medication, diving, and DCS

[Thrillhouse]

Hi,

I currently have 11 dives logged and am going for one this afternoon. My friend and I are going alone in a Marine Protected area down to see some wrecks at 40ft (which we know not to penetrate). However, I'm sort of stuffed up and am wondering how this will affect me? We've gotten an awesome deal on our rental and I'd hate to throw it down the drain, as we still have 2 tanks left each. I took half a pill which stops nasal congestion which can make the taker a bit woozy, but honestly I feel fine... We're going diving in about 5 hours; should this be a problem?

Also, is it true that one can get crippling DCS from 40ft? My room mate said she treated someone who was disabled from the condition and that it can occur from any depth, but quite frankly she knows nothing about diving other than that it takes place in the ocean and involves seeing fishes. Any thoughts?

 

[gary-ramey]

Yes you can get bent at 40ft. You have to remember that your pressure doubles at 33ft. My feeling is that gettting bent is not your biggest concern. If you take some nasal decongestants and are able to clear on your way down, you might experience problems on the way back up. A reverse block is awful. Its basically the air in your sinus's/ear unable to escape as you ascend. I've had one in my ear before and had to do a really slow ascent with multiple stops to keep pain to a minimum. I guess if it were me I'd have to determine how "stuffed up" I am. I always get some stuffed up feeling going into the humidity so I always take a 12 hour sudafed before diving. I can clear without it, but it helps me clear easier with it. I'd also define woozy. If it literally makes you dizzy, cancel the dive and go another day. If you're talking about a slight drowsy, medicine head type feeling then only you can make that call. How comfortable are you with your ability? Can you drive when you feel this way? How many logged dives you have etc. The are other issues about medicines that affect the way you think and react. I've heard of divers having full blown panic attacks while on medicines that they were not normally subject too. One thing that is a certainty about SCUBA is that panic can kill you. The best thing I can suggest to you is to visit a Dr who is also a diver.

Cheers

 

[jefffalcone]

I take claritin d almost always before I dive. As long as you are sure the decongestant you take won't wear off, you will be fine. If a decongest wears off mid-dive, it can lead to a reverse block. Take something with a time release and don't worry about it.
Altough unlikely, you can get DCS at any depth. Do a proper ascent and obey NDLs and the chance of getting DCS at 40 ft is next to nothing.

 

[tracydr]

Read " The Last Dive", the chapter where the author gets severely bent after deciding to dive what he considered an "easy dive" not feeling well on advil and sudafed. Will make you think twice about calling a dive anytime you don't feel right about things, despite the "great deal" on rental equipment. Won't be such a great deal if you drown or end up in a chamber or on a ventilator.

 

[TSandM]

First off, "stuffy" comes in various grades, and how much congestion will affect you when you dive is something you sort of have to learn. If you can't clear your ears on land, you almost certainly won't be able to clear them in the water, so that's a place to start. The agency that certified me teaches against using decongestants and diving, because if they wear off underwater, you could end up in a world of hurt from reverse block. In practice, the long-acting medications like time-release Sudafed and Afrin nasal spray have a very small chance of wearing off during a single dive. Sudafed may predispose to oxygen toxicity, but that's only really an issue if you are diving Nitrox near the MODs.

Nobody medical is going to tell you it's okay to use decongestants and dive because of the liability. It's certainly better to solve your congestion problem another way -- With nasal steroids, or antihistamines, or something that addresses the cause of the congestion, rather than treating the symptom. But in practice, with some common sense and a fair amount of conservativism, a lot of divers use these medications.

On your second point, DCS includes the bends AND arterial gas embolism. It would require a very long dive to 40 feet to set you up for the bends, unless you did an EXTREMELY rapid ascent after a long stay. But AGE is a risk from any depth, if you hold your breath or ascend precipitously.

 

[SharkDiver36]

Medications work differently at depth then they do on the surface.

My suggestion is any doubt at all, don't dive.

I sought after and found a Dr. who is also a diver and is well aware of how pressure can affect med's.

As far as getting bent....

To deep
To long
To fast (ascent)

Break any one of these and you could very well get bent. Oh, and just because you don't viloate any of these, doesn't gaurantee you won't get bent either. You can still follow every dive rule, no computer viloations and still get bent.

 

[Gene_Hobbs]

We have a section on Drug Interactions in our "Suggested Reading List" for the Rubicon Research Repository. There is really not much work available on this topic.

 

[rawls]

DCS includes the bends AND arterial gas embolism

"DCI" includes the bends and AGE. DCS is the bends.
I use sudafed when I am a little stuffy, but as TSandM stated...It's all about the degree. Being an instructor I have to qualify my statement by saying I am not suggesting its use. Just to cover my butt It's each individual's choice to use decongestants or not.

 

[Blackwood]

A reverse block is awful. Its basically the air in your sinus's/ear unable to escape as you ascend. I've had one in my ear before and had to do a really slow ascent with multiple stops to keep pain to a minimum.

At least some good came of it

 

[DandyDon]

Anyone check the NDL for 40 ft? 140 minutes! I think you can get AGE from 3 ft, tho - if you really screw up.

At least some good came of it

A reverse block is never good - but I suspect that a very large percentage of USAmerican divers at least have used pseudophendrine HCl or PSE (the original OTC drug and the origin of the name Sudafed) to dive. I do for every Air dive, and the night before for planned Nitrox dives.

It is probly good to take the extended formula, and always good to try taking the med when you are not going to dive, drive, or anything else that could be hazardous as a test in advance of using it in the water.

Claritin D includes both loratadine, the OTC antihistamine orginally known as Claritin, plus PSE.

So many brand names have been expaned to include various drugs and combinations, it's really important to know exactly which ones are in yours. Some "Sudafed" products now do not contain any PSE, so they can be sold from the shelf rather than from behind the counter. I don't think they are as effective.