Migraines triggered by diving.

[uncfnp]

Seems that since you had an uneventful dive history prior to the dive associated migraines, an eval is in order and I would also bark up the TMJ tree first. Also keep in mind the theoretical risk of triptans interfering with off gassing due to the vasoconstriction they cause. I had a bubble test here in the Triangle a while back. For me, the problem, which showed up early on, was corrected with correcting my breathing and I suspect the migraines were caused by CO2 retention.

UNCPNP
Beat Dook

Hi lulubelle! Thanks for the info. What did you do to correct your breathing? I'm not aware of any breath holding but I will be more aware next dive.

Just got the results of my sinus ct. Nothing really helpful there. I'm to f/u with ENT if I get another SI after my next dive trip so he can take a look while I have an active infection. Otherwise just the usual predive routine.

---------- Post added February 13th, 2013 at 09:45 AM ----------

I can relate to some of your text uncfnp. I also get those annoying migraines very often after diving, and i also am experiencing problems with my sinuses. I have noticed my attacks usually comes with early morning diving (like 6.30ish) and repetitive diving. When you say migraine with aura, what do you mean? I'm sorry for my non sufficient english skills. I will definately look closer to PFO even though a lot of you have pointed out some mistakes i know i am doing, by not breathing properly.

Sorry to hear you're another migraine sufferer. A migraine with aura is someone who experiences a sensation, in my case visual, before the headache starts. I get a small flickering blur in the center of my vision that gradually enlarges and spreads out. As the spot goes away, the headache starts.

Although my migraines occur nondiving as well they are fortunately infrequent (I've had these headaches for almost 40 years now), since my dive related migraines occur at the end of my diving, the short acting triptans should not pose an increased risk for me.

 

[lulubelle]

Hi lulubelle! Thanks for the info. What did you do to correct your breathing? I'm not aware of any breath holding but I will be more aware next dive.

---------- Post added February 13th, 2013 at 09:45 AM ----------

Although my migraines occur nondiving as well they are fortunately infrequent (I've had these headaches for almost 40 years now), since my dive related migraines occur at the end of my diving, the short acting triptans should not pose an increased risk for me.

BEAT DOOK!

I wasn't breath holding, but I think I may have been breathing too shallow upon ascent. For me, what I changed was to implement a longer safety stop at 15 - 20 feet, slowed my ascent after my mid depth, and focused on full/slightly exaggerated exhalations while ascending. Those changes seemed to eliminate the post dive headaches. My breathing pattern when at depth is very slow and steady naturally.

As DocVikingo said, the risk of triptans interfering with offgassing is entirely theoretical, but given that you continue offgassing for quite some time after you leave the water, it should not be discounted. The other concern being that some of the symptoms of migraine can mimic some of the symptoms of DCI. I had a nearby dive medicine doc go postal on this whole point and my migraines are very classic, generally hormonally triggered, and have never occurred with diving. But as a fellow migraineur, I would also be likely to take one if I had a post dive migraine as nothing else would likely touch it. But I would not get back in the water that day.

 

[Divejones]

Laurence Stein DDS DocVikingo &
uncfnp

Could this just be mild DCS and initial benign symptoms of delayed ottic barotrauma, itchy skin happens when N2 releases subcutaneous and the whole thing not PVO related, and not a big deal at all. ? Just a thought

 

[uncfnp]

Laurence Stein DDS DocVikingo &
uncfnp

Could this just be mild DCS and initial benign symptoms of delayed ottic barotrauma, itchy skin happens when N2 releases subcutaneous and the whole thing not PVO related, and not a big deal at all. ? Just a thought

For what its worth, the headaches resolved within 2 hours of either the triptan and Ibu 800 (I routine take both) or once just the Ibu.

 

[uncfnp]

Just an update in case someone reads this in the future. In January I did see ENT and took 3 weeks antibiotic to "get my sinuses in top condition" then had a CT that was essentially normal. Next dive trip was Bonaire in March with slow easy descents/ascents and Max depths about 80. Averaged around 40 to 60. Used a SeaCure mouth piece. No headaches, no TMJ and no rashes! Next trial will be May when I dive Florida under similar conditions as the dives in the original post. Keeping my fingers crossed...