Sinus Congestion Medicine Before Dive

[scubamickey]

I see people referring to Afrin as a recommended/chosen decongestant for diving. Is there a specific reason for choosing this brand or will others work just as well (Drixoral, Dristan, Otrivin, etc.) ?

Afrin is a nasal spray and acts directly on the swollen membranes. Immediate action. The other stuff you mention are oral medications and take a while to get into the system and take effect.

I stopped taking Sudafed this year and just focused on proper and slow equalization. It worked! No need for anything other than my regular dose of Veramyst which I need regardless of diving.

 

[kkgodiving]

I had used Nasonex nasal spray (once every night) on dive trips and it has not cause any problem during the dive.

If you have prob equalizing, you may may want to consider using Doc ProPlug. I do not have much prob equalizing but had previously damaged both my ear drums from diving which continues to trouble me until recently when I gave ProPlug a try. It slows down the pressure building up in the middle ear and my ears have been great from the last 24 dives. I have also started to rinse my ears with fresh water and use ear drops after every dive to prevent infection.

 

[fisherdvm]

Since DAN is considered the UTMOST authority on diving (sarcasm), and all questions concerning the medical aspect of diving is ALWAYS answered with "Call DAN". You can trust your answer being completed by calling an EMT at DAN, who will read you verbatim what is published below in the link:

Scuba Diving Magazine - Ask DAN

Or these links:

DAN Divers Alert Network : Pseudoephedrine & Enriched-Air Diving?

DAN Divers Alert Network


Or as I've cut and paste here:

Over-the-Counter Medications
April 2004

Q: Should I be concerned about using over-the-counter antihistamines and decongestants when diving?

A: No drug is completely safe. Drugs are chemicals and, by design, alter body functions through their therapeutic action. Moreover, they may have undesirable effects that vary by individual or environment. Most drugs have never been specifically tested in a diving or hyperbaric environment, but by understanding their usual actions and side effects it may be possible to predict what might happen when divers use them. So, research your medications. Learn their active ingredients. Warnings and directions provided by the manufacturer may alert you to the potential for a problem.Antihistamines are most often used to provide symptomatic relief of allergies, colds and motion sickness. They may have side effects including dryness of the mouth, nose and throat, and blurred vision. A side effect of many antihistamines is drowsiness, which could exacerbate nitrogen narcosis and impair a diver's ability to think clearly and react appropriately as needed. If an antihistamine is used by a diver, it should ideally be one of the less sedating type.

Decongestants cause narrowing of the blood vessels, which can relieve congestion by reducing swelling of the nasal mucosa. Decongestants may cause mild CNS stimulation and may have side effects such as nervousness, excitability, restlessness, dizziness, weakness, and a forceful or rapid heartbeat. These drugs can cause blood pressure to increase, particularly in people with hypertension. Medications known to stimulate the CNS may have a significant or undesirable effect on a diver. Package precautions or warnings may advise against use by individuals suffering from diabetes, asthma or cardiovascular disease.

 

[fisherdvm]

Now, if I had made one comment about my personal belief about this matter, no matter how conservative I am (very conservative), I would get chewed up royally by a master diveinstructor who lurks this board. Yet it is OK for everyone else to post any thing about everything here.... she had to pick on me.

But it is absolutely OK for so called "scuba" docs to publish articles advocating the use of decongestant much more liberal than I would ever dare. Read the December 2006 article of Scuba Diving Magazine. I was very critical of their doctor's comment of popping a sudafed before a dive.

One thing I do have to admit, about one in every 15 dives, I'll pop a claritin (loratidine) at least one hour before the dive. Sure hope that master dive instructor isn't reading..... Claritin lasts at least 12 hours.... Works great for some individual with seasonal allergy.

The emphasis here is on Claritin, not Claritin-D, which has a decongestant added.

I used to use Afrin spray, as it was advocated by some "scuba docs", but further reading into its effectiveness (so so to non at all), and the side effect (throat irritation if you tilted your neck back to get it to where it counts) - I don't use it any more.

 

[Saltair]

When a flew for my dinner I used Afrin from time to time. I have always had allergies and am alwasy dealing with some degree of congestion. Afrin worked good for flying, but I only used it when my head was super congested. Too much use leads to a nifty reaction when you stop of becoming REALLY congested. Because my head is always a little "stuffy" I am leary of anything that might clear me out before I dive and then wear off and have my sinuses close back in on me at depth. I use a daily prescription spray whether I dive or not and leave it at that. even with my constant mild congestion emphasis on early and proper equalization has worked, and have yet to have problems. If I cant equalize I dont force the issue, but usually it works ok.

 

[spectrum]

As TSandM zeroed in on there is often a fine line between technique and need for medication. When a diver is starting out it is easy to think that the technique is simple and that medication must be what is missing. The catch is that for many some conditioning of the Eustachian tubes is required before you get consistent results form good technique.

When starting out I suggest equalizing once daily. On dive day do it on the way to the site, when you arrive while you gear up, bobbing on the water and on every breath as you drop. Over time some of these may fall from the routine as unneeded.

When I started out doing pool work the doctor set me up with Flo-Nase which seemed to help. I then went for a year taking nothing and had no issues. Since then I have been on AleVert for nuisance topside allergies. Over the same 3 years I went from being hopelessly deaf after air travel to not even noticing the pressure changes on this weeks flights. Your tubes will become more cooperative with frequent equalizations.

Pete

 

[cmburch]

I have had problems with my sinuses since I was a kid. They tend to be clogged without any nasal drip. This has been due to allergies? or sinus infection - see doctor immediately to get it taken care of. I also sometimes have pain on airplanes - reverse squeeze?.

I always take time released Sudafed when freediving and on SCUBA. Be careful about the side effects. High blood pressure, etc.

I also always carry Afrin on the airplane and sometimes with me when I freedive and take if needed. The doctor warned that Afrin is addicting.

Both these medications also solved my motion sickness problems. I have not had motion sickness in over 10 years since I have been using time released Sudafed.

I usually have no problems clearing.

 

[NZarathustra]

Do you guys take any sinus decongestion medicine before you dive? I am in the middle of my certification classes and I noticed last week I had a problem clearing my ears so this week I popped a sudafed and a squirt of affrin and I felt great....do you guys use anything?

I just got certified last month, so I... er... feel your pain. I also had huge amounts of trouble equalizing.

What worked for me was to practice, practice, practice... I "equalized" my ears at my desk at work, in the shower, sitting in traffic... just to get the feel of it. I read somewhere that the eustacian tubes need to be "trained" to equalize.

Definitely watch the video mentioned earlier as well. It's very helpful.

Now I have absolutely no issues equalizing, which allows me to concentrate on other stuff.

I don't want to get in the habit of equalizing via medication, just 'cos I don't want to become dependent on it when I can just do it myself... but I don't fault those who do either.

Good luck!

 

[scubamickey]

The problem with all those mandatory warnings on drugs is that uneducated people assume that all those side effects WILL happen to them. Sudafed is probably not going to raise your blood pressure dramatically unless you have hypertension. It does nothing for me for example. My BP is a steady 105/60 and even when I have a cold and popping sudafed every day for a week it doesn't budge. You need to consider your own individual risk factors and how the drugs make you feel. Not make a blanket decision based on FDA warnings that may or may not mean anything.

 

[Rickg]

I see people referring to Afrin as a recommended/chosen decongestant for diving. Is there a specific reason for choosing this brand or will others work just as well (Drixoral, Dristan, Otrivin, etc.) ?

I take 12-hour Sudafed (the original formula - not the new PE junk) for the first couple of days of my dive vacations whether I need it or not - more like "insurance" than anything else because I don't want to screw up my dive vacation early in the trip. After day 2 or day 3 I usually find that I can stop taking and don't need it for the remainder of the trip. I also keep Afrin in my dive bag but typically don't use it unless I have a problem with a post-dive sinus headache. IMHO, Afrin has to be some of the most god-awful tasting stuff in world.

(NOTE: This is only my own personal experience and I am not a doctor.)

If you use the Scubaboard Search function and type in "sudafed" or "afrin" you will find wealth of previous threads that discuss this quite thorought.

And as TSandM said, watching that video is an absolute must if you are having trouble equalizing.