Pain after pool dives?

[Cruisin Home]

You need a new Doc. You need to see a real ENT and get a CT scan. You most likely have an infection and a blockage of your frontal sinus (just above your eye). Antibiotics dont wear off in hours like you suggest this is just your false placebo like perception. The fact you are on a second course suggests that you have an intractable, drug resistant problem. Likely need a course of steroids (also dangerous) to dilate your sinus membranes and allow the "puss" (to drain from your sinus.

And if you pay attention to your training you will see that the biggest pressure changes are in the first 10 feet so yes, pool diving can produce issues if you have trapped air spaces in your body.

Not too impressed with your instructor either. Safety is paramount. There is always another day to dive. If you are going to survive in this hobby you must learn that either you will someday take a stupid risk instead of abandoning a dive.

 

[TSandM]

Man, there's a lot of rhetoric and some plain misinformation in this thread.

I concur that the pain you describe sounds like a frontal sinus that couldn't equalize. Whether it was a reverse block or just sinus squeeze would depend on whether the symptoms began with descent, or only upon ascent. If it occurred on descent, you could easily have filled the sinus with edema fluid and blood, and this will take significant time to resolve.

Many sinus issues are not bacterial infections. The track record of antibiotics in acute baterial sinusitis is poor, and courses of two to four weeks are often required to see any significant improvement. I agree that a CT scan will give a lot of information about the amount of fluid in the sinus cavity, but CT is overkill for the majority of uncomplicated sinus issues.

Saying that a physician is a quack for recommending that a diver use antihistamines or even OTC decongestants is really not called for. Non-drowsy antihistamines are often recommended for people with seasonal allergic symptoms, and I have seen any number of people here who have been instructed to use decongestants, if a good medical evaluation shows that they are likely to have problems equalizing due to anatomic issues.

To the OP -- I'm not sure your antibiotics are doing you a great deal of good, and I don't think there is any particular reason to believe that the Omnicef will work much better than the amoxacillin, given the bacteriology of sinus infections. But if you are asymptomatic by the time your dives are scheduled, I don't see any reason not to try to do them. Monitor your symptoms, and abort if you redevelop pain. At that point, I would highly recommend an evaluation by a diving-savvy ENT doc.

 

[Togalive]

Once again, I really appreciate all the knowledgeable replies, its a great help

So just an update for you guys. I have began to irrigate my sinuses twice a day with luke-warm saline solution and a kit designed for it (by the way, if you havent done it, it is quite possibly the weirdest sensation I have ever felt) so hopefully that will help to some degree. I also have a doctors appointment with a different doctor, so we will see what he says, personally Im hoping he will pursue a more aggressive treatment given the circumstances. Based on what he says, I'll either have to call the dives for this weekend, or possibly not if he actually gets to take a look up in there and says its ok. But right now its looking like theres no diving this weekend for me :/

 

[Cruisin Home]

You are correct TS&M that the track record of anitbiotics in sinus infections are poor. they are often repeatedly over prescribed, mostly by GPs. I would retract my statement somewhat and say that if this is an isolated incident that a CT would then not be prudent. However if this is a recurring chronic problem then a CT is most definitely the correct approach. Even great ENTs don't have 3D xray vision. These problems, originating in the osteo meatal complex are primarily mechanical in nature, and permanent relief is usually only achieved with surgery (I am a living testament to this, new person/diver after surgery). Sinus meds have their place but unfortunately are overused resulting in "rebound" effect thus creating a horrible dependence on the medication.

I did not mention the word quack, I suggested he see a specialist instead of a general practicioner, which I believe you suggested as well.

Togalive: If this is a recurrent problem you should see an ENT and disucss getting an image and the options of surgery. Saline rinse, in my opinion, is the best thing that anyone can do on a daily basis for your sinus. I do it every morning in the shower as recommended by my ENT and close friend Dr. Peter Catalano, pioneer of the now famous minimally invasive balloon sinusplasty procedure.

 

[TSandM]

Crusin' Home, you didn't use the word quack, but someone else did. And I agree with your last post completely.

 

[Cruisin Home]

Thanks

 

[Togalive]

So another update for you guys. I went to the doctor this morning and actually got to see a different doctor who himself dives. After explaining everything, he said "well, I wouldn't think it was irrational if you did try to do your certification dives this weekend" and he made sure that I knew to immediately let my instructor know if I began to feel any pain whatsoever on my way down. Also, he reccomended that even just as a precaution, for me to take a 12 hour sudophed an hour before the dive. I spoke to my instructor, and he agreed with the doctor, so it appears that the dives are a go for this weekend. I will post up how they go, I feel confident that I should be fine, but if I feel ANYTHING I will call my dive without a second thought...

 

[shakeybrainsurgeon]

The potential downside of diving with a sinus condition requiring several meds, several trips to doctors, and producing severe pain after a pool dives is: bad

The downside to delaying these dives until you are completely well is....???? Loss of money? Angry dad? Fear of looking wimpy? Irritated instructor? What??????

All of life is a risk/benefit analysis, but the scales seemed staggeringly tipped in this case to waiting things out.

I'm not getting the point of this discussion at all. It's like another thread where the OP had visual obscuration, skin rashes and extremity tingling after every series of prolonged or repeated dives and people were discussing whether she should get a workup and whether insurance would pay for it. If it walks like a duck, etc... that poster had DCS and was (and remains, I think) in denial. This OP has a serious sinus problem and anyone who suggests he do an elective certifying dive until the issue is resolved should take lessons in how ducks walk and quack.

When people go to multiple experts and seek multiple opinions, they are not usually seeking the truth, they are seeking to validate what they want. They will go to doctors until they find one that tells them what they want to hear and voila, that will be the "smart" one.

This is a recreational sport. These are elective training dives, not a lunar landing, and this is a temporary and acute illness, not some chronic hayfever.

True, people dive on meds all the time, but with chronic illnesses like hayfever, the sufferer usually has years of experience regarding the severity of symptoms, response to meds, times and conditions which worsen the illness, etc. Inexperienced divers with acute, unpredictable illnesses are another matter entirely.

Experts can legitmately question whether the medical profession is too onerous in preventing people with medical conditions from enjoying the sport, conditions like asthma, diabetes, COPD, epilepsy, MS, parkinsonism, etc. But I would hope that suggesting that an elective set of dives be postponed for an acute sinusitis, especially when the diver has had serious symptoms at only six feet in a swimming pool, would not be all that controversial.

 

[farsidefan1]

The sinus flooding helped my wife get rid of a sinus infection that had lasted for yrs (flareups). Glad you are dealing with an experienced doc now. My wife loves her "neddy pot" I think that is what she calls it.

 

[Togalive]

@shakeybrainsurgeon
While I value your position, just like all the helpful posts put up here, I have only gone to the doctor I went to today so I could ask him specifically whether or not I should stay out of the water based on previous sinus issues, and the pain I felt. In his opinion, I need a CAT scan of my sinuses (good call to those who suggested it!) As it is looking more like I have Chronic Sinusitis opposed to a simple sinus infection, as I have been battling them for quite awhile now. However financially a cat scan is completely undoable for my family at this time. My goal was to get an official diagnosis from a doctor who is also a diver, from which I could weigh the risks and make a decision, and I got just that. My condition has vastly improved from a few days ago, in both terms of congestion (sinus irrigation and stronger meds seems to be helping a lot), and also the residual pain. I realize there is still a risk in my diving this weekend, but I feel well enough to dive (no more congestion), and I am prepared to call the dive if I get any pain or trouble equalizing. In the end, just to make sure I was not tricking myself into thinking anything, I left the decision entirely up to my instructor whome I trust, and he believes that as long as I stop and tell him if I feel any pain, there is little reason to not do the dive.

@Farsidefan1
Its good to hear I'm not the only one shooting water up one nostril and watching it come out the other! I am using a squeeze bottle with a nozzle, but only because I couldn't find a Neti Pot.

P.S: just another update, as stated before, any sinus congestion is gone as of this time and all that's left is slight drainage in the back of my throat. As I type this I am breathing free and easy through the very nostril that was completely clogged before I hope to get a CAT scan in a month or so, but between college and everything else, there isn't a penny left to satisfy such a big pricetag.