having ear probs days after diving

[ScubaSteph]

Hello all -
I went diving over the weekend (all shallow 20 feet or less) and had some trouble on the last dive clearing my ears (wondering if the sudafed wore off during the dive). I couldn't clear my right ear so I just hovered at about 15 feet and then gave up and surfaced. My ears continued to feel "funny" after I surfaced, but they usually do. Now by "funny" I don't mean painful...just like there is a bubble in them...a slight bit of pressure I guess. I'm also feeling a slight bit of pressure behind my eyes. Well anyway, today is Friday which is 5 days after that and they've felt ok then "funny" on and off since Sunday. I should mention that I was getting over a sinus infection (had been on meds for a week) and did take sudafed (may have OD'ed a little on that). Am I suffering from some kind of a sinus squeeze or something...and what can I do? It's not painful...just irritating cause I don't feel quite right and am afraid to try to dive this weekend.
Thanks in advance!

 

[Boogie711]

Steph - I'll warn you now you may take some heat for taking Sudafed before diving. You should NEVER do that.

It can wear off at depth, and your sinuses clog up. Now you have PRESSURIZED air inside your head, and no way to clear it, and it's time to ascend.

See the problem here? In short, your head could explode, and brain matter is hard to clean off the inside of a mask if someone wants to steal your gear. OK - just kidding about that, but....

Never never never take a decongestant before diving.

 

[ScubaSteph]

WHAT?!?!?! That is what my open water instructor suggested I do when I told him about my chronic allergy problems. He said he always pops Sudafed before & during diving to keep the passages clear. What should I do then?

 

[DocVikingo]

While appreciate the nature of your caution regarding Sudafed, I think that your reply suggests some misunderstandings.

The following is a response to this question provided several months ago by BillP, a dive medicine savvy physician who frequently contributes to this forum. I believe that it sums up the issues with elegance:

"Sudafed and diving

Howdy Amber:

No, it's not necessarily a bad thing.

If a diver is concerned about their Sudafed (pseudoephedrine) "wearing off" during a dive, then they absolutely should not dive. I don't mean they shouldn't dive on Sudafed, or they shouldn't dive with congestion- I mean they should not dive at all ever because they're simply too stupid to dive. A diver who can't figure out how to time their Sudafed for a dive is also too dense to figure out how to keep from running out of air during a dive or even avoid running out of gas in the boat on the way to the dive site.

OK, I'm kidding- sorta. Your pharmacist is right, djhall. A 12 hour (or 24 hour) Sudafed "taken an hour or so before the dive" will not "wear off" during the dive*. IMO, the whole "wearing off" argument is a straw man that has no validity (except in cases of gross stupiditiy), but is easy to knock down to make a point. Now what is a valid concern is that the Sudafed will be inadequate for the dive to begin with. Just as you'd be dumb to plan a 350' dive on air with an aluminum 80 or to try to take your 18' runabout from Miami to the Bahamas using ¼ tank of gas, it would not be wise to rely on Sudafed to clear congestion when you're too congested to dive in the first place. The Sudafed might not be adequate to clear the congestion, even though it's working as designed, and you could suffer a squeeze or reverse block and barotrauma injury. I have no problem with using Sudafed to assist with clearing when you could dive without it, but taking it to enable diving does have risk.

About oxygen toxicity and Sudafed, there is a theoretical concern. Pseudoephedrine is a central nervous system (CNS) stimulant. High partial pressure of oxygen is also a CNS stimulant. Theoretically combining the two might increase the risk of CNS oxygen toxicity. (However, caffeine is also a CNS stimulant and has the same theortetical concerns as pseudoephedrine, but the only laboratory evidence indicates that it significantly reduces the risk of CNS oxygen toxicity.) IF you're approaching the oxygen exposure limits for recreational diving on an enriched air dive, then you should be aware of this theoretical concern. But if you're making a 40' dive on air, fuggetaboutit. Sudafed should create no significant increased risk of oxygen toxicity in that situation. On pseudoephedrine and diving DAN says:

"In normal, healthy divers breathing air, occasional use of pseudoephedrine at the recommended dose is probably safe. This presumes that the drug has been taken during periods when no diving has occurred and that no undesirable reactions have occurred. However, one should avoid chronic (daily) use when diving, and it seems reasonable to avoid the drug entirely if diving while using oxygen-nitrogen mixes where the PO2 during a dive might exceed 1.4 ata, the current recommended "safe" open-circuit scuba limit."

IMHO, DAN is a very careful and conservative organization.

HTH,

Bill

*Keep in mind that pseudoephedrine doesn't work instantly so it won't help much if you take one right before entering the water. Also, a "12 hour" pseudoepherine doesn't have it's "full effect" for the full 12 hours. When I take Sudafed to help with clearing I time it so my dives will be well within that 12 hour period.

The above information is intended for discussion purposes only and is not meant as specific medical advice for any individual."

Best regards.

DocVikingo

 

[Boogie711]

I digress, and apologize for undue alarm. Thank you Doc.

To summarize - if you need Sudafed in order to dive, don't dive?

 

[ScubaSteph]

ok...thanks for the replies but nobody has told me what they think is wrong with my ears or what I can do about it. I have an appt. this afternoon with my new PCP (I don't think he does the dive medicine thing) to look in my ears. I'm feeling a bit alarmed - like I might have done something serious to my ears. HELP!

BTW - I'll throw out the Sudafed