On Thu, 28 Nov 2002 12:38:49 +1100, David Strike <[log in to unmask]>
wrote:

>On Thursday, November 28, 2002 5:10 AM, Ray C. wrote:
>
>>
>http://story.news.yahoo.com/news?tmpl=story&ncid=594&e=9&cid=594&u=/nm/20021
>127/hl_nm/diving_medications_dc
>
>G'Day, Ray.  You've been quiet on the list for far too long!  :-)

He was too busy enjoying all those Door Prizes he won in Cozumel!
He and his wife won more door prizes than the rest of us put together. :-))

But as far as his cited news goes, it's nothing more than a Tabloid
report of a Tabloid survey to arrive at a Tabloid headline.  :-))

"Pre-Dive Medications May Put Scuba Divers at Risk"

Sure.  Not disputing that at all!

The keyword is "May".  Of the hundreds of so-called "studies" that
come to the conclusion such as "Eating <anything> MAY cause cancer"
are usually true statements that require no study, but the studies
themselves are improperly conducted, conclusions invalidly drawn,
and produce results that at best benefit the BANK ACCOUNT of the
"researchers" for useless future "research".  :-)

But your reaction (as well as the typical Aussie tendency to
REGULATE everything <G>) deserves a comment or three to substantiate
my counterpoints.  :-))

>I guess the dangers of using medications/drugs is something that many of us
>tend to be aware of without neccessarily thinking too deeply about.
>Paradoxically, while I've never taken anything for impending sea-sickness
>other than ginger tablets, I regularly used to carry - and use - Sudafed.
>Especially when they could be bought across the counter at, say,
>supermarkets.  Despite having an awareness of the controversy surrounding
>their use when diving, I always considered that I was using them
>'responsibly'!

That's of course the VALID commonsense approach, as long as you do so
'responsibly'  :-)   and I have every reason to believe you DID.

The controversy is more over the IMPROPER use of Sudafed over cases
of more than minor sniffles and colds, on more serious colds and
OTHER symptoms that require the consultation of DAN  :-), and the
INDIVIDUAL diagnosis or treatment of a physician, or an M.D. who is
an ENT Specialist (in that order, depending on the seriousness and/or
frequency of the 'symptoms').

>(I wasn't, of course!  The slightest sniffle I'd and pop one
>before diving.  Especially when I was teaching, or wanting to
>maximise the number of liveaboard trip dives.) :-)

Nothing wrong with THAT!  So long as they were mere sniffles, no
chronic use, and no worse symptoms or adverse effects from such use!
That's the diagnosis of Dr. RLING (whose name is on the Sydney
Harbour bridge :-)), based on merging all the advice of several
different physicians, his own diving experience, as well as
M.D. ENT Specialists, on Sue, who had much more serious symptoms,
including the puncture of eardrums, several times!   ;-)


>Now that their sale has been restricted to pharmacies - and you
>actually have to ask for them, rather than picking them off the shelf -

Ah, but that's only for AUSSIES, who tend to regulate EVERYTHING,
with or without good cause!  :-)   In this case, without good cause,
IMHO, because even the overly-conservative (compared to European
and other countries) FDA of the USA still have it as an over-the-
counter medication, requiring only the "commonsense" of the consumer
to purchase and use.

> I haven't used them for over a year.

Had you used them, you MAY be better, or you MAY be worse, compared
to your present state, and you MAY even have found it a suitable
remedy for an occasional overdose of Phyco-Plonk!  :-))

>Funnily enough, since discontinuing their use, I
>no longer seem to suffer from as many sinus sniffles!  :-)

Now THAT's a funny attribution to a funny Aussie regulation!  :-)


Here's the RELAVANT anecdotal account of Sue's case.
She almost never had any sniffles when she dived, but she often had
trouble clearing her ears on descent because of a COMBINATION of
an "improper" use of the Valsalva and her normally narrower-than-
usual nasal passage, to the extent that she had punctured her
ear drum 3 times (once as a newbie on her 2nd dive after cert;
and twice after she had over 1000 dives, while on liveaboards!).

The latter was what made her consult not only ENTs (M.D. Ear-
Nose-and-Throat Specialists), but scuba-diving ENTs, which resulted
several of time recommneded that she uses the prescription nasal
spray Nasacort (with no adverse side effects and non-habit forming)
as necessary, but REGULARLY (everyday, starting several days before
every dive trip!).  Since her use, I've met divers who use the same
prescription by their MDs, and one Dive Master on the Sun Dancer
liveaboard who said she used Nasacort before EVERY dive.  :-)

Thus, taking prescription medication before dives is definitely NOT
a counterindication to diving, according the M.D.s or DAN!   I take
prescription medication every day, diving or not -- but that's not
related to colds or sniffles. :-))


There's MORE to this story ... relative to Sudafed!  :-)

The three common maneuvers for ear-clearing are:

1.  The Valsalva:  hold nose and blow.
2.  The Frenzel:   use tongue to open air passage.
3.  The Toynbee:   swallow.

Sue can't use the Toynbee because her mouth is always too dry to
swallow.  In fact, I have to be her mask-defogger, in spitting on
her mask as often as she uses her own spit.  :-)))

Neither of us had much luck with the Frenzel though others swear
by it, or swear at it.  :-)

So, we both use the Valsalva.  The conventional wisdom of using this
manoeuver include:  NEVER blow too hard; start equalizing BEFORE you
feel the need to, or before the ear hurts;  equalize on every breath
the first 30 ft of descent; if difficulty to equalize occur later,
ascend beiefly to equalize before re-descending, etc., etc. ...
We learned those ... over the years.

I was fortunate that by minding the conventional wisdom, I never had
any difficulty descending quickly, even to MY max depths :-)

I didn't realize until recently that *I* was at fault, at least in
part, for having accused Sue that she had blown TOO HARD in using
the Valsalva, or having violated one of the "conventional wisdom
rules", especially when she had her pin-point punctures.

It was her PRESENT diving MD who suggested that she might not have
blown hard enough when she had difficulty descending!!!  :-)

Where did Sudafed come in???  We're getting there.  :-))

She had consulted and worked with several ENT Specialists over her
"ear problem" and everyone agreed that the use of Nasacort was
appropriate for her, until we moved from Clemson to Chattanooga,
when we had to look for a new ENT for her here.

That was when I learned that DAN (Divers Alert Network) made
MISTAKES, in its referral!  When we called DAN to ask for referral
of Scuba Diving ENT Specialists in the Chattanooga area -- the
answer we got was that there was NONE, and that the closest ones
were in Atlanta or Knoxville!  They gave us two names in Atlanta.

Since Atlanta is practically our 2nd home, so we phoned the DAN
referred "ENT Specialist".  But when I phone his office, the
appointment clerk who answered the phone was quick to deny that
he was an ENT, and I wasn't sure if he was an M.D.  :-)  The
DAN referral mystery was suggested by the appointment clerk that
this PERSON (might have been a chiropractor or protologist <G>)
took some DAN Oxygen Provider course!!  The referral in Knoxville
was no better.

The NEXT local ENT we contacted immediately suggested that Sue
go off Nasacort and take SUDAFED (non-prescription) instead!!!
I came to the conclusion that he must have played doctor on TV only.
Sue is now under the care of an M.D. Physician, who is NOT an
ENT Specialist, but a scuba diver :-)) who put her back on the
Nasacort medication, under prescription!

This is a very, very long story for the bottom line:

1.  If's OKAY to use Sudafed provided you use it with minor sniffles
    AND commonsense.

2.  DAN is not infallable.  DAN makes mistakes!

3.  When in doubt, you ALWAYS need to consult a physician (more than
    one for 2nd and 3rd opinions if neceesary) to make the PROPER
    recommendation, on a CASE by CASE basis, after personal
    examination AND knowledge of case history!

While (3) is not abolutely infallible, it's FAR better than anything
else, especially over the advice from newsgroups and LISTS, even
if those advice come from M.D.s without having examined the subject.

Safe BLOWING (a la Valsalva) and safe SUDAFED (a la commonsense)!

-- Bob.