Alternobaric Vertigo?

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Raystafarian

Registered
Messages
58
Reaction score
20
Location
Yokohama, Japan
# of dives
50 - 99
So something happened over the weekend and I'm still a little puzzled about what we should have done.

Two divers, both at around 20 dives - every dive together. My buddy pretty much always has difficulty equalizing ears - since we were OW certified. She always takes it slow down and will constantly adjust if she has trouble clearing. I have no problem clearing, so I usually just watch and wait. We've never had to thumb a dive because of equalizing.

We were at about 30ft maybe 30 minutes into the (shore) dive - she had the regular amount of trouble equalizing on the way down. We had been at depth for probably 10 minutes (the bottom was sloped) when she circled around to look at something (that I think was a few feet lower than we were, but it's difficult to tell). When she came back to where I was she gave me "something wrong" signal and I gave her "OK". She started to do an "OK" but then thumbed up.

When I went over to her, her eyes weren't in panic mode, but the best I could describe it was she looked sleepy. I grabbed her BC facing her and thought about putting my hand on the reg to keep it in her mouth if she went unconscious, but she shook her head "no".

So we ascended at a normal rate and when we got to 15 feet she wanted to do the safety stop. We do no deco diving, so I wasn't too concerned about hanging out at 15 feet. We made it for about one minute and she still looked sick, so we surfaced.

When she surfaced, she inflated and wanted to take off her mask. I asked her what was going on and she said she was really dizzy and felt like she was going to throw up. I told her to keep her mask on and puke through the reg if she really needed to. After maybe 30 seconds on the surface, she was back to being alert and said she didn't feel sick anymore. I asked her if she knew what had happened and she said she didn't and we should descend back to 15 feet. So we started to descend and I was below her when she thumbed again (maybe at 5 ft) and went to the surface. I followed and she said when she went back down she got dizzy and feeling sick again. So I reeled in the dive float toward us and we started a surface swim back to shore.

She kept talking while we were finning back and was convinced she needed food - like it was low blood sugar. We ate breakfast and hydrated before the dive. She doesn't have any issues with blood sugar. Anyway, she sort of sat and relaxed as I packed the gear (20 minutes), we changed and then we drove and got some food.

I asked her what happened and she said she didn't know, just that when she came back to the platform I was at, she got dizzy and felt lightheaded and sick, but it subsided once we surfaced. I thought maybe it was dehydration or low blood sugar or something.

The next day, she sent me an article on alternobaric vertigo - saying this pretty much described what she thought had happened. She has no lasting effects, no pain or difficulty hearing, no dizziness or lightheadedness on land. She wasn't congested the day of the dive, didn't take any medicine, or wear ear plugs or a hood or anything like that. She said she doesn't remember having any abnormal difficulty equalizing, but can't remember what exactly happened between the time she left the platform and came back (maybe 20 seconds).

If it was alternobaric vertigo, from what I could tell - we didn't handle it properly. She's unsure if it happened when she descended a little or ascended a little, but I think it was ascending maybe 3 feet. What I think we should have done is gone back down and had her equalize back at that depth. Of course, we didn't have a sign for "I feel dizzy" (we do now), so she couldn't communicate that to me, which maybe would have suggested an equalization thing, but who knows if I would have thought that quickly.

We've never experienced anything like this - she just takes her time equalizing. Should we have known that this was a thing and how to handle it? For most things, you don't want to surface, but the way she was looking sleepy made me uneasy about staying under if we didn't have to.

I found this article that describes some new ways for her to try to equalize - so that may help a bit. Other than that - how can we improve on being prepared for something like that?
 
There is a chance she got a perilymph fistula or similar inner ear problem that caused the symptoms. In that case hearing loss may result from repeated exposure to unequalized pressure. It is hard to tell from the information in the original post. I would advice to consult a diving physician before continuing to dive. Also I believe most dive operators require a medical statement about fitness to dive if you have experienced vertigo while diving before (provided you tick the box...).

Edit: Please note that perilymph fistula is very rare and difficult to diagnose even with a precise history. It is much more likely that there is a benign reason behind the symptoms. However, it can also be dangerous to fall victim to strong vertigo at depth even if no direct damage to your ears is going to result. Maybe other members have better insight, but I think I would still play it safe and see a doctor for a proper history and evaluation.
 
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When I first started diving in 2008 I ALWAYS had trouble clearing my ears until I began using Doc's Pro Plugs. Clearing was SO much easier with these in place. They are vented so the water trickles in to the ear canal very slowly. The cold water won't wash in and out of the ear canal which, in my case, helped with after dive ear pain. They come in various sizes and a sizing guide so it's best to find them at a local dive shop so you can be sure to get the correct size for you if you choose to give them a try.

Being in Florida, we dive A LOT. My Eustachian tubes have gotten quite a work out and I no longer need to use the ear plugs. I can rocket to the bottom, head down, with all my fellow divers. :)

Good luck!

Kathy
Lithia, Florida
 
Go see a doctor. No matter how much you don't want to, you won't have good piece of mind while diving until you do.

I have a friend that has dived quite a bit (maybe 150 days per yr, 20 yrs, just for fun). He told me of exactly one incident where his sense of balance suddenly went nuts while ascending from a deep wreck dive: first a spinning sensation, then vertigo, then nausea. His buddy shot a SMB and he made it up the line mostly by keeping his eyes shut and just concentrating on and staying calm and breathing deeply and slowly. It came on with no warning, for no apparent reason. He was checked by a doc as OK, stayed dry a week and it's never happened again.

Hopefully your friend will also get past this with nothing more than in interesting dive story!
 

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