Breast Pain After Diving

[Imla]

Hi everyone

I have been diving for 12 years (700+ dives) in all conditions with dry and wetsuits. In 2016 I had my first episode of the breast pain. I had been on a liveaboard and diving 4 dives a day (no decompression dives) and after three days or so my breasts swelled considerably and particularly the left breast with very sharp pain. I continued diving as it was towards the end of the trip and I had no discomfort in the water. My breasts had swelled in the same way that they did after the birth of my first child. They returned to normal within hours of the end of the trip.

I usually do 4 trips a year with 20+ dives each trip. I have lost track now of the number of times my breasts ache after diving. I have never had the bends and never used a decompression chamber. I did have oxygen once after a dive when I surfaced too quickly but this was as a precaution and was two years ago.

I have just returned from another week of diving of two dives each day and each day after the second/last dive within 40 mins I have breast pain. I do not have any lumps or change in the texture of the skin. The pain subsides after about 1-2 hours which is why I am able to carry on diving. The swelling is not as extreme as it used to be.

My regular temporary symptoms are:

Within one hour of diving either one or both of my breasts have sharp pain and tightness and/or some swelling. There is no lumpiness, discolouration, rash or change in skin texture. The pain lasts for approximately two hours. The reason I can do multiple dives is that the surface interval is roughly one hour so I am back in the water before the onset of pain and I have never had the symptoms during a dive – only on the surface. I dive mainly with Nitrox but also on air if Nitrox not available. I have not noticed any difference between the two.

I do not have high blood pressure and I do not take any medication. I have one cup of coffee in the morning and 1-2 glasses of wine in the evening after diving. I have a healthy diet and exercise regularly. I am not overweight but my breasts are generally large and heavy 40DD and although I appreciate probably mainly consisting of fat but the sheer weight to me implies more of a fluid consistency.

I have not sought medical assistance as my GP does not have specialised dive knowledge and therefore would not be able to advise me.

From what I have read there really is no definitive answer for a condition that clearly affects many, many women. The positives are that there does not appear to be any documented decompression sickness cases for these women and certainly no documented deaths. I am inclined to follow the thought that it is a fluid movement issue.

At present I manage the pain with paracetamol after diving but from what I have read I think a medication to diminish fluid retention and an anaesthetic taken prior to the onset of the pain would be the best medication. If there are any doctors out there to comment it would be great particularly as this thread has been running for the past 19 years with no conclusions.

Since this thread has been running for such a long time I was wondering if any progress has been made with regard to treatment and what a long term prognosis is.

I see one of the common denominators in this thread are generally on the topside of brasizes. Would you say your swimsuit/bikini/bra (in drysuit) are thight? Compressing in any way? Could it be worth a try do do a dive "bra-less"?

 

[Duke Dive Medicine]

Hi everyone

I have been diving for 12 years (700+ dives) in all conditions with dry and wetsuits. In 2016 I had my first episode of the breast pain. I had been on a liveaboard and diving 4 dives a day (no decompression dives) and after three days or so my breasts swelled considerably and particularly the left breast with very sharp pain. I continued diving as it was towards the end of the trip and I had no discomfort in the water. My breasts had swelled in the same way that they did after the birth of my first child. They returned to normal within hours of the end of the trip.

I usually do 4 trips a year with 20+ dives each trip. I have lost track now of the number of times my breasts ache after diving. I have never had the bends and never used a decompression chamber. I did have oxygen once after a dive when I surfaced too quickly but this was as a precaution and was two years ago.

I have just returned from another week of diving of two dives each day and each day after the second/last dive within 40 mins I have breast pain. I do not have any lumps or change in the texture of the skin. The pain subsides after about 1-2 hours which is why I am able to carry on diving. The swelling is not as extreme as it used to be.

My regular temporary symptoms are:

Within one hour of diving either one or both of my breasts have sharp pain and tightness and/or some swelling. There is no lumpiness, discolouration, rash or change in skin texture. The pain lasts for approximately two hours. The reason I can do multiple dives is that the surface interval is roughly one hour so I am back in the water before the onset of pain and I have never had the symptoms during a dive – only on the surface. I dive mainly with Nitrox but also on air if Nitrox not available. I have not noticed any difference between the two.

I do not have high blood pressure and I do not take any medication. I have one cup of coffee in the morning and 1-2 glasses of wine in the evening after diving. I have a healthy diet and exercise regularly. I am not overweight but my breasts are generally large and heavy 40DD and although I appreciate probably mainly consisting of fat but the sheer weight to me implies more of a fluid consistency.

I have not sought medical assistance as my GP does not have specialised dive knowledge and therefore would not be able to advise me.

From what I have read there really is no definitive answer for a condition that clearly affects many, many women. The positives are that there does not appear to be any documented decompression sickness cases for these women and certainly no documented deaths. I am inclined to follow the thought that it is a fluid movement issue.

At present I manage the pain with paracetamol after diving but from what I have read I think a medication to diminish fluid retention and an anaesthetic taken prior to the onset of the pain would be the best medication. If there are any doctors out there to comment it would be great particularly as this thread has been running for the past 19 years with no conclusions.

Since this thread has been running for such a long time I was wondering if any progress has been made with regard to treatment and what a long term prognosis is.

Hi Mary,

From your description, it appears as if you are getting lymphatic decompression sickness. It's likely that the reason your symptoms disappear while diving is that you are back under pressure and compressing whatever bubbles are there, along with breathing a slightly higher partial pressure of oxygen. It sounds like it resolves without treatment which is of course a good thing, but it may be an indicator of decompression stress and without being evaluated by a professional it can be hard to discern subtle subclinical signs of DCS. I would recommend you try diving more conservatively on your next trip: change the conservatism setting on your computer if you can, don't dive the computer to the edge of the no-stop limit, and consider diving nitrox using the air setting on your computer. If you're doing a 10'/3m safety stop, you could lengthen it. Also, going down to three dives a day and/or taking a one-day break halfway through the trip might help.

Best regards,
DDM

 

[chillyinCanada]

Again, to put emphasis on Imla's post, has there been any change in your swimsuit, new wetsuit tighter in chest area, or new bcd?

I share your pain.

 

[Mary Blyth O'Hara]

Thank you very much DDM for your reply. I looked at the lymphatic as well as a possibility however the symptoms were not a good fit eg "Lymphatic Decompression Sickness: Divers can recognize lymphatic decompression sickness by a swollen area (or areas) that holds an indentation for a few moments when depressed. Also characteristic of lymphatic decompression sickness is a peculiar pitting of the skin over the swelling, similar to the pitted skin of an orange. . I have my computer set conservatively and usually add an extra minute or two to the safety stop." My breast do not hold an indentation and there is no skin pitting. The skin is stretched tight and the swelling is solid and painful. The swelling is not so much of an issue anymore it is the pain. As a medical professional, is there any other source of information you can direct me to. I am still baffled as to why I cannot find any research on this topic. This website is the only one I have found that features any information on these symptoms

Thank you also Chilly. I try not to use a wetsuit and this past week only had a rash vest on. It really makes no difference in the apparel I wear. My BCD does not restrict my bust and I have used several different styles. I also ensure that I am very well hydrated which I also considered was a possible source of the problem but again this has had no change in the symptoms. I am just so sorry that since this thread started there has been no research or interest in a problem experienced by many women.

 

[Mary Blyth O'Hara]

I see one of the common denominators in this thread are generally on the topside of brasizes. Would you say your swimsuit/bikini/bra (in drysuit) are thight? Compressing in any way? Could it be worth a try do do a dive "bra-less"?

Braless is effectively what my one piece suit is and it makes no difference.

 

[tegz3]

I have just done the first day of my dive course certification today - the pool dives. We spent a number of hours in the pool, at a depth of no more than 4.5m, so nothing intensive. However upon getting changed at the end of the day, I noticed something a bit odd; there was a secretion from my breasts. To clarify - this is not normal, and not something I have seen or experienced before. I do not have children, have natural non-augmented breasts on the smaller side, but do suffer from endometriosis and so hormonal issues. Has anyone else experienced this, or does anyone have any potential explanation? I take it it’s not something I need to be concerned with for our shore and boat dives in the next couple of days?

 

[Duke Dive Medicine]

I have just done the first day of my dive course certification today - the pool dives. We spent a number of hours in the pool, at a depth of no more than 4.5m, so nothing intensive. However upon getting changed at the end of the day, I noticed something a bit odd; there was a secretion from my breasts. To clarify - this is not normal, and not something I have seen or experienced before. I do not have children, have natural non-augmented breasts on the smaller side, but do suffer from endometriosis and so hormonal issues. Has anyone else experienced this, or does anyone have any potential explanation? I take it it’s not something I need to be concerned with for our shore and boat dives in the next couple of days?

Hi, good morning. Can you characterize the discharge? Was it clear or cloudy? Color? Amount? Thick or thin? What type of outer garments (swim suit, wetsuit) were you wearing? Did you notice anything about the fit of your dive gear around your chest? Are you under a physician's care for anything else besides the endometriosis? Is there any chance that you could be pregnant?

Please feel free to take this to PM if you feel like these questions are too invasive/personal for a public forum.

Best regards,
DDM

 

[Bubblesong]

I have never heard of this in my 30 years as a woman diver. I don’t believe it is related to pool work. My suggestion is to make a doctor apt. Today.