Sinus pain, followed by blood in eye.

[DandyDon]

Sorry for your discomfort (and sorry for me reading your graphic description while eating breakfast ).

Good luck with this and please post back with the outcome.

Uh, this is not a forum for dine & read.

Man, I hate stories like this. I don't read anything that suggests that you had an acute bacterial sinusitis. You had a reverse block, pretty clearly, which implies congestion and occlusion of the drainage pathways from the sinus, but that DOESN'T mean you had or have a bacterial infection. Unless you had purulent (green or brown) sinus drainage prior to the event, or fever, or a history of chronic purulent sinusitis, they jumped the gun on antibiotics. This is why we have so many resistant bacteria in the world now!

(Pete, I'm not mad at you -- I'm mad at your doctors.)

50 years later and still happening. As a kid, anytime we felt bad we'd go to the local quack house and get a shot of penicillin - didn't have to wait to see a doc, SOP. Dad nearly died of a reaction to one of these, but he and the quack were business partners in some ventures so we kept going back. He almost crippled me from his treatment to a football injury by I had a license then and informed my parents that I was going to the city the next day. One by one, he tried to do us each in, but we all quit him but mom. He finally got her.

Today, the quack house if named for him, his son runs it, and I pay taxes for it. It's good for the Mayberry economy tho.

Find better doctors, Pete - and good luck.

 

[Bubbletrubble]

The hemorhage in the eye probably happened from a sneeze and it's not related to the sinus pain. It will clear up on it's own. I went to a Centra care at his recommendation and they have put me on two antibiotics and an antihistamine. One I swallow, the other is swabbed in my nose.

I forgot to add before that it's pretty common for mask squeeze to cause subconjunctival hemorrhage. It's also true that a forceful sneeze/cough, retching, choking, straining, or strenuous exercising could cause it. Out-of-control hypertension or trauma (of course) could also cause it. If you noticed the hemorrhage immediately after diving and you don't recall sneezing forcefully, then I'd put my money on the mask squeeze. As you probably found out, no treatment is required so long as there's no infection or trauma (unlikely).
As Lynne wrote, the antibiotic treatment you received is not the current standard of care. Doctors are human and they make mistakes.
Get well soon...

 

[The Chairman]

I have been sneezing a lot lately for some reason... with a little congestion that clears right up when I blow my nose. Maybe I am allergic to DEMA?

The red streak is almost gone this morning. There is just a tad bit left, not that there was a lot to begin with. You have to lift the lid to really see it now. Kewl!

 

[doctormike]

Lynne,

he cited the "orange" that preceded the whole event as the reason for the antibiotics. I just took it as blood thinned out by the mucous, but he took a sample to culture. and will let me know if there is anything. I see this as a knee jerk reaction to that swine flu.

OK, late to the party, but I might as well chime in...! I didn't spend all those years in snotology school for nothing! And I have experienced that release of a blocked sinus on ascent... it ranks up there along with removing ski boots as one of the greatest feelings in the world... I have never been quite so happy to have a mask full of blood and snot.

SO, on to the case. As always, I fundamentally agree with my colleagues TSandM and DandyDon about the overuse of antibiotics in general and in this case in particular. However, for the archived record, I just wanted to bring up a few points, not so much to defend NetDoc's doctor, but to make some points that might be helpful in the future...

1) It is not unheard of to treat a patient with sinus barotrauma with antibiotics if there is a suspicion of extension (e.g. soft tissue air in the periorbital space - the space around the eye). The sinuses are contaminated even when there is no acute sinusitis, and forcing material from that area into a sterile body space has the potential to cause an infection (a serious one, like a periorbital abscess). I would probably err on the side of preventative antibiotic treatment if there was subcutaneous emphysema (air around the eye).

2) Antihistamines are not decongestants, and should only be used for allergies. I'm not sure why they were given in this case. Usually, three days of Afrin is good for anything related to suspected sinusitis.

3) The Neti-Pot is great, I highly recommend it..!


Mike

 

[DandyDon]

Glad you mentioned the Neti-Pot. My dive bud, who has severe equalizing issues swears by it. I, who has no equalizing problems but do battle allergies constantly, find it seems less beneficial than simple saline spray. Do results vary greatly?

 

[doctormike]

Glad you mentioned the Neti-Pot. My dive bud, who has severe equalizing issues swears by it. I, who has no equalizing problems but do battle allergies constantly, find it seems less beneficial than simple saline spray. Do results vary greatly?

Well, they are both saline (salt water) solutions, but the spray really only moisturizes the nose. The idea of the Neti-Pot is that you are irrigating out the entire nasal airway with a river of saline, that removes debris, etc... Also, the saline acts as a mild decongestant. You can get one version of the Neti-Pot here for about $14, we have them in the office for our patients at $8 (we get them in bulk).

Mike

 

[The Chairman]

2) Antihistamines are not decongestants, and should only be used for allergies. I'm not sure why they were given in this case. Usually, three days of Afrin is good for anything related to suspected sinusitis.

Like I said, congestion clears after a good blow! However, I had a run of sneezes (7) in front of the doctor and my eyes have been itching for days. He gave me the option of buying Claritin or using the prescription. I think Claritin works better as my eyes are still kinda itchy!

 

[doctormike]

Like I said, congestion clears after a good blow! However, I had a run of sneezes (7) in front of the doctor and my eyes have been itching for days. He gave me the option of buying Claritin or using the prescription. I think Claritin works better as my eyes are still kinda itchy!

OK, so itchy eyes might mean some allergic component... Glad that it works for you! Some people get a little drowsy from those drugs (even though they are not supposed to do that!).

Best,

Mike