vestibular bend (IEDCI) - will the balance restore completely?

[eglantine]

Hi all

I am a recreational diver with 70 dives under my belt and very cautious, but got bent 3 weeks ago after an uneventful (a bit cold though) dive to 30m (40 min), nice slow descent/ascent, no deco, safety stop 3/3, no whatsoever pain in the ears nor forced valsalva. Ear fullness and vertigo/nausea/vomiting followed 30 mins after the dive to total surprise of my friends/the local club, got to the chamber 4 hours later, 8 sessions, a week in the hospital. My ears cleared quickly in the chamber, but the balance has improved very slowly. The diagnose was "vestibular or inner ear DCS".

Im back at home now and fortunately my ear are ok, but my balance is still weird (I can walk, but lose my balance when looking at sides/quick head movements). The ENT said after a test wth special googles that my vestibular organ is a bit damaged and he prescribed Betaserc that Im taking now.

I would have never thought my "simple" dives (30 m is the maximum I have been to) would give me this condition and it scares the hell out of me, I am a runner and very sporty, but now I cant even walk straight:/.

Has anyone had the same and how look it took to recover (completely I hope)?

PS I wont probably dive again (missing diving!) and will get tested for a PFO in a month.

 

[stillswimmingincircles]

I had a very disturbing incident happen while I was diving the GBR. I don’t think it was the bends. But I really looked at everything in relation to diving. However after getting off the boat, 1 day after, I was overcome with the most unbelievable rocking and bobbing, visual disturbance, and I walked like I was drunk. This went away while in motion on the plane and in cars. It was weird. Hoe could I feel so off standing still, but get in a car, it’s gone? It literally felt like I was the most sea sick person on the boat, just in my living room.

They diagnosed this as MdDS. A rare brain disorder. You can google it. There are videos by the mdds foundation that duscrube it well. I am now not so sure, that this a brain thing. I think it’s a little studied inner ear issue. I’ve been reading about the otoliths in your inner ear. And an otolith disfunction sounds like it matches to the tee. The otoliths, are responsible for linear motion. Forward and back, and up and down. Your semicircular canals, are responsible for rotational motion. So otoliths: rocking and bobbing vertigo. Semicircular canals: room spinning vertigo. I even found ONE mention of this in relation to diving. There is more in relation to pilots and astronauts.

This took me 4.5 months to get over. I consistently did vestibular and eye exercises. It was hard, and quite frankly I considered suicide. I could not see living like that. Yes. It was that bad. But it did get better. I consider myself back to normal now. I will never dive again, or go on a boat. I’ve been told it can come back. Completely sucks.

What kind of vertigo do you have? Is it spinning, or more the motion of a boat?

I was tested for a PFO too. Negative.

 

[Flotsam]

I'm so sorry about your injury! Hopefully a dive medical professional will chime in with a more knowledgeable response, but I wonder if your ENT could prescribe some rehab or PT for the balance problems. Years ago, I was diagnosed with vestibulo-ocular reflex deficit (non-dive related) and it felt like I was walking through the world over uneven ground with my eyes closed. I was sent to PT and given exercises to recalibrate the reflex. It worked wonderfully! Even with some permanent damage to your vestibular system, rehab may help the brain rewire or compensate for the injury.

Wish you the best with your recovery!

 

[eglantine]

Thank you very much for both replies.

Swimmingincircles - I have a friend who had a similar problem only from getting up too quickly in her bed in the morning. I think it is related to these "christals" or otoliths that you mentioned - they got misplaced - and with some motion they can get back to their normal place again (hence you feeling better in a car). I must say, your vertigo seemed much worse than mine! Mine was the spinning type, not rocky, but now I feel much better, apart the feeling that my head is a bit "light" or "weird" and side movements destabilise me somehow. I googled already vestibular exercises and I will definitely start doing them.

Msbovary, thanks for your message, I consider visiting a PT maybe in a month, depending on my progress. Balance problems are so scary.

 

[Alastor]

For what I experienced from a friend with a vestibular nerve infection, the brain will regain the balance using other signals and suppressing the noise from the injuried nerve - in her case the left vestibular nerve was irrimediably damaged to a complete functionality loss.
The brain, then, learnt to use mainly the other vestibular signals, the sight and also the signals coming from the soles.
She took 3 months to reacquire balance to drive again a motorcycle, it could have been faster with a little trainig to be performed everyday.
One of the doctors said to use the nintendo wii balance board and try to play with it for at least half an hour a day.
The continuous training stimulate the brain to remap all the signals in the correct way in less time than doing the normal activity.
So, you will definitely find again your balance and, moreover, you will dive again without any problems.

 

[Wookie]

I have suffered a vestibular hit. The vertigo went away for me after the first treatment unless I'm diving. If I'm diving, I still get vertigo 15 years later. I close my eyes, wait for the spinning to stop, carry on. It's been a thousand or so dives since. I probably will deal with it forever.

The good news is that I now get perfect scores on the Wii Fit hula hoop app.

 

[eglantine]

This is all very reassuring, danke! Sorry for the friend who suffered the vestibular nerve infection, she is so brave to have made the recovery. My hit was so mild compared to hers and Im so happy that my ears are ok.
I already biked today, concentrating on the road in front of me.
Not sure about diving, first I need to find out why I got bent after an apparently normal dive. But maybe one day I will dive again.... 1000 dives wow.

 

[Wookie]

That's what vestibular hits are. They occur on fairly normal dives. Mine was, 30 feet for 66 minutes. Symptoms immediately on surfacing.

 

[Dr Simon Mitchell]

Hello,

The natural history of disequilibrium after inner ear DCS is for it to gradually improve. Most people make a full recovery, whilst some retain some degree of vulnerability to transient disequilibrium that can be provoked by certain things - like moving in a particular way or having your head in a particular position.

The most likely outcome is full recovery or very close to it. This is thought to be a function of the left and right vestibular organs recalibrating (for want of a better word) against each other over time.

The PFO test will be interesting. About 75% of people with your story turn out to have a large spontaneously shunting PFO (as compared to < 5% in the general population).

David Doolette and I published a review article on relevant matters in 2015.

MITCHELL SJ, DOOLETTE DJ. Pathophysiology of inner ear decompression sickness: potential role of the persistent foramen ovale. Diving Hyperbaric Med 45, 105-110, 2015

I would be happy to send it to you if you PM me an email address.

Simon M

 

[eglantine]

Uhh... Im relieved and hope for a full recovery. I will update this thread after the results of my RMI and heart ultrasound. Will send you a PM, Simon, thanks!