Equalization problems, can they be surgically corrected?

[uncfnp]

Dr Lizzi prescribed it (nasonex) and gave it to him. He hated it, taste issue. I will have to nag a bit more. If it could only be given for a few days in advance he could be compliant, but since it needs to be given on routine dosing to be effective...

Make sure it is Nasonex not Flonase. Flonase has a strong odor and taste. And if he decides to try again make sure he is using it correctly (see attached)

It never helped me but others find it beneficial.

Another nasal steroid option is Qnasl but it is prescription. The advantage here is it is an aerosol and some tolerate that better than spray. And Flonase has a new OTC mist option.

Last info about nasal steroid sprays, the usual dose for both Nasonex and Flonase is two sprays once a day but one spray twice a day works better for some.

 

[Duke Dive Medicine]

It might help him depending on his anatomy. Here's a picture; note the position of the opening of the Eustachian tube.

Best regards,
DDM

 

[fmerkel]

I've been dealing with sinus congestion and nasal issues my whole life and they really showed up when I started diving; bloody nose and reverse block, and sinus headaches.
I first started on nasal steroids > huge difference. That carried me ~8 years.
Then I started having problems again. A treatment with high dose steroids for a week+ along with antibiotics bought me about 3 more years.
Finally it got too bad and I had nasal surgery > big improvement. That lasted another 7 years before I needed (requested actually) the surgery again.
I could always clear my ears, but the upper respiratory tract is a connected system where parts definitely affect one another.

Recommendation:
Nasal rinses daily. Just do it. Makes a huge difference, especially if you have allergies.
Nasal steroids. Just do it. If it's horrible to him, do it for ~ a week before diving.
Pseudofed about an hour before diving.
Afrin can be used for a couple days but not suitable for dive vacation lasting longer than 2-3 days. You get 'rebound' and get worse.
Papaya Enzyme - suck pills on the way to the dive. No side effects, some varieties taste pretty good. Acts as a mild local anti-inflammatory.
Step up option - Get some [Sinus Blaster]. This is a hot pepper nasal spray that acts as an anti-inflammatory. Yeah, it burns, but it's temporary, has no other nasty drug side effects, and works pretty well. I use it all the time since I discovered it.

Long term.
Get allergy tested if appropriate. Treat as necessary.If allegra works he probably has allergies.
Strongly consider nasal surgery. Clearing up the sinus issues may improve the ear issues-not a guarantee, but a reasonable possibility.

Thoughts:
Deviated septums are pretty common. Only a problem if it's serious enough.
Chronic congestion is not uncommon. Surgery can help, but so can appropriate medication/allergy treatments.

Congestion switching sides is normal, with one side always being worse. I have found if i lay propped up on an elbow with the blocked side up, then doing leg raises with the top leg. Something about that position coupled with the exercise will generally get the congestion to switch sides, sometimes fast and easy, sometimes more stubborn.
Simply just laying flat with the blocked side up is not nearly as effective if it works at all.

 

[Dizzi Lizzi]

Not going to be a quick fix but have you been to an allergist? I had the exact same issues as your husband (chronic sinus issues, deviated septum, congestion) and after got tested for allergies, started the immunization shots. No surgery and my life is waaaay better now.

good advice, I never thought of that. Will add that to MD list.

I used to constantly be congested, saw an ENT after having a sinus infection in every month of the year in 2008. A cat scan later and he ID'd many restrictions and what not. I had FESS, septum corrected, tonsils removed, all in one go. I swear by the surgery from a quality of life perspective, for me it made a huge difference in breathing, sleep, mood, etc. As for diving, I noticed no differences, but I wasn't having issues before the surgery either.

That's super encouraging, he really suffers. Feels like a hang over some mornings without the fun the night before.

Does your husband ever suffer heartburn/gastritis/GERD? If answer is yes, does he take meds for that? Surprisingly enough GERD can give you a stuffy nose especially overnight.

only when he overindulges. No donuts after 3pm. Also FYI GERD can make you choke/cough while eating. the esophagus gets all unhinged with some GERD. Says the voice of experience.

Make sure it is Nasonex not Flonase. Flonase has a strong odor and taste. And if he decides to try again make sure he is using it correctly (see attached)

It never helped me but others find it beneficial.

Another nasal steroid option is Qnasl but it is prescription. The advantage here is it is an aerosol and some tolerate that better than spray. And Flonase has a new OTC mist option.

Last info about nasal steroid sprays, the usual dose for both Nasonex and Flonase is two sprays once a day but one spray twice a day works better for some.

Yep he had flonase, I had nasonex. He tried my nasonex... if the real MD suggests it, he will try again. thanks for the info.

 

[Dizzi Lizzi]

thanks, I will show him all this, esp the great pic that DDM posted. We conceded to the sudafed on the trip, decided nope on the afrin...to iffiy on when it will stop working.

 

[Marie13]

I have chronic congestion from allergies (grass, mold, pollen, ragweed, etc.). I wake up every morning congested. I got tested when I was 5 or 6 (and I'm 47). Not bad enough for allergy shots, but I've *always* taken something daily for them. In fact, I had to get signed off to dive by my doc due to taken the daily meds. I take Zyrtek-D (the D is the pseudo ephedrine, the good stuff) daily in the morning. I use the 12 hour tablets, as the 24 hour ones don't seem to do much. If I'm particularly congested from a cold or such, I'll take one in the evening. An hour or so before I dive, I use Flonase. The added Flonase does the trick.

The sinus rinse bottle (at Walgreens next to the neti pot) is much easier to use than the neti pot. Using it daily makes a difference.