Sinus pressure question

[lrstokke]

I am in Aruba and am working on my open water certification. Completed the confined water and had no problems but not a whole lot of work on equalizing. I went to the doctor about 10 days ago and my lungs were clear and I felt the same as I do today with sinus pressure in my cheek bones under my eyes.

I'm scheduled for Dive 1 & 2 tomorrow for the OWC and the instructor was telling me about when she had a reverse block and tried to explain to me about the congestion on the assent has to have somewhere to go and when it doesn't then you get a reverse block ... or at least that's how I understood it, which may not be right.

Anyway, I don't have a cold. I always seem to have a little sinus/allergies going on and today have some congestion after being in the pool all day yesterday. How do I know if I should not finish the OWC? Did anyone else have this question come up?

 

[DocVikingo]

Hi lrstokke,

Sounds like incomplete/slow clearing of the maxillary sinuses (http://indianasinus.com/sinusdiagram.jpg) with associated irritation/inflammation. Based on the description provided to date, it unclear whether this is a result of isues on descent, ascent or both.

Three actions you may wish consider are:

1. Trying a saline spray (e.g., Ocean Premium, Ayr, Xlear, Simply Soothing Saline, Entsol) is an excellent place to start.

If that doesn't prove fully effective, you may wish to experiment with a slightly more complicated nasal lavage.

Heres' my sidebar on nasal irrigation from the May, '08 issue of Undercurrent (Scuba Diving Magazine, Undercurrent Reviews Dive Resorts, Liveaboards, & Diving Gear):

“Shooting Saltwater Up Your Nose

Is your nose stuffed up enough that diving isn’t appealing, or even to the point where congestion may dangerously interfere with equalization of the ears?

It may sound a bit zany and gross, but the evidence, both published and anecdotal, largely supports the salubrious effects of saline irrigation on both nasal membrane drying and congestion (e.g., from long airplane flights, breathing hyper-dry scuba gasses and allergens). Such irrigation shrinks the mucus blanket and flushes out the excess, reducing nasal irritation and swelling.

There are scores of salt-based OTC nasal washes on the market such as Sinucleanse, BreathEase and an array of NeilMed products. Many come with a soft syringe. Or you can purchase special tips that attach to oral hygiene devices (e.g., the WaterPik NA-2 Gentle Sinus Rinse).

Many divers choose a simple home remedy that is cheaper and works just as well. Boil two cups of tap water for 10 minutes, stir in one teaspoon of salt (refined sea salt is recommended to avoid additives) and one-quarter teaspoon of baking soda (sodium bicarbonate). Adding more salt than recommended can do more harm than good, so don’t overdo it.

After the brew has cooled to lukewarm, draw it into a clean nasal or ear syringe until full, then lean over the sink, squeeze gently and allow the solution to run through the nasal passages. Sniff it in, spit it out, then gently blow your nose. Repeat with the second nostril. Again, don’t overdo it - - one or two treatments a day should be sufficient.

Now go make your next dive. - - Doc Vikingo"

2. Watch ""The Diver's Ear - Under Pressure" --> Doc's Diving Medicine Home Page

3. Try an oral decongestant such one of the long-acting Sudafed products with pseudoephedrine --> Sinus Pressure Pain and Cold Congestion Relief - SUDAFED®

It is likely relief will occur relatively promptly.

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.

 

[stairman]

Lots of things need to go right before diving. Any lung conjestion at all is dangerous due to bubble retention in mucous. If you can pop your ears a few times before diving, you can usually do it while diving OK. If you get a reverse block, you need to pinch your nose and suck in thru it , reverse of what is normally done to equalize. Some folks take meds before diving for sinus issues and While I have no experience with thAt, be sure it wont wear off before the dive is over.

 

[lrstokke]

Thank you both. I was not able to go down on Dive 1 b/c I think I wasn't sure that I was equalized (and possibly nerves contributed) but did the 2nd dive and was fine.