Unsafe recommendation in Dec '06 SCUBA Diving Magazine

[rakkis]

An article titled Stop the Dive Wreckers suggests in page 86:

"If it's an hour 'til dive time and you're still blocked [from congestion], go ahead and take Sudafed to shrink the inflamed sinus passages and relieve pressure on the eustachian tubes."

:no


Please do not put yourselves at risk or an ear injury by following this foolish advice. Sudafed is temporary and you put yourself at a very real risk of it not working towards the end of your dive. Thereby being ripe for a reverse block on ascent.

If at all congested, DO NOT DIVE. That is, of course, unless skipping diving that day is worth more than rupturing an ear drum/middle ear barotrauma/ear infection/etc.

 

[Tassie_Rohan]

I often dive when slightly congested.

I think the basic rule is: can you still equalise while on the surface without taking a decongestant? If so then give it a go: be prepaired to call off the dive and take the first few meters easy. If you can't equalise without sunafed then sit it out.

I'll often dive when at the tail end of a cold, when I can equalise again - helps clean out the plumbing. Others have problems no matter how slight the cold: so individuals vary a lot.

I'll take a guess that divers are split 50/50 on the use of sunafed.

I use to use Sunafed all the time - until I had a reverse block. Never again. I'm happy to sit out a dive -there plenty more to come. If someone wants to use sunafed than take the 12 hour stuff and stay shallow.

Worse part of diving with a cold? Clearing your mask with a snotty nose - oh the horror, the horror...

Cheers,
Rohan.

 

[fisherdvm]

I would be learly of making a point blank statement about sudafed. I think a non drowsy antihistamine like claritin or allegra would be fine, along with a nasal spray like Afrin.

But it is on a case by case basis. Diver's as a group have higher incidence of hearing loss. I think it would be best not to dive unless you are fairly recovered from a cold, or that your allergy symptoms are under good control.

Sudafed certainly can elevate your blood pressure, and I would be hesitant to add it to a stressful situation in a person at risk for heart diseases.

 

[DWJ]

Diver's as a group have higher incidence of hearing loss.

.

Interesting stat. Can you share where you got this. I'm not disputing it, just curious.

I don't use afrin because of the rebound effect. I have used sudafed but only if i'm at the beginning or tail end of a cold. Common sense is required.

 

[rakkis]

Just so we're on the same page, the primary reason why you should be careful with anticongestants is because even though symptoms may disappear in the short run, mucus and tissue inflammation may return during the dive. If you're out of good luck for the day, this may be enough for you to get a block when trying to ascend.

Since I am not a medical doctor and I do not listen to breathing sounds* of my OW students before each dive, I am not qualified to say that even very mild congestion symptoms are OK to dive with. In a class setting, I take my responsability to my students seriously. Thus, I would never allow them to take an easily avoidable risk of serious injury. I actually spend more time than some instructors going over the reasons behind blocks/ear trauma.. as I believe that when educated about the matter, people will tend to make the right decisions.

Will you rupture an ear drum/need oval window reconstructive surgery every time you dive at the tail end of a cold? Probably not. But there are enough statistics out there to convince me it's not the smartest thing to do.

Do I take the risk sometimes? Sure.. most people that dive enough (and certainly dive professionals that have schedules other than their own) will dive when they're not 100%. The difference is that having been around diving for a while, we understand the risks and choose to accept them. As a publication that caters to a sizeable new-diver readership, SCUBA Diving has a responsibility to at least mention the possible risks associated with taking anticongestants when diving. They failed to do this.. and this is why I'm disappointed.

* Blocks are not the only thing to be worried about. Upper respiratory track congestion is sometimes associated with fluid/mucus build up in the lungs. Depending on the severity, length of the condition, and physiology of the individual, mucus may block off a section of the lung. Upon ascent, the trapped air has nowhere else to go but through the lung. Pop.

 

[fisherdvm]

I had blood coming out of my nostril a year ago, and crepitus (air under the skin) by my ear after a dive. I questioned my ENT colleages and did a medline search. I can't recall the study, but apparently barotrauma to the inner ear is the cause of the hearing loss.

 

[fisherdvm]

When I have prescribed Afrin, it is only for 3 or 4 days of use, so you don't have a rebound. When I go diving, it is only for 1 snort before the dive. That's it. No more. So rebound really can not happen the way I use it.

 

[Hemlon]

Each person must know how they will respond to any given medication before taking it while diving.

That being said, I routinely dive while on Sudafed as a treatment for nasal congestion. I know how it affects me and I have been diving while on it for over 5 years.

As fisherdvm said, I would frown on making ANY negative statement against it.

What works for one person, will not work for another.

 

[tstormdiver]

I have occaisionally taken Sudafed before diving when I have slight congestion from allergies (in the Ohio valley there aren't many who don't have allergies), if the congestion is severe I don't dive. The drug really doesn't have any major side effects that affect me. I usually take a 24 hr time release tablet in the morning before the dive(s) & it lasts me all day. I'm in no way saying that this works for everyone, but it does for me. I typically don't have any trouble equalizing anyway. I know of many divers that take decongestants before diving. It is a risk, yes, and you do have to use some common sense. I wonder if the recommendation against decongestants before diving was made before the dawning of long lasting decongestants. The older decongestants used to only last 4- 8 hrs and could certainly wear off before the end of a dive, you have a bigger window of oppertunity with the longer lasting medications.

 

[Rick Inman]

I think the basic rule is: can you still equalize while on the surface without taking a decongestant?

I'm with T.R. on this one. If I can equalize on the surface, I'll dive.

But if I need to medicate to dive, I won't dive.

Easy, simple, safe.