No More Scuba Dry Mouth!
January 2002
By Ernest Campbell
What Caused My Dry Mouth?
After two days of diving recently, I developed an irritated throat that progressed to a rather nasty condition--dry and quite sore--for another six days after returning home. Because I am scheduled to take a weeklong live-aboard trip soon, I need some advice on how to prevent dry mouth and throat irritation from repeated diving.
- Peter H. Meyer, Allen, Texas
It may be that your problem was a viral pharyngitis or some other infectious condition. It also could have been caused by not swallowing while under water. Saliva can help prevent the dry mouth caused by the dry air in your scuba cylinder. Your saliva glands can be stimulated by using the SeaCure mouthpiece (www.seacure1.com) or placing minty toothpaste on your mouthpiece.
If your dry mouth was caused by dehydration, however, you need to examine your habits before you dive to prevent dehydration on your next dive. The air in your scuba tank is as dry as the Sahara, the moisture having been removed from it in order to protect the inside of your tank and regulator from corrosion. Each incoming breath of dry air picks up moisture from your throat and lungs and carries it out when you exhale, so every breath represents a loss of water.
How much? Not as much as you'd guess from the cotton-mouth feeling that results. On a four-tank day you'll breathe about 260 cubic feet of dry air (assuming 80-cubic-foot tanks--actually 77.4--and a minimum pressure of 500 psi). The maximum amount of water that much air could have contained (at 100 percent humidity, 86F) is about one cup. In fact, you probably lose less. Research reported in the journal Respiration Physiology suggests that most of this water loss occurs in the first 15 minutes when your upper respiratory tract dries out. Regulators that trap moisture in the second stage to moisten incoming air lessen, but probably don't entirely prevent, the drying effect of breathing tank air.
Hydration Hazard: Caffeine
Yes, a cup of coffee is mostly water. But the caffeine is a diuretic, sucking water out of your tissues and sending it to your bladder. As a result, drinking 12 ounces of coffee results in 12, 15, 20 or more ounces of urine and a net loss in your hydration score.
Caffeine is sneaky. It's in more foods and beverages than you might think. Popular soft drinks have a range of caffeine concentrations between 36 and 48 milligrams, with Jolt Cola the chart topper at 72. Coffee has the highest concentration, up to 180 milligrams per five-ounce cup. Tea can have as much as 50 milligrams per cup, and both tea and chocolate are loaded with substances called xanthines, which are also diuretic.**
Nine Ways to Beat Dehydration**
The importance of being well-hydrated before you dive cannot be overstated. Drink water several hours before and between dives, particularly if making multiple dives. Follow these tips:
-
Drink water.
-
Stay out of the sun and wear a hat.
-
Drink water.
-
Eat foods high in water, like fruits and salads.
-
Drink water.
-
Don't eat too much protein, the digestion of which requires more water than it contributes.
-
Drink water.
-
Take it easy with caffeine and alcohol.
-
And drink water. At least a gallon a day.
Suck It Up: SCUDA
Divers with a severe dry mouth problem may want to consider another equipment solution, the SCUDA (self-contained underwater drinking apparatus) made by SCUDA Marketing. The SCUDA is a wine-skin type device that holds water and allows you to drink through your regulator--squeeze the bag and water squirts into your mouth. The SCUDA doesn't affect the breathing characteristics of a regulator, but because it attaches to the primary hose, it does affect regulator ergonomics. There's also the possibility that you'll gag on water squirted inadvertently or too forcefully into your mouth. The SCUDA is not a great idea for most divers, but those with serious dryness of the mouth may want to try it.
A Case of "Land Sickness"
Two years ago after a weeklong live-aboard trip, I experienced "land sickness"--some dizziness, feelings of motion and slight nausea for four days. I am going on the same trip again this month. Any tips on prevention?
- Leslie Cucuel, via e-mail
We haven't heard it called "land sickness," but the situation you describe is an adaptation of the vestibulo-ocular reflex. When you get off a live-aboard, it can feel like you've just gotten off a spinning merry-go-round. This interesting phenomenon affects most astronauts and seafarers, at least to a small degree. The vestibulo-ocular reflex is a complex mechanism, but, basically, we'd have blurry vision if it didn't exist. This reflex is one of the most rapid, accurate and adaptive mechanisms in the body. It's what allows wild animals to stay fixed on prey while hunting at top speeds, Gail Devers to see the finish line while straddling hurdles at full stride and teenagers to see 'NSync on the stage while bouncing around during a concert. Your condition is a lingering effect of the constant visual motion you were used to on the boat and your body is taking a bit longer to return to normal. It can last up to several weeks. Unless prolonged or severe, it should resolve without treatment.
Beach Boo-Boos
My wife and I were on a diving trip in Cozumel a few weeks ago. I got stung by something that I thought was fire coral (black with white tips) and later my wife got stung by some floating things (maybe jellyfish) while she was swimming. I had little, red, itchy dots on my hands that after two days turned into little blisters. My wife got little red spots on her hands and chest that basically look like red freckles. After three weeks, things only got a little bit better. What was it, and what can we do about it?
- Peter Roberts, Los Angeles, Calif.
You could have brushed against some fire coral, though fire coral is usually reddish-orange with white tips. In any case, you were definitely stung by the nematocytes of a marine organism. The nematocyte is present in hydroids, fire corals, jellyfish and many other ocean creatures. It fires a toxic dart when it comes in contact with the skin, leaving a reddish welt that stings, burns and itches. Scratching, rubbing or applying fresh water makes more of the nematocytes fire and worsens the problem.
Your wife could have encountered sea bather's eruption or sea lice. This is caused by coming into contact with the larvae of the thimble jellyfish or nematocysts (the discharge from the nematocyte) from several other ocean organisms, which abound in Caribbean, Gulf of Mexico and Florida waters at certain times of the year. It usually has a local name, such as aqua mala, but is caused by the nematocytes of jellyfish, hydroids or anemones.
It most often affects the skin under the swimsuit, around the edges and in skin creases, and recurs if the suit is not rinsed properly.
Treatment of both your conditions currently includes taking an antihistamine for the itching and applying an over-the-counter hydrocortisone cream (0.5 percent) to the rash areas. More serious eruptions might require epinephrine, systemic steroids and steroid cream.
Minimizing the Sting
There are some measures you can take to help prevent or lessen the number of stings you get from marine beasties:
-
If you have a history of severe reactions to marine stings, stay out of the water when there are beach warnings or signs of sea lice outbreaks.
-
Avoid wearing T-shirts while in the ocean. Use a topical sunscreen and limit sun exposure for protection against solar injury. A topical sunscreen or suntan lotion may actually protect skin from penetration by the nematocysts.
-
Reduce the surface area of swimwear that could trap larvae, using smooth, tight-weave bathing suits that may trap fewer larvae than suits with an open-weave fabric.
-
Change out of your swimsuit as soon as possible. Most lesions occur from contact with contaminated swimwear. Then shower to rinse off loose larvae. If possible, rinse off with salt water first, then fresh water
-
Swimsuits should be thoroughly washed with detergent and heat-dried after use. Symptoms could recur if your put on a suit that has been air-dried. Air-dried nematocysts still have the potential to fire.
Answers to questions are offered as information only and not as medical diagnosis or advice and should always be used in conjunction with advice from your personal diving physician.
Please send your dive medicine questions to RSD, 6600 Abercorn St., Suite 208, Savannah, GA 31405. Fax: (912) 351-0735. E-mail: [email protected].
Ernest S. Campbell, M.D., FACS, makes his home in Orange Beach, Ala. He is a retired surgeon, avid diver and webmaster of "Diving Medicine Online" (www.scuba-doc.com).
January 2002
By Ernest Campbell
What Caused My Dry Mouth?
After two days of diving recently, I developed an irritated throat that progressed to a rather nasty condition--dry and quite sore--for another six days after returning home. Because I am scheduled to take a weeklong live-aboard trip soon, I need some advice on how to prevent dry mouth and throat irritation from repeated diving.
- Peter H. Meyer, Allen, Texas
It may be that your problem was a viral pharyngitis or some other infectious condition. It also could have been caused by not swallowing while under water. Saliva can help prevent the dry mouth caused by the dry air in your scuba cylinder. Your saliva glands can be stimulated by using the SeaCure mouthpiece (www.seacure1.com) or placing minty toothpaste on your mouthpiece.
If your dry mouth was caused by dehydration, however, you need to examine your habits before you dive to prevent dehydration on your next dive. The air in your scuba tank is as dry as the Sahara, the moisture having been removed from it in order to protect the inside of your tank and regulator from corrosion. Each incoming breath of dry air picks up moisture from your throat and lungs and carries it out when you exhale, so every breath represents a loss of water.
How much? Not as much as you'd guess from the cotton-mouth feeling that results. On a four-tank day you'll breathe about 260 cubic feet of dry air (assuming 80-cubic-foot tanks--actually 77.4--and a minimum pressure of 500 psi). The maximum amount of water that much air could have contained (at 100 percent humidity, 86F) is about one cup. In fact, you probably lose less. Research reported in the journal Respiration Physiology suggests that most of this water loss occurs in the first 15 minutes when your upper respiratory tract dries out. Regulators that trap moisture in the second stage to moisten incoming air lessen, but probably don't entirely prevent, the drying effect of breathing tank air.
Hydration Hazard: Caffeine
Yes, a cup of coffee is mostly water. But the caffeine is a diuretic, sucking water out of your tissues and sending it to your bladder. As a result, drinking 12 ounces of coffee results in 12, 15, 20 or more ounces of urine and a net loss in your hydration score.
Caffeine is sneaky. It's in more foods and beverages than you might think. Popular soft drinks have a range of caffeine concentrations between 36 and 48 milligrams, with Jolt Cola the chart topper at 72. Coffee has the highest concentration, up to 180 milligrams per five-ounce cup. Tea can have as much as 50 milligrams per cup, and both tea and chocolate are loaded with substances called xanthines, which are also diuretic.**
Nine Ways to Beat Dehydration**
The importance of being well-hydrated before you dive cannot be overstated. Drink water several hours before and between dives, particularly if making multiple dives. Follow these tips:
Drink water.
Stay out of the sun and wear a hat.
Drink water.
Eat foods high in water, like fruits and salads.
Drink water.
Don't eat too much protein, the digestion of which requires more water than it contributes.
Drink water.
Take it easy with caffeine and alcohol.
And drink water. At least a gallon a day.
Suck It Up: SCUDA
Divers with a severe dry mouth problem may want to consider another equipment solution, the SCUDA (self-contained underwater drinking apparatus) made by SCUDA Marketing. The SCUDA is a wine-skin type device that holds water and allows you to drink through your regulator--squeeze the bag and water squirts into your mouth. The SCUDA doesn't affect the breathing characteristics of a regulator, but because it attaches to the primary hose, it does affect regulator ergonomics. There's also the possibility that you'll gag on water squirted inadvertently or too forcefully into your mouth. The SCUDA is not a great idea for most divers, but those with serious dryness of the mouth may want to try it.
A Case of "Land Sickness"
Two years ago after a weeklong live-aboard trip, I experienced "land sickness"--some dizziness, feelings of motion and slight nausea for four days. I am going on the same trip again this month. Any tips on prevention?
- Leslie Cucuel, via e-mail
We haven't heard it called "land sickness," but the situation you describe is an adaptation of the vestibulo-ocular reflex. When you get off a live-aboard, it can feel like you've just gotten off a spinning merry-go-round. This interesting phenomenon affects most astronauts and seafarers, at least to a small degree. The vestibulo-ocular reflex is a complex mechanism, but, basically, we'd have blurry vision if it didn't exist. This reflex is one of the most rapid, accurate and adaptive mechanisms in the body. It's what allows wild animals to stay fixed on prey while hunting at top speeds, Gail Devers to see the finish line while straddling hurdles at full stride and teenagers to see 'NSync on the stage while bouncing around during a concert. Your condition is a lingering effect of the constant visual motion you were used to on the boat and your body is taking a bit longer to return to normal. It can last up to several weeks. Unless prolonged or severe, it should resolve without treatment.
Beach Boo-Boos
My wife and I were on a diving trip in Cozumel a few weeks ago. I got stung by something that I thought was fire coral (black with white tips) and later my wife got stung by some floating things (maybe jellyfish) while she was swimming. I had little, red, itchy dots on my hands that after two days turned into little blisters. My wife got little red spots on her hands and chest that basically look like red freckles. After three weeks, things only got a little bit better. What was it, and what can we do about it?
- Peter Roberts, Los Angeles, Calif.
You could have brushed against some fire coral, though fire coral is usually reddish-orange with white tips. In any case, you were definitely stung by the nematocytes of a marine organism. The nematocyte is present in hydroids, fire corals, jellyfish and many other ocean creatures. It fires a toxic dart when it comes in contact with the skin, leaving a reddish welt that stings, burns and itches. Scratching, rubbing or applying fresh water makes more of the nematocytes fire and worsens the problem.
Your wife could have encountered sea bather's eruption or sea lice. This is caused by coming into contact with the larvae of the thimble jellyfish or nematocysts (the discharge from the nematocyte) from several other ocean organisms, which abound in Caribbean, Gulf of Mexico and Florida waters at certain times of the year. It usually has a local name, such as aqua mala, but is caused by the nematocytes of jellyfish, hydroids or anemones.
It most often affects the skin under the swimsuit, around the edges and in skin creases, and recurs if the suit is not rinsed properly.
Treatment of both your conditions currently includes taking an antihistamine for the itching and applying an over-the-counter hydrocortisone cream (0.5 percent) to the rash areas. More serious eruptions might require epinephrine, systemic steroids and steroid cream.
Minimizing the Sting
There are some measures you can take to help prevent or lessen the number of stings you get from marine beasties:
If you have a history of severe reactions to marine stings, stay out of the water when there are beach warnings or signs of sea lice outbreaks.
Avoid wearing T-shirts while in the ocean. Use a topical sunscreen and limit sun exposure for protection against solar injury. A topical sunscreen or suntan lotion may actually protect skin from penetration by the nematocysts.
Reduce the surface area of swimwear that could trap larvae, using smooth, tight-weave bathing suits that may trap fewer larvae than suits with an open-weave fabric.
Change out of your swimsuit as soon as possible. Most lesions occur from contact with contaminated swimwear. Then shower to rinse off loose larvae. If possible, rinse off with salt water first, then fresh water
Swimsuits should be thoroughly washed with detergent and heat-dried after use. Symptoms could recur if your put on a suit that has been air-dried. Air-dried nematocysts still have the potential to fire.
Answers to questions are offered as information only and not as medical diagnosis or advice and should always be used in conjunction with advice from your personal diving physician.
Please send your dive medicine questions to RSD, 6600 Abercorn St., Suite 208, Savannah, GA 31405. Fax: (912) 351-0735. E-mail: [email protected].
Ernest S. Campbell, M.D., FACS, makes his home in Orange Beach, Ala. He is a retired surgeon, avid diver and webmaster of "Diving Medicine Online" (www.scuba-doc.com).
