Legal Excrement: This section is intended for general education purposes only, and is not a substitute for medical examination. Any unusual symptoms you develop after scuba diving could be due to a serious condition. See your health professional immediately. What's more, this section is shoddily researched and may contain horrible errors, so we won't even imply that anything in here is accurate. In fact, it's probably dangerous to be reading this. You might get eye strain and sue. Better quit now!

BARODONTALGIA:
   Tooth pain during diving may be due to tiny pockets of air within your dental work. During descent, the air pocket becomes a "relative vacuum," creating pain. Pain during ascent means that air has filtered into the space, and pressure is building up. Sometimes this pressure can actually make a crown break or fall off.
   The pain can occur under crowns, caps, veneers, fillings, or root canals. Active infection at the roots of a tooth can also be affected by pressure changes.
   Damage to dental restorations is more common in divers using Heliox, because the helium more quickly enters these spaces when you're at depth, then expands as you ascend.
   If you get tooth pain on diving, tap on your teeth with a finger until you identify the "problem tooth." Then see your dentist.

CIGUATERA FISH POISONING:
    Ciguatera poisoning is the most common disease caused by eating fish. The flesh of the fish contains a colorless, odorless, tasteless poison. This poison is created by a type of plankton around coral reefs. Small animals eat the plankton, then larger fish eat the small animals. Toxin builds up in the fish's tissues.
    Fish containing ciguatera toxin are usually from the tropics, south Florida, or Hawaii. Common species include red snapper, grouper, amberjack, and barracuda. Cooking does NOT eliminate the toxin. Neither does drying, smoking, or marinating.
    Symptoms usually begin a few hours after eating the toxic fish meat, but can occur as late as two days. Most often, the illness begins with vomiting, diarrhea, and abdominal cramps. The toxin causes tingling sensations, abnormal hot and cold sensations, weakness, and muscle pain in the legs. Hot feels cold, and cold feels hot. Heart and lungs may be affected.
    The symptoms usually last about a week, but sometimes go on much longer -- months or years. Some victims have a return of symptoms after drinking alcohol or eating a large amount of meat.
    There's no antidote for the ciguatera toxin. Patients with severe poisoning may need to be in the hospital to control severe vomiting and pain.
    You should get emergency care if you suspect ciguatera poisoning.

COELENTERATE STINGS:
    Fire coral, hydroids, and jellyfish have stinging cells that "fire" venom into your skin. There's an immediate burning sensation followed by a swollen rash. With jellyfish stings, there may be long rope-like welts that are intensely painful. The more poisonous jellyfish (sea wasp, Portuguese Man-o-War) can cause unbearable pain, muscle spasms, shock, and loss of consciousness.
    If there are bits of jellyfish tentacle on the skin, inactivate the stinging cells with vinegar or alcohol. Remove any visible bits of tentacle with tweezers or pliers. Then get rid of any stuck stinging cells by gently shaving the skin.
    Antihistamines such as diphenhydramine 50 mg every 4 hours (sample brand Benadryl) can help with the symptoms. Apply hydrocortisone cream to the reddened areas three times a day. It usually takes several days for the rash to go away.

CORAL ABRASIONS:
    When you rub against a coral reef with bare skin, the coral's stinging cells "fire" toxin into the scratched skin. This causes burning pain or itchy welts around the scratch, called "reef rash."
    Inactivate any stinging cells on the surface of the scratch with vinegar or alcohol, then wash the abrasion thoroughly. Antihistamines (for example, Benadryl 50 mg every four hours) will reduce the severity of the welts and itching. Hydrocortisone 1% cream applied three times daily can make the reaction resolve more quickly.
    It can take several weeks for the scrape to heal. See your doctor if there is increasing redness, swelling, worsening pain, or fever.

DECOMPRESSION SYMPTOMS:
    Decompression sickness ("the bends") is caused by nitrogen bubbles in your blood stream. The bubbles form after scuba diving, when you "saturate" the blood with nitrogen.
    The nitrogen bubbles can block small blood vessels. Decompression sickness can affect skin, joints, muscle, abdomen, and brain. Symptoms depend on where the bubbles form, but can include joint pain, muscle pain, spotty skin discoloration and swelling, abdominal pain, chest pain, shortness of breath, or neurological symptoms.
    Decompression illness is more likely if you fly or go to high altitude after diving, or if you dive while dehydrated or physically tired. An area with poor circulation is more likely to be affected -- for example, if you dive deep and long several times, and leave a tight wet suit on during your surface intervals, you can suffer decompression "hits" to your hands and feet because the wet suit slows the circulation out of the extremities.
    Mild decompression symptoms (such as "skin hits") may not require treatment -- but more dangerous problems can pop up at any time. So any case of suspected decompression illness should be immediately evacuated from the dive area and evaluated for possible treatment in a pressure chamber.

DENGUE FEVER:
   This is a viral illness transmitted by the Aedes Aegypti mosquito. It is rare, but found in the Caribbean, South Pacific, Asia, and from Mexico to South America. The only prevention is avoiding mosquito bites. Use DEET-containing mosquito repellants, long clothing, and netting around the bed.

DIVER'S HEADACHE:
    Diver's headache can have several causes. These include neck muscle headache, hyperventilation vascular headache, sinus headache, fume headache, tension headache, dehydration headache, hypertensive headache, and (worst case) decompression illness. The best treatment for any of these headaches is prevention. If you commonly get a headache while diving, try to identify the cause, then eliminate it.
    Neck muscle headache: This headache usually starts at the back of the head, but can become generalized. It usually begins gradually after a couple of dives. It's caused by chronically tilting the head up during the dive -- for example, looking upward while swimming horizontally. The muscles where the back of the head meets the neck may be tender to touch. Ibuprofen (up to 800 mg every 6 to 8 hours) and ice packs can help.
    Hyperventilation vascular headache: This is a pounding headache that can occur at any time during or after a dive. The cause is breathing more rapidly that you should (hyperventilation). So it's more common in free-divers than scuba divers. Reduced carbon dioxide levels during hyperventilation lead to constriction of the blood vessels of the brain. When the vessels relax again, they often dilate and throbbing pain begins. Sensitivity to light and nausea are common. Caffeine is often very helpful for this type of headache, when combined with ibuprofen, aspirin, or acetaminophen.
    Sinus headache: This headache begins with congested sinus openings, so the sinuses don't equalize during descent or ascent. The pain is usually most intense in the face area, and often begins as an ache in the cheekbone, eye, or forehead. Besides ibuprofen (800 mg), use a nasal decongestant spray (example Afrin) to unplug the sinus. If blood and pus-like material come out your nose, you have progressed from sinus congestion to sinusitis -- and you will need antibiotics.
    Fume headache: Diesel fumes. You need clean air.
    Tension headache: "Ordinary" generalized pressure-type headache due to travel hassles, disrupted sleep patterns, and altered activity patterns. Treat with rest, fluids, and an analgesic such as ibuprofen or acetaminophen.
    Dehydration headache: This headache throbs when you stand up. It seems to be better when you lie down. Often, you may have a "head rush" when you first stand up. The headache occurs because decreased blood vessel volume lets the brain "sag" down when you're upright. Alcohol, caffeine, and snug wet suits make this headache more likely. (Alcohol and caffeine act as diuretics, flushing extra water out through the kidney. Wet suits compress the veins of the skin, pushing blood into the central circulation. This fools the body into thinking there's too much fluid in circulation, so it orders the kidney to eliminate some -- which causes the familiar need to pee in the wetsuit.) Treatment is rest and lots of fluids.
    Hypertensive headache: Some divers are sensitive to decongestant medicines such as pseudoephedrine (Sudafed) and phenylpropranolamine. The blood pressure can jump up significantly. Combine struggling with heavy tanks and cumbersome wet suits, and a hypertensive headache develops. This headache often comes on during the physical activity, and eases once you slow down. Have your blood pressure checked during the headache. If it's elevated, stop activity until it goes away. Avoid decongestants in the future.
    Decompression headache: Any new headache after diving accompanied by a neurological symptom (blind spot, localized weakness, numbness or tingling, etc) should be considered a symptom of decompression illness until proven otherwise. You need immediate medical attention -- and probably a compression chamber.

DROWNING, NEAR:
    Near-drowning is one of two things: loss of consciousness underwater, or aspiration of water. After the initial treatment, the victim may seem fine, then deteriorate.
    Swelling of the brain may develop a few hours later. This is caused by metabolic damage to the brain while it was deprived of oxygen. Symptoms can include confusion, worsening headache, vomiting, or inappropriate sleepiness.
    Occasionally, lung problems develop after 8 to 12 hours after aspiration of either salt water or fresh water. Watch for shortness of breath, wheezing, chest pain, fever or chills, or cough.
    Depending on the severity of the episode, some near-drowning victims require hospitalization. Many can be watched at home. But an emergency physician should decide this; the victim must be seen and evaluated.

EAR BAROTRAUMA:
    Ear barotrauma is damage to the ear due to rapid pressure changes. This happens when the ears aren't equalized properly while scuba diving or snorkeling. The eardrum is stretched by the pressure change. Sometimes it ruptures. Hemorrhage can occur within the middle ear, or even in the tissue of the eardrum itself. Symptoms can include pain, loss of hearing, nausea, or vertigo (whirling dizziness).
    A slap on the ear area (such as a water-skiing fall) adds other risks: the bones of the middle ear may come apart, or the organ of hearing and balance in the inner ear can be bruised.
    A middle ear infection can develop when water enters through a torn eardrum. This requires antibiotic treatment.
    You should have your ear examined. Usually the eardrum will heal well, but sometimes the bones of the middle ear are disturbed, or the inner ear is damaged.

EAR INFECTION, MIDDLE:
    Middle ear infection (otitis media) is common in divers. The middle ear cavity becomes filled with infection. Pressure and stretching of the ear drum cause pain.While usually a complication of a cold or sore throat, otitis media occurs in divers when germ-filled fluid is sucked up the eustacian tube by unequalized ears.
    Symptoms include earache, decreased hearing, and a sense of "water in the ear." However, these symptoms can be the same as outer ear infection, earwax impaction, and ear barotrauma. A physician exam is required.
    Antibiotics are required. A 10 day course is usually prescribed. A decongestant may be recommended. You may need anesthetic drops or other pain medication. A follow-up exam may be recommended to make sure the infection has completely cleared.
    If the ear begins to drain, it means the ear drum has ruptured. This will usually heal spontaneously. However, it means you should keep the ear dry until re-examined by a doctor.

EAR INFECTION, OUTER:
    Otitis externa is an infection of the outer ear canal. This can be very painful. It's sometimes called "swimmer's ear," because it often occurs after prolonged water exposure. Earwax makes otitis externa more likely, because it holds water and germs in the ear canal.
    The usual treatment is antibiotic/antiinflammatory ear drops. Occasionally, a wick will be placed in the ear to draw in the medicine. If the infection is severe, an oral antibiotic may be prescribed. Pain medication is often needed. Avoid getting water in the ear.
    Outer ear infections often take longer to heal than you might expect. Some tenderness and ache in the ear may persist for about two weeks.
    Your dive store has ear drops that help prevent otitis externa.

EAR WAX IMPACTION:
    A severe buildup of earwax in your ear canal is called a cerumen impaction. Symptoms often begin after diving because (1) the water pressure shoves the wax further into the ear canal, and (2) water soaks into the plug, enlarging it.
    A large plug of wax can cause earache, decreased hearing, or itching. It can even lead to infection of the outer ear. The symptoms can be identical to middle ear infection, so a medical exam is recommended.
    An impaction of earwax can be removed by the physician using special instruments, or can be irrigated out using a stream of water (often a little of both is required). Some less severe impactions are removed using ear drops that dissolve wax.
    In the future, don't get soap in your ear canal. Soap doesn't remove wax -- it simply hardens it in place. Don't use cotton swabs. These just push the wax into large clumps, where it doesn't flow out normally. Dust and smoke also contribute to wax buildup. Earwax softening drops are available without prescription, and can be used periodically.

EARDRUM PERFORMATION:
    Ruptured eardrum can occur when the ears don't equalize, yet the diver continues to descend. It's also common with a "head slap" on the water, such as a sideways fall from the dive deck.
    The ruptured eardrum alone is usually not serious. It will probably heal completely within a week or two. If the perforation is too large to heal, further treatment may be necessary. You need to see a doctor.
    Antibiotics are given if the perforation resulted from infection, or if the middle ear cavity may have been contaminated at the time of perforation.
    Do not allow any water to get into your ear until the doctor has told you the eardrum is healed. Use an earplug or Vaseline-covered cotton ball for showers. DO NOT SWIM. Follow-up examination to assure complete healing and complete return of hearing will be necessary, and is usually done in one week.

GIARDIA:
    Giardia is the most common intestinal parasite infection in the US. The cysts of the parasite are found in contaminated fresh water. Ponds behind beaver dams are common locations for giardia. Most patients get the parasite backpacking, swimming, or water skiing. Fresh-water scuba divers are less prone to the parasite than swimmers.
    The usual symptoms are foul-smelling diarrhea, intestinal bloating, and cramping. In mild cases, the only symptoms may be loose stool and urgency to have a bowel movement after eating.
    This parasite can be cured with medication -- for example, metronidazole (Flagyl). There is no immunity after infection. You can catch it again. It's not usually contagious person-to-person. You have to be exposed to cysts of the parasite in contaminated water.

HYPERACTIVE GAG:
   A hyperactive gag reflex can be a problem for some divers. If your regulator mouthpiece makes you gag, this can be hazardous.
   The first step is to simply experiment with different mouthpieces. A slightly different fit may cure your problem. If you identify a specific part of the mouthpiece that makes you gag, you can experiment by trimming a small portion away.
   "Desensitization" is a useful technique. After all, your tongue and teeth don't make you gag, do they? If your mouth becomes used to having something in it, you won't gag. Take the mouthpiece off your regulator. Now put it in your mouth while you read a book, watch TV, or putter around the house. Work up to an hour of time with the regulator in your mouth.
   Next, attach a light weight (a couple of ounces) by a six-inch string to the outside of the mouthpiece. Clean your house while the weight swings back and forth, tugging and pulling on the mouthpiece. When you can go an hour without gagging, you're ready to dive gag-free.
   For more urgent relief of gagging, you can try a topical anesthetic, such as infant teething gel. This may decrease the sensitivity of the membranes in your mouth.

MALARIA PROPHYLAXIS:
   Certain areas of the world have mosquitos that carry the malaria parasite. Malaria can be a very serious illness -- it kills millions of people every year. But it's usually preventable by taking prophylactic drugs.
   First, use a DEET-containing bug repellant, wear long clothing, and (if away from air conditioning) sleep in netting.
   Chloroquine is the traditional prophylaxis for malaria, but the parasite is resistant to this medicine in many parts of the world. Mefloquine, one 200-mg tablet per week (starting a week before leaving and continued for four weeks after your return) is the usual first choice. Mefloqine shouldn't be used by divers with epilepsy or psychiatric disease.
   Doxycycline, 100 mg daily, is an alternative to Mefloquine. You will sunburn more easily while taking this drug.

MASK SQUEEZE:
    "Mask squeeze" occurs when you don't puff air into your mask. As you go down, the mask "sucks" on your face. This bursts small blood vessels around the eyes. It can cause bruising, subconjunctival hemorrhage (blood spots over the white of the eye), and swelling. It rarely causes injury inside the eyeball.
    The small hemorrhages in the skin fade in a few days. It can take a couple of weeks for subconjunctival hemorrhage to clear up. The blood may spread for a few days. This type of hemorrhage isn't dangerous.
    See the doctor immediately if there is loss of vision, twinkling lights or shadows in your vision, or increasing pain.

MARINE PUNCTURE ENVENOMATIONS:
    Sea urchins, stonefish, catfish, and stingrays have spines that can puncture. The spines can break off under the skin. Even if the spine pulls out cleanly, it often leaves its "skin" behind. The skin on a spine contains mild poison. There is also risk of infection.
    The main symptom of poisoning is VERY severe pain at the site of the puncture. The area may immediately become swollen and red. If the poisoning is severe, there may be weakness and difficulty breathing.
    Initial treatment is to soak the area in very hot water for 30 to 60 minutes. This may inactivate the toxin.
    Pain is best controlled by local anesthetic. If nobody has a shot of lidocaine, you can try an anesthetic spray (example, Solarcaine, Bactine) or make a paste of a broken diphenhydramine (Benadryl) capsule and work it into the wound.
    If any portion of a spine is left behind, it should be removed. A doctor needs to do this. Usually the sting site will be cut open to remove the spine and venom.

NOSEBLEED:
    Nosebleeds are common in divers. Nosebleeds during descent are due to mask squeeze. Failure to equalize the pressure in the mask to match the water pressure creates a relative "vacuum" in the mask and nasal passages. This can make fragile blood vessels in the nasal membranes break. These nosebleeds can usually be prevented by slow descent and frequent equalization of the mask. If nosebleeds still occur on descent, they are due to "sinus squeeze" -- unequal pressure between the sinuses and the nasal passages. Decongestants such as pseudoephedrine (sample brand, Sudafed) can help.
    Nosebleeds during ascent are usually due to congested sinus openings, causing "reverse" sinus squeeze. Higher pressure in a plugged sinus pushes the membranes around the sinus opening outward, causing a tear. Ascent nosebleeds can usually be prevented by slowing the ascent, and using decongestants prior to diving.
    If nosebleeds consistently occur on one side (despite use of oral decongestants and proper ascent/descent speeds and mask equalization) you can try a decongestant nasal spray (sample brand, Afrin) about an hour prior to diving, used only in the nostril that bleeds. Expect some rebound congestion in that nostril about 18 hours later.
    If a nosebleed doesn't stop promptly as you exit the water, pinch the entire soft part of the nose shut for 15 minutes. If blood runs down the back of your throat, or if bleeding resumes when you release the pinch, blow all blood and clots out of the nose, then spray the bleeding nostril several times with a decongestant spray. Then pinch the nose again for 15 minutes.

SAND GNAT BITES:
   These tiny gnats, called No-see-ums, bite the skin and drink blood. The anticoagulant that they "spit" into the bite causes stinging and itching.
   When on a sand area, wear light-colored, long clothing to cover arms and ankles. A hat can keep them from biting the scalp. Avoid perfumes, fabric softener, or anything else that smells sweet. Apply a DEET-containing repellant. Citronella candles may help in enclosed areas.
   Once the bites have occured, they can be treated with hydrocortisone 1% cream. Individual bumps can be covered with small bandages to drive the medicine into the skin. Diphenhydramine (example Benadryl), 50 mg every four hours, can help with itching.

SCROMBOID FISH POISONING:
    Scromboid poisoning occurs when you eat fish meat that wasn't properly refrigerated. A toxin forms when raw fish of the tuna and mackerel family sits in a warm environment. The toxin isn't destroyed by cooking.
    The toxin may give the fish a peppery or metallic taste. You should never continue eating a fish that tastes funny.
    About 15 to 30 minutes after eating the fish, symptoms start. These include pounding headache, flushing, rapid palpitations, lightheadedness, and shortness of breath. Some victims may also have vomiting, diarrhea, abdominal pain, hives, or wheezing.
    Scromboid poisoning is treated with antihistamines. If you're in the wilderness, take 50 mg of diphenhydramine (sample brand, Benadryl). Otherwise, see a doctor. Adrenaline and IV fluids may be needed for more severe cases.

SEABATHER'S ERUPTION:
   Seabather's eruption is an itchy rash caused by the larva of a jellyfish. It's also called "sea lice." The tiny larvae "fire" their poisons into the skin, causing rash between 4 and 24 hours after exposure. The rash tends to occur where the larvae can become trapped against the skin, such as under the bathing suit or under long hair.
   Symptoms such as nausea, vomiting, diarrhea, aches, muscle spasms, low-grade fever, and headaches can accompany the rash, particularly in children.
   Bathing suits with tight fabric are more resistant to the larvae. Avoid wearing T-shirts in the ocean. Sunscreen can help.
   Once the rash develops, use 1% hydrocortisone cream on the rash, and take diphenhydramine (sample brand Benadryl) for itching. The rash usually goes away in about a week.

SWIMMER'S ITCH:
   Swimmer's itch is an allergic reaction to tiny parasites that burrow into your skin while swimming in contaminated inland (non-salty) water. It usually starts a few days after the exposure, and can persist for a several weeks. The rash is more common in waders than in divers, because most fresh-water divers wear wet suits and avoid murky foul waters.
   The parasite, called a shistosome, normally attacks birds such as ducks and geese. The larva of the parasite, called a cercaria, burrows into human skin, but can't develop any further. An allergic response occurs around the parasite, causing itchy red bumps.
   The rash can be treated with hydrocortisone 1% cream. Individual bumps can be covered with small bandages to drive the medicine into the skin. Diphenhydramine (example Benadryl), 50 mg every four hours, can help with itching.

SEA SICKNESS:
    Sea sickness is caused by the eyes seeing one thing (the inside of the boat) and the organ of balance detecting another (you're moving up and down). The "argument" between the two senses triggers nausea. Sea sickness tends to diminish with time. The more time you spend on a boat, the less severe the motion sickness becomes.
    There are several remedies for sea sickness. The most effective over-the-counter medication is meclizine (sample brands Bonine, Dramamine II). The 25 mg pill usually prevents motion sickness when taken once a day, but can safely be taken up to every 8 hours. Meclizine can cause drowsiness. It's best to take it at bedtime, starting a day or two before your dive trip, so the "groggies" can wear off. Don't drive the Salt Lake to Long Beach route while taking medicine!
    Some people get relief from Coke syrup, ginger, or pressure-point bracelets. These aren't terribly effective. Frequent small snacks help. Avoid fatty foods. Absolutely stay away from diesel fumes!
    The scopolamine patch (sample brand Transderm-Scop) can last up to three days, and is very effective for motion sickness. Usually, there's not as much drowsiness as with meclizine. The patch requires a prescription.
    "Regulator mouth," the dryness from breathing dehumidified air, is increased by meclizine and scopolamine. A simple expectorant (guaifenesin) will keep your mouth more comfortable.

SHELLFISH FOOD POISONING:
    Shellfish food poisoning is caused by bacteria called vibrio parahaemolyticus. While usually due to eating raw oysters, sometimes the bacteria get into cooked oysters, clams, and crabs.
    Symptoms start a few hours after eating the seafood. There is usually vomiting, abdominal cramping, and watery diarrhea. Sometimes there's blood in the diarrhea.
    Mild cases go away after a day. You need to get plenty of fluids to prevent dehydration. Use a rehydration solution such as Pedialyte or Lytren. While bulking medicines like Kaopectate are usually harmless, avoid anti-diarrhea pills like loperamide. These medicines "cork" the germs up inside you, and can make you sicker.
   More severe infections are treated with antibiotics. See a doctor if you're feeling more ill.

SHELLFISH POISONING, PARALYTIC:
    Shellfish poisoning is caused by eating toxic clams or oysters. The poison is created by a type of plankton -- the type that causes "red tide". The shellfish eat the plankton, and toxin builds up in the shellfish. Cooking doesn't eliminate the poison.
    There is often immediate tingling of the mouth and lips after eating the shellfish. Then comes numbness and difficulty swallowing, talking, and breathing. It may be several days before the symptoms go away.
    There's no antidote for the toxin. Patients with severe poisoning may need to be in the hospital.

SINUS SQUEEZE:
    Your sinuses are air-filled cavities that join onto the nasal passages. When you ascend or descend, the pressure in each sinus must adjust to match the air pressure in the nose. For those with healthy normal sinuses, this occurs automatically. But if the sinus openings are plugged by polyps, mucous, or congestion, "sinus squeeze" occurs.
   Mild cases can be treated by simply slowing your ascent and descent, and blowing gently into your nose -- just as you do to equalize your ears. A mild salt-water spray (example Ocean) can decrease congestion around the sinus openings and clear mucous from your nose.
   More severe cases may require use of decongestants in pill form (example pseudoephedrine) or topical spray (example Afrin). Be aware that nasal decongestant sprays have a "rebound" effect -- the congestion increases dramatically when the medicine wears off.
   If sinus problems are chronic, your doctor can prescribe a steroid nasal spray to decrease swelling and sensitivity in the nose. To be effective, this medicine must be started a week or two before the dive trip.

TEMPOROMANDIBULAR JOINT (TMJ) SYNDROME:
    TMJ syndrome is pain in the temporomandibular joint, where the jaw joins the skull. It's common in scuba divers, and is caused by pressure on the joint as you bite the regulator mouthpiece.
    Symptoms can include pain in the temple or in front of the ear, headaches, clicking with jaw motion, locking of the jaw, and trouble fitting the teeth together.
    Most cases of "scuba TMJ syndrome" go away with antiinflammatory medicine like ibuprofen (800 mg three times a day). The joint should be rested. Stay on a diet that requires no chewing -- such as milkshakes, applesauce, and puddings. Avoid any motion of the jaw that provokes pain. Periodic ice packs help decrease swelling and pain.
    If the symptoms resolve quickly, you may not need further care. Consider buying a regulator mouthpiece that extends back into the molar area, so you can hold the regulator with less clenching of the jaw.

TRAVELER'S DIARRHEA:
    Traveler's diarrhea starts when you pick up bacteria that are different than those in your intestines. You have E coli germs in the colon. And you're used to them. And everybody where you live has similar strains of this germ. But when you travel to another area, you can pick up a new strain that temporarily causes diarrhea. You get diarrhea when you go to Mexico; Mexicans get diarrhea when they visit Chicago.
    Traveler's diarrhea can be avoided by drinking only bottled water or pop, and avoiding raw fruits and vegetables. Or boil your water. Remember that ice cubes in your drink can contain the bacteria.
    Many travelers prefer to take an antibiotic to prevent traveler's diarrhea. You have to see your doctor to get the prescription. The drugs most commonly used are trimethoprim-sulfa (sample brands Bactrim, Septra) or doxycycline. If you plan to experience all the local cuisine, antibiotics can save your dive and your vacation.
    Peptobismol, one tablespoon four times a day, has also been shown to prevent most cases of traveler's diarrhea. It's also a great treatment for diarrhea once it occurs.
    To treat traveler's diarrhea, take about 4 tablespoons of Peptobismol at once, then a tablespoon every hour for eight hours. Leave your stomach empty (except for the Pepto) for the first few hours, then begin sips of clear liquids (like Sprite, Gatoraid, etc). Progress to simple starches (applesauce, toast, banana) as you get better.

YELLOW FEVER:
   This is a viral illness transmitted by mosquito. The virus is found in Aedes Aegypti mosquitos in Africa and South America. Vaccination can prevent the illness, and is strongly recommended if you are traveling to an area with high rates of yellow fever. Use DEET-containing mosquito repellants, long clothing, and netting around the bed.