Sick/Headaches during and after dives - ear issue?

[Jody2803]

Hi All,

I hope this is the right place. I apologise in advance for the length of my post but I think I need to post all my experiences to see if there are patterns I have not noticed. I do have a few possible causes but I am very open to the thoughts of others as I am probably one bad dive away from throwing in the towel.

Did my Scuba Diver course in Dahab March 2010. I was a nervous diver to start with but some 1:1 got me through my SD and I did a total of 8 shore dives and 3 boat dives, with no medical problems at all.

In March 2011 I did the remaining pool sessions of the upgrade to OW. I then did my OW dives in the Maldives from shore and another 5 shore dives. No particular problems, first boat dive fine, on way back from second boat dive I had to fight not to be sick but it was pretty rough, I'd struggled to get back on the boat so put it down to that.

For Xmas 2011 I bought myself a travel BCD and set of Scubapro regs as we had booked a trip to Kenya and I wanted to do some more dives.
Went to Kenya March 2012, diving was very early so I'd forced some breakfast down but wasn't really ready to eat. Entry was backwards roll (new to me, I was a bit nervous) and the visibility wasn't great, had to descend along the mooring rope. Regs tasted 'funny', not something I'd noticed in pool tests. After about 20 minutes I realised I was heaving a fair bit, motioned to my buddy that I wasn't good and I needed to abort the dive. As soon as we started ascending I couldn't stop being sick and a splitting headache ensued. This continued well after I was back in the boat and on getting back to shore I had to go to bed for the majority of the day due to the headache.

Had a day off diving at advice of dive centre and booked for next day. Again, up early, forced a small breakfast and out on the boat. Air/regs tasted odd again, heaved a few times during dive but completed the full dive. On way back to shore I was sick over the side of the boat, headache came on again but not as severe as first time. Still put me to bed for a few hours that day. Did wonder if air was contaminated due to the weird taste, one day in the pool they sprayed repellant and the smell of the air was just as pungent as what I could taste - assumed it was some of that in the air...but no one else ever mentioned it. Decided not to dive anymore. Did also find travel BCD awkward, wouldn't sit properly and kept riding up meaning tank valve right above my head and I couldn't look up or straight ahead, just down.

Mentioned funny tasting regs to some diving friends after this trip and they said it could be a coating out on them when new, it should wear off OR it was the air.

Went to Maldives June 2012, took my regs and BCD again. Did a check dive from shore, getting aggravated with BCD and it riding up, Regs still taste a little odd, but not like they did in Kenya. Dive went well, I was fairly relaxed other than BCD. Developed headache on getting out of water but a small sleep got rid of it. Signed up for a boat dive. Got told off for focusing on camera too much so put it away to concentrate on dive. Some strong currents along the wall but don't believe I over-exerted myself. Sea was fairly calm but on way back to island, I was sick again. Headache follows. Dive centre manager talks to me and I explain what happened in Kenya. He suggests I may not be exhaling properly and getting a build up of CO2, giving me a headache...OR, the BCD forcing my head down was causing me a sinus problem. Suggests my next dive I focus on breathing, buoyancy and use dive centre BCD. Decided not to dive again this trip.

Did see my own doctor after this trip who confirmed I do have some fluid in my inner ears, I had suspected as much because I often have to 'pop' my own ears, even when on land.

Went to Marsa Alam June 2013. Was hesitant about diving again but great dive guide convinces me to do a shallow scuba review and see how I feel, was shore entry. Went fantastically, did some skills tests and then a gentle dive. Was so pleased with how it went, and continued to go (all shore diving) that I actually did my AOW cert this trip. Apart from one dive where I felt a bit disorientated after searching for my buddy, I felt fine the entire time. No headaches, no sickness, just 9 amazing dives and a very happy me.

Fresh from the success of Marsa, in Sept 2013 we book a last minute break to Sharm, where I am determined to continue my diving feeling really confident. Dive is done from the resort pontoon on a wall, rather than having a visible bottom. I feel fairly relaxed, always making concious effort to breath properly. Seems to be going well until a few minutes from the end of the dive where I feel giddy and nauseous. Start ascending and the headache starts, how I was not sick on the pontoon or in the centre I will never know. Another day of holiday lost as I had to go to bed until late afternoon, decide not to dive again this trip.

So, my dilemma is that this year we have Thailand, Maldives and Egypt planned, and I really want to dive but this sickness, and the headaches in particular are a killer. I feel like my head is actually being split open and the only way I can overcome it is to sleep for a few hours. This means I am avoiding any multi dive trips in case the first one ends up badly. I have been so close to giving it up but it took a lot for me to overcome my initial anxiety and I don't want to walk away, I love the reef and being in the water! If anyone has any ideas would be very grateful and realise I should probably go and see a specialist dive physician too.

Just some over things to add:

I am 31, overweight but active, I gave up smoking 14 months ago
I don't drink a lot of alcohol and I try to drink a lot of water to stay hydrated
I haven't yet tried sea sickness pills although I do remember the crew handing them out on my first ever boat trip
I have no BP issues

So far, I have come to the conclusion that shore diving seems to give me the greatest chance of a successful dive. Diving from boats/moving things seems to end in tears for the most part. I am wondering if it's a balance/disorientation issue?

Thanks

Jody

 

[al248005]

My buddy had similar symptoms for one summer. He would get nauseas and headaches on ascent and often get sick once we hit the surface. He was told by his doctor it was vertigo. He held off for a couple months over the winter and it quit. You on the other hand I find it hard to believe you had vertigo for 2 years constant. Have you contacted DAN? They could point you in the direction of an EN&T diving doctor in your area.

 

[DocVikingo]

Bummer, Jody.

It's possible that what you are experiencing is C02-related headache.

If this is the case, you'll want to make sure that your reg is tuned to factory specs (just because a reg is newish doesn't insure that tuning is spot on), and do mention the "funny" taste to the shop when you take it in.

Also make sure you are not "skip breathing," or holding your breath too long between inhalations/exhalations. Breathe fully, slowly & regularly.

Finally, dive with as little effort as is possible given the conditions. Don’t overexert.

Regards,

DocVikingo

This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice to you or any other individual, and should not be construed as such.

 

[Duke Dive Medicine]

Jody,

Concur with DocV above in that this sounds most like CO2. The bad-tasting air in Kenya is suspicious for contamination but if everyone was breathing from tanks filled with the same gas source that would be unlikely. Anxiety could be a factor, as could poor physical condition and depth/gas density.

Another consideration is your hypercapnic ventilatory response (HCVR). Typically the body compensates for elevated arterial CO2 levels by increasing the respiratory rate. Some people's bodies do not respond appropriately, however, and the result is hypercapnia (high CO2).

Here's an article that goes into a little more detail:

http://www.diveassure.com/new/documents/Diving_and_Carbon_Dioxide.pdf

Best regards,
DDM

 

[vincent54]

I wouldn't rule out something like a Migraine, triggered by the pressure change. A diagnosis from a Neurologist wouldn't be a bad idea. I know I get them when low pressure fronts come through, and get the nausea that you feel when seasick. Any headache is miserable. Good luck

 

[Imla]

I can think of a couple things.
I used to have splitting headaches as well. I found multiple causes. And they seem to corrolate with your story.

#1 Get your exact leadweight dialled in. This will ensure you need just the appropriate amount of gas in bcd, and will make buoyancy control easier. This ties in with
#2 Get your buoyancy dialled in. Make sure that you can make full, relaxed cykles of breathing while staying at the same level in the water column.
#3 Do Slow ascents. Don't just do a safetystop at 5m and then pop. Challenge yourself to do 1 full minute at every meter from 6m and up.
#4 Get your nitrox certification and dive nitrox

Now... This will help in different ways. Being correctly dialled in on weights makes buoyancycontrol easier. Good buoyancy makes it easier to relax. Being relaxed makes breathing easier, and breathing properly ensures that you dont get the intense headsplitting CO2 headaches.

Now... Good buoyancy and slow ascents will also allow your body to deal with microbubbles in a more delicate way (Sorry, english is my 2nd language). Headache and fatigue can also be symptoms of light bubbleformation in tissues. Giving the body time to ventilate the nitrogen from 6m and up, also reduces the load on the tissue.
Nitrox will reduce nitrogenload if used on air-tables (Air setting on computer)

I assume that these two elements are largely a part of why the dives in Marsa went so well. You had time. You relaxed. Your guide was attentive to what you experienced.
Also, diving along a shore makes a slow ascent against the reef a lot easier.

But most of all... Breathe properly, exhale adequately and SLOW those ascents!

 

[Jody2803]

Thank you all very much for taking the time to read and reply. You know when you just get soooo frustrated and think the only thing to do is give up? That's kinda where I am now.

Couple of things I realised I didn't put in....

After the Maldives in 2012 I didn't use my reg again, I've used rental equipment ever since
My air consumption for the most part is very, very good (maybe I don't breathe properly!)

A few times lately at the safety stop I have felt a bit anxious, it's my least favouite part of the dive because I'm just not good at floating around relaxing, I know I'm on my way out of the water so I just want to get out. Imla, I think you are right about Marsa....most of the dives meant we came up so slowly and I never found them difficult.

I want to find a way to make it easier as soon as possible, each bad dive just makes me more likely to stay out of the water. One of the guides in Sharm did suggest Nitrox but we were only there for a week and having to go to bed for the day after a dive is a quick way to ruin a holiday!

Will keep all this in mind and have a think about what to do next

 

[Imla]

Nitrox is possible to do most of online, and with just a little checkup at the diveshop.
The fact that you say you have a very very good sacrate makes me question that maybe you are skip-breathing.

fokus on breathing enough rather than having a long dive.

 

[TSandM]

My air consumption for the most part is very, very good (maybe I don't breathe properly!)

There's the red flag. I'd be willing to bet that you skip breathe and retain CO2. I recognize the symptoms, because I do it, too. I have to make a deliberate effort to breathe regularly, because I appear to be very CO2 tolerant. I've had headaches after some dives that involved swimming hard that almost made me vomit. (Jalapenos for lunch weren't a great idea, either.)

Focus on a relaxed, REGULAR breathing pattern, with no breath-holding -- no pause at either end of a breath. Your gas consumption will go up a little, but I'l bet the headache problem gets better.