What’s In Your Dive Medicine Kit?

kerryPFI instructor and ER Physician Dr. Kerry Hollowell shares her tips on over-the-counter medications that just may save your dive day.

Lets talk about some over-the-counter medications and other remedies that are useful to have handy while diving. Let’s face it, sometimes our bodies need a little help in terms of mucous management, inflammation, and even sea sickness in order to have a pleasurable diving experience.

Below are a few things I always carry with me on any dive trip in order to deal with these issues. My first and foremost advice, though, is to take care of your body, stay in shape, and take as little medicine as possible.  Sometimes, though, when that’s not enough, you may find the following useful:

  1. Mucinex: (generic name Guaifenesin) is a mucolytic. This means that the drug thins out your mucous making it easier for you to equalize your ears and sinuses. It’s good to start this medicine 2-3 days before you plan to dive and to drink plenty of water with it. Staying hydrated helps the medicine do its job as well as prevent against kidney stones. It is maximum dosage is 1200mg twice per day. The pills usually come in 400mg and 600mg tabs. Make sure that whichever brand you buy doesn’t have any other medical ingredients, such as pseudoephedrine or any other substance that will increase your heart rate and shorten your breath hold. This medicine is tolerated easily by most people with no significant side effects, but potential adverse effects include:  kidney stones, nausea, vomiting and rash.
  2. Neti-pot: This is a great little device you can take with you on any trip. It  comes in many forms. My personal preference is the Neil-Med netipot only because I can apply more force to the water going in my sinuses as well as the fact that it’s small and easy to carry. This device comes with small saline (salt) packets that you dissolve in water. It is best to use it with distilled water only. If you don’t have access to distilled water, then you can use tap water if you boil the water first and then let it stand until it returns to room temperature. Never use plain tap water without boiling it first. This device is great for flushing out your sinuses, whether it be mucous or blood after a sinus squeeze from diving. This is not a medication and there are no adverse effects. There have been a couple of case reports of people who used tap water getting an infection, so remember your choice of water is important.
  3. Meclizine: For those of us who get sea sick often, this medicine can be very effective and doesn’t produce drowsiness like medications containing dimenhydrinate.  Read the labels of brands such as Bonine and Dramamine, to be sure which medication it actually contains. There is also a medication called Stugeron (generic name Cinnarizine), which although not available in the US, is available to divers in Canada and the Caribbean and elsewhere. There are also other options including scopolamine, ginger tablets or fresh ginger, and a pressure band for the wrist. These medicines and methods are all potential anti-sea sickness options and some work better than others. You will need to self-experiment to find which one works best for you.
  4. Ibuprofen: This medicine belongs to the class called NSAIDs (non-steroidal anti-inflammatory drugs), and can be very effective at reducing swelling particularly in the middle ear area, which often gets “squeezed” a bit if you wait too long to equalize.  The dose of this medication is 200 to 800 mg three times per day. It is helpful, once an inflammatory process with associated pain has set in, to take this medication routinely for 5-7 days to allow for treatment of the inflammatory process. One word of caution; long term use of this drug may cause gastrointestinal upset and ulcers. If you are prone to development of ulcers then you may not want to take this medication or you may want to take this medication along with an acid-reducing drug to reduce the irritation cause in the stomach.
  5. Afrin: (generic name Oxymetazoline) This is a decongestant nasal spray that can reduce nasal congestion. It should only be used sparingly, as repeated chronic use of this nasal spray can cause rebound nasal congestion once you discontinue the spray. This is good to have on the boat in the event you are unable to dive due to difficulty with equalization due to congestion. Just a quick spray in each nostril and it may be enough to open up the passageways allowing you to equalize and dive that day.
  6. Ear cleaning drops: I use a combination of isopropyl alcohol and vinegar mixed in a 50:50 ratio. Mix equal parts white vinegar (which contains a germ-fighting acid) and isopropyl alcohol (which helps dry out the ear). Apply a few drops after every pool or ocean adventure to prevent ear infections.

As i mentioned above, keeping in good general health and fitness will go a long way toward ensuring you’re fit to dive, but if you are knowledgeable about the medications and remedies listed above, you may be able to rescue a dive day that you would otherwise lose to unexpected congestion.

One final word about all the medications noted above. It is best to consult your physician before starting any new medication or if you have any concerns regarding these medications or their potential side effects.

Be Safe and Happy Diving!