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Old 09-05-2014, 06:19 PM   #1
steepNdeep
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Question Sinus infections

After a decade+ of freediving & several decades of swimming in freshwater, I finally popped my sinus 'cherry'. I dove hard August long weekend with 4 long dives & a few days later a sinus infection had taken hold. (Every story needs a pic - my first flattie from that trip. )

At first I tried the natural route & bought my first nasal douche (neti bottle) & tried several natural concoctions starting with sea salt & purified water. Eventually I gave in, went to the doc' & finished 2 rounds of anti-biotics, but I can still feel it... WTF.

How many of you have battled a diving induced sinus infection? What worked for you?

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Old 09-05-2014, 06:46 PM   #2
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Re: Sinus infections

Me too! I just finished tonight my last anti biotic pill.

I had pressure in my ears for several days that went away and then came back again. With a keys trip planned for the following week, I went to the dr to be safe. He gave me the salt water up your nose deal, Flonase, and the anti biotic.

I felt fine a day before I got there but sat out the first day to be safe. Been fine ever since.

He said I had a deviated septum and that my nose was inflamed causing my esteceion tube to not work properly. He thought I got an infection from swimming in nasty water a day before the symptoms started.

Who knows what the cause was but I'm good now.
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Old 09-05-2014, 06:47 PM   #3
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Re: Sinus infections

Today I got what I think is the sinus squeeze, pain above left eye and got a bloody nose. Felt pain on first drop and had no clue why. Hoping it doesn't turn into an infection.

I think I will take some sudafed before my next dive.
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Old 09-06-2014, 01:14 PM   #4
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Re: Sinus infections

Yeah, it sucks eh boys... With the holidays & stunning weather, I was chompin' at the bit to get back in the water, so I researched the hell outa possible remedies & pushed the limits trying to get back in the water. My doc' put me on anti-biotics (amoxicilan + clavic' acid), I took guaifensin tabs (ie: Mucinex) to expel flem/mucous & did neti yoga to clense my sinuses.

After 3 weeks I was feeling OK, but on a trip I tried to dive - my ears were screaming at 6', it was impossible to equalize & I had severe sinus pain/pressure from barotrauma in my upper left sinus. I mucked around the shallows & got some vid for my youngest who loves starfish.

I tried again a few days ago, but my ears still squeaked trying to equalize & after a minute or so, I carefully made it to ~20'. More neti-yoga & I was finally able to dive deep enough to get some food & we managed limits of crabs, including a monster redrock. But I still couldn't equalize past 30'...

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Old 09-06-2014, 01:26 PM   #5
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Re: Sinus infections

Based on my research, what I found was that it is dangerous to freedive on pretty much ANY medication. Neti yoga with 1 cup of sterilized water + 1 tsp sea salt + half tsp baking soda, was about the only remedy that is 100% safe while diving.

Also, I rinse my ears with a solution of 50% Vinegar / 50% isopropyl alcohol to kill anything capable of growing in there.

"Freediving just by itself puts a lot of stress on the cardio vascular system, just think of bradycardia, peripheral vasoconstriction, vasodilatation in for example the brain, bloodshift, spleen contraction, changes in blood pressure, changing Ph of the blood; every dive again, even shallow ones.
- Thick blood puts extra strain on the circulation, increases the chance of developing blood cloths and emboli.
- Blood thinners increase the chance of bleedings and blackouts. Increased metabolism or a significantly changed diet makes sensing safe dive time or depth inaccurate.
- Medication altering heart rate or metabolism could increase chances of developing arrhythmia of the heart during and after freediving.
- Dehydration adversely affects the capability to freedive and thickens the blood. In general freediving is not recommended for people who need this kind of medication.
Also be aware of and avoid medication found relatively safe for scuba diving but that can have an influence on the heart like:

Antibiotics - Sport and infections, especially ones so severe that medication is used, do not combine and can be dangerous.

Nasal spray - Containing substances like Xylometazoline, Oxymetazoline or Tramazoline and pills containing pseudo-ephedrine (pseudo-ephedrine is related to adrenaline) like Sudafed® alter heart rate &/or metabolism which could increase chances of developing arrhythmia of the heart during and after freediving.

Also, nasal spay additives and preservatives like benzalkonium are often used which hurts the cilia which are part of the cilia mucous system which keep your sinuses and ears healthy.

Sudafed because it could adversely affect susceptibility to nitrogen narcosis and oxygen poisoning. Sudafed should possibly be considered more dangerous in freediving for in freediving it has more negative side effects like decreased bottom time, the heart is under more stress from freediving than from scuba diving and nitrogen-narcosis effects are worst when you descend fast.

If you need decongestants to be able to freedive or have a cold: skip the dive."


Here is the best website that I found with freediving-specific medical info: http://www.apnea.nl/Medmed.htm
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Old 09-06-2014, 01:28 PM   #6
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Re: Sinus infections

For the bubble blowers , here are some scary scuba near-misses while on meds:

>>>At the weekend I went to Plymouth to do some mix gas diving, I have been suffering with a cold for a few weeks now’s but did not want to cancel because I would still have to pay. Anyway I decided to go and use a concocksion of Sudafed, Oltravine and Beconase nasal spray.

The first dive went ok I could tell I was bunged up but I could still clear my ears ok. On the second dive I wanted to go in first because I was doing the longest run time, on the way down the line I was a bit out of breath and starting coughing a lot and bringing up a lot of flem.

When I reached the bottom the shot was in the wreck securely so I did not have any work to do, I did a dil flush as I was still having problems getting my breath I found this made breathing a lot easier and checked my cell readout all ok. I got my breath and lined off as the viz was shit after about 15mins I was getting a bit breathless again so I turned around and headed back to the shot and headed up after 28mins because I was feeling crap. On the way up I was still coughing and bringing up flem I finally reached the deco station so I started to relax. I was still coughing a lot on my stops but I completed my deco obligation ok and surfaced.

When I got back on the boat I was finding it hard to get my breath so I was helped off with my kit. I started to cough and bring up blood so I went onto my 70% bailout bottle. The skipper wanted to call the diving doctor but I said I was ok and was not bent and the blood was due to my cold. Anyway after about 1hr I was still coughing up blood and the skipper called DDRC and spoke to the diving doc. I was still insisting I was fine and it was just a cold, but she wanted me to go to hospital and have a chest x-ray . I spoke to her and said I did not want to go to A&E because of the long waiting times. Anyway she persuaded me and I arranged to meet her at A&E. I had found out the skipper had arranged an Ambulance to take me but I made him cancel it and said I was fine.

My friends gave me a lift to the hospital, I booked in and was informed that they were expected me and was told to follow the blue line to the X-Ray department. I was X-Rayed straight away and the Diving Doc turned up about 30mins later. I was taken to a cubicle and was giving a complete examination which included shaving parts of my chest to have an ECG. I was still insisting I was fine and was not bent after 30mins the diving doctor agreed with my diagnosis. But informed me that I had a MEDISTIVAL EMPHYSEMA. She went on to explain that I had most probably ruptured some alveoli and air had escaped to the pericardial sac (the sac around the heart). Apparently I had a shadow around my heart on the X-Ray. She then informed me that there was a chance that the air could expand and cause me to have a PNEUMOTHORAX (a collapsed lung) and I needed to stay in hospital for observation and stay on oxygen for the night. She then went on to give me some information which really hurt NO MORE DIVING FOR 3 MONTHS.

I spent the night in hospital and was discharged the next morning my only symptoms are I have a sore throat apart from that I fell fine. The treatment I received from DDRC was first rate also my skipper Richard King was fantastic even thou I kept telling him there was nothing wrong with me. As you can imagine I am very pissed off to make things worst I have finally received the final part to enable me to fit my Kiss Hammerhead and now I can't test it for three months. I just wanted to share this information so other people can learn from my mistake.

The drugs did not damage the lungs, but because I had flem on my chest it stop the gas escaping and the overpressure made the alveoli rupture. Thus causing the gas to escape.
I found this on a web site:-

Mediastinal/Subcutaneous Emphysema - A more common occurrence in pulmonary overpressure is for the alveoli to rupture and for the air to track up along the vessels into the mediastinum and from there up to the neck under the skin. The gas may rarely enter the pericardium (sack around the heart ) or the peritoneum (abdominal cavity).
The signs and symptoms of mediastinal emphysema include substernal pain that is worse on inspiration, coughing, and swallowing. There may be X-ray evidence of mediastinal widening or frank (obvious) air but respiratory symptoms are present only in severe cases. It is usually accompanied by subcutaneous emphysema.

>>>thanks for posting your story! I understand the temptation to dive when you probably otherwise should avoid it.

Just two weekends ago my wife and i headed up the the nothern sunshine coast in BC. it was not slated to be a major dive trip, more just chilling out, doing some sea kayaking in the direction of desolation sound and maybe a dive or two reconisance for future trip. I promptly caught a cold on the way up. Waited a few days as symptoms worked their way from sore throat to sinus congestion. the last day my better judgement got temporarily drowned out by my desire to check out mermaid's cove/saltary bay just to see if this "Diving Hot Spot" was all it was talked up to be. I took some sudafed and waited an hour. We got all suited up and in the water and my ears just didn't want to clear. I went onto open circuit for a bit to get a little more back pressure and was slowly able to work my way down. i took my time and made sure i didn't go down any further till the pressure cleared in my middle ear. I was well aware of the likelyhood of a reverse block. Any time i read a story like this i'm pretty much saying the typical line, "this guy deserves whatever is comming to him" but here i was pushing it because i really wanted to dive this one spot, a long way from home, that i would otherwise not know if it was worth comming back to...not the greatest logic in the end.

so, we finally made it down to the famous 9' mermaid statue that stands a the top of a 175fsw sheer drop off. It did turn out to be a beautiful spot with some remarkable attributes...but was it worth it? Well, as to be expected on the ascent my ears sounded like fish tank bubbler. I patiently went up a few feet and let them fizz, then a few feet more until ironically i made it to 15fsw. My right ear at that point wouldn't budge any more, felt like it was going to explode if i went any further. so i sat there for quite a while, tried to equalize, and then got the bright idea to go back on open circuit to create a little more back pressure...which actually worked. Once at the surface everything was more or less fine, accept for the feeling of cotton balls in my ears. a week and a half later my ears are finally starting to clear up but still have some liquid in them...was it worth it? Nope! Why did it feel like it would be? I know better, no excuses, i was just fool hardy. Hope stories like these sink in for others benefit.


>>>Not quite the same thing, but many years ago did a dive to approx 22m, in cold water, was a little stressed, on Open circuit, rich (ish) nitorx mix (PO2 > 1.4, < 1.6) after taking sudafed for a cold. Descending the shot, has several strong symptoms of what I think was mild oxygen toxicity, tingling in lips, whole body tingling, vision narowing etc, etc. Maybe just me / maybe just conditions that day, but NO way would I dive after taking cold medications now, or if I dod it would be an air dive / LOW set point
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Old 09-06-2014, 02:32 PM   #7
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Re: Sinus infections

Thanks Dean for sharing all that information. It was really helpful. I have used nasal spray (Afrin) to help out a sticky sinus, but it seems that even that has issues. Lots of stuff to think about here. Bottom line, don't be reluctant to bag a dive and do something else if the air spaces in your body aren't cooperating.
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Old 09-08-2014, 11:48 AM   #8
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Re: Sinus infections

Thank you for the info, I really need to heal up and get back in the water ASAP. I've always found myself taking part in hobbies that mess with my body. Thinking about it, I know it has all been worth the inconveniences!
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