Headaches, nausea, vomiting upon surfacing, NOT seasickness!

[idocsteve]

I've had a recurrence of a problem that almost stopped me from diving over 10 years ago..after an uneventful dive and a slow ascent, I get a pounding headache and nausea that results in violent retching, and it's gotten worse.

Yesterday my girlfriend and I dove the Panther, a 57 foot wreck dive off of Long Island on a boat charter called the Jamaine.

2 weeks prior we did a 60 foot wreck off another charter, and both times, immediately upon surfacing I felt a pounding headache that seemed to originate in my upper neck but seemed to settle in around my sinuses..top front part of my head, over my eyebrows, even in my cheeks. This last dive we tied in at about 32 feet, so we're talking about a relatively shallow ascent up the anchor line plus we did a 3 minute 15 foot safety stop.

On that first incident I made it to the boat before retching over the side, but on yesterday's dive I threw up in the water, right into my regulator. As I said, the problem is evidently getting worse not better. Sometimes I'll feel a "mild headache and slt nausea" after the first dive, and if I do the second (following a one hour SI), that's when it really hits.

Key points

- I make it a habit to ascend VERY slowly
- As far as I can tell, I maintain a steady and regular full in and out breathing cycle, I do not breath hold to save on gas consumption (which is known to increase C02 buildup)
- 10+ years ago I had this very same problem and it was completely erradicated with a sudafed (the small red pill). For years I took one an hour or two prior to a dive, but around 5 years ago I got away from doing it and had no problems until last summer when the symptoms started creeping back.
-For yesterday's dive I took a generic which says on the box it's the same active ingredient as sudafed. I took it about an hour before the dive and as I said I was worse than the dive 2 weeks ago
- I do suffer from mild sinus congestion but I don't take meds (for that or anything else)
- I don't typically suffer from seasickness, this only occurs immediately following a dive and as stated, it starts IN the water.

 

[flots am]

I've had a recurrence of a problem that almost stopped me from diving over 10 years ago..after an uneventful dive and a slow ascent, I get a pounding headache and nausea that results in violent retching, and it's gotten worse.

Could be a lot of things. CO Poisoning, Migraine, DCS (possibly from a PFO).

You might want to get checked out by an actual doctor

-For yesterday's dive I took a generic which says on the box it's the same active ingredient as sudafed. I took it about an hour before the dive and as I said I was worse than the dive 2 weeks ago

Unless you bought it from the pharmacist, and had to sign a sheet and show ID, your Sudafed isn't sudafed anymore. The formula was changed because of abuse and it's use in creating other illegal drugs.

Flots.

 

[idocsteve]

Could be a lot of things. CO Poisoning, Migraine, DCS (possibly from a PFO).

You might want to get checked out by an actual doctor

Unless you bought it from the pharmacist, and had to sign a sheet and show ID, your Sudafed isn't sudafed anymore. The formula was changed because of abuse and it's use in creating other illegal drugs.

Flots.

Thanks.

My girlfriend was concerned so she called DAN. They're trying to find me an ENT that takes my insurance plan and who can see me ASAP. I'm headed on a dive trip to Curacao next week.

Yeah I knew about the limited availability and need to present ID for sudafed due to the new regulations.

If nothing else I'm going to get myself the real stuff for next week and see if it helps.

 

[Doc Intrepid]

Steve,

I don't have enough knowledge of other factors (e.g. weather, wind, height of seas, etc.) from your charter boat episodes to comment specifically, but I may be able to give you a few thoughts to consider.

I've only been seriously nauseous twice on long off-shore rides, and both were 60-70 miles off North Carolina on the wrecks. In both cases contributing factors were long swells, waves of 3' to 5', and relatively low winds combined with issues with the exhaust that kept (what seemed to me to be) clouds of diesel exhaust fumes swirling around the stern of the boat.

The combination of the swells, the rocking, and breathing the diesel fumes for a couple hours gave me the same symptoms you describe, and like you, once after ascending following the first dive I threw up through my regulator when I hit the surface and smelled the diesel off the stern of the boat. The second time I didn't heave, but I was as miserable as if I had.

What I started to do was take Triptone (similar to Bonine), the night before and the morning of the charter, and drink lots of water. I also made it a point to not remain near the stern at all, to avoid most of the diesel exhaust fumes.

I've no idea how these factors impacted your diving experiences, or whether there was a corellation between your nausea and these factors, but I've experienced the same thing as you describe on a couple occasions, and after reviewing the weather, etc. it seemed to me that these things in combination were the proximate cause of my nausea.

Something at least to think about. (And I dive with Sudafed on occasion also, but it doesn't seem to do anything for me at all with regard to long trips offshore like the Triptone does. Hope this helps.)

Doc

 

[ERP]

I'm not a doctor, To me it sounds like it's some sort of obstruction in your sinuses. It could just be narrow sinus passage ways getting blocked or it could be something in the sinuses.
Either way I'd be tempted to go see an ENT specialist.

 

[Troutmaster]

First, what ERP said. Second, get the REALLY sudafed, not sudafed PE. The stuff behind the counter that as the same amount of paperwork as buying a handgun contains pseudoephidrine, a much better decongestaint. Other stuff is phenylephrine, not as good at clearing out your sinuses, but it can't be converted into methampetamine.

I am not a doctor, but I have sinus problems too. If a decongestant is preventing the problems, I would think that it is a sinus problem, so take the sudefed and dive happy. It will raise your blood preasure, so if you have high blood preasure you might want the ENT to recommend an alternative.

 

[idocsteve]

First, what ERP said. Second, get the REALLY sudafed, not sudafed PE. The stuff behind the counter that as the same amount of paperwork as buying a handgun contains pseudoephidrine, a much better decongestaint. Other stuff is phenylephrine, not as good at clearing out your sinuses, but it can't be converted into methampetamine.

I am not a doctor, but I have sinus problems too. If a decongestant is preventing the problems, I would think that it is a sinus problem, so take the sudefed and dive happy. It will raise your blood preasure, so if you have high blood preasure you might want the ENT to recommend an alternative.

Thanks, this is what I'm thinking too. Sudafed fixed me 10+ years ago, it's the most likely fix now. The only question was why the generic didn't do the trick and I think you just answered that question.

 

[DandyDon]

So did your "same as sudafed" pills contain pseudoephedrine...?

 

[idocsteve]

I've only been seriously nauseous twice on long off-shore rides, and both were 60-70 miles off North Carolina on the wrecks. In both cases contributing factors were long swells, waves of 3' to 5', and relatively low winds combined with issues with the exhaust that kept (what seemed to me to be) clouds of diesel exhaust fumes swirling around the stern of the boat.

The combination of the swells, the rocking, and breathing the diesel fumes for a couple hours gave me the same symptoms you describe, and like you, once after ascending following the first dive I threw up through my regulator when I hit the surface and smelled the diesel off the stern of the boat. The second time I didn't heave, but I was as miserable as if I had.

Doc

Thanks Doc

In all cases it was relatively calm seas and the boat motor was not running, it had been off since we tied into the wreck prior to the first dive, and no other boats were around.

 

[idocsteve]

So did your "same as sudafed" pills contain pseudoephedrine...?

I gotta check the box, it's at home. I recall the box says "same active ingredient as sudafed" but it's their CVS generic brand.