Rogue Phoenix:
Hey guys I have a question I was hoping you could clear up for me. My girlfriend is about to take the basic open water scuba course for her certification but she kinda has allergies. Stuff like pollen and pet dander gets to her if she's around too much. They aren't real bad but she usually has a kinda runny stuffy nose. Is it safe for her to dive? Would she be able to take some kind of decongestant? I know this pry seems like a stupid question but I've been outta the water for a while and can't remember wether or not this would cause a problem. Thanks everyone.
Hey, everyone...
I agree with the above, wanted to add a few points (I'm an ENT doc)...
As most of you probably know, a squeeze is caused when increasing air pressure in the airway with descent (regulated by the first and second stages) can't make it into the ear or sinuses. This is because the pathway to the ears and sinuses are (simplistically) thin tubes lined with mucosa (the lining of the mouth, nose, etc..). Some people have intrinsic problems with these tubes, not related to any acute illness. These people generally have bad ear or sinus disease, and most don't become divers. Other people have some transient condition (usually allergies, sinusitis or a cold) which makes the mucosa swell, and blocks the pathway to the ear or the sinuses.
There is this concept that you should not use decongestants while diving, since they can wear off during a dive. This could cause a reverse squeeze (sinus or ear pain on ascent), which is more dangeous than a regular squeeze (pain on descent). With a reverse squeeze, you may not have the air to wait it out or go slow. Furthermore, you obviouosly can't abort an ascent! As the pilots say: "takeoff is optional, landing is mandatory.".
However, many people do safely use these drugs and dive (especially limited, recreational diving). When faced with missing a trip to a beautiful shallow tropical reef on the only week of vacation you are going to get in a year, people will load up on whatever is available to try to save the dive. Can't say that I haven't done this myself!
SO, what I recommend (and this does not constitute any medical recommendation for any particular patient!) is to see how easily you can equalize before any dive, and let that be the thing that decides whether to go or not. It should be apparent pretty quickly whether this is going to be possible for you, since you double your pressure in the first 33 feet. Even just free diving to the bottom of a swimming pool should let you know if you are going to be able to equalize on a dive.
As far as specific medications:
1) Decongestants- OK for SHORT TERM use (less than three days), they come as oral (like Sudafed) and nasal (like Afrin). Sudafed helps with the sinuses and the ears, Afrin just with the sinuses. Not a great long term solution for allergies. As mentioned above, sometimes come combined with other drugs like antihistamines.
2) Antihistamines
a) first generation (Benadryl). causes drowsiness, not used as much for this.
b) second generation (Allegra, Zyrtec, Claritin). Better, but can still cause some drowsiness. Also pretty drying.
3) Singulaire- new allergy medicine, similar to antihistamines, it blocks the cascade of chemicals that cause allergy symptoms
4) Nasal steroids (Flonase, Nasonex, etc..) pretty safe, take a week or so to work, helps keep the sinus drainage pathways open, don't do anything for the ears, may cause local symptoms (like nosebleeds)
5) Nasalcrom- a nasal spray that helps block allergy attacks by stabilizing certain cells involved with the allergic response. Need to be taking it before the attack.
6) Astelin- an antihistamine in nasal spray form
7) Antibiotics- used for sinus infections (foul, runny nose) along with other therapy.
8) Nasal irrigation- this is great... very safe, cheap and effective. I recommend this all the time for people with chronic nasal problems. May not be enough by itself, but a good addition to other therapy-
http://www.neilmed.com/
Happy Diving!
Mike
Another example is Claritin D. Both these medications are a combination of Antihistamine and decongestant. One unplugs ya and the other dry's ya up. I personally prefer the Claritin D over the Allegra D. For me it just seems to work a little better. It's also available over the counter now and its cheap. Ken :42:
) Since I don't encounter these allergens underwater or in my regulated air, they haven't (yet) affected my diving plans. There have been a couple times when I seriously wondered whether I'd be calling off a dive, but equalization hasn't been an issue so dives have proceeded!
