Nasal decongestant sprays & diving..

[SC Short Stick]

not sound too much like a new guy, but ive been reading the Navy Diving Manual and Chapter 3 is of interest in regard to the Eustacian tube and being able to clear your ears before a dive in order to prevent ear squeeze.

"Preventing Middle Ear Squeeze. Diving with a partially blocked eustachian tube
increases the likelihood of middle ear squeeze. Divers who cannot clear their ears
on the surface should not dive. Divers who have trouble clearing their ears shall be
examined by medical personnel before diving."

If taking something to clear/minimize mucous in your Eustacian Tube, will a product like the Afrin nasal spray be best to "dry you up"?

thanks,
Ben

 

[SubMariner]

on the subject, what about something like benadryl, its used to fight allergies, but it also dries you up. I'm a freediver and am not breathing the dry compressed air, will this be a better option than sudafed?

-Ben

Ben,

I'm not a pharmacist or a health care professional (nor did I stay at a Holiday Inn last night), but as previously stated in this thread, there is a difference between a decongestant like sudafed and an antihistamine like benedryl: the first one clears up congestion, the second one dries you up. So it all depends on what you are looking to do.

From my own experience, most divers are looking for something to clear up congestion (and ease or allow them to clear their air spaces). Thus the decongestant is used most often.

Please refer back to the rest of this thread regarding Afrin.

Better yet, consult a physician knowledgeable in hyperbaric/diving medicine.

Bonne chance,

 

[SC Short Stick]

I dont know if i stated it in this thread...im a new to spearfishing via the freedive. I learned about barotrauma and how the ears work from the USN Dive Manual (chpt 3). My theory in taking the benadryl is to keep my Eustacian Tube clear to allow maximum effect of Valsalve maneuver or anyother form of ear-clearing to prevent middle-ear damage. Im currently not experiencing any congestion or excess mucous. I just wanted to know whether it would actually prove benficial or not? I guess im going to do a little experiment tomorrow and just take some an hour or so before i hit the water. Unfortunately, we all know that benedryl makes you drowsy. Ive got a 1 mile paddle on a surf board to get to my spot to wake me up though. Last time i went out i got seasick really bad. At about 15-20 feet down, i would bob 2-3 ft when swells were overhead...couple that with Mc Donalds for breakfast and operation fishfood was well underway!

Ill let you know sat afternoon if it helped (benadryl) or not.

thanks
ben

 

[gert7to3]

IMHO:
Benedryl (diphenhydramine) Ref: Benadryl Information from Drugs.com
It's an antihistamine. I take it on a trip and keep it around the house for emergency use. It can be very helpful if you have an allergic reaction (bee sting, hay fever attack, etc.). I would not take it on a regular basis for equalization problems.

Afrin (oxymetazoline nasal) Ref: oxymetazoline nasal medical facts from Drugs.com
It is a decongestant. I take it along on a trip, because it could help relieve my sinuses. Especially if I came up with blockage or that water in the ears feeling. I would not use it regularly because it drys out sinus tissue and can quickly lead to rebound effects. It is a 12 hour medication. If you start taking a toot before each dive, on a multi dive day, you are overdosing yourself.

Sudafed (Pseudoephedrine) Ref: Sudafed Facts and Comparisons at Drugs.com
It is a decongestant. I have used it in the 4-6 hour tablet/capsule form. It doesn't seem to push you into rebound situations the way nasal sprays can. I use the 4-6 hour version to reduce dosage overall on multi dive days. It can still dry you out too much. IMHO, You should avoid taking 12 hour dosages multiple times within the recommended dosage period.

Sudafed (diphenhydramine) is related to amphetamine, which is commonly called "speed". This is why it has restrictions on quantities, so illegal drug producers can't use it for raw material.

What do I take? I use saline nasal irrigation. I think the big problem with all of the decongestants is that they dry you out, too much. Add extremely dry tank air and things shut down. Irrigation cleanses the sinuses and hydrates them.

I am not a physician and this is not medical advice coming from me.

 

[JCR]

When diving, how often do you do the saline irrigation? Just as needed or on some schedule as a preventative?
Thanks
JR

 

[gert7to3]

On diving days I use a Neill Med bottle in the morning when I get up, then a few toots of saline nasal spray before each dive. It's the drying effect of decongestants and dry tank air which your bother me most.

Also, I will use Claritin (loratadine) for general antihistamine purposes. It works more slowly than Benedryl, but has fewer side effects.

Finally, I will take my reg out of my mouth and work up a little saliva during a dive. This helps my mouth and it's good emergency exercise if my reg gets displaced. I'll also breath my octo to make sure it works well.

Again, I'm not a doctor, but this could give you starting points for a consultation.

 

[SubMariner]

Wow... this old thread has really come back to life!

Just a bit of background on my own experiences with this type of discussion:

Back in '92 or '93 I was on mini-dive vacation with some friends in the Ft. Lauderdale area. I don't exactly remember when it happened, but during one phase of the dive my ears refused to clear, resulting in barotraumas to both ears, the left worse than the right. I saw a regular physician, who cleared me to fly back home to Canada. The only meds he prescribed was pain killers.

Upon my return I saw my diving/hyperbaric physician, who was aghast that I had been allowed to fly when it was obvious (to him) that it could have caused serious injury to my ears. He put me on decongestants for about a week and forbade me to dive for at least three months, after which he had be come back for re-exams. If memory serves, I think I was back diving within 6 months.

During the course of my treatment this dive physician told me that most barotraumas occur because people are not getting their ears ready to dive. He advised clearing your ears well before you hit the water: while putting together your gear, suiting up, at the surface. And of course clearing them well before you felt discomfort as you descended. Additionally, he advised against using any nasal decongestant sprays not only for rebound effect if over-used, but also because they tended to wear off quickly at depth, leaving you open to reverse blocks.

He further advised that I should not use a decongestant prophylactically because he felt that they also tended to wear off quickly u/w. (Mind you, this was before the 12 hour dosages were available.) He felt that if you stretched out your Eustachian tubes sufficiently prior to the dive, you shouldn't need to to anything else. I guess his opinion was that if you have to keep using decongestants to dive, then you'd better be looked at by a dive physician or at least an ENT.

Now, I'd be lying if I didn't admit that I have used sudafed (et al) since then. But the instances have been few & far between. And they've always been the 12+ hour versions. And only if I didn't have a cold or similar upper respiratory problem that I may have felt truly precluded me from diving. However, I want to stress that this has been my own experience. I am NOT giving anyone advice or advocating that they use or don't use anything. I am simply telling people what happened to me.

Thus endeth the lesson,

 

[gert7to3]

The reason I settled upon a 4-6 hour Sudafed tab instead of the 12 hour version is that the med usually had a strong initial effect, say within a half hour; then a plateau; then trailing off. The trailing off period seemed to occur at about the same rate between the two products. It simply lasted longer with the 12 hour version. This is all subjective, not a medical recommendation, and I currently use saline irrigation rather than meds. I will have meds along to use if there is problem after a dive.

 

[pharmguy]

Wow... this old thread has really come back to life!

During the course of my treatment this dive physician told me that most barotraumas occur because people are not getting their ears ready to dive. He advised clearing your ears well before you hit the water: while putting together your gear, suiting up, at the surface. And of course clearing them well before you felt discomfort as you descended. Additionally, he advised against using any nasal decongestant sprays not only for rebound effect if over-used, but also because they tended to wear off quickly at depth, leaving you open to reverse blocks.

He further advised that I should not use a decongestant prophylactically because he felt that they also tended to wear off quickly u/w. (Mind you, this was before the 12 hour dosages were available.) He felt that if you stretched out your Eustachian tubes sufficiently prior to the dive, you shouldn't need to to anything else. I guess his opinion was that if you have to keep using decongestants to dive, then you'd better be looked at by a dive physician or at least an ENT.

Now, I'd be lying if I didn't admit that I have used sudafed (et al) since then. But the instances have been few & far between. And they've always been the 12+ hour versions. And only if I didn't have a cold or similar upper respiratory problem that I may have felt truly precluded me from diving. However, I want to stress that this has been my own experience. I am NOT giving anyone advice or advocating that they use or don't use anything. I am simply telling people what happened to me.

Thus endeth the lesson,

Nasal spray decongestants really only work locally in the nasal passages. The eustacian tubes are located such that as the spray goes down your throat it is vitually impossible for the spray to go up the tubes to clear them.

I am a big fan of the Sudafed 12 hour formulations. Much better kinetics and it minimizes the chance of wearing off during a set of dives. Can't guarantee the entire 12 hours but 8 hours is very likely for most people. I agree that if you need Sudafed before every dive then you need better therapy and should see an ENT.

Jason
Lic Drug Dealer