Reading others experiences about wanting to bolt helped to keep me “calm”

[Tricia]

Thanks to all of you for sharing you insights. I think this thread confirms what happened to me a few weeks ago in the Bahamas because it's just as you all described it.

At the last minute, the resort instructor assigned my buddy and I a third diver. I really don't like that because you don't know who you're dealing with. As it turned out, this guy seemed to want to prove that he was Michael Phelps and so he took off like a bat out of hell and left us to follow him. At one point, he led us into a "swim through" (where the coral is closed over your head for just a moment). I got into that narrow canyon and after a few seconds thought, "I want OUT of here!". I realised my breathing was way too shallow and that I was starting to have a panic attack. We were at about 32 meters and as soon as there was a wide enought opening above my head, I ascended to 25 meters. I calmed my breathing and then met my two buddies on the other side of the swim through and we continued our dive - except that I was VERY low on air and made it back to the bar on the reserve.

When I had needed to ascend to 25 meters to calm down, I had been able to signal "our leader", but my original buddy didn't see me and was furious later. She also castigated me about my "claustrophobia" (that's what I assumed it was) and told me I needed to get help for it.

Looking back now, I realised that I probably was narced and then was over-breathing the reg and getting too much CO2. As for the claustrophobia, I only occasionally get it in very tight spaces (like a small elevator here in Europe or an MRI machine) and I never get it when I'm diving in the "open" during the day. So I avoid night dives (can't see the surface) and I avoid swim throughs, just in case. So does this make me a bad person or an incompetent diver? Reading this thread makes me realise this can happen to any of us, for a variety of reasons.

Thanks again for sharing!
Trish

 

[PR_SMITH]

Trish,

None of that makes you a bad person or an incompetent diver; you are aware of you comfort zone and make efforts to stay within in. Quite sensible, in my opinion.

Smiffy6four

 

[hypersonic]

lamont,

This situation started on the surface and never abated throughout the dive.

Trust me, to go thru a 120 cu ft tank in 25 min, I was breathing long and deep.

Your seem to be fixated on the fact that rapid uncontrolled breathing underwater can only be caused from too much CO2.

And further, my doctor has nationally recognized qualifications related to scuba diving and I suspect he understands the physiology far better than you.

 

[InTheDrink]

No offence hypersonic, but I'd probably defer to Lamont's experience in this if I were you. I see a road of only pain ahead of you ...

 

[dave4868]

Too much CO2 or not enough???

On a Cozumel dive I entered the water in a state of high anxiety and breathing heavily. In spite of dropping to the sand to try and settle down on three different occasions, I could not stop the heavy breathing and the urge to bolt and panic. I went thru a 120 cu ft tank of air in 25 min.

Upon returning home, I discussed the dive with my doctor who dives and lectures on medical issues related to diving. He suspected too little CO2 and suggested that the problem may have been solved by taking short breaths or while on the bottom, holding my breath.

It's pretty clear that your doctor was viewing your situation as anxiety-related hyperventilation which removed so much CO2 from your body that your blood levels of CO2 dropped below normal (hypocapnia).

From Wikipedia, a pretty accurate overview on anxiety-related Hyperventilation Syndrome:

Hyperventilation syndrome - Wikipedia, the free encyclopedia

People with HVS feel like they can't get enough air, but the opposite is actually true: they have too much oxygen and too little carbon dioxide in their blood. The hyperventilation is self-promulgating as rapid breathing causes carbon dioxide (CO2) levels to fall, and respiratory alkalosis (high blood pH) develops. This makes the symptoms worse, which causes the person to try breathing even faster, which further exacerbates the problem.
The respiratory alkalosis leads to changes in the way the nervous system fires and leads to the paresthesia, dizziness, and perceptual changes that often accompany this condition.

END QUOTE

In non-submerged conditions, typical strategies to defuse this physiologic cycle include breathing into a paper bag, holding one's breath, or taking shorter, less frequent breaths. Those measures reduce the amount of CO2 removed by the lungs, allowing blood levels to come back up toward normal.

Employing similar techniques while submerged would work, but with the obvious added risks. Your doctor knows you and apparently felt you could manage those risks.

Personally, while submerged and working hard, I sometimes need to use the steps of "stop, think, breathe", but if I got to a point requiring additional measures to counteract a hyperventilation syndrome, I'd probably be wise to just abort the dive.

And that's coming from someone who feels pretty confident in being able to assess and manage my emotions under water.

FWIW, here's another pretty good Wikipedia overview that includes hypercapnia in divers (elevated levels of CO2 in the blood- CO2 retention):

Hypercapnia - Wikipedia, the free encyclopedia

Additional Sources of CO2 in diving




There are a variety of reasons for carbon dioxide not being expelled completely when the diver exhales:

• The diver is exhaling into a vessel that does not allow all the CO2 to escape to the environment, such as a long snorkel, full face diving mask, or diving helmet. The diver then re-inhales from that vessel (Increased deadspace).[8]
• The carbon dioxide scrubber in the diver's rebreather is failing to remove sufficient carbon dioxide from the loop (Higher inspired CO2).
• The diver is over-exercising, producing excess carbon dioxide due to elevated metabolic activity.
• The density of the breathing gas is higher at depth, so the effort required to fully inhale and exhale has increased, making breathing more difficult and less efficient (Work of breathing).[4] The higher gas density also causes gas mixing within the lung to be less efficient, thus increasing the deadspace (wasted breathing).[8]
• The diver is deliberately hypoventilating, known as "skip breathing" (see below).

END QUOTE

your doctor is incorrect. you had too much CO2, and you were feeling suffocated and were hyperventilating which is actually not efficient at eliminating the CO2.

what you need to do is fully exhale and get all the CO2 out and then take a deep, but controlled breath, pause slightly (with your airway open) to let the CO2 and O2 exchange across the lung and then again fully exhale to expel all the CO2. hyperventilation doesn't efficiently exchange the CO2 and you don't fully deflate your lungs to expel the CO2.

taking your doctors advice and taking short breaths would make the problem worse, as would trying to hold your breath. that would build up more CO2 which would cause more narcosis, anxiety and panic. you need to get the CO2 out and/or ascend to the point where it breaks the narcosis-panic cycle.

Usually true, but not applicable to this case apparently.

With hyperventilation related to anxiety, a different process has taken place. This is different than the typical CO2 retention often seen in diving.

lamont,

Sorry, but I tend to agree with the diagnosis by my doctor.

I'd suggest you do more research on hypocapnia, which is often described as hyperventilation.

For further reading, check on hypercapnia which is often described as hypoventilation.

Confusing for sure but in turn, I suspect some of the other incidents on this thread relate to hyperventilation (too little CO2) rather than hypoventilation (too much CO2).

In fact, my doctor talking in terms I can relate to, said there is a transducer in your body that detects both high and low levels of CO2, and when triggered cause the same involuntary reaction, heavy breathing.

lamont,

This situation started on the surface and never abated throughout the dive.

Trust me, to go thru a 120 cu ft tank in 25 min, I was breathing long and deep.

Your seem to be fixated on the fact that rapid uncontrolled breathing underwater can only be caused from too much CO2.

And further, my doctor has nationally recognized qualifications related to scuba diving and I suspect he understands the physiology far better than you.

It can be confusing, but those Wikipedia overviews may clarify things a bit.

I'd just suggest one not equate some of these terms with others, as some terms describe conditions (levels of CO2) that can be associated with processes (breathing patterns or effectiveness of breathing). They aren't synonymous.

You've shared another very helpful aspect of dealing with anxiety while diving. Thanks!

What you've described emphasizes that being self-aware and pro-active are key and they come with experience.

That's not to say I haven't ignored experience and run into trouble myself....

Dave C

 

[PR_SMITH]

Trish,

None of that makes you a bad person or an incompetent diver; you are aware of you comfort zone and make efforts to stay within in. Quite sensible, in my opinion.

Smiffy6four

A question comes to mind here, did you make your dive buddy and divemaster aware of what you were comfortable/not comfortable with?

 

[John_B]

And further, my doctor has nationally recognized qualifications related to scuba diving and I suspect he understands the physiology far better than you.

Can you share this insight so we can all learn from it?

 

[John_B]

When I had needed to ascend to 25 meters to calm down, I had been able to signal "our leader", but my original buddy didn't see me and was furious later. She also castigated me about my "claustrophobia" (that's what I assumed it was) and told me I needed to get help for it.

Your "original buddy" was as responsible for receiving your signal as you were to give it. If the human torpedo could see your signal, why couldn't she? Maybe you should've been furious with her?

 

[lamont]

lamont,

This situation started on the surface and never abated throughout the dive.

Trust me, to go thru a 120 cu ft tank in 25 min, I was breathing long and deep.

shallow and rapid can also burn through a tank extremely fast.

Your seem to be fixated on the fact that rapid uncontrolled breathing underwater can only be caused from too much CO2.

And further, my doctor has nationally recognized qualifications related to scuba diving and I suspect he understands the physiology far better than you.

its still a horrible idea.

if you've got panic and anxiety at the beginning of the dive, don't do the dive, and if you do make a mistake and wind up on the bottom with a panic attack, then abort the dive. if you are breathing hard due to exertion at the surface due to the gearup/entry then take a breaker on the surface before descending. if you can't do it right at the surface then try to do it shallow. if you can't do it shallow then find some way to get out of the current on the bottom or hang off the wreck/bottom to get it under control. and the way to breathe to get it under control is deep and slow(-ish) breathing -- if you can't fix it with that then get out of there.

trying to skip-breathe to stop a panic/anxiety attack underwater is terrible advice.

 

[hypersonic]

Dave4868,

Thanks for good detailed explanation on CO2 levels.

And thanks to lamont for the healthy discussion. There is probably something to learn from everybody on this.

FWIW, the Cozumel dive took place in May. In July, I was on a live-aboard and did 15 dives with no problems. In 3 weeks will be diving in Hawaii and in Cayman over Thanksgiving.

On the live-aboard, I related my experience on the COZ dive to one of the dive masters. He told me of a similar experience where an individual diving with him surfaced with an out of control breathing situation. They put him on oxygen and rushed him to shore where they were met by EMS personnel...his breathing was still out of control. After getting a description of the guy's symptoms, they removed the oxygen and told him to slow his breathing and hold his breath. In five minutes, he was reported to be walking around and feeling quite normal.