Antihistamines, Decongestants and Diving

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incub69

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According to my otolaryngeologist, I have extremely narrow eustacean tubes. This makes equalizing a very slow, and sometimes painful, experience, especially on the second and later dives of the day. If I get ANY pain, I am certain to develop hyperbaric trauma and lose 80% of my hearing within a few days. This condition lasts from 2-4 weeks.

The Doc recommended Afrin: two snorts in each nostril before my first dive of the day and one snort/nostril on subsequent dives. I sill wind up with HBT to some degree, because I tend to hurry the equalization process. However, without the Afrin I couldn't dive at all.

I have been using Afrin for years to help (when required) sinus (rather than ear) equalisation: from shallow recreational dives to deep trimix dives on open circuit and closed circuit rebreather. The effect of two snorts in each nostril will last the whole day regardless of the number of dives. The main issue with Afrin (or any product based on Oxymetazoline Hydrochloride) is that it will stop beeing effective after 4-5 days of consecutive usage: great for long weekend dives but not recommended for diving holidays.
 

HKu

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Ear candeling....

My mother taught me to NEVER EVER put something in my ears.
Being a grown-up now and as a medically trained professional, I can confirm she was right.

And I'd say that goes especially for burning items. :no: :no: :no:
 

Chugwhump

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I am having a VERY VERY bad year with my ragweed allergy this year.
Claritin and Flonase at night.
Flonase, Singulair, and Sudafed in the morning.
I was a little loopy and a lot irritable for the first week or so and my body has adjusted (but I am usually grumpy, so who knows).
I have been diving pretty much in the 50'-90' range for the past few weeks, and early on I pretty much felt narc'ed all the time.
I told my dive buds that I needed to be watched prior to my first "under the influence" dive, and I am doing well.
I have adjusted and no longer feel the effects above the water or below.
Actually, My gas consumption is astoundingly better.
I am about 10-20% better.
I think I am just a lot more relaxed.
I read the DAN site and everything else I could find on the subject regarding consumption of the meds possible effect/side effects at depth, and and for me,
in WARM WATER, I am doing fine. My buddies are continuing to watch me carefully for possible adverse effects from the meds (or they are just amused at ridiculous style of buoyancy control).

Chug
Killed over 20 with some friends yesterday.
 

DiveMaven

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I'll use Claritin D once in awhile when slightly congested, but if I have a cold, runny nose, or serious congestion, I'll sit out diving that day (or days). For whatever reason, sometimes I get slight congested for a couple of days after flying, and this is the exact situation where I don't hesitate to take a 12 hour Claritin D.

I read a few years ago on DAN's website that using Allegra and diving nitrox was contraindicated, so although I like Allegra D, I stick to Claritin D for safety.
 

MKS @ Medina

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I'm one of those people who would have to give up diving if they couldn't dive with congestion. It took a while to find out what worked best for me, but after 86 dives I have very few problems caused by congestion. Since I like to dive nitrox on dive vacations I'm careful to use OTC drugs that contain no pseudophedrine. I usually take a night time antihistamine that lets me wake up feeling comfortable. I'll follow it up later in the day when necessary with another OTC daytime non-drowsy antihistamine. But my lifesaver has been using a dive mask with a purge valve. When I start to feel even a minor discomfort while diving I exhale through my nose using the purge valve. It usually relieves the discomfort after a couple of breaths and I can go back to breathing normally through the mouthpiece. I have very little trouble equalizing and no after dive headaches. But anyone that dives with anithistamines needs to be really careful to hydrate well or you can suffer the effects of dehydration and ruin your trip. I was lucky enough to dive for a week at CoCo View in Roatan last fall. I was going through a really bad allergy attack at the time and only missed one dive. And that was due to getting motion sickness on the boat, not to being so stuffed up. I'd recommend a purge valve to anyone suffering from congestion problems.
 

captainjpar

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I suffer from allergies all spring and summer long and besides the obvious symptoms of being a snot factory I feel clouded and tired constantly. Going to an allergist and getting the proper shots would be the best solution but I hear that people with extreme symptoms still have to use a supplement so I take a Claritin D 24h midday thru-out the bad months and it works wonders. It clears the head and clears the sinuses and it's non-drowsy unlike some antihistamines. You can't just take one on the day of a dive and expect it to work though as the allergy med takes a few days to build up and manage the allergy. If you don't want to take them all summer long just start a regimen a week before and during a dive outing. My buddy who could never equalize does this and it helps him greatly. If you are congested due to cold think twice. I ignored my DAN Doc, went to only 25' and ruptured capillaries and was blowing blood for the next 2 days.
 

judyjaymd

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Agreed! As an ENT doc and diver, I agree whole-heartedly. If you regularly need to decongest to make it through dive, a thorough ENT consultation is in order. With reference to NeilMed's pulsatile irrigation, I offer one caution. It is a product that I use regularly in my practice which is primarily rhinology and, for people with chronic sinusitis, it is indispensable. For the uninitiated, care must be taken to avoid irrigation which is too aggressive as it can cause reflux back up the Eusachian tubes, creating the problem you are trying to avoid. GENTLE pulsatile irrigation is key.
 

bronk

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I have pretty bad allergies and when diving locally (summer allergies bad) or in the tropics I have to have the drugs. out. Based on recommendation by my ENT (prior to starting diving), I take Nasalcrom to calm down the sinuses , Opcon-A eye drops which provide great relief from itchy eyes and then normal antihistamine - Allegra or Claritin. Sudafed (or generic) as well. The 3 way attack on the allergies is much more effective than one alone. This makes the difference between being able to dive or not as the congestion from repetitive dives builds. For Allegra, I have much better luck with the regular (12 hr) version rather than the extended release (which only seems to last 18 rather than 24). I have been taking this combination for years, so I am well acquainted with the side effects. I think it is better for me to take the nose spray, eye drops an antihistamines proactively and then use the decongestant (sudafed) as needed rather let things flare up and be really stuffed up. Also stock up prior to a trip. A few years back I did not have sudafed and got stuffed up on a trip. I then had to pay $1.75 per pill at the local quickie mart!
 

lpshanet

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I'll use Claritin D once in awhile when slightly congested, but if I have a cold, runny nose, or serious congestion, I'll sit out diving that day (or days). For whatever reason, sometimes I get slight congested for a couple of days after flying, and this is the exact situation where I don't hesitate to take a 12 hour Claritin D.

I read a few years ago on DAN's website that using Allegra and diving nitrox was contraindicated, so although I like Allegra D, I stick to Claritin D for safety.

I think it's REALLY important when quoting something like this (and even more so when acting on it) to be very detail oriented in your facts. Otherwise, bad information can be spread. I mention this because I am unaware of any contraindication for Allegra (fexofenadine) specifically with relation to nitrox. In fact, there is some feeling that Allegra may even have a beneficial/protective effect in terms of ox-tox.

From scuba-doc.com: <<Allegra has none of the effects that mimic adrenaline and is safe to use with nitrox. It reduces the risk of oxygen toxicity, unlike some other allergy medications that may actually increase the risk of oxygen toxicity. Another point: Allegra has fewer sedative side effects than other allergy medications.>>

The confusion that is almost certainly responsible for the misinformation is the fact that Allegra-D (as opposed to regular Allegra) may have some risk. This is not because of the actual Allegra (which is fexofenadine), but because of the decongestant (which is the "D" in the name). The decongestant is the already discussed pseudoephedrine (a.k.a. Sudafed) and is one of the substances that mimics adrenaline. Because of that, your Claritin-D is just as bad/risky as Allegra-D in this regard, as they both employ that same decongestant category. However, regular Allegra is not an issue. We must be careful when providing second hand info.

If I'm mistaken in guessing how you may have misapprehended this, please help us out by providing a link to the DAN information you referred to.
 
https://www.shearwater.com/products/peregrine/

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