Years FIRST silliest question...

[cybordolphin]

Is it possible to plug your nose and have your mouth shut... and cause damage to your lungs during a HARD sneeze. Much to the same effect as ascending too quickly while holding your breathe during a dive?

I did this when younger... and caused a very strong pulling pain feeling in my chest. It reoccurs from time to time (the pain).

Could this weaken my lungs and make diving riskier? Could there indeed be small air bubbles much the same that which occurs during a dive accident? "Mediastinal Emphysema"?

I know this sounds silly. But is it possible? And how could one find out if they have something like this pre-existing. Should it be checked prior to diving?

Thanks for any input.
(and feel free to give me silliest question award for the new year)
.... so far.

 

[Drew Sailbum]

:box:

If you have any doubt whatsoever as to whether you are medically fit to dive, then by all means get checked by a competent dive physician.

It tends to reduce those unpleasant :drown: episodes.

Getting down off my soap box, now I'll say:

I seriously doubt there is any lifelong residual effects from a hard sneeze years ago. Not impossible, just unlikely.:shaking:

 

[cybordolphin]

Thanks.

Actually it was a bad habit I had while sneezing. lol.

Anyway.

How can a physician tell if you suffer from say Mediastinal Emphysema? Is it a lengthy process to find out? Simple or otherwise??

Thanks again.

 

[Drew Sailbum]

Haven't even played a physician on TV. :blah:

Mediastinal emphysema is air bubbles trapped under the skin, outside of the lungs, along the breastbone. This can be as a result of a lung overpressurization injury, and is a danger of rapid, breath-holding ascents.

Significant cases of mediastinal emphysema can result in a "crackling" appearance of the chest, with pockets of air that easily move about under pressure. If enough air has escaped into the chest cavity, pressure may be exerted against the lungs making it difficult for the lung to fill. And all that medical jazz. :snore:

Diagnosis can be clinical (observation, listening via stethoscope) or radiological (x-ray). Fairly simple. Treatment involves providing an escape route for the trapped air, and treatment of the lung injury as needed.

 

[neil]

Not quite accurate, Sailbum. A mediastinal emphesyma is air trapped in the space between the lungs, heart and the sternum; the mediastinum. It's not visible or palpable like the subcutaneous emphesyma you are describing. I'm not a doctor, cybordolphin, but I'm sure you'd know if you had this problem: substernal pain, breathing difficulties. Very serious injury. The air trapped in this way can put pressure on the heart and vessels. So, never hold your breath, and I guess when you sneeze, let 'er rip!
Neil

Sailbum: It's a pneumothorax that would cause a lung to collapse and not inflate. You're sort of combining the injuries, I think.

 

[Walter]

Reminds me of a Calvin and Hobbes strip. Calvin walks up to his dad and says, "If I held my nose and kept my mouth closed when I sneeze would it come out my ears or would my head explode?"

Dad replies, "Gee Calvin, I don't know."

Calvin looks pensive and says, "Either way, I'm afraid to try it."

DSSW,

WWW™

 

[scuba-sass]

Walter - LOL !!!!

I miss Calvin....

Scuba-sass

 

[BillP]

Is it possible to have barotrauma from increased airway pressure at the surface? (Sneezing, valsalva, etc.) Yes. It can and has happened.

Is it possible to have an increased risk of future injury due to a past injury? Yes, I suppose it's possible, but I'm not personally aware of any cases. They may be out there, though.

Is either scenario likely? I would think not.

HTH,

Bill

 

[Dr Deco]

Dear cybordolphin:

This question is akin to, can you burst your eardrums by holding shut your mouth and nose when you sneeze? This is second only to, how do you pronounce Uranus? (Although all are surpassed by, do reindeer fly?)

I would think that it would not seem possible to get a pneumothorax without some underlying anatomical defect since the space between the lungs and around the heart are at the same pressure as the air inside of the lung. BillP appears to be aware of some instances however.

A compression of the chest muscles would increase the pressure of both cavities (lung and ediastinum) simultaneously. I might imagine this to be akin to two inflated balloons, one inside of the other. Can you force air into the inside balloon by squeezing the outer balloon? Not really, since squeezing the out one also increases the pressure on the inner.

Spontaneous pneumothorax is possible and indicates a weakness of lung tissue.

Some things can occur however. The increased pressure can force mucus and bacteria into sinuses to cause an infection. The pressure wave has also been reported to cause an aneurysm (= enlargement of a blood vessel). I am also told that you should not bother to try to sneeze and keep your eyes open, because it is impossible (it is claimed that it will rip the muscle that holds your eyelids up). How is that to start the New Year !

Dr Deco:doctor:

 

[BillP]

I wish that I could remember now where I read about it, but pneumomediastinum might be more common than you would suspect. With the advent of CT unsuspected "silent" asymptomatic pneumomediastinum is occasionally found in patients having CT's for other unrelated reasons. Some of these people have no known anatomic defect to explain the gas in the mediastinum. There are reports of otherwise normal moms developing pneumomediastinum from labor and even a case report of a glassblower presenting with pneumomediastinum. Most cases of "spontaneous" pneumomediastinum are associated with another known problem- most notably asthma- but apparently not always.

Of course it is possible that the otherwise "normal" people who develop pneumomediastinum from straining might in fact have an as-of-yet undiscovered abnormality that caused the problem, but it's extremely difficult to get a live person to consent to an autopsy. (I know, I've tried.) And this does beg the question of whether this as-of-yet undiscovered abnormality would lead to an increased risk with diving. I haven't seen anything about it so dunno. I suppose it could.

Bill