problems at GBR, recommended i post here.

[stillswimmingincircles]

I am Naui Certified from when I was in my 20's. I had open water 2 and one advanced course in ice diving completed. Some recreational diving in the Caribbean but most of it was cold water diving as a young enthusiast. Looking back. I was a relaxed , fit, normal weight diver who never used much air, trained but had the youthful indifference of "nothing will happen to me". My deepest dive was 85 feet. Common dives were 30-60 ft. I got re-certified with Padi a month before the trip. in the time frame from my late 20's till now (48), I had not done any diving. I had one minor incident on the second checkout dive. Which I spoke to the dive master about. She brushed it off as Vertigo. It was a 9-11 ft dive in a very murky channel. You could barely see your hand in front of your face. upon ascent, maybe 3 feet from the top. I suddenly got very flushed, hot, and felt like my head was swimming. I would not have been capable of looking at my gauges. pop! up on the surface. gave it a minute. felt fine.

Before this trip. I did have a medication change. i have knee problems, and was taking diclofenac sodium (a NSAID)along with pepcid (the NSAID causes grief). however I think these 2 medications, messed with my thyroid levels. This is a replacement hormone I have been taking for 10 years. however the dr. added T3 to the mix. looking it up, this can cause anxiety issues for some people. I choose to stop taking the diclofenac and pepcid while diving for the 7 days. I didn't want anything that could mask the pain of getting the bends.

I had booked a 7 day live aboard trip after a 8 day land trip in Sydney. I am 5'7", 230 pounds, and a BMI of 35. I had recently lost 45 pounds and am still in process. I gave up the dieting for the trip. I was still eating the healthy meals provided. I was also trying to drink water on a regular basis. As well as coffee. I had taken Dramamine before boarding First 2 hours on the boat. I had motion sickness. Vomited, was given 2 Quells. overall I would say I was pretty solid after that. only took Dramamine one more time.

This was my first stupid mistake. second day of diving. I had a camera and got carried away taking pictures,I stopped looking at my air, or gauges. I was at 97 feet and had 70 bar! My dive buddy was waving me up! I started to hustle. If I was on land, I would call it a very purposeful fast walk. I felt worried. I knew I could not shoot to the surface. I started a steady climb. my dive buddy was too far ahead of me, and I could not reach him. I am now at 55 feet! ugh! keep going. 45 feet. Where is my dive buddy?!! Turns out he stopped, to take a picture with the boats photographer. I am watching my air go down. finnally 20 feet! I am at probably about 20 bar of air. I opt to do my safety stop. Tapping my gauge, nervously watching my air. c'mon. c'mon. as i finish I see my buddy. We motion to ascend up the mooring line. I ascend in a slow control manner. meanwhile my mind is going : oh my god! hurry up! relief at every fsw that goes by. I inflate my BCD on the surface. 0 bar reads on my SPG. 97 foot dive. Crisis averted. I am embarrassed. My dive buddy is holding it back, but I can tell he is upset with me. I never told him, how close it was for me, but I apologize profusely. telling him I will never do that again. I did speak with one older guy, a former instructor and told him what I did. He proceeds to tell me he made the same mistake! Got carried away with what he was doing, and forgot to watch his gauges! I am thinking, wow! dive instructor! I was shocked at how easily you can loose site of your depth. I mentally vow to stay with my buddy. dive with a dive master, and watch my stuff! I THANKED MY LUCKY STARS!

I also discovered that I don;t breath like I used to. I did not feel as relaxed either. The dives were easily deeper on a consistent basis, 60-80 ft on the GBR, and later 85feet or more on Osprey. There were a few opportunities to do some tunnel diving. Did I feel anxious? maybe. I might say it felt like I was pushing myself to go beyond a little of what I was comfortable with. there was one day when the current was so strong, they had to send out the dingy to collect every single diver. At least two divers got stuck in a tunnel, because they went in the wrong tunnel. they wiggled backwards to get out. I felt like I was normally breathing for like, 6 breaths, and then I had a huge compelling need to breath really deeply. like really fill my lungs. repeat. This equated to me have dives of 30-35 minutes, when other divers made it for 45-60 minutes. i recognized this and tried to work on my breathing. but it never changed. I wondered what happened to the girl who did it without thinking? I also struggled with buoyancy. I was always trying to get my feet down. and when I was on the bottom. I would have to add air to my BC. I am thinking now, that I was overweighted.

All in all we did 7 days of diving. I dove most days 3 dives. maybe two days 4 dives. first 3 days it was a NITROX mix of 32%. the last 4 days ended up at 33%. Every dive I completed a 3 minute safety stop at 15 feet. most of my dives were never more that 35 minutes. Due to my air consumption. I usually had a slow descent, due to the fact that my ears will not equalize with the val salva maneuver. I have to stop breathing, swallow, and then they will go.

Day 7, first dive of the day. During the dive brief and after my wetsuit is halfway on, i feel like I am getting motion sick. I go back to my cabin, and take a Dramamine. in hindsight this was probably not wise. I finish gearing up, and do a giant stride off the back. This will be a straight drop down, due to currents. Not down a mooring line. The Visibility for the first and only time, was like glass. most of the rest of the trip the visibility wasn't as great due to the full moon. I got in and started to descend. all is going well. I OK signal to my dive buddy. there is one other couple with us, and a dive master leading. we Ok a few more time, I am watching my depth go down. Then I am thinking. Wow, this is really BLUE. And wow, I can't believe how easy this is? (usually I am working on my ears) they didn't seem to bother me at all. I am guessing this is somewhere around 50-60 feet. those are the last numbers I remember. The dive master tells me he thought I was dropping too fast. My dive buddy thought I was normal (dive buddy has 18 dives). I turn to find my dive buddy. i can't. i roll over, maybe he is on top of me. Nope. I don't see him. I see nothing but blue. I look at the gauges. 97 feet. 97 feet?! I feel confused. What happened to 55? I look up. I see the bottom of the dive boat, it appears close, maybe 35 feet. But the dive people under it. look like ants. Weird I think. look at my gauges again. 91 feet. oh. it looks like the dive master is going back to the boat. I wonder why? I start to swim torwards him. gauges again. 97 feet. no. 91 feet. this doesn't make any sense. Why is the image of the boat and divers not moving? I am now swimming hard. ugh. I have a weird thought in my head. Am I alive? wouldn't the picture of the boat and divers change? I am so confused. Why am I swimming up and the gauge keeps going down to 97? if I was dead, wouldn't somebody have grabbed me by the BC? So confused. then I have a thought. something is not right. me. i am not right. Now I start to feel panic. before I was just confused. Ok. What to do. I cannot tell you the effort of mind this took me. I had to tell them I was crazy. I am now breathing like a freight train. keep the regulator in. I make the crazy sign beside my head. I have no idea where anyone is. I can't see anything but the little ant divers. I cannot see my gauges. I think the little ant sees me. I think the ant diver turns. I start motioning for him to come here with my hands. I motion faster, I breath faster. I cannot see anything now. Is someone coming? I am scared. I feel arms. OMG! I feel arms. Someone has me. has this. hands on my elbows. the most comforting feeling in the world! breathe. I grip his arms. i feel like we are going up. ok. breathe. breathing. lots of breathing. suddenly at 40 feet I can see. I can see the dive master looking at my gauges. still holding my arms. I am gripping his. I know this is 40 feet because I noticed it on the gauges. 30 feet. feeling better. loosen my death grip. 20 feet. he signals 3 minute safety stop. I signal back. Ok. I am good now. Normal ascent to the surface. He raises his fist for a dingy to pickup. and I gratefully get in the boat. strip of my gear, and go upstairs and lay down on a lounger. My SPG read 100 feet (never saw that number) and 13 minutes. The other divemaster. called it 13 minutes of education. I ended up talking to that first customer/dive instructor who said I should probably go back in for an easy dive just to kind of get on the horse again. I did in fact do that. I went for 2 dives 60-75 feet. With no incident. was a little nervous? yes. was the dive ok? yes. was is the best idea for me? probably not physically ( i have barotrauma in both ears and vertigo now) mentally, maybe.

I asked what the others saw. the divemaster said he saw me drop fast. this made him uncomfortable. he said he was swimming back, and says he was maybe 10-20 feet ahead. he tells me the other dive buddy and couple were above me. They all said they saw me make the crazy sign by my head. The 3 of them were trying to get the dive masters attention. my dive buddy and the other couple did not know what to do. I f I was not with the dive master I would have been in trouble. probably dead. The dive master had seen my signal and was swimming back quickly,. I asked him what he thought at that moment. He was like "oh ****" . he didn't know. however he did great. And I am beyond thankful. There was no other conversation about this with any of the staff. I did talk about it a little with other divers in an effort to understand. I am still at a loss.

 

[stillswimmingincircles]

So, I am just posting a follow up, of how I have been. And a request for some possible feedback.

So part of the story I did relay, because at the time, I didn't see it as relevant. was in crossing the coral sea. The crossing was rough. Tossing you in the air on your bed, eventually I put my arm under the mattress to try and stay on. People in top bunks fit tossed to the floor. There was no sleep, I think for anyone. Yesterday I was relating my story to a nurse. She has worked in neuro. She said it is very probable that I got a concussion.

I said I was not symptomatic on the boat. Tired. Very. Almost every night, I left the dinner table early, because I couldn't stay awake after that. I just figured they were long days. She said many times concussion symptoms don't become apparent till days after. This I did not know.

Flying back from cairns, I had tingling in my hands and feet. This caused me anxiety on the flight. Arriving back in Sydney...just really tired. Again...just figured travel.

Next morning, didn't feel quite right. Severe motion sickness hits me in airport. Sleep 13 of the 15 hours of first flight.

Arrive home. And SEVERE rocking and bobbing. Nausea and sickness rated at 9 out of 10. Couldn't walk. Couldn't raise my head. Next day go to dr. Didn't think it was possible, but I am worse. He sends me to ENT. That dr, says I have fluid behind the ears, and dried blood. He tells me it will be like this for 3-4 weeks. I want to jump off a building! Vestibular test scheduled 2 weeks out.

1st week back, I was completely debilitated. Next week, I try to work. I work in a hospital. Standing at a computer, I start to have the same feeling I had, at the bottom of the ocean. Am I here? Very surreal? But brief. Then I can't stand, tingling is moving up extremities. I get nurses. I sit down and say: I am really not feeling well. My BP was thru the roof. The world is unstable again. Go to ER. MRI showed severe acute bilateral mastoiditis. Blood work normal. ENT disagrees. Says it is just fluid, a lot of it, behind the ears. I tend to agree. No pain. No redness. My GP put me on Augmenton, for 7 days, to play it safe.

2 week, after antibiotics feeling better. But the world visually still seems off. Like viewing a movie where the talking is out of sync, just visually. I can't watch TV, walking down aisles in stores bothers me, my family talks too loud. Since being back, I can't sleep more than 4 hours. I feel such pressure in my head. It makes me feel sick. But the rocking and bobbing had stopped. I am leaning a lot on the anti nausea meds the hospital gave me. They help some. Oddly I feel ok to drive, normal . Standing is the worst. End of two weeks I go, for vestibular tests. Somewhere around the tow week mark, I was able to fall asleep and make it for 8 hours. Improvement started after this. All ok with vestibular tests, and small hearing loss in right ear. 5 days later ENT says ears drums responding normally again. It's 3 weeks and I feel better. But still off. And I still fall over when trying to put on my pants or socks.

So now it's about 4 weeks. And I still have slight pressure on my head. Much better. Still some balance issues. I would say no rocking or bobbing. ENT diagnosed as mal disembarkment syndrome. I am just wondering, if it was a combo of ears and concussion. Can you really get a concussion from bad seas? I have never heard of this before? Symptoms match well for both mal disembarkment, and concussion. And throw in the ears...and if I never feel this way again, it will be too soon!

only other thing I can think of in regards to this, is I was getting tired by the end of the week, and may not have been watching my water consumption as I was, earlier in the week.

 

[stillswimmingincircles]

These two threads were from my post of "GBR near miss for this novice diver", on Accidents near misses forum. it was recommended that I post here, as someone might have some insight for me.

 

[Bubblesong]

You mentioned that you were diving Nitrox, but did you test your own gas or see it tested in front of you? Bad air fill would explain the nitrogen narcosis and CO contamination would explain the nausea. The rest of the symptoms sound like lingering barotrauma. Did you have tinnitus?

 

[stillswimmingincircles]

You mentioned that you were diving Nitrox, but did you test your own gas or see it tested in front of you? Bad air fill would explain the nitrogen narcosis and CO contamination would explain the nausea. The rest of the symptoms sound like lingering barotrauma. Did you have tinnitus?

I only tested the air for fo

You mentioned that you were diving Nitrox, but did you test your own gas or see it tested in front of you? Bad air fill would explain the nitrogen narcosis and CO contamination would explain the nausea. The rest of the symptoms sound like lingering barotrauma. Did you have tinnitus?

No I didn't know that testing for co2 was a thing. And wouldn't the other divers also have had the same bad air? It was a live aboard. I only felt a little nausea before the dive. The nausea really hit at home. Days after diving. I have had very little tinnitus. Brief (under 5 minutes) and intermittent. The ENT guy when I questioned his mal disembarkment diagnosis, Referred to the caloric test I did. He said it would have shown damage, even if it had healed. I was confused by that, because wouldn't blood behind the ear drums indicate damage? But he was quite adamant.

 

[Duke Dive Medicine]

Hi Circles,

I'm a little confused by the narrative but it sounds like there are multiple things at play. Narcosis could have been a factor at depth (not a function of bad air BTW), but it sounds more like a problem with buoyancy control and overall physical deconditioning which led to a panic attack and maybe some hypercapnia (excess CO2 in the blood). Blood and fluid behind the ears means you probably suffered from barotrauma at some point, perhaps during your uncontrolled descent, but the delayed onset of the nausea and rocking/bobbing (which could be interpreted as vertigo) probably rules out damage to the inner ear and certainly rules out CO poisoning. Mal de debarquement is a possibility.

I'm not sure what you mean by motion sickness hitting you in the airport.... were you in a vehicle at the time? If not, then it probably wasn't motion sickness.

Did you hit your head during the rough transit you mentioned? If not, then concussion is highly unlikely.

It sounds as if you're recovering, which is of course a plus. From what you've described, your symptoms could be explained by a bad case of otitis media (middle ear infection, often seen with mastoiditis) which can cause persistent vertigo like you experienced, possibly complicated by mal de debarquement.

You're already doing exactly what I would recommend, which is, consulting with an ENT physician. If you're not happy with that one, maybe you could seek a second opinion. Also, it couldn't hurt to have your thyroid levels checked given the change in medication.

Best regards,
DDM

 

[stillswimmingincircles]

The motion sickness hit me at the airport while I was getting my tax refund. I just didn't feel so well, in the morning. Then standing in line, I got that rush of heat, and the room started rocking. It stayed with me till the plane started moving. Then returned at layover, and at home.

I could agree with everything, except that I still feel quite unwell, and not myself. There is always pressure in my head, but no head aches. Thyroid levels must wait 6 weeks after any change for the blood work to be helpful. That is next week. Certainly it can have a play, in the fatigue. I was severe when I was diagnosed, 15 years ago....it was bad, but felt very different from this. Dan diver and ENT, both requested I go to See a neuro. So that's slated too...but in about 5 weeks. :/

Walking outside helps. At least the dog is happy

 

[Duke Dive Medicine]

The motion sickness hit me at the airport while I was getting my tax refund. I just didn't feel so well, in the morning. Then standing in line, I got that rush of heat, and the room started rocking. It stayed with me till the plane started moving. Then returned at layover, and at home.

I could agree with everything, except that I still feel quite unwell, and not myself. There is always pressure in my head, but no head aches. Thyroid levels must wait 6 weeks after any change for the blood work to be helpful. That is next week. Certainly it can have a play, in the fatigue. I was severe when I was diagnosed, 15 years ago....it was bad, but felt very different from this. Dan diver and ENT, both requested I go to See a neuro. So that's slated too...but in about 5 weeks. :/

Walking outside helps. At least the dog is happy

Thanks for the clarification.

It's unlikely that motion sickness would occur in the absence of motion. The head pressure could be explained by an unresolved sinus infection, which you should make your ENT and/or primary care physician aware of if they are not already. Re the "generally unwell" feeling, that's pretty vague and best evaluated by someone who can see you in person. I'm surprised to hear that it would take you five weeks to get in to see a neurologist given the acute onset of symptoms.

Best regards,
DDM

 

[stillswimmingincircles]

When I was last at the ENT, I thought the same thing about sinuses. He stuck the camera in there. I hated it.
Saw nothing.

2nd day back, I went to GP. He said he had a difficult time looking at me, that I was so sick. But thought it was ears, too. I didn't know...all I wanted was for it to stop. If you had told me to drink hot pickle juice with anchovies all day...and it would work....would have done it! You could have told me, anything. I was so desperate for it to end.

At the ER, they put me on anti nausea meds ( zofran) for a week...and told me to follow up with GP. Meds kept it under control, ENT said he thinks it's a neuro problem, and to tell GP. So then I called for appointment after relaying info to GP. First 2 weeks were really bad...should have seen neuro then ( but they thought it was ears) and now it's not acute. If I compare arrival, with now...there is a huge improvement.

I just don't know if I buy this mal disembarkment syndrome diagnosis. It seems so obscure...his ENT advice: do not go on any boats again. That's what I left with. :/

 

[Bubblesong]

Say what?!? Don't go on boats? Sheesh!