Girlfriend Injured in Diving Accident

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Location
Thailand
Hello there folks,

Firstly, I appreciate your time in reading this and offering any advice you're able and willing to. Whilst this doesn't technically fall under the type of Diving covered by this forum, it is similar enough for it to fit.

Second, the story:

My girlfriend and I were taking a river-rafting trip in West Thailand (Kanchanaburi, for those familiar). At one point, we stopped and decided to take a dive off a tree by the river-bank. The tree was about 4 m tall. The water was deep with no rocks or debris. I took a view dives and then my girlfriend followed. When she came out of the water, there was a pressure in her ears. It lasted much of the day, which prompted me to have her do some breathing exercises to help clear her ears - mouth and nose closed, breathe out, which brought immediate relief.

Although the pain subsided, it's remained at a very low-level for over six weeks now and has shifted places to her sinus. She describes it as a bubble between her nasal cavity and her brain that she can sometimes feel. When she has a headache, which she frequently has, both prior to her dive injury and after, the pain in the nose is intensified.

At present, she's sick with a flu, plus a bad headache, which has intensified the pain in her nose. It's quite painful, according to her. She lives in a remote part of Thailand, and if she goes to most of the government hospitals, she'll end-up sitting for several hours for the doctor to give her a half-assed exam and throw some paracetamol and anti-biotics her way.

If it's possibly very serious, she can afford to pay to see a private specialist in a private hospital, but it won't be cheap and will probably take a lot of time - about 4 hours just to get to the hospital. If not, from what I've read and gathered, it sounds like perhaps she has an infection in her sinus, and that she should just take: anti-inflammatories, decongestents, and antibiotics, to clear what, to me, sounds like an infection. All three of these, I would add, you can purchase without a prescription in Thailand.

I realize it's a little out-of-place for this forum, but also a little relevant and, I hope, that you could lend your time and advice to help this fellow human.

Thank you for your consideration and time, again,
Bee
 
I am going to move this thread to the dive medicine forum where it will get the attention of our medical staff.
 
Being out of the way as you are, I would agree with your provisional plan for decongestants.
It sounds as though this might have been a brief sinus squeeze. The squeeze may have ruptured a small blood vessel which partially filled the sinus, hence the ongoing discomfort.
Decongestants will help keep the tissue swelling down, so that the opening to the sinus can drain. Typically, a blood clot will liquefy in about 2-3 weeks. And it will then suddenly drain yellow clear "motor oil".
The problem is that blood is an excellent culture medium for bacteria.
If there is increased pain and fever, I would quickly make the trip to a doctor. An infection can progress rapidly, depending upon the bacterium involved.
 
Did she dive or jump? If she jumped, did she hold her nose to keep water from jetting into her nasal passages and beyond?
 
Hello @BeeOnLotus

It sounds as if she suffered from ear barotrauma that may have progressed to a middle ear and sinus infection. If, as @lowflyer implied above, she got water into her middle ears and sinuses, she could be brewing something nasty. The fact that the "flu" has happened in close temporal proximity to this incident is worrisome. I would recommend she get herself in to see a physician who can assess and diagnose her appropriately.

Namaste,
DDM
 
Did she dive or jump? If she jumped, did she hold her nose to keep water from jetting into her nasal passages and beyond?

She jumped, feet first. I told her to hold her nose to keep the water from going in, but I'm not sure that she held it properly. Even when I did it, the impact surprised me and I lost my grip a little bit and some water sprayed in my nose. Looking back, I should have been more clear with her.

Thanks for the advice from the other two posters. Miraculously, her fever has literally vanished over night, along with her headache. The feeling from the pocket in her sinuses remains. Because she's on the birth control pill, which, as she's told me, she shouldn't mix with anti-biotics, we're going to wait 10 days until her cycle finishes, then start a treatment of anti-biotics for 10 days. We will start using the decongestents immediately, though. If a fever kicks up again, though, I'll have her go to a doctor - better safe than sorry.

Thank you again, I really appreciate you sharing your time, experience, and knowledge!

I will update this eventually to let you know how things go.
 
I wish her well, but not getting to a doctor is worrisome to me?
 
Being on BCPs is not a reason to avoid most antibiotics when an antibiotic is indicated. I'm not saying she should be on one now, but I would suggest that she not avoid proper medical attention for fear she may need an antibiotic.
 
She jumped, feet first. I told her to hold her nose to keep the water from going in, but I'm not sure that she held it properly. Even when I did it, the impact surprised me and I lost my grip a little bit and some water sprayed in my nose. Looking back, I should have been more clear with her.

Thanks for the advice from the other two posters. Miraculously, her fever has literally vanished over night, along with her headache. The feeling from the pocket in her sinuses remains. Because she's on the birth control pill, which, as she's told me, she shouldn't mix with anti-biotics, we're going to wait 10 days until her cycle finishes, then start a treatment of anti-biotics for 10 days. We will start using the decongestents immediately, though. If a fever kicks up again, though, I'll have her go to a doctor - better safe than sorry.

Thank you again, I really appreciate you sharing your time, experience, and knowledge!

I will update this eventually to let you know how things go.

BeeOnLotus, the possible interaction is that it may render the birth control pills less effective. If antibiotics are necessary, it's arguably worth a few days of abstinence.

Jokers, try to restrain yourselves ;-)

Best regards,
DDM
 
BeeOnLotus, the possible interaction is that it may render the birth control pills less effective. If antibiotics are necessary, it's arguably worth a few days of abstinence.

Jokers, try to restrain yourselves ;-)

Best regards,
DDM

That's been a potential concern but, except for Rifampin and maybe Griseofulvin, not proven to be of clinical significance.
Abstinence always works, however, if one is concerned.
 
https://www.shearwater.com/products/swift/

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