Someone please define "congested"

[glbtrekker]

I have read and understood that one should not dive when they are congested. I understand that, I am looking for a definition of what congestion is as it relates to scuba.

Allow me to describe my situation. I am currently taking OW class and have been cleared by my doctor to do so (childhood asthma). I have struggled all my life with environmental allergies and go through seasons of the year when I realize that I would not be able to dive due to sinus drainage, runny nose, etc.

However, during the rest of the year I might not have those symptoms but still suffer from inflamed tissues in the nose that will block at least one nostril 70-80%.

In fact, that's the way I am right now. No head cold, no runny nose, no drainage, but inflammation. Is this considered congestion? Or do I only need to worry when I am blocked by mucus.

 

[bajashack]

I have read and understood that one should not dive when they are congested. I understand that, I am looking for a definition of what congestion is as it relates to scuba.

Allow me to describe my situation. I am currently taking OW class and have been cleared by my doctor to do so (childhood asthma). I have struggled all my life with environmental allergies and go through seasons of the year when I realize that I would not be able to dive due to sinus drainage, runny nose, etc.

However, during the rest of the year I might not have those symptoms but still suffer from inflamed tissues in the nose that will block at least one nostril 70-80%.

In fact, that's the way I am right now. No head cold, no runny nose, no drainage, but inflammation. Is this considered congestion? Or do I only need to worry when I am blocked by mucus.

From one person to the next it may very, I will not claim to be a Dr. however at any case you run into the possibility of a squeeze or a reverse squeeze, with any type of congestion or inflammation. You need to be very aware of your situation while you are diving. You should never feel any type of presume or unconformableness, if you do this is your body telling you that something is wrong and evaluate the situation and abort the dive if necessary so you don't cause damage or permanent damage to your ears.

 

[Bubbletrubble]

Yes, that's considered nasal congestion. I'd be concerned that you have accompanying sinus inflammation, which can lead to sinus squeeze. Inflammation in the "wrong" areas can lead to problems with ear equalization. At the very least, I would ensure that I can equalize. Feel free to practice this topside. There are several techniques to learn (and most instructors may only teach one method). Click on the link in my sig to read about the various techniques on Dr. Kay's website. With experience, you'll get a better feel for what constitutes being "too congested to dive."

Perhaps the best thing you can do is to head-off the underlying cause of your congestion -- allergies. Find a second-generation antihistamine, e.g., loratadine (Claritin), cetirizine (Zyrtec), etc., that works for you. I would steer clear of the first-generation H1-antagonists due to the common side effect of drowsiness/sedation.

In the short-term, you can try the highly regarded saline rinse known as a Neti-pot. The saline solution has some mild decongestant effects that might be helpful. You could also try a pill-based decongestant (pseudoephedrine, phenylephrine, etc.) provided that you take the med early enough to be effective during the dive...but not too early so that it wears off during the dive. I find that 12-hour formulations work well in certain circumstances. Be sure that you don't have any medical conditions or are taking any other meds that would contraindicate dosing with such pill-based decongestants.

During class (and once class is over, too), I highly recommend that you equalize early and often during your descent. It should never be a painful process. If it hurts, ascend a little and keep trying to equalize. Since you're just learning about buoyancy control, it can help to walk hand-over-hand down an anchorline or buoyline to ensure that you are descending slowly. Take all the time you need. It would be a good thing to let your instructor know ahead of time that you might have problems clearing. Know how to communicate the "ear equalization problems" hand signal (point to ear and give the wavy hand sign) underwater.

If you are too congested to equalize, then don't dive. Period. If you can't equalize your ears, then you risk rupturing your eardrum. If you have sinus congestion, the initial descent will likely be a very painful one (feels like an icepick is jabbing you in the forehead). During basic OW class, you don't want to have to deal with any of this stuff. Simply reschedule with the instructor. He/she will understand -- it happens all the time.

 

[vladimir]

Perhaps you should ask your doctor about fluticasone propionate nasal spray. It is prescribed for allergies and non-allergic rhinitis. Since it is a steroid it reduces inflammation and, in my experience (1 data point!), eases clearing.

 

[Bubbletrubble]

Perhaps you should ask your doctor about fluticasone propionate nasal spray. It is prescribed for allergies and non-allergic rhinitis. Since it is a steroid it reduces inflammation and, in my experience (1 data point!), eases clearing.

vladimir brings up a good point. If you've tried all of the other stuff and nothing seems to work well, definitely bring up the issue with an allergy specialist or your primary care doc. It might be appropriate for you to escalate to prescription-based meds like fluticasone propionate (Flonase) or montelukast (Singulair).

 

[lamont]

imo, i think you should dive the problem and see what happens.

i dive all the time with allergies and it isn't an issue for me, it takes cold congestion for me to have an issue with diving. when i get a cold i have bad sinus squeeze, but allergies are 'runny' enough of inflammation that i can clear through an allergy (although sneezing through a regulator is kind of annoying and somewhat unsatisfying).

if you get sinus squeeze, then solve the problem. if you don't get sinus squeeze you don't have a problem. don't worry about fixing something in advance that you haven't proven is an issue yet.

(and i do find that zyrtec works wonders for me)

 

[glbtrekker]

Thanks to all...sorry I did not get back earlier, but I had an early morning. Anyway, I've gone through most prescribed or OTC allergy medicines on the market. Most 2nd gen. antihistamines work about as good for me as a sugar pill. The only one that I have had limited success with is Zyrtec but it does produce limited drowsiness. Actifed is the only other thing that has ever worked for me and it really does make me drowsy. Nasal sprays, prescription or otherwise, seen to do little good either. I've also tried Nedi pots (for about two years now) and can honestly tell very little difference.

I'm not trying to be negative here, just really haven't been able to find much that helps.

Having said that, I really do appreciate the replies. I have learned a lot. Specifically I didn't realize that sinus problems would cause equalization problems for the ear. Perhaps that's why I could not equalize (skin diving skills) in our first pool session.

I went to the pool today to see if I could work through the problem and still struggled with equalization. Above water its not a problem, I can pop my ears by wiggling my jaw or yawning. Underwater I struggled a little more. I did finally get my right ear to release correctly, but it took 5-10 seconds of gentle blowing while pinching off the nose. I'm thinking if I had more time (I ran out of air while trying), I might could have coxed the left ear to clear as well.

So my question is this, does it take some people longer to clear their ears under water? Or, is this strictly due to allergy problems?

 

[spectrum]

So my question is this, does it take some people longer to clear their ears under water? Or, is this strictly due to allergy problems?

It will vary between divers but usually for lack of practice and conditioning.

There is some skill in sneaking up on your years with just the right pressure or in executing any of the alternatives to the Valsalva.

Equally true is that your tubes will respond to persistent equalization. Be sure you equalize 1 or 2 times daily.

 

[Bubbletrubble]

Please read this webpage on Dr. Kay's website. It explains the relevant ear anatomy. Inflammation in the nose and/or sinuses does not necessarily affect one's ability to equalize the ears. Equalization occurs through the membranous Eustachian tubes which connect the middle ear to the nasophraynx. These tubes are normally closed and must be opened (by yawning, jaw thrust, chewing, etc.) in order to equalize the air pressure in the two spaces. It's possible that inflammation in the soft tissues of the nasopharynx (surrounding a portion of the tubes or at the mouth of the tubes) can obstruct the Eustachian tubes or make it more challenging to open them.

People will have different anatomy that make the patency of the Eustachian tubes highly variable. This leads to some people being able to equalize more quickly/efficiently than others. As explained previously, inflammation in the nasopharynx due to allergies can hinder ear equalization.

Please read the webpage that I linked to. Dr. Kay describes several ear equalization techniques (Valsalva, Frenzel, Toynbee, Edmonds, BTV, Roydhouse, Lowry, Twitch). Try them all and see what works best for you. Bear in mind that it might be wise to practice these techniques while using a mouthpiece, as this simulates what it would be like to equalize during a dive.

Hope this helps...

 

[Web Monkey]

Thanks to all...sorry I did not get back earlier, but I had an early morning. Anyway, I've gone through most prescribed or OTC allergy medicines on the market. Most 2nd gen. antihistamines work about as good for me as a sugar pill. The only one that I have had limited success with is Zyrtec but it does produce limited drowsiness. Actifed is the only other thing that has ever worked for me and it really does make me drowsy. Nasal sprays, prescription or otherwise, seen to do little good either. I've also tried Nedi pots (for about two years now) and can honestly tell very little difference.

You need to see a good ENT. Sinuses problem can nearly always be fixed with drugs, surgery or both. I wouldn't just leave it alone or continue using OTC decongestants, since they can actually make the underlying problem worse over time.

Terry