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Scuba Forum / General / March 2006

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Sinus Infection from Scuba

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CJB - 14 Mar 2006 17:10 GMT
On the fourth day of a scuba diving course in the Caribbean - with
water going up my nose and down my throat etc. - I developed a severe
sinus blockage. I could breathe OK through my nose, so this wasn't a
cold.

However my ears started to ache and I couldn't equalise them. I also
had a feeling of being heavy headed. The local pharmacist gave me some
eardrops called Sofradex with a steroid. This seemed to have stopped
the infection and I no longer have earache, but even now nearly a week
afterwards my sinuses are still blocked and I now have a splitting
headache. Also I get little twinges of pain in the sinus region but in
random places. I'm also getting nosebleeds and bright yellow mucus
discharges.

Also I'm getting disturbed sleep with the weirdest of dreams and
nightmares.

This was all unexpected - but since I've never been diving before and I
didn't know what precautions to take. And the PADI Training Manual
remains silent on the issue.

Therefore please can someone tell me if there are any web sites on
sinus problems caused by recreational diving, and how to prevent them.

Many thanks - CJB.
chilly - 14 Mar 2006 18:23 GMT
> On the fourth day of a scuba diving course in the Caribbean - with
> water going up my nose and down my throat etc. - I developed a severe
[quoted text clipped - 9 lines]
> random places. I'm also getting nosebleeds and bright yellow mucus
> discharges.

I hope you are headed for the doctor's office soon.  You probaby have an
inner ear infection as well as a sinus infection.

> Also I'm getting disturbed sleep with the weirdest of dreams and
> nightmares.
[quoted text clipped - 5 lines]
> Therefore please can someone tell me if there are any web sites on
> sinus problems caused by recreational diving, and how to prevent them.

Equalize on shore, on the boat, on the surface immediately before descent.
Equalize gently every foot or so as you descend, don't blow too hard. Don't
force it.  If you are having trouble clearing, ascend a little bit and try
again.

It is not unusual for new divers to develop sinus infections from poor
equalization technique.

http://faculty.washington.edu/ekay/MEbaro.html

http://www.diversalertnetwork.org/medical/articles/article.asp?articleid=13

> Many thanks - CJB.
CJB - 14 Mar 2006 19:14 GMT
Thank you for your replies and for the links. I guess this is due to
poor equalisation - but whilst the PADI Manual mentiones the importance
of this it is silent on the effects of not doing so properly. CJB.
chilly - 14 Mar 2006 19:23 GMT
> Thank you for your replies and for the links. I guess this is due to
> poor equalisation - but whilst the PADI Manual mentiones the importance
> of this it is silent on the effects of not doing so properly. CJB.

I guess you've got no doubt now. ;^)

As you said, Module One does address the importance; it just doesn't give ya
all the gory details of what you are experiencing now.
Dillon Pyron - 16 Mar 2006 02:51 GMT
>> Thank you for your replies and for the links. I guess this is due to
>> poor equalisation - but whilst the PADI Manual mentiones the importance
[quoted text clipped - 4 lines]
>As you said, Module One does address the importance; it just doesn't give ya
>all the gory details of what you are experiencing now.

I sure talk about it in class.  With pictures of nicely blown out
eardrums.
Signature

dillon

Could have been is in the past
Could be is in the future
There is only the now

Matthias Voss - 14 Mar 2006 20:23 GMT
>>On the fourth day of a scuba diving course in the Caribbean - with
>>water going up my nose and down my throat etc. - I developed a severe
[quoted text clipped - 12 lines]
> I hope you are headed for the doctor's office soon.  You probaby have an
> inner ear infection

That's a bit far fetched.

as well as a sinus infection.

That's easy to see.
ENT, antibiotics, decongestants.

Matthias
chilly - 14 Mar 2006 21:03 GMT
> > I hope you are headed for the doctor's office soon.  You probaby have an
> > inner ear infection
>
> That's a bit far fetched.

Why do you think so?

> as well as a sinus infection.
>
> That's easy to see.
> ENT, antibiotics, decongestants.

Right.  He should see a doctor.

Instead of being diagnosed by either one of us here.
Chris Guynn - 14 Mar 2006 22:28 GMT
> > > I hope you are headed for the doctor's office soon.  You probaby have an
> > > inner ear infection
[quoted text clipped - 11 lines]
>
> Instead of being diagnosed by either one of us here.

But we're so much more qualified than any doctor he might find.  ;-)
chilly - 14 Mar 2006 23:44 GMT
> > > > I hope you are headed for the doctor's office soon.  You probaby have
> an
[quoted text clipped - 14 lines]
>
> But we're so much more qualified than any doctor he might find.  ;-)

There's a good chance.  I just read that in another thread.  But in the
meantime, let's see what Dr. Murray Grossan (E.N.T)  has to say on the
subject:

Middle Ear Infection
Ear pain can come from the middle ear. This may be a regular middle ear
infection (otitis media.) Except for when the ear drum is bulging outward
severely, this type of infection is not especially painful. In children is
painful because pus builds up and bulges the ear drum. It may be caused by
blowing the nose too hard and forcing the nasal pus up the eustachian tube
into the middle ear cavity where the bacteria multiply. If there is heavy
phlegm or pus in the nose, using the pulsating sinus irrigator daily 5 days
before diving may prevent eustachian tube blockage.

Outer Ear Infection (External Otitis)
Ear pain, especially after several dives, is most commonly caused by an
irritation of the ear canal. The problem here is that once the canal starts
to swell, it is surrounded by bone and this acts like a pliers squeezing on
the sore ear canal. Generally pain here is 3x greater that the same swelling
on your hand or cheek. If the canal swells completely shut it is VERY
painful. Fortunately the severity of the pain doesn't mean it is more
serious, just that the swelling is in a tender sensitive area.
You can prevent outer ear pain by NEVER washing your ears with soap and
water. You need the wax in your ear to protect you from the ravages of
swimming and diving. Alcohol and peroxide both take away natural wax and
make one prone to outer ear infections. I advise my divers to always put
baby oil or olive oil in the ear canal before washing the hair and any
activity where soap or water can enter the canal. Because of the shape of
the ear canal, like a bent baby bottle, once the soap gets in there, you
cannot take it out and it just lays there and reduces wax and oil formation.

Treatment should be started at once. Do not put heat to the ear. The pain is
due to the swelling, so heat will cause it to swell more. Take an
antihistamine such as chlorpheniramine 4 milligrams (no prescription)4 times
a day. Proteolytic enzyme tablets are good for reducing swelling (Papaya
Enzyme) The doctor may elect to give an antibiotic. Ear drops such as
Cortispoin Otic Solution are good. If the canal is very painful and swollen
we generally put a wick or drain in. This allows the drainage to come out
and the medicine to go in. It is important to clear this type of condition
as quickly as possible because the longer the outer ear infection stays, the
more tendency to reoccur. Therefore you should stay out of the water until
clear. Once you have had this type of infection I advise my divers to take
an antihistamine the moment they feel this coming on. Do not take
antihistamine while diving. Any antihistamine can make you drowsy and add to
nitrogen narcosis -remember, every 33 feet is equal to one martini.
Chris Guynn - 15 Mar 2006 00:00 GMT
> > > > > I hope you are headed for the doctor's office soon.  You probaby
> have
[quoted text clipped - 19 lines]
> meantime, let's see what Dr. Murray Grossan (E.N.T)  has to say on the
> subject:

My opinion* is that his best course of action is to go to Jamaica for a week
and smoke as much pot as possible.  Yeah, that should make him feel better.
;-)

*please note: my opinion on this matter is mostly worthless.
Grumman-581 - 15 Mar 2006 00:00 GMT
> Treatment should be started at once. Do not put heat to the ear. The pain is
> due to the swelling, so heat will cause it to swell more. Take an
[quoted text clipped - 6 lines]
> as quickly as possible because the longer the outer ear infection stays, the
> more tendency to reoccur.

I've had a couple of ear infections over the years... It doesn't take much
of a treatment to cure it with the drops that I was perscribed quite a few
years ago... They expired 6 years ago, but still work great... The bottle
says "neomycin and polymyxin B sulfacts and hydrocortisone"... 4 drops in
the affected ear each night with a bit of cotton ball as a plug... Try to
sleep with that ear "up" as much as possible... After a couple of nights,
it's better... One bottle is in a saline solution, the other in a glycerine
solution...
Matthias Voss - 15 Mar 2006 00:15 GMT
>>>>>I hope you are headed for the doctor's office soon.  You probaby
>
[quoted text clipped - 7 lines]
>>>
>>>Why do you think so?

See below. Inner ear is not he same as middle ear.

Matthias

> There's a good chance.  I just read that in another thread.  But in the
> meantime, let's see what Dr. Murray Grossan (E.N.T)  has to say on the
[quoted text clipped - 41 lines]
> antihistamine while diving. Any antihistamine can make you drowsy and add to
> nitrogen narcosis -remember, every 33 feet is equal to one martini.
chilly - 15 Mar 2006 00:49 GMT
> >>>>>I hope you are headed for the doctor's office soon.  You probaby
> >
[quoted text clipped - 9 lines]
>
> See below. Inner ear is not he same as middle ear.

OK, my bad.  I meant inner as opposed to outter.

In any event, I suspect we are agreed.  The guy should get himself to a
doctor for a diagnosis.

In his original post he requested advice and cites as to what could happen
to him.   May I hope that you and I agree that he has at least received that
much?
Matthias Voss - 15 Mar 2006 01:10 GMT
>>>>>>>I hope you are headed for the doctor's office soon.  You probaby
>>>
[quoted text clipped - 18 lines]
> to him.   May I hope that you and I agree that he has at least received that
> much?

There is still one advice not given:
Not to expect that any remedy might be an instant solution.
To live through it and accept that it may take some time,
and that the body can fight it for a good part with his own
resources.

When I began diving, I had a similar event. Yellow/red clots
when sneezing.. Forgot to equalize because I was stunned by
the viz down to 70 ft.
Pain between one ear and the jaw, blocked tubes for about 3
days. Went all by itself. With a little luck.

Matthias
chilly - 15 Mar 2006 06:21 GMT
> > In his original post he requested advice and cites as to what could happen
> > to him.   May I hope that you and I agree that he has at least received that
[quoted text clipped - 5 lines]
> and that the body can fight it for a good part with his own
> resources.

Agreed.  However, didn't he say he had been suffering for over a week now
and there has been little improvement?

> When I began diving, I had a similar event. Yellow/red clots
> when sneezing.. Forgot to equalize because I was stunned by
> the viz down to 70 ft.
> Pain between one ear and the jaw, blocked tubes for about 3
> days. Went all by itself. With a little luck.

:^)  Sounds disgusting.

When I was a new diver, I don't think I ever had something like that as a
result of my poor equalization efforts.  However, I had my share of 'middle'
ear infections.  And I still get an outer ear infection now and again.
Dillon Pyron - 16 Mar 2006 02:57 GMT
>> >>>>>I hope you are headed for the doctor's office soon.  You probaby
>> >
[quoted text clipped - 18 lines]
>to him.   May I hope that you and I agree that he has at least received that
>much?

We're all stooopid enough to ask questions like "My foot is all
swollen and black.  I dropped a bowling ball on it last week.  What
should I do?"
Signature

dillon

Could have been is in the past
Could be is in the future
There is only the now

chilly - 16 Mar 2006 05:09 GMT
> >In his original post he requested advice and cites as to what could happen
> >to him.   May I hope that you and I agree that he has at least received that
[quoted text clipped - 3 lines]
> swollen and black.  I dropped a bowling ball on it last week.  What
> should I do?"

Don't go bowling anymore.
Joe English - 16 Mar 2006 14:07 GMT
>>>In his original post he requested advice and cites as to what could
>
[quoted text clipped - 11 lines]
>
> Don't go bowling anymore.

drop it on your other foot maybe you won't need fins
CJB - 15 Mar 2006 19:04 GMT
OK - folks - very many thanks for taking this seriously (well most of
you anyway) and for the pointers and info. Whatever it was is now
clearing up, but I've now got a runny nose from the damned English
weather. Maybe this'll flush out the mucus!!

Before I went diving I was under the impression that in order to
equalise it might be a good idea to clear the outer ears with ear wax
removal drops. But as is opined above perhaps it is best to leave wax
in there as a protective. Also I like the idea of applying baby oil
into the ears just before diving.

Incidently my instructor opined that Jonson's baby shampoo is good for
cleaning masks with on the grounds that the ingredients are declared
and known (unlike commercial defogging compounds), that if it is safe
for babies' eyes then it is probably safe for adults', and that you get
a lot for the price.

The sinus infection wasn't expected but this wont put me off diving.
And now I know a little better what to expect and how to attempt to
prevent it.

Very many thanks to everyone -

CJB.
Matthias Voss - 15 Mar 2006 21:15 GMT
> OK - folks - very many thanks for taking this seriously (well most of
> you anyway) and for the pointers and info. Whatever it was is now
> clearing up, but I've now got a runny nose from the damned English
> weather.

At it's best.

Maybe this'll flush out the mucus!!

Watch you brains.

> Before I went diving I was under the impression that in order to
> equalise it might be a good idea to clear the outer ears with ear wax
> removal drops.

It is. But not to ease equalizing but when you've got a
condition where this would help.
It is called "swimmers ears". People doing a lot of
training, swimming, diving in called waters may see their
most exposed tissues in the outer ear swell and grow bony
extensions which, in consequence, may impede the backflush
of water entering the outer ear cavities ( we all probably
have found us doing this one legged limping limbo, to get
rid of these gurgling noises in the ears.
Right. That's to help the water get over ever so little
obstructions in the outer ears. These obstructions may be
made up of self grown wax. The wax removal drops may help
here, especially when combined with a rubber/silicone
rubber( to be preferred) bulb syring which you will use to
flush your outer ear with clean well-tempered water.

_DO NOT_  mix up the syringes designated for either left, or
right ear, unless you want to give those nasty germs a free
ride from one side to another.

Also, _ DO NOT_  mix up the syringes meant for sucking with
those meant for flushing.
Explanation: Sooner or later you will arrive at a condition
when your ears really hurt, and discover that flushing will
help, but will better help with flushing followed by sucking
dry. May be all done with the same type of bulb syringe, but
please not with the same one. Unless desinfected.
Desinfect as much as you can, especially the suck syringes.

But as is opined above perhaps it is best to leave wax
> in there as a protective. Also I like the idea of applying baby oil
> into the ears just before diving.

Right!. Baby oil, medical olive oil, medical almond oil. You
will feel your ears liking it.
But: remember to flush, and clean. Some oils will develop
waxy residues.

Have your ENT specialist clean your ears before you go diving.
And, have him/her look up after you got a problem, even when
you think you resolved it by your own means.

Matthias
Dillon Pyron - 16 Mar 2006 02:55 GMT
>> > > > I hope you are headed for the doctor's office soon.  You probaby
>have
[quoted text clipped - 61 lines]
>antihistamine while diving. Any antihistamine can make you drowsy and add to
>nitrogen narcosis -remember, every 33 feet is equal to one martini.

Hmm, sounds like I need to start drinking more.

Signature

dillon

Could have been is in the past
Could be is in the future
There is only the now

Don - 15 Mar 2006 00:01 GMT
>> > > I hope you are headed for the doctor's office soon.  You probaby have
> an
[quoted text clipped - 14 lines]
>
> But we're so much more qualified than any doctor he might find.  ;-)

Now that's fuckin funny. See what I mean Bob? Don't force your humor.
Matthias Voss - 15 Mar 2006 00:12 GMT
>>>I hope you are headed for the doctor's office soon.  You probaby have an
>>>inner ear infection
>>
>>That's a bit far fetched.
>
> Why do you think so?

It would imply either a non scuba related trigger, or an
"explosive equlizing with a window rupture. Which is
unlikely, becuase this would provoke significant hearing
loss, and vertigos/dysbalance.

Matthias
Dillon Pyron - 16 Mar 2006 02:52 GMT
>> > I hope you are headed for the doctor's office soon.  You probaby have an
>> > inner ear infection
[quoted text clipped - 11 lines]
>
>Instead of being diagnosed by either one of us here.

Yeah, but I'd enjoy the cough test a whole lot more if you did it. Now
the DRE I can skip entirely if my life didn't depend on it.
Signature

dillon

Could have been is in the past
Could be is in the future
There is only the now

chilly - 16 Mar 2006 05:09 GMT
> >Instead of being diagnosed by either one of us here.
> >
> Yeah, but I'd enjoy the cough test a whole lot more if you did it. Now
> the DRE I can skip entirely if my life didn't depend on it.

:^)
 
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