Experiencing a nosebleed while scuba diving

 

Experiencing a nosebleed while scuba diving isn’t uncommon and even though the sight of blood in your dive mask looks terrifying, a nosebleed isn’t a severe problem as long as it isn’t persistent.

Nose bleeds are witnessed more often with newer divers than with experienced divers simply because of the way a new diver equalizes  as he descends.

New divers frequently report nosebleeds after diving primarily because they are unaware of the importance of equalizing the sinuses and middle ears (via the Valsalva method). The barotrauma that is produced when the sinuses are not cleared can cause blood vessels in the lining of the nose to burst. These vessels lie very close to the top of the mucous membrane lining in the nose and sinuses, and the blood can come from the lining in either. This type of barotrauma, generally the result of air being trapped within the sinuses, is not always painful, though the presence of blood can be disconcerting to a new diver. With this type of injury, blood can run down the back of the throat or pool in the sinus below the eye and emerge at a different time.

Scuba Diving nosebleeds can be categorized :

Nosebleed Scuba Diving During Descent.

These are very common as the nosebleed scuba diving individual is experiencing these effects of a little thing called ‘mask squeeze‘. This is when a scuba diver is often so overwhelmed at the start of the dive that he/she forgets to equalize regularly during a descent trying to keep-up with the group. At 7 meters (22ft) if a diver has not equalized their ears, they will need to ascend in order to do so. However the novice diver often does not want to leave the group and will force equalization, often rupturing the delicate inner lining and capillaries of the nose septum and sinus, causing the nosebleed. Divers must equalize little and often as they go down, and if they reach a depth where they have forgotten to equalize, it is better to ascend a few meters than try to force an equalization at depth.  Mask squeeze results from not equalizing the pressure in the mask to match the water pressure and it creates a vacuum in the mask. This directly affects the nasal passages. . It can easily be remedied by performing a slow descent while frequently adjusting the equalization of the mask.

Reverse sinus squeeze.

In the same manner a nose bleed that occurs during ascent is known as a reverse sinus squeeze, caused when the sinus is at a higher pressure than the outside, and unable to equalize fast enough due to the congestion, it causes the sinus blood vessels to be sucked outward in the form of a nose bleed on ascent. The reverse sinus squeeze can be minimized by slowing your ascent if you suffer from a minor cold or stuffy nose.

Most nosebleeds stop immediately as you come out of the water and don’t warrant an emergency room visit or medical advice. The diving instructor will verse you well on nosebleed scuba diving because although it is common, it scares many potential scuba divers away after only the first time because they have experienced this nosebleed scuba diving and they stay away from it forever not realizing how easy it is to remedy.

Prevention of a nosebleed.

Avoid diving altogether when you have a cold. Knowing when you are fit to dive is vital to diver safety.

If while descent you feel a pain in your forehead or sinuses, call off the dive and surface.

Try blowing your nose gently underwater to see if that helps decongest the sinus, if not ascend.

If your nosebleed is minor, leave it alone, lightly pinch your nose and tilt your head back, and it will heal automatically in 15minutes or so.

Excessive nosebleeds require a doctor’s examination, as often the blood inside the sinus can get infected by bacteria and cause sinus infections other complications so you might need to get it checked out by an ear-nose-and-throat specialist for evaluation.

If you have recurring nosebleeds every dive, you probably have a congested sinus, and will need to take care of it before diving again.

Always remember to descend slowly equalizing gently and frequently, and ascend slowly to allow sinus equalization to take place naturally, and you should have a blood free mask when you surface.

It’s always best not to dive with a cold or any condition that may block the sinus air passages.

Divers who are unable to clear their sinuses or have frequent nosebleeds when scuba diving should see their personal physicians or ear-nose-and-throat specialists for evaluation.

What Makes Divers Want to Pee While Diving?

When diving, I suddenly get the urge to pee, even though I voided only minutes before. Why do I need to pee so soon? This physiological phenomenon is known as immersion diuresis, a fancy term for your body’s response to feeling under pressure.

The human body is full of blood. The volume of blood may increase or decrease with hydration and other factors

The body has various mechanisms in place to maintain a constant volume of blood at all times. This keeps you from exploding when your blood volume begins to increase.Blood is shifted to your body’s core, and the hypothalamus gland thinks this means your total fluid volume is too high and instructs your kidneys to make urine.

Cold Water Makes You Pee In Your Wetsuit:

One reason that divers feel the need to urinate in their wetsuits underwater is called cold water immersion diaresis..

When a person jumps into cool water, his body automatically attempts to minimize heat loss by shunting blood alway from his skin’s surface and extremities and towards his warm body core and vital organs. This is part of a phenomenon known as the mammalian diving reflex.

Although the total volume of blood in the diver’s body has not changed, the volume of blood in his body core (particularly his heart) has increased. This triggers the body’s high blood volume management system, which mainly involves increasing the rate of urine production in the kidneys (diaresis) as discussed abov

Weightlessness Makes You Pee in Your Wetsuit:

Weightlessness, or near weightlessness, also causes blood to shift towards the body’s core. This headward fluid shift was first observed in astronauts, who had to pee more than they normally would while in space. Weightlessness, like cold water immersion diaresis, triggers the body’s high blood volume management reactions which increase the production of urine.

Neutral buoyancy as experienced by scuba divers so accurately mimics the experience of weightlessness in space that it has been used both to train astronauts and to conduct experiments about the effects of weightlessness. And, like weightlessness, neutral buoyancy also triggers the increase of urine production and makes you need to pee.

What can you do to avoid immersion diuresis? In simplified words: How Can You Reduce the Urge to Pee In Your Wetsuit?:

 Avoid diuretics like caffeine before you dive.

Drinking less diuretic fluids, such as coffee, before diving will reduce (but not eliminate) a diver’s need to urinate underwater.

Intentionally dehydrating yourself might seem like a good idea, but dehydration increases fatigue and predisposes you to decompression sickness.

On land, consuming large quantities of water will cause a person to urinate more frequently. A diver might assume, therefore, that consuming less water will reduce his need to pee. This is not the case. A diver’s body will sense the increased volume of blood in his body core regardless of his hydration level.

Dehydration will only cause your pee to be smellier and darker than normal.  Dehydration makes the result stronger in odor and color.

If you’re well-hydrated, your urine will be nearly clear and odorless. Almost like water. So who’s to know?

The Embarrassment Factor

There is a well-worn joke that divers belong to two schools regarding peeing in their wetsuit: Those who do and those who lie about it.

There’s no health risk to peeing in your wetsuit. Most people don’t realize that urine is sterile, unless you already have an infection of the urinary tract. The worst you have to fear is a case of diaper rash if the urine stays against your skin several hours, and this too is less of a problem when your urine is diluted. Solution: Open your wetsuit under water and rinse it between dives.

The Need to Pee Underwater Is a Normal Reaction to the Dive Environment:

So don’t be embarrassed by your urge to urinate. Simply remember to wash your suit in fresh water after diving (and not in the same rinse tank as the regulators!)

 

The Warmth Factor

Try to stay warm. Stay warm by using a thicker wetsuit. A side effect of your body’s response to cold is the production of urine. Wearing a hooded vest under your wetsuit may save you from having to empty your bladder when you least want to. On the boat, stay out of the wind, bundle up and wear a hat.

Cold water immersion diaresis and the headward fluid shift caused by the perceived weightlessness of neutral buoyancy combine to significantly increase a diver’s urine production. Eliminating either of these factors will reduce the need to pee underwater. However, no matter how warm or dry a diver is underwater, he will still be neutrally buoyant (hopefully) and urine production will still occur at a faster than average rate. This is why pee valves are popular among drysuit divers

True or false? Urinating in a wetsuit is a quick way to warm up.

False, and here’s why: You may feel warm initially, but it will actually lower your body’s warmth. And, if you’re wearing a tight-fitting wetsuit that doesn’t flush easily, a semi-dry or dry suit, then this warming-up technique loses a lot of its appeal

What To Do with a Wetsuit that Stinks

It couldn’t be helped. You felt the urge to pee during a dive, and so you did. Now you’re afraid your wetsuit will stink. What should you do?

1. Give it a hot rinse.

This is the most important part of regular stink prevention. Walk right past the rinse tank where other divers are busy dunking their suits in the filth rinsed off other gear, and go back to your room at the resort or home and rinse it in hot, fresh water. The easiest way to do this is to take your suit in the shower with you. Hot water is better than lukewarm water for breaking down salts from the ocean and from your body.

2. Hang it. After rinsing, hang your suit to dry on a wide wooden or plastic hanger, preferably one made for wetsuits. Use a wide hanger to keep the front and back of the suit apart so it can dry more quickly.

   3. Soap it. Every once in a while give your suit a soapy bath. Scrub it well inside and out. Use a sponge on the slick neoprene and a soft-bristled brush on any nylon linings. Just about any kind of soap will work to kill the odor, but some are better than others. The best soaps for the job are commercially available “wetsuit shampoos” (check your local dive store) or a gentle baby shampoo. Dish and laundry soaps are too harsh to use regularly on your wetsuit, but will do the job in a pinch.

 

 

Conclusion

Everyone else is peeing in their suits, why should you miss out on all the fun?

 

Controlled Descent

Descending from the surface should be as easy , but it sometimes can deteriorate into an exhausting struggle with our gear and our mounting anxiety.

The solution is to handle descents the same way you’d eat an elephant: one bite at a time.

The ability to make a controlled descent is important for three reasons:
1. If a diver experiences ear equalization problems and he cannot arrest his descent, he risks an ear barotrauma.
2. A diver must be able to descend without landing on the bottom because even a gentle fin kick can irrevocably injure coral or other aquatic life. Landing on a shipwreck or cave floor can not only destroy delicate historical information, it can stir up sediment to the point that visibility is dangerously reduced.
3. A diver should be able to stay close to his buddy during descent.

Avoid task-loading problems by breaking down your descent into discreet, manageable steps

On the Surface

After you and your buddy make your entries, don’t rush to descend. Relax, regroup and recheck. Make contact with your buddy, clear the entry area and float comfortably buoyant with your snorkel or regulator in your mouth and your face in the water.
Take a few moments to establish a slow, full breathing pattern and acclimate to the water temperature, especially if it’s cold. Then begin to methodically recheck your gear to make sure nothing has come loose on entry — your weight belt buckle or your mask strap, for instance. Listen and look for hose leaks and freeflows. If you’re wearing a dive computer, confirm that it is activated. Once you’re satisfied that everything is in order, visually check over your buddy’s equipment.
If surface conditions such as a current or wind chop make you uncomfortable, these checks can be performed while holding onto a current line or just under the surface on a descent line.
Practice your ear equalization technique a couple of times to loosen up the muscles. As a last step before descending, compare gauges and set your watches.
Begin Your Descent
Once the “thumbs down” signal is given, both buddies should begin their descent at the same time and remain together all the way to dive depth. Keep your right hand free to equalize your ears as you drop below the surface.
To start your descent, establish negative buoyancy by venting air from your buoyancy compensator (BC).

With your left hand, raise your deflator hose straight above your head and depress the button while dipping your right shoulder. This position will ensure that the air has an unobstructed path to flow up and out. If you have previously performed a weighting check and are correctly weighted, you should immediately begin to descend slowly and effortlessly.
If you fail to sink, first stop all kicking and other body motions and exhale fully. This is often enough to trigger a normal descent. Next, try squeezing any remaining air out of your BC while keeping the deflator hose up and the button fully depressed. Only after you’ve tried the above should you consider adding weight.
Some divers try to deal with an inability to sink by “duck diving” — swimming head down to propel oneself under the surface. This takes a lot of effort and also makes equalizing difficult. A better option is to use a descent or down line, which often hangs vertically into the water near the entry area of the boat especially for that purpose. Or you can use the boat’s mooring or anchor line.
Try easing yourself down the first few feet (1 m) along the line while remaining in an upright position; remember to equalize your ears as you go. You may be properly weighted but just need that little bit of increased pressure to force out air trapped in loose spots between your body and wet suit and in your gear. It is also easier to relax and exhale fully once your head is under the surface. If you still don’t sink, you’re probably underweighted.
If you determine that you are either under- or overweighted enough that you can’t proceed with a safe, enjoyable dive, signal your buddy to abort the descent. Return to the boat to add or subtract lead.
To control anxiety, stop your descent and hold onto the line until your breathing and heart rate return to normal. Remind yourself to clear your ears often by equalizing every time you move your hand down on the line.

Allow yourself to float downwards until you can no longer easily control your buoyancy with your lungs. Once you reach the point that you continue to sink when you inhale, you are no longer neutrally buoyant. When you are neutrally buoyant you should rise slightly when you inhale fully. Remember, the goal is to maintain neutral buoyancy throughout the descent, not negative buoyancy. Add a tiny, tiny amount of air to your BCD. You should be able to stop descending or rise slightly when you inhale. Take some time to find this point of neutral buoyancy.
Regroup:
After descending a few feet and reestablishing neutral buoyancy, take a moment to check that your ears are properly equalized. Look at your depth gauge and notice if you are approaching or have reached your intended depth. Check on your buddy. If all is good . . .

Descend by Exhaling Once Again:
Once you have regrouped, continue your descent by exhaling fully. The goal is to control your descent by working your way slowly and carefully down through the water column using you lungs to descend and your BCD to keep yourself neutrally buoyant. When you arrive at your desired depth, you should have to do very little to fine-tune your buoyancy.

Equalize, Equalize, Equalize
As soon as your head sinks below the surface, equalize your ears and continue to equalize at least every couple of feet all the way to dive depth . The key to successful ear clearing is “early and often” — start early and do it often. This prevents pressure from building up against the eardrum, causing pain and difficulty equalizing.
Don’t continue your descent if you do experience ear discomfort; it won’t get better. Instead, ascend a few feet until you can equalize, then continue your descent more slowly, equalizing even more frequently . You can’t equalize too often.
Avoid looking down while trying to equalize; it can pinch the Eustachian tubes, making them more difficult to open. Raise your chin and stretch your neck to each side to help air flow through the tubes. Blowing harder is not the answer.

Slow Your Descent
The deeper you descend, the more negatively buoyant you’ll become as the increased pressure compresses the air spaces in your exposure protection. You may need to slow your descent by adding air to your BC with short bursts from your power inflator .
Stop your descent at least 1 m before you reach dive depth. Make yourself neutrally buoyant and hover. Confirm with your buddy that you’ve both completed a successful descent. Roll to a horizontal trim and begin your dive.

By taking it one bite at a time, every descent will start you off relaxed and ready to enjoy a perfect dive.

As you gain experience with controlling your descent, you will become more efficient and effective. Eventually, you will deflate exactly the correct amount of air from your BCD in one shot, exhale and float down, add air to compensate for the increased negative buoyancy at the correct moment, and continue quickly down.

Once mastered, a controlled descent is more efficient than dumping the all air from your BCD at the beginning of the dive because you do not waste time fighting with your buoyancy on the way down. You arrive at your desired depth neutrally buoyancy and ready to swim off on your adventure.

Be patient. Every diver can properly control his descent with understanding and practice.