alternobaric vertigo

[simba7171]

OK, I just learned what alternobaric vertigo is, kinda. I have done probably 500 dives or so and 80% of the time I get dizzy for 3-5 seconds when I first start my ascent, then it goes away and i can go to the surface with out a problem

I never knew what caused this except it felt as one ear would release preasure before the other, no pain involved. Anyway, I stopped diving about 5 years (I used to spear fish for a living diving mostly alone) I stopped diving due to this vertigo although I never blacked out or anything like that.

I just researched the web on it and am getting conflicting stories on this subject. Some places say its a minor problem and as long as your aware of it, its not a big deal, worst that can happen is get sick of have problems finding your way to the surface, which I have niether.

Some sites say never dive again with this problem. These are such huge contridictions and I am confused now. I am really wanting to dive (for fun only) again and I want to know a few things.

A. anything I can take to help prevent this? I would think so since 20% of the time it doesnt happen to me. Is there a surgery I can go though that will make it never come back?

B. Anyone else have this problem and still dive? Any tricks to make it happen less like tilting your head or anything?

C. Is there a real danger of me passing out? Even though it hasnt even made me sick or anything? As long as I dont see a threat of me passing out I think I would be ok.

Any opinions or facts I would appreciate, I normally dive 100-150' if that makes a differnce in any of these questions.

 

[Damsel Fish]

Never knew it had a name. I found that I have it most often when I am make small changes in depth (like rising up a little to go over a rock or stump). I think it has to do with how quickly I'm moving. I just drop back down and stop for approximately 5 seconds or so and it goes away. The only time it caused me any trouble was the first time it happened and I got sick to my stomach then. That hasn't happened again anyway.

I have continued to dive and have even continued to work with students as a divemaster and have never had any problem.

 

[simba7171]

does this happen to you most dives? Do you still go deep 100'+?

 

[scubadoc]

Answers to questions are for information only, do not imply diagnosis or treatment and should always be used in conjunction with the advice of your local physician.

The dizziness that you describe is most often due to 'alternobaric vertigo' and can be due to unequal pressures in the outer ears, the middle ears and can also be due to unequal stimulation of the ear drums by water of unequal temperature hitting the ears (caloric vertigo). True vertigo is not usually of psychological origin.

More questions are in order:
Did you at any time have difficulty clearing an ear on descent?
Do you have any buzzing/roaring/tinnitus in the ears? Is there any deafness or headache?

Initial thoughts as a diving doctor:
1. It is most likely alternobaric vertigo.
2. It could be dive-related involvement of the inner ear.
3. I definitely think you should see a Diving/ENT Specialist before you go diving again.

What to do?

First, find out if there is a physical cause, such as wax in the ear canal, or if there is blockage of the Eustachian tubes from any number of reasons. A visit to a diving oriented ENT physician would be an appropriate thing to do. A call to DAN or the nearest hyperbaric chamber usually results in a referral to their ENT consultant. Our web site has a page of diving related services and physicians in your locale at http://www.scuba-doc.com/listchmbr.htm .

Best regards for safe diving!

Ern Campbell, MD
Diving Medicine Online
http://www.scuba-doc.com

Ten Foot Stop Newsletter
http://www.scuba-doc.com/sbscrb.html

 

[simba7171]

Thanks scuba doc.

I have already been to the doctors and they cant find anything wrong with my ears. I have no other problems (head aches, problems clearing going down ect).

I know its my ears clearing at differnt times coming up because I can hear it coming out my left ear at which point I become dizzy for a few seconds. I have never felt in danger of passing out or anything but this is my question.

I usually come up very slow but what IF I had a serious problem (out of air or whatever it might be) and had to make a fast controlled ascent. Would going that initial 5-10 feet fast cause my vertigo to be worse to where maybe someone would pass out? Have you ever heard of this happening? During normal dives, it seems very controlable, yet I have not seen what happens if I were to have to go up quick for some reason.

 

[simba7171]

Also doc, do decongestions help prevent this? Or how about the pills people take to prevent seasickness?

 

[scubadoc]

This dizziness is rarely a big problem. Decongestants (Sudafed) might be helpful. Seasickness meds would not be indicated.

A test of a rapid ascent would answer your question but would be ill advised.

Best advice - if it happens again, move back down a few feet and try again more slowly. Be assured that in your case it probably won't get much worse.

scubadoc

 

[Rick Murchison]

Do not do the rapid ascent test. It's been done. The answer is known, and it is this: alternobaric vertigo is worse if the pressure difference occurs rapidly vice slowly. A really rapid change can make you feel like you're tumbling uncontrollably and can be extremely disorienting if unexpected.
I've never heard of anyone passing out from this - assuming that's your problem, which it sure sounds like.
I highly recommend you follow Scubadoc's advice to make sure you don't have something going on that's really bad. It sounds like you just have one ear that clears a little easier than the other, in which case it's probably no big deal...
Rick (not a doctor... no medical advice claimed or offered... see an ENT and do what the ENT says)

 

[simba7171]

Thanks a lot guys, you have been most helpful. I can handle dizzy for a few seconds I just wasnt sure if it could lead to worse things although I have A LOT of dives and it really never seems to differ as far as that one was worse or less than the last one.

I really wish they would do some more studies on this like with differnt meds or something. You would THINK there would be a way to prevent it since it doesnt happen 100% of the time.

Another funny thing, how come it only happens the first few feet I come up off the bottom? Since my ears are not equalizing at the same time (I know this happens to be my problem) why would it start acting fine after the first 5 second dizzy spell? I usually am diving 100-150' and you would think I would get dizzy again around the 30' range going up but never once have I got dizzy two times on the way up. Just strange I think. THanks again for all the help.

 

[Rick Murchison]

I suspect that the initial venting of air from one ear is being hindered by a "sticky" eustacian tube, and once it's opened it stays open for the remainder of the ascent - so no more problems. This has always been the case whenever I've had it, too - just beginning the ascent, then fine.
Rick