Sudafed and diving

[spatman]

i have plans to dive tomorrow, but have the remnants of some sinus congestion lingering. i've heard a few other divers mention that they take sudafed before a dive to help relieve it.

is there anything i should know before i go ahead and do this?

[Joshua Smith]

No, not really- plenty of people will tell you never to do this, but I've taken Scubafed before a dive many times. It works great.

[Nwbrewer]

I use a surface ear clear as my test. If I can clear, but there's a little congestion, I take the recommended dosage 4 hours before I dive, then pop a "booster" dosage right before I get in. (Note this is the 4 hour stuff, I'm not taking more than the recomended. Don't do this with the 12 hour) Never had an issue. Like Josh said there is lots of advise to the contrary, I'm not recomending anybody do this, just letting you know what I do.

Jake

[selkie]

In the old days at Divers Institute of Technology our instructors (Old Navy and Commercial Divers) claimed Sudafed was the only decongestant tested at pressure. I have a feeling those test were personal test. That being said there is always the risk of a reverse block. Another point is that recreational diving is meant to be fun and unlike working diving there is no need to take unnecessary risks. Each diver will have to gage there own risks exposure but at least make sure your dive buddy knows so they can also make an informed decision about diving.

Just my two cents

[Tangfish]

I use a topical nose spray. If figure that the more places being affected by a drug in my body, the greater the chance of something unintended occurring. Best bet though is to stay dry. Play some video games or something.

[Sounder]

I've done it. The "warning" you get is if it were to stop working while you're diving with a reverse-block as a result.

My official fancy Dive Master (with NAUI liability insurance) advice is to call DAN and consult with your friendly local ENT dive medicine physician specialist before utilizing any medication during a dive.

[loanwolf]

you take risks with any decongestant or antihistamine.

1) reverse block.
2) Apprehension and sleepiness at pressure.
3) it makes you more susceptible to a type 1 hit.
4) it makes you more susceptible to O2 toxicity.

Be careful if you take it. All agencies and DAN recommend not to take anything that is over the counter. only prescribed decongestants and antihistamines that are usually the new steroidal type.

[BASSMAN]

I dove once with some minor remnents of a blocked sinus, I checked on the surface to see if I could clear my ears.
And I could, so I thought I was Good to go. "WRONG".
As we decended I felt this pressure right at the corner of my eye. It felt like someone was driving a nail into my head. Just as I turned my head to thumb the dive, it cleared, and all was okay. I wish I would have taken some Sudafed before that dive. I've never felt a reverse block and I hope I never do. But as long as you feel everything is cleared at the surface you should have no problems. As long as you don't get stuffed up at depth.(Sudafed wears off).
I keep some in my S.A.D. kit!

[LCF]

Loanwolf has it right. Sudafed is a sympathomimetic, which means that it has effects similar to adrenaline. It can raise blood pressure and heart rate, and increase the likelihood of abnormal heart rhythms. There is anecdotal information that it may increase susceptibility to central nervous system oxygen toxicity, and the mechanism is plausible, as such drugs often lower seizure thresholds.

All of that said, it is likely that, in the young and healthy person with no blood pressure or cardiac problems, the biggest issue with decongestants is going to be heightened anxiety, or having them wear off underwater. Use of the time released preparation helps with both of those problems, as the serum levels reached are lower (thus minimizing the anxiety effect) and the duration of action is longer.

Topical decongestants may not be as useful as the oral ones, as they require contact with the swollen area to work. They are pretty good for opening the nose, less useful for the sinus drainage pathways and plus-minus for ears.

Anyone who uses decongestants to be able to dive really has to understand the potential damage that can be done, should they fail to last the whole dive. The risk is both hearing loss (temporary or permanent) and damage to the balance mechanism (again, possibly permanent). If you encounter ANY difficult equalizing on descent when you are using decongestants, it is a VERY good idea to abort. (And, BTW, I have dived on decongestants, so there's no "holier than thou" going on here!)

[BASSMAN]

Wow, If I didn't Know any better, I would think that was advice from Valerie!
Good info Lynne, thanks!


I love this Board!

[LCF]

Well, Valerie and I work in the same field!

[Zen Diver]

And I couldn't have said it better myself.

(And, Lynne has more medical education than me...)

-Valerie

[spatman]

thanks, everybody, for all the great advice.

i went diving today after taking sudafed, and SURVIVED!! yay, me.

my cold is in it's end phase, so my sinuses weren't really that clogged up. if it had been earlier in the cold's lifespan, i would have not gone diving. i took the sudafed mostly as a preventative and to help clear what little crud remained. there was no anxiety or any other ill effects. the very first ear clear on our decent was a tiny bit stubborn, but with a little patience it cleared on it own and i had no other problems for the remainder of the day.

please note that your mileage may vary, and that i am not a doctor, nor do i play one on tv.

[BigFameOne]

Did you stay in a Holiday Inn Express last night? Cause if you did, I hear, that is close enough.

[Sounder]

And I couldn't have said it better myself.

(And, Lynne has more medical education than me...)

-Valerie

Sure, doctors have more medical education... but NEVER underestimate the value of a battle-tested and seasoned ER nurse!! :hello2: :naka: I'm sure Lynne will be the FIRST to agree with me!!

[BASSMAN]

Well, Valerie and I work in the same field!

I did not know this tid bit of information!
E.R Nurse? or LPN? or M.D.?

[dsteding]

Well, Valerie and I work in the same field!

I did not know this tid bit of information!
E.R Nurse? or LPN? or M.D.?

Lynne is an ER doc, works over in Moses Lake between prolonged stints underwater.

[BigFameOne]

As a survivor of Leukemia, when I was 9, I have learned much about the medical field and while I value doctors a great deal NOBODY should ever devalue the contributions of the nurses around them, while I credit those doctors for beating my cancer, I credit the nurses with keeping me alive long enough to do so. It was their willingness to sit with me when I was ill or hold my hand through the 2nd spinal tap of the day that kept my spirits up. I believe that was as important if not more important than the person who prescribed my chemo drugs.

I think both Lynne and Valeris are great resources around here, thanks to both of them for the info they can share.


That said I have also taken sudafed for dives before, against the information in my OW manual as well as some of the reading I had done on it on various boards, etc. I was having trouble clearing my ears, and had some lingering cold symptoms. My OW instructor was getting ready to move, and I was afraid my window was closing to get my OW dives in. I took sudafed and made the dives with zero issues. I would do it again, but I would maybe more careful, and be more willing to call a dive rather than add medicine to the mix. I had already called 4 OW dives and was a bit desperate to get my dives in.

[Peter Guy]

A nurse friend once told me that "Nurses treat patients, doctors treat disease." From what I can tell, that is more often than not a true statement.

[Sockmonkey]

Just for the sake of complaining... I typically take claritin before diving as I did yesterday. While still a little snotty from the tail end of a head cold... I could still clear my ears easily on the surface by pinching my nose and creating pressure. In fact I was able to clear on land far more easily than I could the previous weekend at Redonulous.

However yesterday I couldn't descend past 12-15 feet without a lightning bolt of pain above my right eye and into my ear. There really is no telling sometimes.

Bummer for me... and worse for CaseyB since I hosed his first dive.

Silly photos taken in air to follow.

-Eric

[LCF]

What you probably found out, Eric, is that you could clear your ears, but not equalize your sinuses. The drainage pathways out of the sinuses are harder to collapse than the Eustachian tube, since they pass through bone, but they're smaller caliber and therefore easy to shut with swelling or thick secretions. This is why testing your ability to equalize on land may not be predictive of whether you'll actually be able to dive.

BTW, there should be no problem with Claritin with diving, as it does not produce drowsiness and does not work through a vasoconstrictive mechanism.

[ArcticDiver]

A bit of personal experience for whatever it is worth to those who have clearing problems.

When I certified I had trouble clearing. I went the sudafed route with 12hr tabs. Of course in my case I'd taken enough of it over the years under a variety of conditions so I knew what my personal reaction to the drug would be. Never take a drug when flying or diving that you haven't previously tested. But, I finally decided enough was enough and decided to get an updated evaluation from a good, note the word "good", ENT.

After allergy testing and a variety of images the result was that I had no alllergies. So, medications designed to alleviate allergy symptoms weren't called for. I did have smallish eustachean tubes, chronic rhinitis and some tissue swelling from environmental conditions I'd been exposed to over the years.

The ENT prescribed a nasal steroid to be taken starting a period before I start a dive trip. This works great in my case since I have to do batch diving. If I were diving daily as some of you do I don't know if any problems would arise.

Also, knowing I had no structural issues I practiced very aggressive clearing until it became much easier. In fact, even when I have snotty nose from rapid climate change I can still dive, albeit with slower descents and ascents.

Message: There is no substitute for a proper exam by a knowledgeable ENT who actually cares about patients. The result will be the correct drugs, if any are called for. Also, there is no substitute for proper clearing technique that is well practiced.

[BASSMAN]

Lynne is an ER doc, works over in Moses Lake between prolonged stints underwater.

Moses Lake

Isn't that kind of a long commute from Woodenville?

[Sounder]

Lynne is an ER doc, works over in Moses Lake between prolonged stints underwater.

Moses Lake

Isn't that kind of a long commute from Woodenville?

She goes for a few days at a time so she just stays there for her 12-on/12-off shifts. It worked out great for me on my way back from Montana - I met Lynne in Moses Lake for dinner!!

[Mattleycrue76]

So the consensus seems to be if you're ok clearing on descent and the meds don't wear off you'll be fine? Has anyone ever experienced a reverse block despite being able to clear fine on descent?