Girlfriend wants to get back into diving

[smellzlikefish]

She and I shared a lot of really neat underwater experiences when she was first certified, but she always had this sea sickness issue that came on at the wierdest times. We tried everything from ginger pills to wrist-bands to all three available OTC meds. The medications worked-sometimes. She has always had a problem with motion sickness to where she even gets sick on hikes. That part made me think there is something other than motion-sickness at play here. Then I started to notice that it was the more strenuous dives (long swims/hard currents) that got her really sick. She put down her reg and BC about a year ago because she was so sick of it but has recently been making noises like she wants to give it a try again. Any ideas what else might be going on here and what we could do to fix it?

 

[spectrum]

Is it safe to assume she is otherwise healthy and reasonably fit?

 

[Bubbletrubble]

This is more than just seasickness.

First, I'd recommend that your gf get a comprehensive physical exam by an internist. Then, have her see an ENT and/or neurologist for the motion sickness.

It sounds like it could be exercise-induced or pressure-related. It's not unheard of for cardiovascular issues to present like this. The differential diagnosis should include neurological problems as well.

 

[smellzlikefish]

Spectrum-she is reasonably fit, no weight problems, heart issues or any other obvious problems.

Bubble trouble-Great suggestions. She has had a full dive physical including chest x-rays, ear/eye tests and bloodwork and they found nothing to be concerned with. Correct me if I'm wrong, but from I've heard, ENT's can do little for motion problems. The neurological issue is a good thought as is the cardiovascular idea. I doubt she'll take any of my suggestions, but I'll make some anyway and dive carefully in the meantime.

 

[Bubbletrubble]

Bubble trouble-Great suggestions. She has had a full dive physical including chest x-rays, ear/eye tests and bloodwork and they found nothing to be concerned with. Correct me if I'm wrong, but from I've heard, ENT's can do little for motion problems. The neurological issue is a good thought as is the cardiovascular idea. I doubt she'll take any of my suggestions, but I'll make some anyway and dive carefully in the meantime.

I'm glad that your gf has had a comprehensive physical with bloodwork.

The ENT would assess whether any anatomical issues existed that might be promoting the motion sickness. One possibility is Eustachian tube dysfunction hindering ear equalization, which could lead to middle ear barotrauma. Another possibility is a perilymph fistula. Alternobaric vertigo, vestibulofibrosis, and Meniere's disease (probably not triggered by pressure) should also be considered in the differential diagnosis. ENTs can do certain surgical procedures to treat some of these disorders. They can also treat the conditions more conservatively with medication. You may want to PM doctormike (ENT) who is a medical mod here at ScubaBoard.

Neurologists tend to do a bunch of weird tests that can help arrive at the proper diagnosis. At some point, an audiologist might get involved.

Just so you know, many of these conditions are exceedingly difficult to diagnose and can be challenging to treat. It's good news that your gf only gets dizzy/motion-sick under very specific circumstances -- at least that's what your initial post seemed to describe. Perhaps they are such extreme circumstances that it's not even worth looking for a medical cause. But if your gf wants to try out diving again, it might be worth the time and effort.

Good luck and keep us posted on things...

 

[cutlass]

Because hiking and "more strenuous dives" were mentioned, my first thought also focuses on exercise-induced nausea. So if the ENT is clear and she wishes to pursue it, you might consider a referral to a sports medicine specialist.

Until then, in no particular order, here are some questions to privately think about:

Is she exercising within her current level of conditioning?
How long and profound are the episodes of nausea and is there anything that relieves/worsens them?
Are there other signs or symptoms? Unexpected or profound or lengthly bouts of breathlessness? Unusually aware of heartbeat or heartrate? Feelings of doom? Tingling or numbness? Clumsiness or unexpected weakness or feelings of losing sphincter control? Lightheadeness, dizziness, or headache? Confusion or emotional changes? Changes in vision, hearing, or other senses?
What is the timing and content of her meals? What about in relation to the exercise? Regular BM's? Maintaining a steady weight?
How's her fluid maintenance? Water or other drinks? How much, how often? Pee frequency, volume, color, odor, texture (e.g. any frothing) all ok?
Is she getting good quality sleep? Any festering stress or anxieties?
How are her living and working environments? Is she exposed to anything out of the ordinary; e.g. raw construction or fabrication materials?
Are her cycles normal?

Basically, these are looking for hints of pain or chemical/nutrient/hormonal imbalances which may affect nerve irritability; the former may be occult and the latter may be subacute until exercise exposes them.