Dizziness & Fatigue/Lethargy After Diving

[SiC]

THIS IS A DUPLICATE OF MY ORIGINAL POST ON "DIVING MEDICINE". MAYBE IT SHOULD HAVE GONE HERE INSTEAD. MODERATOR PLEASE FEEL FREE TO DELETE EITHER POST. APOLOGIES FOR ANY INCONVENIENCE.

Hi guys. Newbie here.

Wondering if anyone can offer any views on this? Obviously it does not replace a consultation with a trained physician

I've been diving around 3 times a day for an average of 6 days a week in warm water (24C), for around 6 weeks continuously now. All the dives are WITHIN the tables' limits and typically go 30m, 20m, 15m over the space of 7 hours with typical surface intervals between of 1 hr and 3 hours respectively. After around a month I've started getting the following (so far just a mild annoyance, not affecting my performance, just restricting my post-dive social life!!):

1) dizzy on standing up after lying down after diving (e.g. after a siesta, but NOT usually the morning after)

2) lethargy and fatigue - mostly in the evenings or late afternoon after 3 dives that day, with a feeling of heaviness in my limbs and light-headedness, and sometimes a sensation of being a bit dazed. I can push through it if I need to go out and forget about it if I'm busy.

I've read about low BP but I'm wondering why it might have started just now (if that's what it is?)

Background:
35, very fit (runner, low resting heart rate c. 50bpm); very lean and feel the cold more underwater than the other guys; good on air, very relaxed low exertion style; usually very good RE alcohol intake and hydration and getting good sleep; history of mild allergies (and there's mould in my room); eating like a horse here but in the past I have got a bit ratty when gone 4+ hours without food; eating more sugar and white flour lately than I have in a while and craving peanuts and sweet things

The onset of this coincided with a few good nights (!) and general increased caffeine intake, so I did think temporary dehydration and low blood volume; but I've been drinking water like crazy ever since and I'm still getting it on and off?

I'm great in the day, and underwater - but I'm sooo tired of an evening... I wouldn't mind if I was living a rock 'n' roll lifestyle!

Any ideas, very welcome. Low BP, some sort of mild hypoxia, allergy???

Cheers

 

[TSandM]

I'm going to divide the possible answers into two parts: 1) Could this be subclinical DCS? That's Dr. Deco's territory, and I think he would need more information about profiles to give you the best answer. What ascent procedures are you using on these dives? What gas are you breathing? How long are the dives?

2) Could there be a non-diving-related medical cause for the symptoms? You're not going to get a very satisfactory answer here, either, because the symptoms are so non-specific. Dizziness or more properly lightheadedness with standing can be a symptom of volume depletion (of which dehydration is one type). It can also be associated with anything that affects the body's ability to compensate for the change of distribution of fluid due to gravity -- So anything that prevents your heart rate from increasing when it needs to, or causes your blood vessels to dilate, can cause lightheadedness on standing.

One thing that stood out for me -- You said you've been drinking water like crazy. Is this because you were worried about dehydration, or because you're thirsty? Diabetes is a disease that CAN cause all the symptoms you mention, and produces intense thirst.

As far as fatigue and lethargy go, the list of conditions that have those as associated symptoms is WAY too long to even begin to list -- ranging from viral illnesses like mono or CMV to endocrine problems like hypothyroidism to rare and serious conditions like aplastic anemia. If your symptoms are persistent and worrisome, I'd see a doctor. A good history and physical examination, combined with appropriately chosen lab tests, is the way to approach something like this.

 

[shakeybrainsurgeon]

You don't state your gender, but the reference to "guys" suggests you are a male. This is important, since the possibilites for a female diver are different (pregnancy, iron-deficiency, fibromyalgia). Anemia is a possibility, but unlikely due to low HR. This HR could be due to hypothyroidism, as noted above.

In addition to seeing a doctor, and since DCS is "in the differential", you might stop diving (gasp) for a period of several days or weeks and see if the symptoms improve.

 

[60feet]

Broadly, I'd divide the cause into either 1) diving related or 2) non-diving related. Reflect back to the onset of the symptoms, then a few days before that to see if there was a sudden change in your normal activities (exertion, sleep) or diet. If you're certain that there was no change in your normal on-land activities, I would put more weight on the probability that it's something dive related. For example, something like diabetes will most likely not come on all of a sudden if you don't have a history of it. If it's more probable than not that it's dive related (and I'm not asserting here that it is... only you or a physician can make that determination), then I'd offer a couple of suggestions for your consideration:

1) You mentioned napping post dive. Light activity is encouraged after a dive; napping is not because it slows down your circulation and reduces offgassing of nitrogen. Dr. Deco has addressed this in this thread: http://www.scubaboard.com/showthread.php?t=149868

2) Consider taking a day off from continuous diving every 3 days of diving. This would give your body extra time to offload nitrogen from your body.

There are other things you could do, and I'm sure others will point them out. I just offer these two as a start. Good luck and hope you'll find the cause and solution soon.

The above is not medical advice and should not be taken as such.

 

[TSandM]

diabetes will most likely not come on all of a sudden if you don't have a history of it.

Just to correct -- This is untrue. People can develop diabetes at any age, and the first symptoms are often thirst, frequent urination, and weight loss, along with weakness and feeling unwell.

 

[60feet]

Just to correct -- This is untrue. People can develop diabetes at any age, and the first symptoms are often thirst, frequent urination, and weight loss, along with weakness and feeling unwell.

You're right, Lynne. What I meant here was the timing of the OP getting diabetes to coincide with his diving timeframe and the onset of symptoms is, of course, possible, but I wonder about the statistical probability, hence my wording "most likely not..."

 

[shakeybrainsurgeon]

Of course, there's the old medical adage, when you hear hoofbeats, don't look for zebras. In this healthy, fit person making daily 30m dives for weeks with progressive non-specific fatigue, malaise and limb heaviness developing simultaneously, it is DCS until proven otherwise. I say stop diving now and, if symptoms resolve, you have an answer.

Just my opinion.

 

[60feet]

Of course, there's the old medical adage, when you hear hoofbeats, don't look for zebras. In this healthy, fit person making daily 30m dives for weeks with progressive non-specific fatigue, malaise and limb heaviness developing simultaneously, it is DCS until proven otherwise. I say stop diving now and, if symptoms resolve, you have an answer.

Just my opinion.

I have my suspicion too (psst... it's same as yours... sub-clinical DCS), but I'm waiting to see a response from Dr. Deco or Doc Vikingo. Meanwhile, I agree with your suggestion; it's the most logical way to quickly determine if there's causality between his repetitive diving and the symptoms.

 

[TSandM]

I think Dr. Deco would like to see some profile information . . .

 

[dumpsterDiver]

That is almost an unbelievably grueling string of continuous diving. I think most very active scuba divers would normally be limited to say 5 days in the water per week. Even crew on live-aboards have travel (and weather) days.

I think you would be better off drinking 3 beers a day rather than doing 3 tanks; chill for a few days. Diving with continuous daily exposure to those depths has to hard on anyone's body.