Newbie here, trying to get back

[Kristine Murphy]

Hi everyone. I'm the newbie. I got dive certified a 'few' years ago, okay so like 25 years ago and I'm trying to get back into diving but I'm starting to think its not going to be possible.

Long story short. Dive certified in Cuba in 95, loved it. Last dive I did there went to 70ish feet in a little rougher than normal seas, puked and surfaced. Most likely too fast. Went to medical a few times complaining of dizziness and they said I was fine. Transferred so I didn't dive forever and tried to start again 2 years ago. Can't seem to dive without getting sick, including in a pool in a refresher course.

I've been having issues with vertigo for many years and have been trying to figure out why with ent specialist and the 4th one I saw yesterday mentioned perilymph fistula. Looking it up the symptoms are all there and the potential cause could be the dive in 95. I'm getting tested for it in 5 weeks but trying to do my research now. I can't seem to find much on repairing one so old.

Anyone with experience with these things?

 

[rhwestfall]

Welcome to SB. To get yourself a little traffic in regard to your question, you probably should copy it and post over in the medical forum.

Short of that, @Duke Dive Medicine now may give you some thoughts if he can.

 

[Duke Dive Medicine]

Hi everyone. I'm the newbie. I got dive certified a 'few' years ago, okay so like 25 years ago and I'm trying to get back into diving but I'm starting to think its not going to be possible.

Long story short. Dive certified in Cuba in 95, loved it. Last dive I did there went to 70ish feet in a little rougher than normal seas, puked and surfaced. Most likely too fast. Went to medical a few times complaining of dizziness and they said I was fine. Transferred so I didn't dive forever and tried to start again 2 years ago. Can't seem to dive without getting sick, including in a pool in a refresher course.

I've been having issues with vertigo for many years and have been trying to figure out why with ent specialist and the 4th one I saw yesterday mentioned perilymph fistula. Looking it up the symptoms are all there and the potential cause could be the dive in 95. I'm getting tested for it in 5 weeks but trying to do my research now. I can't seem to find much on repairing one so old.

Anyone with experience with these things?

Hi @Kristine Murphy , welcome!

It's possible that you did some inner ear damage on that first dive, but without more details it would be difficult to draw any conclusions. I know it's been a while, but can you describe how the dive went? How far into it did you get the nausea? Can you describe the post-dive dizziness? When did you notice it? Were you lightheaded, or did it feel like the world was spinning? When did it start in relation to the dive? Did you have difficulty equalizing on the dive, or notice that one ear was equalizing and the other one wasn't? Did you have any ringing in your ears (another symptom of inner ear barotrauma)? How bad were the dizziness and nausea, and how long did it take to resolve?

Usually with perilymph fistula, the unaffected inner ear apparatus sort of assumes the duties of the injured side, and the risk in diving is injuring the other one and having permanent symptoms. From your description though, I wonder more about some sort of Eustachian tube dysfunction in one of your ears that's causing one of them to equalize before the other. This pressure difference in the middle ear can lead to vertigo - the technical term is alternobaric vertigo.

Best regards,
DDM

 

[Kristine Murphy]

Hi @Kristine Murphy , welcome!

It's possible that you did some inner ear damage on that first dive, but without more details it would be difficult to draw any conclusions. I know it's been a while, but can you describe how the dive went? How far into it did you get the nausea? Can you describe the post-dive dizziness? When did you notice it? Were you lightheaded, or did it feel like the world was spinning? When did it start in relation to the dive? Did you have difficulty equalizing on the dive, or notice that one ear was equalizing and the other one wasn't? Did you have any nausea or ringing in your ears (other symptoms of inner ear barotrauma)? How bad was the dizziness, and how long did it take to resolve?

Usually with perilymph fistula, the unaffected inner ear apparatus sort of assumes the duties of the injured side, and the risk in diving is injuring the other one and having permanent symptoms. From your description though, I wonder more about some sort of Eustachian tube dysfunction in one of your ears that's causing one of them to equalize before the other. This pressure difference in the middle ear can lead to vertigo - the technical term is alternobaric vertigo.

I'm also going to move this to the diving medicine forum.

Best regards,
DDM

I don't remember a lot about the actual dive. I did have a bad ear infection for 2 months prior to the dive and it was the first time going down farther than 40ish feet. I'm pretty sure it was more lightheaded than anything. I do know for certain that this last dive I could not stand up on my own, the world was tilted more than spinning. I was sick to my stomach for months afterwards with no medical reasoning. I've had issues on and off for years with the world tilting on me since the dive where I got sick. I was perfectly healthy prior to that.

The ents are testing me for the vestibular disorders, vng and bppv testing has come back normal. MRI normal, CT scan for those bones came back normal too.

 

[Duke Dive Medicine]

I don't remember a lot about the actual dive. I did have a bad ear infection for 2 months prior to the dive and it was the first time going down farther than 40ish feet. I'm pretty sure it was more lightheaded than anything. I do know for certain that this last dive I could not stand up on my own, the world was tilted more than spinning. I was sick to my stomach for months afterwards with no medical reasoning. I've had issues on and off for years with the world tilting on me since the dive where I got sick. I was perfectly healthy prior to that.

The ents are testing me for the vestibular disorders, vng and bppv testing has come back normal. MRI normal, CT scan for those bones came back normal too.

So, nausea for months after the dive in 1995, occasional vertigo since then as well, negative for BPPV, and an acute aggravation after a benign dive. You mentioned a pool refresher course... did you get the vertigo after every dive during that course, or only the one you mentioned?

Best regards,
DDM

 

[Kristine Murphy]

So, nausea for months after the dive in 1995, occasional vertigo since then as well, negative for BPPV, and an acute aggravation after a benign dive. You mentioned a pool refresher course... did you get the vertigo after every dive during that course, or only the one you mentioned?

Best regards,
DDM

It was just the one dive in the pool for the refresher. I have not been able to dive without vertigo since the one where I got sick in 95. Granted that's only been 3 dives.

 

[Duke Dive Medicine]

It was just the one dive in the pool for the refresher. I have not been able to dive without vertigo since the one where I got sick in 95. Granted that's only been 3 dives.

Thanks for clarifying. Can you describe your equalization technique? Do you use a Valsalva maneuver? If so, how vigorously do you do it? Do you ever notice one ear clearing before the other, either on ascent or descent?

Exactly where in the pool refresher dive did you notice the vertigo (descent, ascent, post dive)? How long did it take for the vertigo to resolve after? Did it go away spontaneously or gradually?

Best regards,
DDM

 

[Kristine Murphy]

Thanks for clarifying. Can you describe your equalization technique? Do you use a Valsalva maneuver? If so, how vigorously do you do it? Do you ever notice one ear clearing before the other, either on ascent or descent?

Exactly where in the pool refresher dive did you notice the vertigo (descent, ascent, post dive)? How long did it take for the vertigo to resolve after? Did it go away spontaneously or gradually?

Best regards,
DDM

In the pool dive and subsequent dives I used the Valsalva maneuver and it was difficult each time to equalize. The pool dive I don't think I ever truly felt equalized but started feeling sick on the surface, pool depth 12 feet. The other dives the same, up to 30 feet, slow ascents, I'm okay when I first got down and then started feeling nauseous, surfaced and things got worse on the surface. The last dive I was out of commission for 48 hours before I felt somewhat human.

 

[Duke Dive Medicine]

In the pool dive and subsequent dives I used the Valsalva maneuver and it was difficult each time to equalize. The pool dive I don't think I ever truly felt equalized but started feeling sick on the surface, pool depth 12 feet. The other dives the same, up to 30 feet, slow ascents, I'm okay when I first got down and then started feeling nauseous, surfaced and things got worse on the surface. The last dive I was out of commission for 48 hours before I felt somewhat human.

Ok, so you're talking about multiple dives here - I have one dive in Cuba in 1995 where you vomited on the bottom, then a single pool refresher. Were there other dives, and if so, did this happen every time? Did the vertigo and nausea come on consistently at a certain point in the dives?

With the pool dive, you felt nauseous after the dive, on the surface? During the following 48 hours where you were out of commission, did you get better gradually, or all at once?

Sorry for all of the questions, but this will give you a good baseline history to relay to your ENTs and may help with diagnosis.

Best regards,
DDM

 

[Kristine Murphy]

Ok, so you're talking about multiple dives here - I have one dive in Cuba in 1995 where you vomited on the bottom, then a single pool refresher. Were there other dives, and if so, did this happen every time? Did the vertigo and nausea come on consistently at a certain point in the dives?

With the pool dive, you felt nauseous after the dive, on the surface? During the following 48 hours where you were out of commission, did you get better gradually, or all at once?

Sorry for all of the questions, but this will give you a good baseline history to relay to your ENTs and may help with diagnosis.

Best regards,
DDM

First, I totally appreciate you taking the time to help on this. So thank you.

First 5 dives for certification (1995) were fine. Pool to start, open water after that, no issues. Open water were mostly calm water, the bay didn't get much action for wind.

Two dives after certifying were fine as well (1995) usually about 30-40 feet, outside of the bay but calm waters.

95 dive where I got sick, last dive until 2018, choppy seas, first time diving where there was choppiness, first time wearing shorty suit, only wore skins before that. First time going down past 60, went to 70ish. Had a bad ear infection in months prior, I do not remember if I struggled to equalize, vomitted in regulator about 20 mins in and surfaced immediately. I honestly do not remember anything of that day after that. Went to doctors after complaining of upset stomach, dizziness. Nothing done. I'm pretty sure my hearing was okay, I had to pass a hearing test to transfer.

2018 did refresher course dive in the pool, full wetsuit, swam around at the bottom, equalizing was a challenge. Thought it was due to out of practice. Started getting nauseous when I was under at about 8 feet, surfaced, got out of my gear to get to the trash can. Out for the rest of the day, okay a day or two later.

2018 open water dive, full wetsuit, took two dramamine, equalized okay, spent about 25 minutes at roughly 30 feet, surfaced slowly, started getting sick on way back to boat, by the time I was climbing aboard I could not stand up.

2019 lake dive, dramamine again, up to 15 feet but went up and down. A little dizzy but manageable.

As for the non-diving times. I had a horrible attack while flying commercial airlines two years ago, full dose of dramamine. I have had trouble with ear pressure for what seems like ever, I'm constantly moving my jaw and popping my ear, I noticed when I have a bad head and I blow my nose I feel fluid in my ear. I have issues with turning my head too quickly, standing too quick, anything too quick.