Ear drops to help equalize?

[TravelDave]

Almost as long as I've been diving, I've been taking Sudafed (as a crutch) to make sure I equalize ok. Not sure if I need it or not, although I have had occasional challenges (pretty rare).

Just got certified on Nitrox and as a safety measure I want to stop the Sudafed. An instructor suggested using ear drops to help with equalization. Has anybody had any luck with this? If so, what kind of ear drops would be good? Any other suggestions?

Thanks,
Dave

 

[Papa_Bear]

No ear drops will effect your ears equalizing, but Ear Beer can help you dry them so you don't get an infection!

 

[DocVikingo]

Hi TravelDave,

Taking a medication "as a crutch" when one is "not sure if I need it or not" is of questionable wisdom. It might make sense to be sure it is in fact needed before proceeding.

Additionally, saying that one is using "Sudafed" is rather minimally informative as there are about 17 of them ----> SUDAFED®, the #1 nasal decongestant for cold, sinus and allergy relief.

The only ones among these that may be problematic with nitrox are those containing pseudoephedrine, and even then the issues remain largely theoretical. There is no compelling body of scientific evidence that sympathomimetics like pseudoephedrine do in fact increase risks while diving nitrox, e.g., increased risk of sustaining oxygen toxicity ("ox-tox").

In any event, the diver may wish to try one of the Sudafed formulations not containing pseudoephedrine, such as Sudafed PE (SUDAFED®, the #1 nasal decongestant for cold, sinus and allergy relief) that contains phenylephrine and is easier on the central nervous system.

As for ear drops, given a normal and healthy external ear canal there is no reason to anticipate that these would in any way facilitate equalization.

If the diver feels that he absolutely must use something, he could discuss prescription steroid nasal sprays (Steroid Nasal Sprays), like Flonase, with his physician.

Helpful?

Regards,

DocVikingo

This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice to you or any other individual, and should not be construed as such.

 

[DandyDon]

Have you seen a physician about your ears?

Have you seen the 45 minute video linked below?

If you run a on this forum for *ear* with the asterisks, you'll find a large portion of the threads deal with similar issues and have a wealth of info.

 

[TravelDave]

Thanks for the responses. I had been taking "real" Sudafed (with pseudoephedrine) 12 hour formula. Since I pretty much always took it, it's hard to say whether it was actually doing something or whether I would equalize fine without it. I think my plan for Bonaire is to start out with not taking anything and see how things go. It's easy enough to abort a dive if I have problems. If I do have issues, I may try one of the other formulas without pseudoephedrine. I had previously read some of the posts that talk about the theories behind not taking Sudafed with nitrox (and the fact that the link is tenuous at best), but it's probably worth playing it safe. It will also be good to see how clearing goes without Sudafed.

Thanks again!
Dave

 

[OceanObsessed]

TravelDave,
I know alot of people that use Afrin (nasal spray). It really works well for me.
-Chris

 

[DocVikingo]

TravelDave,
I know alot of people that use Afrin (nasal spray). It really works well for me.
-Chris

Hi OceanObsessed,

While Afrin (oxymetazoline) indeed can be effective, no discussion of it is complete without consideration the well-know rebound effects associated with such medications.

Rebound, known in the med biz as rhinitis medicamentosa, results from abnormal swelling and enlargement of the lining of the nasal cavity secondary to the extended use (on the order of 3-5 days, or even less) of Afrin or certain other decongestant nasal sprays (e.g., ephedrine, phenylephrine). This swelling blocks the nasal airway and causes discomfort.

The sufferer is then caught in a vicious cycle-->the spray must used to reduce the rebound congestion-->the congestion is temporarily relieved-->once the effect of the last dose of the spray wears off, the nasal mucosa swell again-->another dose of spray is required to provide relief. Worse, response to the spray decreases and more frequent doses are needed to provide adequate decongestion.

Often this is simply very annoying for 3-4 days after one stops using Afrin, but can be bad business and a difficult cycle to break.

Use such nasal spays only as directed and if you think you've developed rebound decongestion, see an ENT pronto.

Also, be aware there are more effective and safer steroid nasal sprays available by prescription.

Regards,

DocVikingo

 

[OceanObsessed]

Hi OceanObsessed,

While Afrin (oxymetazoline) indeed can be effective, no discussion of it is complete without consideration the well-know rebound effects associated with such medications.

Good point DocVikingo and thanks for the summary on the rebound effects.

I've used Flonase for years and my ENT has prescribed other sprays (I can't remember the names of them) that I have tried too but I have to say that nothing I have tried is even in the same league as Afrin when it comes to clearning up sinus/equalization problems on the spot. I know this will vary from person to person but this stuff works like magic for me.

 

[Hetland]

I've had ear problems, and more recently, what I believe was a sinus barotrauma (blood-tinged mucus in mask after ascent, but no pain). I was taking fexophenodine at the time, but I seem to do much better on sudafed (pseduoephedrine). I was about to switch back, but it seems like I'm understanding that steroidal nose sprays may be where I need to go instead.....

 

[DocVikingo]

I've had ear problems, and more recently, what I believe was a sinus barotrauma (blood-tinged mucus in mask after ascent, but no pain).

Hi Hetland,

It is not uncommon for a diver to occasionally show a small amount of blood-tinged mucus in the mask. As long it is only very occasionally and the amount of blood is not copious, it typically is not a matter concern nor a compelling sole reason to change sinus medications that have proven effective.

Best of luck.

DocVikingo

This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice to you or any other individual, and should not be construed as such.