dizzyness after diving?

[viceroy]

I've just completed my Open Water in November and after the course most of the people who dived (including myself) suffered from slight dizzyness for about a week after we got back home. Home being at 1500m above sealevel and the course being done at sealevel

Is this normal for people new to diving?

 

[BillP]

Hi viceroy:

I wouldn't call it "normal" to have dizziness after diving, but it probably is common, particularly in new divers. I would say that the most common reason to have persistent dizziness after surfacing is probably inner ear barotrauma. If a diver has difficulty clearing their ears due to inexperience, inattention, or congestion, lack of clearing or forceful clearing can cause pressure injury to the delicate inner ear structures that control balance. The symptoms can start immediately after diving or be delayed. Auditory changes such as hearing loss, fullness in the ears (like you have water in your ears), ringing in the ears, etc. are often present too, but don't have to be. Inner ear barotrauma can be avoided by clearing ears and sinuses gently, early, and often, and avoiding diving with congestion. New divers frequently have problems with clearing.

Another cause for dizziness after diving is alternobaric vertigo. When one ear clears better than the other, there can be a difference in the pressure between the two ears- most often on ascent. Symptoms usually occur during the ascent or within 2 minutes of ascending, and usually only last 10 minutes or less. There may be "squeaking" or "crackling" noises in the affected ear as the pressure equalizes. Avoidance of alternobaric vertigo is the same as with inner ear barotrauma.

Decompression sickness with either DCS of the balance mechanism of the ear or of the part of the brain controlling balance can cause dizziness after diving. It can occur many hours after ascent but usually sooner, persists for more than a few minutes, and can be associated with other signs or symptoms of DCS.

Cerebral arterial gas embolism can cause dizziness after surfacing. Symptoms usually begin very soon after ascent, persist for more than a few minutes, and are commonly associated with other signs and symptoms of a decompression injury. Avoidance of CAGE involves preventing air trapping on ascent such as from breath holding.

HTH,

Bill

 

[viceroy]

From what you've described, it sounds like we were suffering from the first item in the list...

 

[DocVikingo]

Hi viceroy,

Given your statement that, "...most of the people who dived (including myself) suffered from slight dizzyness for about a week after we got back home," I'm not convinced this mystery has as yet been solved.

Is there any evidence that all of the affected divers had problems clearing, or suffered from one of the other maladies astutely adduced by BillP? I guess it's possible, but does strike me as rather improbable.

To pursue this further:

1. How many divers in total reported dizziness?
2. Was this the sole symptom or were there other complaints, such as those BillP mentioned?
3. Did the instructor(s) or any assistant(s) mention experiencing similar phenomenon? How did they respond to the students' curious report?
4. Did any member of your group actually seek medical attention? If so, what was found?
5. Anything else that seems pertinent.

Best regards.

DocVikingo

 

[viceroy]

Well to answer the questions,

There were about 5 of us who suffered the symptoms, there was also ringing in our ears, and slight loss of hearing. Basically apart from the dizzyness it was just like having both ears blocked

The symptoms only manifested themselves after we got back home which as I mentioned is 1500 meters above sea level where we did the course. One of the guys did go to the doctor but was told that nothing serious was found to be wrong with his ears except that they were tender on the inside.

since the symptoms went away farely quickly, non of us has had reason to see the doctor again

 

[DocVikingo]

Thanks, viceroy, that was informative. Any of the dive docs care to have a go at it?

DocVikingo

 

[octodiver]

Viceroy,

How long after diving did you wait before going to altitude? Did you go by the
flying/ascending to altitude rule?

Your symptoms are actually very UNCOMMON. While it is true that many new
divers experience what they describe to me as a sense of fullness with
reduced hearing, it's normally caused by water being trapped in the outer
ear canal. Using swimmer's ear will usually dry it up. Also allowing warm
water to gently run in the ear (when taking a shower, for instance) will help
to dislodge some of the excess wax which is trapping the water, in the first place.

Dizziness, loss of hearing, and ringing go beyond that, and are symptoms of
inner ear barotrauma. I experienced this injury, myself, about a year ago.
It spontaneously occured while diving in about 60 feet (I had no difficulty
equalizing, at all). I was told by 2
doctors that it was labrynthitis, a type of virus. The symptoms went away
after a few days of sudafed and anti vert. However, every time I
returned to work (diving), they came back.
I went to a diving doctor who properly diagnosed it as inner ear
barotrauma (after ruling out inner ear DCS), but it is not a common dive
injury.

The puzzling thing is that you are experiencing it as a "group". So, my question
is whether you all "as a group" understood that when attempting to equalize,
you MUST NOT do so when actually feeling the pressure and/or pain (however
slight it may be). Maybe you all waited for that "feeling" before equalizing
and thus, "bruised" the middle ear (which might explain the tenderness the
one diver felt), and forced fluid into it.

The other puzzling factor is the altitude, and how that may be contributing...

Octodiver

 

[Rick Murchison]

My bet is that it's from something you all ate.
Rick

 

[John Reinertson]

I'll give this thread a try, but It'll get long.

1.Octodiver's symptom's are indeed those of inner ear barotrauma. It is difficult to separate that from simple infection/vestibulitis the first time, but the repetitive symptoms signal inner ear damage as a likelihood.

2.External ear water or wax causes a fullness and muffling, but not normally dizziness or tenderness. her remedies (swimmer ear compound and rinsing with warm water) are appropriate. Pain should be investigated for coexistent ear infection or middle ear barotrauma.

3. Middle ear squeeze or middle ear barotrauma is very common. I'd bet at the end of a week on a Caribbean dive boat half the divers would show some visible sign of middle ear squeeze.
This is the most likely syndrome to produce both a muffled sensation and mild dizziness.

4. DCS can produce dizziness and ear discomfort, but with five people showing similar symptoms the odds favor middle ear barotrauma. Neurologic DCS is possible, but with an incidence of a few casesper 10,000 dives, getting five cases in one whack all presenting with injury to the same portion of the CNS is not likely.

5. Octo's comments regarding ascending to altitude is very pertinent. Since most commercial flights are pressurized to around 7,500 to 8,000 feet, and we know that data suggests somewhere between 12 and 24hours is needed to offgas before ascending to that altitude, driving to almost 5,000 ft (1500m) should require an appropriate interval after the dive before ascending. We all need to remember that our bodies don't care whether we fly or drive, altitude decompression is still occurring.

6. Ultimately this is answer is incomplete because we don't have full and complete histories and no physical exam to give a diagnosis.
I'm confident that probabilities favor the above explanation, but that's far from certain, and many other factors could affect the story.

7. Ultimately, the advantage of these questions is we get a chance to discuss and learn from others, and the more we know, the better we can be as informed divers.

Good thread.. Ear problems are more common than almost any other dive injury.

Dive safe and equalize early and often,
John Reinertson

 

[Rick Murchison]

"Most [divers] dizzy for about a week..." given the wide variability typical in pressure related injuries, and the uniformity of symptoms described, I'm still betting on a food-borne pathogen.
Rick