Eyebrow pain while descending

[Christozs]

I was diving last Thursday in Denmark in max 4m water as an after work relaxation activity with a new dive club.

We were playing around the underwater "witch park" for about 35 minutes until we surfaced as the visibility made us miss some landmarks and we wanted to be sure we are on the right spot to start heading to the shore. When we saw we were at the right spot to turn and head to the shore we signaled "down" and we went back to 3-5 meters. And that's when it happened...

I felt a stabbing feeling on my right eyebrow, i was equalizing constantly (both ears and mask) and the pain was just there. I immediately signaled something is wrong, my buddy and i surfaced and swam outside as i was in pain. It was annoying me for hours, i had to get a painkiller to be able to relax and sleep. The next day i had a small annoyance there but since then i am fine. Maybe a bit of a light headache since then but that could be from fatigue too.

Reading about it i could see it may be a sinus barotrauma (the pain was exaclty on the purple circle on the right picture) and one of the articles was saying i should be careful with flying. I am flying tomorrow (Exactly a week after it happened). I visited a doctor and he told me that since i have no running nose or fever or any other symptoms i am good to fly, but knowing Danish doctors being a bit too loose about things i thought it would be a good idea to get the opinion of the more experienced ones in here

 

[fmerkel]

Yes, sinus barotrauma. Been dealing with it for 25 years.
You can't really 'clear' the sinuses, like you can your ears. The Eustachian canal is not always open, kind of 'floppy' and the clearing procedure opens it up so pressures can equalize.
Sinuses are a cavity with a small (mostly) permanent opening. They are trapped in the rigid skull. The opening, like the rest of the nose, is lined with a membrane that is subject to swelling. Things like allergies and colds can definitely make it swell. Excessive pressure changes can also make it swell. Since it can't swell 'out' it swells in. This makes the opening smaller, or closes it off completely. The difficulty then goes from more difficult to impossible.

Flying subjects the sinuses to the same pressure changes but MUCH more slowly. Generally they can clear fine flying, but the ears are a larger space, needing more air exchange, and if the canal is closed it can't clear at all.
It sounds like you didn't do any major damage, just an insult. Chances are it will be OK a week out.

If not inappropriate for you. taking some pseudofed (systemic decongestant) about an hour before take-off should help. Wears off in about 4-6 hours so that that into account. Descending is more of a problem than ascending....usually.
Note-My first scuba trip I had terrible trouble with sinuses. I didn't know WHAT the problem was, I had to miss a few dives, and managed to accomplish a couple more using Afrin (see below). Used Afrin for the flight home. Uncomfortable but made it OK.

For a backup, I recommend you get some Afrin. It's a MUCH stronger localized decongestant. You could use it when you sit down after boarding the plane. It works fast and should last 12 hours. If the flight has multiple segments and last a long time you have to consider that it will wear off and you will be in the same predicament. You can use it a few times in a row, but then it will start to work less well, and things can get worse when it wears off.

Long term, if this is a regular problem see and ENT. Nasal steroids may be of good use.
Descending......slowly.....allowing air to get through the tiny opening helps A LOT! I stop at 10-12 feet for 2-5 minutes before continuing a slow descent. Quick descents are REALLY bad.

 

[Seaweed Doc]

Sounds like classic sinus barotrauma for sure. I can usually clear mine, but during allergy season Flonase (fluticasone propionate) is my best friend. You can get it over the counter in the USA, though this hasn't always been true and you should check with your doctor. In my case, a doc recommended it.

 

[USdiver1]

If you dive long and often enough, you will experience sinus barotrauma. Sorry for your pain, it sucks but is generally not serious. As others have said Afrin nasal decongestant or similar is usually pretty effective in avoiding sinus barotrauma.

 

[JMBL]

Baroma trauma seems likely, but hopefully, it might not be that bad, but a strong congestion due to cold water. You spoke of Denmark, so I assume that water temperature had more to do with a Mojito than with a hot bath.

Each time I dive in water around or below 14°C I've got problems with my sinuses. Rinsing them with saline solution helps a great deal (before and after the dive). It's cheap, available everywhere without a prescription, and easy to carry on a dive boat.

Btw, I'm no doctor, so if I were you I'd pay my GP a visit, to be on the safe side.

 

[TooCold]

When considering decongestants, many popular over-the-counter products contain phenylephrine as the active ingredient, which has been shown to be ineffective. Some examples: Sudafed PE, Mucinex, Dayquil, Tyenol Sinus, Advil Sinus Congestion.

Here's a link to a US study:
FDA study and recommendation.

 

[Christozs]

Thank you everyone,
The flight is just 1 hour long, so i will take my chances since both all of you and my doc said it should be fine.
If i feel any discomfort i will plan to get some Afrin before the flight back on Sunday.

Thank you so much again and safe diving to all of you!

 

[Juliet of the Sea]

When considering decongestants, many popular over-the-counter products contain phenylephrine as the active ingredient, which has been shown to be ineffective. Some examples: Sudafed PE, Mucinex, Dayquil, Tyenol Sinus, Advil Sinus Congestion.

Here's a link to a US study:
FDA study and recommendation.

Absolutely true. Afrin does work well and the generic name is "oxymetolozone." Generally the pain of a sinus squeeze or reverse block is well treated with OTC pain meds like ibuprofen.

 

[John C. Ratliff]

Check also to see whether your mask is over that area, and may be pinching off the sinuous opening. If its strap is too tight, it could be causing the problem. If the skirt goes over that area, try switching to a different mask (the old oval masks are usually sealing above that area).

SeaRat