Sinus DCI?

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Easdem

Contributor
Scuba Instructor
Divemaster
Messages
199
Reaction score
39
Location
Raleigh
# of dives
1000 - 2499
I have been having funky head issues since doing the AOW training dives at a local quarry a couple of weeks ago. All toghether I did 8-9 dives over two days according to my computers (some were short succesive dives to work on skills that the computers sepparated as individual dives).

All but one of the dives was above 35 ffw and I completed a 3min safety stop on anything deeper than 25ft or when my computer prompted me to. No ascent rates were violated (i usually ascend much slower than 30 ft/m).

The deepest dive was to 76ffw @ 49 degrees, it was cold as hell, for 5 minutes TBT with a 1 minute deep stop and 3 minute stop at 15 as per my computer.

There were a lot of long surface swims back and forth from dive to shore. Some at a leisurely pace others much more hurried (due to weather). I am in good shape, never felt too tired or winded. I ate, snacked and made sure to stay uber hydrated. I drank lots of water and sports drinks between dives and overnight at home.

At some point during the second day (right after the deep dive I think) one of my class mates noticed a little blood coming out of one of my nostrils. I wiped, blew my nose, no blood came out, I felt fine so I dove on.

After the second day of diving was over I felt like a million bucks, proud of what I accomplished in an awesome 2ft visibility packed up and went home.

When I got home I cleaned my gear, took a warm shower, had dinner and then I started feeling bad (about 3 hours later). I felt tired, somewhat lightheaded/dizzy with sinus pressure and the strangest thing, my cheeks felt heavy (still do sort of) and some lower jaw discomfort. I attributed these last two symptoms to an tight rental hood (I have a HUGE head) because the area of discomfort was outlined where the hood fit on my face, and I suspected I was experiencing some jaw fatigue.

I woke up early the next day, still feeling like the night before but now with some muscle soreness, likely from the long swims and hauling all the gear around but I called DAN that afternoon; I never really had these sort of symptoms.

The DAN dude discounted DCS as the cause of my symptoms and recommended I make an appt with my GP. I decided to self medicate with sudafed and ibuprofen. I saw some improvement in the lightheadedness and “cheek/jaw” thing but the congestion continued to worsen. At that point I made an appointment with a dive savvy ENT and got seen today.

It turns out I have a sinus infection the Doc thinks may have been precipitated by a reverse block (hence my nose bleed). But I got no real answer about the “cheek/jaw” thing. She mentioned (if I did not misunderstand) that there are instances in Sinus DCI that micro-bubbles form in the lower jaw area and cause jaw pain... Shortly after the explanation started there was a long scope probing my sinus cavity and sort of lost interest in anything else that was going on...

Did I misunderstand? How likely is it in my case? Should I be concerned or is that something that will resolve on its own?

At least for now no SCUBA until I complete my treatment (could be as long as 6 weeks). I hope not because have a Rescue Class in 4 weeks!

Sorry for the length, a very long way to ask 3 questions… I tend to overexplain...
 
....The DAN dude discounted DCS as the cause of my symptoms and recommended I make an appt with my GP....It turns out I have a sinus infection the Doc thinks may have been precipitated by a reverse block (hence my nose bleed). But I got no real answer about the “cheek/jaw” thing. She mentioned (if I did not misunderstand) that there are instances in Sinus DCI that micro-bubbles form in the lower jaw area and cause jaw pain...


Hi Easdem,

The description given appears consistent with involvement of maxillary sinus. If so, appropriate treatment should begin to show benefit relatively quickly, but return to SCUBA may not be advisable for 3-6 weeks. This infection may be the result of tissue damage secondary to sinus barotrauma. Both sinus barotrauma and infection can result in lingering sinus and jaw/cheek discomfort.

As regards the hypothesis of microbubbles forming in the lower jaw area through a DCS-like process and causing jaw pain, this is a new one on me and doesn't seem convincing. But, then, there's lots I don't know. Possible misunderstanding could be cleared up by calling the GP and asking for further explanation, and also for supporting references such as published research or clinical articles.

Regards,

DocVikingo

This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice to you or any other individual and should not be construed as such.
 
Thanks Doc.

I will get some clarification of the jaw micro-bubble question, I will post an update if its anything interesting..
 
You're welcome.

I'm interested in anything solid you may be able to come up with.

Regards,

DocV
 
I agree with DocViking, never really heard much on micro bubbles in jaw. Much more common joints for bubbles to lodge.

Most likely barotrauma, but can also be aggravated by going from hot temp on surface to very cold a depth. Just like going oustside on a very cold day can cause your sinus to start "running". Best to go very easy on sinus when surfacing & descending. Your sinus will love u for it. On the other hand i have seen folks just surface or descend with brute force despite sinus not clearing properly and result in much the same way you describe. Once you rupture the delicate sinus membranes and bleed you are very prone to infection as one normally has high bacteria counts in sinus. (as many as 30% of people walking around have staph bacteria living in their sinus). This is why barotrauma to sinus cavity can be serious, particularly if you break into optical or brain cavity bringing about much more serious and potentially life threatening infections. I have seen this happen many times thru waterskiing injury.

Be good to your sinus and they will be good to you! hope u feel better and happy diving.
 
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