Had a scare today

[RiverRat]

Glad you're ok. I use the 12-hour Sudafed and dive recreational limits on Nitrox with it. I weigh the risks of enhancing O2 tox (exactly how much of a risk am I taking?) against the risk of blowing my ears or possible trapped air (sinus) injury. I only use the stuff because I'm stuffy quite often from allergies. I stay at 1.4 ata but if I were doing any technical dives I would have to look that much more closer at the risks of Sudafed type drugs. I would like to know if there is any data out there stating that a 12-hour time release Sudafed is that much more safer than the conventional 4 hour tablets. The idea with the time release is that you get a steady, even dose over time and it should not wear off on a dive. I also wonder if this would help reduce the chance of getting a strong "hit" of the drug and possibly have an issue like fgray1 did. I only use the stuff as I'm stuffy quite often from allergies. I should also mention that I use Nasonex (like Flonase I believe) prescription nasal spray. It really "opens" me up and is topical only. It does not affect the system like the ingested drugs do. I may decide to use this over Sudafed but it may not work on the Eustacian tubes. Then again if I have more than usual allergy symptoms I should not be diving anyway right?
I'm not a doctor so don't believe anything I say. You may want to investigate prescription options with your doctor and as well call Dan for additional info.

 

[ReefGuy]

Glad you're ok, Fred.

 

[H2Andy]

Personally, If I don't feel good I thumb the dive before I ever leave the house. I would never taken meds before a dive, not even 24 hoyurs prior to a dive.

not to beat a moribund horse, but isn't this the real issue here?

i know that lots of divers self-medicate before a dive,
but should we be doing this?

 

[dtdiver]

i too am 49
most mornings i feel like crap until up and about for awhile
for my chronic congestion (nasal) i use a nasal spray (flonase), and occasionally (god forbid) a pseudophed.
if i bagged a dive for feeling bad i'd never dive.
but up to this point i've never had flashing lights in my vision.

part of the point is to share experiences, get other viewpoints, and maybe see if anyone else has had or has heard of anyone who has had this experience.
i've heard of ox tox causing this.
some woman survived a near seizure due to wrong mix with a rb (bad O2 sensor), she had the same symptoms.
has anyone heard of these symptoms without oxtox?

dt

 

[Pugsly55]

You didn't mention what type of gas you were breathing but from the type of diving you were doing, cave diving, I would guess it was some sort of oxygen enriched mix. I was of the belief that Sudafed wasn't to be taken when breathing oxygen enriched gas mixes as could predispose you to oxygen toxicity. Some of the symptoms you discribed sound as though that may be a possibility.

I found this info in the net...

Muscle twitching and spasm
nausea and vomiting
dizziness
vision (tunnel vision) and hearing difficulties (tinnitus)
twitching of facial muscles
irritability, confusion and a sense of impending doom
trouble breathing, anxiety
unusual fatigue
incoordination
convulsion.

Factors increasing risk of O2 toxicity

Increasing exposure time
Increasing depth
Increasing the percentage of inspired O2 (As in nitrox mixtures)
The simple act of immersion setting off the diving reflex
Exercise increasing the metabolic rate
Increased CO2 in the tissues (May be due to cerebral vasodilation)
Cold stress (Shivering is a form of exercise)Systemic diseases that increase the metabolic rate (such as thyroid diseases)
Sympathomimetic drugs (Drugs that mimic adrenalin in effect).

Sudafed is a medication often used by divers due to it's decongestive effect. It has few side effects but is a sympathomimetic drug (pseudephedrine). Whether or not it should be used in nitrox or rebreather diving is discussed by Dr. E.D. Thalmann in DAN's publication at http://www.diversalertnetwork.org/medical/articles/article.asp?articleid=51

"In 1962, none other than DAN's Chief Executive Officer, Dr. Peter Bennett, while working as a research physiologist at the Royal Navy Physiological Laboratory in England, published a paper (Life Sciences; 12:721-727, 1962) testing the hypothesis that oxygen toxicity and nitrogen narcosis were caused by similar mechanisms.

He found that in rats, sympathomimetics seemed to enhance oxygen toxicity. Pseudoephedrine was not tested specifically, but it is a sympathomimetic, so we might infer that it has a similar effect. In addition, our current understanding of the mechanisms which produce oxygen convulsions would predict that sympathomimetic drugs might enhance susceptibility to oxygen convulsions. It has been shown that drugs which inhibit sympathetic stimulation seem to reduce the likelihood of oxygen convulsions in animals. No human studies have ever been done. Thus, at least a theoretical reason exists why pseudoephedrine should be avoided while diving on high PO2 dives."

Just a thought.

Stimulants like sudafed (and caffeine) lower your seizure threshold. Meaning, it is much easier to have/induce a seizure in someone taking them. When they perform electroconvulsive therapy on psychiatric patients they first inject them with caffeine (among other drugs for different desired effects) to lower the seizure threshold because then it is much easier to induce the seizure with an electric current. It would be easier for a person hyped up on lots of caffeine/sudafed to have a seizure from oxygen toxicity then if they had not had these types of drugs in their system.

 

[Rocksolid]

Good To Hear That You Are Ok Fred, and That Everything Worked Out Okay. Happy Easter and Happy Diving
Your Ottawa Friend
Darryl

 

[crispos]

Thanks for this post. I dove with a mild headcold yesterday, 111 feet in 35F water. Except for lots of liquids, I didn't treat it. Now I will make sure I don't dive with drugs.
Never know what drug interaction will be caused with pressure, cold, exercise, etc.

All the best.

 

[Rick Murchison]

When taken at normal (recommended) doses, for healthy people, sudafed is no more dangerous than a big cup of coffee.

Just to be perfectly clear, a lack of sensitivity to caffeine is not a reliable indicator that one will not be hypersensitive to Sudafed or Teldrin (Contac, Dimetap, Naldecon etc) or Afrin or Neosynephrine or any other decongestant.
In my specific case, I can drink coffee all day long (after all I'm Navy trained) with no ill effect. A single Sudafed or Teldrin will torch off irregular heartbeats for several days. Oxymetazoline (Afrin & the like) has no such affect.
My point is that for many folks, drug reactions are pretty specific, much like allergies, and sensitivity to one may or may not indicate sensitivity to another.
Be careful with *any* drug.
Rick

 

[mbuff]

My favorite way to deal with congestion from allergies or a cold is saline nasal spray. Even better is using a Neti pot... which helps you basically pour mild saline into your sinus cavity. What comes out would astound you. But you will never feel so clear in your life.

 

[GDI]

I am glad to see the concern here for another diver. Having dived with Fred many times I can tell you he does not allow himself to become a risk under normal circumstances. Fred will call the dive in a heart beat if he has reasons to. We all accept that about him and without questions as to why. On this particular day Fred and I sat at the water on the steps before exiting, about 15 minutes as a means to ensure that he was rested and his heart calmed down before we walked back to the truck. We were only about 10 minutes into the dive when he thumbed it. We didn't even pull the reel. A lesson here is respect your buddy's right to end the dive for what ever reason and to try to avoid doing things that would other wise be out of the norm.