than a couple of days, you should have an evaluation by a physician. But I'll tell you that the average family practitioner (or urgent care or ER doc) is not capable of much more than telling you that you didn't perforate your eardrum and you don't have an active infection. Diagnosis of inner ear trauma requires evaluation by a specialist, and preferably one who is conversant with diving and the ear problems that occur with barotrauma.

 

[BRANDY]

Just a bit of caution . . .

First off, Afrin is not a benign medication. It is a powerful vasoconstrictor, and has a well-recognized rebound phenomenon, meaning that when it wears off, the tissue that was shrunk by its effects swells worse than before. The user is then tempted to redose, and this can lead to a vicious circle of increasing usage and worsening symptoms known as rhinitis medicamentosa, and can require steroids and a period of significant discomfort to get the patient off the medication.

Second, use of pseudoephedrine has been linked to an increased risk of oxygen toxicity seizures, so Sudafed should be used with caution by those breathing Nitrox, especially if you were trained to go to the higher ppO2s (eg. 1.6).

Third, the majority (not all, but most) of ear problems are technique problems, and are due to not equalizing early enough and often enough. This is one of the reasons why new divers are so prone to ear problems -- They're too task-loaded during descent to remember to clear their ears frequently.

If you have been diving and have decreased hearing or ear pain that is persistent for more than a couple of days, you should have an evaluation by a physician. But I'll tell you that the average family practitioner (or urgent care or ER doc) is not capable of much more than telling you that you didn't perforate your eardrum and you don't have an active infection. Diagnosis of inner ear trauma requires evaluation by a specialist, and preferably one who is conversant with diving and the ear problems that occur with barotrauma.

You are absolutly right. I forgot to mention its addictive. This technique is strait from Dive Training Magazine

 

[Mossman]

First off, Afrin is not a benign medication. It is a powerful vasoconstrictor, and has a well-recognized rebound phenomenon, meaning that when it wears off, the tissue that was shrunk by its effects swells worse than before. The user is then tempted to redose, and this can lead to a vicious circle of increasing usage and worsening symptoms known as rhinitis medicamentosa, and can require steroids and a period of significant discomfort to get the patient off the medication.

My ENT gave me Nasonex to use if the Afrin caused any problems, but I've never had a problem weaning myself off it after a 7-10 day dive trip. I try to let the Sudafed do its job, and only hit the Afrin when I wake up with one or both nostrils plugged.

Second, use of pseudoephedrine has been linked to an increased risk of oxygen toxicity seizures, so Sudafed should be used with caution by those breathing Nitrox, especially if you were trained to go to the higher ppO2s (eg. 1.6).

If you're referring to the DAN study, as I recall there was no causality demonstrated, just a correlation that implied that more aggressive divers were more likely to take Sudafed. Therefore, most people ignore the study. If you know of anything more "controlled" I'd like to hear of it and so would the thousands of other divers who regularly take Sudafed before they dive without any problems.

Also, any data from that study has to be balanced against the negatives if all divers were to not take Sudafed. Obviously there would be a significantly greater incidence of ear and sinus trauma, potentially causing spatial disorientation and vertigo, leading to a much higher incidence of DCI and lung expansion injuries. I'll take the Sudafed, thank you.

Third, the majority (not all, but most) of ear problems are technique problems, and are due to not equalizing early enough and often enough. This is one of the reasons why new divers are so prone to ear problems -- They're too task-loaded during descent to remember to clear their ears frequently.

That's fine for new divers. I had difficulty clearing for several years after my tubes got messed up from a nasty middle-ear infection. I also suffer from hayfever-type allergies, tending to wake up with moderate nasal and/or sinus congestion. Even when my passages feel clear, and I have no problem clearing at a moderate rate of descent, I've experienced the occasional bout of alternobaric vertigo. On a free ascent with no visual reference, this can be quite a PITA. Even with the drugs, I get the rare bout of AV, but the incidence is greatly reduced. For me, it's a no brainer. The side effects and potential risks are definitely out-balanced by the benefits.

 

[TSandM]

. The side effects and potential risks are definitely out-balanced by the benefits.

And this is always the decision that has to be made with respect to the use of any medication. I use Sudafed myself (and have used Afrin on occasion) but I'm aware of the characteristics of the medication and the risks associated with its use. I just want to make sure that people reading this forum don't go away thinking that using medications will protect your ears (which it won't, if your technique is faulty), or that these medications are without side effects or long term problems, that's all.

The information about sympathomimetics and oxygen toxicity is anecdotal and no causation has been proven. There is a plausible mechanism, however. I dive Nitrox and use Sudafed, but I don't push the MODs.

 

[Mossman]

And this is always the decision that has to be made with respect to the use of any medication. I use Sudafed myself (and have used Afrin on occasion) but I'm aware of the characteristics of the medication and the risks associated with its use. I just want to make sure that people reading this forum don't go away thinking that using medications will protect your ears (which it won't, if your technique is faulty), or that these medications are without side effects or long term problems, that's all.

The information about sympathomimetics and oxygen toxicity is anecdotal and no causation has been proven. There is a plausible mechanism, however. I dive Nitrox and use Sudafed, but I don't push the MODs.

I agree. "Informed consent" is always the watch phrase, yet a lot of people really shouldn't even be trusted buying OTC meds notwithstanding a multipage product insert of fine print and a nifty molecular diagram of the drug. It doesn't matter how much information is provided if someone can't or won't understand what to make of it.

I'm normally very conservative with respect to MODs, with the caveat that they are time-based and that high ppO2 still takes a little while to circulate before it hits the brain and they are already pretty darn conservative even when based on 1.6 (which should allow 45 minutes on the NOAA charts). The likelihood of getting an oxtox hit at 1.4 is extremely slim even if I'm flying on a maximum dose of Sudafed. It's far more likely I'll get hit by lightning. Does anyone know whether neoprene provides any protection against lightning?

I'm also far more worried about Sudafed raising my blood pressure, since heart attack and stroke are far greater killers of divers than oxygen toxicity. But again, it's a balance. I have to weigh a rise in my BP versus the collateral benefit of the "speed" effect - it completely counteracts any post-dive drowsiness and keeps me going all night.

 

[TSandM]

I have to weigh a rise in my BP versus the collateral benefit of the "speed" effect - it completely counteracts any post-dive drowsiness and keeps me going all night.

Revised ascent procedures might get rid of that post-dive drowsiness -- or staying sober the night before