My first dive, some serious sinus pains!

[TinoD'Voe]

Hi everyone, I'm as new as it can get to this sport. Today I went out with our open water class for our first ocean dive. It was great until I tried to make an ascent from our 40ft depth to the surface. It was the most excruciating experience ever!

The space behind my left nostril felt like it was going to burst and when I finally got to the top I kept blowing my nose to try to clear it. Some serious disgusting stuff came out, including some bloody gunk, but my nose did not continue to bleed after that.

The sinus space continued to feel sore for the rest of the day. At the same time, a few of my molar teeth underneath the sinus were feeling extremely sore and I thought it was some sort of reverse block under my fillings or maybe just some nerves rattled by the exploding sinus space.

It's been several hours now and my sinus feels ok but my teeth hurt a little. Tommorrow is our second day and we're supposed to go to 60ft.

I know we're not supposed to take any decongestant before diving, but i'm wondering what may be the problem and how i can deal with this tomorrow?

During the classes in the pool, there were never any problems. So i had no way of anticipating this incident.

Now here's something strange, I've always had some trouble breathing out of both nostrils at the same time. One has always seemed a little stuffed up while the other is clear. It even gets weirder, they switch back and forth throughout the day! I will feel one sinus clear while the other gets stuffed up and it goes back and forth like that. I have not even paid attention to this for many years, todays incident made me aware of it again and unfortunately, its too late to go to the doctor to get it looked at by tomorrow.

I'm not sure if anyone knows what this could be but any advice will be appreciated. More than anything else i really want to enjoy my dives tomorrow and not feel like my head's going to explode at the end of the day.

Thanks!

 

[Diver0001]

Hi everyone, I'm as new as it can get to this sport. Today I went out with our open water class for our first ocean dive. It was great until I tried to make an ascent from our 40ft depth to the surface. It was the most excruciating experience ever!

The space behind my left nostril felt like it was going to explode and when I finally got to the top I kept blowing my nose to try to clear it. Some serious disgusting stuff came out, including some bloody gunk, but my nose did not continue to bleed after that.

The sinus space continued to feel sore for the rest of the day. At the same time, a few of my molar teeth underneath the sinus were feeling extremely sore and I thought it was some sort of reverse block under my fillings or maybe just some nerves rattled by the exploding sinus space.

It's been several hours now and my sinus feels ok but my teeth are a little sore. Tommorrow is our second day and we're supposed to go to 60ft.

I know we're not supposed to take any decongestant before diving, but i'm wondering what may be the problem and how i can deal with this tomorrow?

During the classes in the pool, there were never any problems. So i had no way of anticipating this incident.

Now here's something strange, I've always had some trouble breathing out of both nostrils at the same time. One has always seemed a little stuffed up while the other is clear. It even gets weirder, they switch back and forth throughout the day! I will feel one sinus clear while the other gets stuffed up and it goes back and forth like that. I have not even paid attention to this for many years, todays incident made me aware of it again and unfortunately, its too late to go to the doctor to get it looked at by tomorrow.

I'm not sure if anyone knows what this could be but any advice will be appreciated. More than anything else i really want to enjoy my dives tomorrow and not feel like my head's going to explode at the end of the day.

Thanks!

First of all, welcome to Scubaboard. You certainly know how to make an entrance.

You have experienced what is called a "reverse block". Your sinuses were able to clear on the way down, meaning that the extra air you needed to keep it balanced got *in* ok but on the ascent the air became trapped and expanded. Your feeling that your sinuses were about to explode is closer to the truth than you might think!

Basically your sinus cavities are supposed to clear all by themselves. There are circumstances when they will not, such as when you have a cold. It doesn't sound like you have a cold so in your case there must be another reason.

In terms of advice I'll say 3 things:

1) I believe you should see an ENT (ear/nose/throat) specialist about this incident and see what they can discover.

2) you need to tell your instructor about it and see if you can put off your next checkout dive until after you have consulted the doctor.

3) Whatever you do, do *NOT* use decongestants when diving. This is asking for trouble. They'll wear off under water and it will happen again and clearly you don't want that.

R..

 

[jbd]

First of all, welcome to Scubaboard. You certainly know how to make an entrance.

You have experienced what is called a "reverse block". Your sinuses were able to clear on the way down, meaning that the extra air you needed to keep it balanced got *in* ok but on the ascent the air became trapped and expanded. Your feeling that your sinuses were about to explode is closer to the truth than you might think!

Basically your sinus cavities are supposed to clear all by themselves. There are circumstances when they will not, such as when you have a cold. It doesn't sound like you have a cold so in your case there must be another reason.

In terms of advice I'll say 3 things:

1) I believe you should see an ENT (ear/nose/throat) specialist about this incident and see what they can discover.

2) you need to tell your instructor about it and see if you can put off your next checkout dive until after you have consulted the doctor.

3) Whatever you do, do *NOT* use decongestants when diving. This is asking for trouble. They'll wear off under water and it will happen again and clearly you don't want that.

R..

I agree with Diver0001 and hope you take his # 2 suggestion seriously.


As to the breathing switching from nostril to nostril over the course of a day I have seen something in the past about this actually being the normal course of events.

If for some reason you do decide to dive today, make sure your ascents are very,very very slow If you notice any sensation of increasing pressure stop the ascent wait a bit and then try to ascend even slower. You really should follow the advice in given by Diver0001.

 

[DocVikingo]

The Dr Decompression forum is described as being for "...questions concerning the scientific aspects of decompression. This forum is to provide information of a scientific nature." Dr. Deco is a Ph.D. research scientist, not a physician.

As your inquiry is of a medical nature, I have taken the liberty of moving it to the Diving Medicine forum where it should get a wider response.

Best regards.

DocVikingo

 

[TinoD'Voe]

Thanks for the suggestions. I took your advice and did not dive today, I'll be joining the next group in two weeks. I also spoke to a doctor who suggested I take some decongestant for a few days to keep the sinus open to help the healing, and to not dive for at least 2 weeks.

 

[fmerkel]

I'll take minor exception to Diver0001 that said your sinuses cleared on the way down but did a reverse block on the way up. Probably they did not clear well and were traumatized on the way down, the opening swelled, and fluid (blood, serum, snot) filled the space along with the compressed air. On the way up the air expands and now the thick fluid mess and air cannot get out the swollen opening and it hurts pretty badly. Nerves to the teeth run right by various sinuses so they were also traumatized. Thus the sore teeth. If you pay close attention (task loaded new divers generally cannot) on the way down you can feel this happening.

Having injured the sinuses you were correct to be instructed to take time off. They need to heal. The recommendation to NOT use decongestants is well meant and commonly stated. Medications are tools and need to be used appropriately and with knowledge. If used wrongly you can hurt yourself. But...

In general sinuses cannot be "cleared" like the ears. They have to be open to work. Yours were not. You may need medication to open them (The Dr. prescribed decongestants, right?). This is a common problem, especially with allergy sufferers. For long term control you may need prescription nasal steroids. For single day dives you can use 12 hour Afrin. It only works in the nose and has little other side effects. When Afrin wears off you will be temporarily worse than you were before. Afrin is NOT good stuff to use for several days in a row because of a condtion called "rebound" that occurs.
Psuedofed, if necessary can be added to this. BUT, since it is a pill it has more side effects and issues to deal with. Some people have increased anxiety. It does increase blood pressure for those with the problem. You may (and I may) hear about danger of increased O2 toxicity but for recreation diving this is of trivial concern. I suggest you look up both of these medications and get familiar with them.

Take a look at the Medicine section of the DAN Network: Ears, Nose, & Throat
http://www.diversalertnetwork.org/medical/articles/index.asp

For the record: I've had reverse block, use nasal steroids for diving, and when the sinuses are cranky will add Afrin and 30mg of pseudofed about an hour before the dive.
I have seen an ENT about this and have studied the problem extensively for several years.

Fritz Merkel
Respiratory Care Practitioner
Asthma Care Instructor

 

[TinoD'Voe]

I took a good look at the DAN website and there's lots of nice info there about sinus and equalization. With regards to steps I can take right now to make sure my sinus is in good condition for my next dive, what actions do you recommend I take right now? The doctor did mention steroid sprays that can be used if there's no improvement, but i'm not sure if i can detect any problems to begin with, its' only when i'm diving that i felt it.

Right now, everything feels normal. The sinus is not hurting and it's clear. I am taking sudafed for the next couple days to try to keep the sinus clear and make sure it all heals. Is there any way to test if I may have problems before i'm diving? Should I try the spray before I go in the water?

 

[ShakaZulu]

I'm using Nasonex, it's a steriod spray and works great.....dive safe.

 

[Mahhz]

You may find some useful info from this thread that I made about a combination sinus/ear problem that I had.

http://www.scubaboard.com/t73402-how-long-for-ruptured-eardrum-to-heal.html

 

[orangeBloke]

Hopefully your sinuses will clear up on their own but if, in the worst case, your sinuses are not unblocking and need some repair work don't panic. I had mine operated on in April this year for chroic sinusitis and have had one of my best years diving since. The operation is short and relativley painless and you'll be amazed how much better you breath - I seemed to get so much more air that I was nearly worried that small children would be pulled across the room when I inhaled

Above all don't push it. If it hurts abandon the dive and talk to the medial experts. Let them get you right before trying again. There'll be plenty of other days to dive