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Comment by onphonenow | Hacker News Reader

Good advice - I wish diving leaned a bit more into managing buoyancy early on. I used to sometimes dive tail for a dive instructor doing group instruction if there was a shaky diver - some stressful moments. My ears hated it because I naturally am a slow decend/ ascend diver

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Have you ever tried taking Sudafed before a dive to see if it helps your ears? I've had minor MEBT (and plenty of discomfort) without, but so far I can shoot right down after taking it.

From the research I did before making the decision to try it, results are very mixed (there are plenty of anecdotes, but studies are few) [0] but it seems like as long as you try it on land first (on a non-diving day) to ensure no side effects, there's not much reason not to give it a go [1].

[0] https://pubmed.ncbi.nlm.nih.gov/1610044/

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3931412/

This is interesting. I've never given it much thought (and didn't know MEBT was a thing), but I've experienced the same discomfort while: SCUBA diving, skydiving, ordinary air flight descent, and even some hilly car driving.

Doc says there's nothing wrong or clogged etc about my eustachian tubes. It's easy enough to manage (except skydiving, where the pressure change is too fast and not under any meaningful control of mine!), but if pseudoephedrine would make things less distracting during SCUBA, I'm interested.

Thanks for the links!

It’s very important to note that pressure plays a role in how quickly the body processes out the medicine. A dose might last 6 hours on land may last much less under pressure. One significant danger to this is a decongestant wearing off unexpectedly early while underwater, resulting in congestion a depth and preventing equalization upon ascent. This could result in a barotrauma often called “reverse squeeze”.

Definitely worth noting, but personally I've never had any discomfort during ascent even prior to using the decongestant, and based on some other comments here, that seems to be because our ears are better equipped to readily equalize when over pressurized than under... approximating a check valve, I suppose?

I use the generic (CVS brand) 12-hour extended release 120mg about an hour before diving, then two dives with a surface interval between, so I'm only relying on about 4 of those claimed 12 hours. I'm not sure the magnitude of the effect you warn of regarding accelerated processing, but there's a good margin to work with. There's also a 24hr formulation available.

I’ve done the same. But my point is the “specs” are not well documented and a novice may not have considered this factor.

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