Sudden congestion syndrome

[boulderjohn]

OK, I made up the term.

I have so far not found anyone else who has ever heard of the following symptoms, so I don't have a real name.

A little over a year ago, I did a week of diving, about 3 a day, in Belize. After about 4 days, I was near the end of a dive when my head suddenly became congested, like turning on a light. I had never had that happen before. I took my mask off a couple times to blow my nose. As soon as I left the water, my head cleared. It happened on another dive later in the week.

A few months later I had roughly the same experience in a week of diving in Cozumel.

Later in the year, I was teaching a refresher course to a student in a swimming pool (sanitized by bromine, not chlorine.) The same thing happened about 4/5 of the way through the 2 hour class. I could not even get to the bottom of the deep end of the pool (12 feet) because I could not clear my ears. Since then something along those lines has happened in roughly 1/3 of my pool instructional sessions, although that first time was the only time I could not reach the bottom of the pool.

Last week I did a series of dives over nearly 2 weeks in Hawai'i, and it happened on 4 of them. One of them was interesting. It was my first dive. For some reason, I was having minor leakage problems in my normally reliable mask, so I had to clear frequently. About 3/4 of the way through the dive, I was instantly congested. Since I was slowly ascending on a multi-level dive, there were no blockage problems, but it was really hard to clear the mask. I tried removing the mask and blowing my nose, but it had no effect. As soon as I left the water, my head started clearing, and I felt perfectly fine within five minutes. On the second dive, whatever problem I was having with my mask disappeared. I had almost no leakage, and I was perfectly fine throughout the dive.

During the year I have done a lot of extended (technical) dives in fresh water. I have only had that problem on 1 of those dives, and again, I had no problem at all on the next one.

Any ideas?

 

[doctormike]

Well, it sounds like you are talking about two separate experiences - nasal congestion and the inability to clear your ears. But as far as the sudden nasal congestion is concerned, that is unusual. Hard to guess over the Internet for something like that, I would start with a good internal nasal examination by an ENT doc to see if you have any anatomic problems (e.g. polyps, etc..).

 

[Scuba31]

Just out of curiousity - were you wearing the same mask for all of those dives? I was just wondering if you may have gotten an irritant in your mask/something that that is getting in your nose that is causing your sinus passages to become inflamed. It could be like your sinuses saying they have had enough. You could try a different mask to see if that help. Just a thought...

 

[Quero]

John, what else happens during those dives that might be related to the sudden onset of nasal congestion? For example, I've suffered from similar sudden nasal congestion and have realized that if water gets deep enough into my nostrils--either salt water or pool water--I get a blocked nose. For some reason my nasal passages just swell. In my case it doesn't seem to be congestion from mucus, but rather something like an "allergic" reaction to getting water up my nose. I rarely demonstrate hovering upside down for exactly this reason. I had a hard time accepting that this was the cause since some of my colleagues advocate nasal irrigation as a means for clearing gunk out of the passages. Some even irrigate using sea water! But careful observation has led me to the conclusion that my nose just reacts badly to getting water in it. Maybe if you think back on what sorts of triggers might be causing your congestion, you may hit on some equally odd culprit. Scuba31's query about your mask runs along the same line of thought. Do you use a commercial mask defogger, for example?

I hesitate to doubt the insights of a medical moderator and in fact offer the following with humility, but I am skeptical of the assertion that the issue of not being able to clear the ears when this happens is separate from the problem of sudden nasal congestion. In my case, at least, if the congestion is severe enough, it seems to swell things up enough that it becomes difficult for the air to reach/pass into the eustation tubes during a valsalva. I would venture to guess that John has identified a valid causal relationship, given his level of diving experience and his first-hand sense of his body.

 

[boulderjohn]

Just out of curiousity - were you wearing the same mask for all of those dives? I was just wondering if you may have gotten an irritant in your mask/something that that is getting in your nose that is causing your sinus passages to become inflamed. It could be like your sinuses saying they have had enough. You could try a different mask to see if that help. Just a thought...

I have been using the same mask for 10 years.

 

[boulderjohn]

John, what else happens during those dives that might be related to the sudden onset of nasal congestion? For example, I've suffered from similar sudden nasal congestion and have realized that if water gets deep enough into my nostrils--either salt water or pool water--I get a blocked nose. For some reason my nasal passages just swell. In my case it doesn't seem to be congestion from mucus, but rather something like an "allergic" reaction to getting water up my nose. I rarely demonstrate hovering upside down for exactly this reason. I had a hard time accepting that this was the cause since some of my colleagues advocate nasal irrigation as a means for clearing gunk out of the passages. Some even irrigate using sea water! But careful observation has led me to the conclusion that my nose just reacts badly to getting water in it. Maybe if you think back on what sorts of triggers might be causing your congestion, you may hit on some equally odd culprit. Scuba31's query about your mask runs along the same line of thought. Do you use a commercial mask defogger, for example?

I hesitate to doubt the insights of a medical moderator and in fact offer the following with humility, but I am skeptical of the assertion that the issue of not being able to clear the ears when this happens is separate from the problem of sudden nasal congestion. In my case, at least, if the congestion is severe enough, it seems to swell things up enough that it becomes difficult for the air to reach/pass into the eustation tubes during a valsalva. I would venture to guess that John has identified a valid causal relationship, given his level of diving experience and his first-hand sense of his body.

My thinking has been consistent with everything you have said. I am glad (for me, not for you) to hear I am not alone in this. I was hoping for a known medical situation and, especially, a course of action.

 

[Quero]

My thinking has been consistent with everything you have said. I am glad (for me, not for you) to hear I am not alone in this. I was hoping for a known medical situation and, especially, a course of action.

My personal solution is not to get water up my nose! (Thus no upside-down hovering.) If I do get water up my nose and consequently suffer from a blockage, I pump a little Afrin in, and that takes care of it. Afrin can be abused, though, so I only do this if absolutely necessary.