Light-headedness + Nausea Upon Surfacing on a Beach Dive

[MilkAndRelish]

Hi Guys,

I'm a new diver (just finished my 7th dive) and I've been noticing that every time I dive I feel light headed immediately when I surface and then I get nauseous. The nausea can last an hour to an hour and a half and I feel like I'm going to throw up. The light headedness lasts a while as well, but isn't my main concern.

This most recent dive (which was also my deepest and longest)- my symptoms were particularly bad. The strange thing is: I don't feel bad AT ALL until I'm actually on the surface and take the regulator out of my mouth.

There was little to no surf, minimal surge, and I drank almost an entire Nalgene water bottle before diving. I was a little bit tired (sleepy) but not too bad. I'm in good shape, and wasn't too cold under water.

This most recent dive, we went to 65 ft and jumped up to about 45 in a matter of minutes. From there, we gradually ascended and did a 3 minute safety stop at 15 feet. From there, we just kind of shot up to the surface. Is it possible that this is related to surfacing too quickly?

Any help would be much appreciated- I love diving but this is SO UNCOMFORTABLE and disheartening.

Thanks,

Eli

 

[dbulmer]

It's difficult to ascertain from your description but assuming you have no underlying medical condition, I wonder if the cause could be related to ear equalisation.

One thing I would strongly recommend is that your ascent from your safety stop is as slow as conditions allow.
A nice slow ascent from the safety stop is good practice and will help you offgas more efficientlly.

In terms of hydration you need to be well hydrated a couple of days before you go diving as well as on the dive day itself.

 

[DandyDon]

Shooting to the surface from a SS is bad. I try to make that my slowest part. Otherwise, what about your ears and equalizing...?

 

[Griffo]

I used to sometimes get the same when I started diving, particularly on strenuous, stressful or deep dives. I no longer do and I put that down to controlled ascents (particularly the last 3m) and getting my breathing under control


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[MilkAndRelish]

Thanks for the responses guys. I have no medical conditions, but I do take a small does (10mg) of citalopram daily. My doctor cleared me for use with this medication.

The dive I did that made me feel horrible was last night (finished around 7:30 pm). This morning, I was still feeling slightly dizzy/light-headed and slightly nauseaous. I drove about 35 minutes and when I got there, we set up our gear and were ready to go when I started feeling worse. I had to call the dive before we even left his house, and on the drive back to my house I had to stop and pull over because I was about to throw up and I felt dizzy.

I called DAN just to be safe, and they said that unless things get worse that it doesn't sound like anything serious.

I rested for an hour, and just decided to try to equalize my ears. I did, and a good amount of pressure was released. I did that about 20 minutes ago and I feel slightly better.

Does this sound like I just need to make sure I equalize better on my ascent and try to go more slowly? Should I see an ENT to make sure everything is OK?

Thank you,

Eli

 

[DandyDon]

Thanks for the responses guys. I have no medical conditions, but I do take a small does (10mg) of citalopram daily. My doctor cleared me for use with this medication.

The dive I did that made me feel horrible was last night (finished around 7:30 pm). This morning, I was still feeling slightly dizzy/light-headed and slightly nauseaous. I drove about 35 minutes and when I got there, we set up our gear and were ready to go when I started feeling worse. I had to call the dive before we even left his house, and on the drive back to my house I had to stop and pull over because I was about to throw up and I felt dizzy.

I called DAN just to be safe, and they said that unless things get worse that it doesn't sound like anything serious.

I rested for an hour, and just decided to try to equalize my ears. I did, and a good amount of pressure was released. I did that about 20 minutes ago and I feel slightly better.

Does this sound like I just need to make sure I equalize better on my ascent and try to go more slowly? Should I see an ENT to make sure everything is OK?

Thank you,

Eli

Hmmm. You still felt bad from the dive the night before? The only way to rule out the need for ENT help is to see one, and even then - ears are difficult to diagnose.

You equalized while resting, and released pressure from last night? That does sound like a reverse block, maybe.

Your ears are your biggest risk in diving generally, and there's a long list of good ideas on how to treat them before diving, on descent, on ascent, and after. I'd like to hear your practices in full detail.

It wouldn't hurt for you to review side effects of your med. Lots of sites have varying info to review.

 

[raftingtigger]

Thanks for the responses guys. I have no medical conditions, but I do take a small does (10mg) of citalopram daily. My doctor cleared me for use with this medication.

The dive I did that made me feel horrible was last night (finished around 7:30 pm). This morning, I was still feeling slightly dizzy/light-headed and slightly nauseaous. I drove about 35 minutes and when I got there, we set up our gear and were ready to go when I started feeling worse. I had to call the dive before we even left his house, and on the drive back to my house I had to stop and pull over because I was about to throw up and I felt dizzy.

I called DAN just to be safe, and they said that unless things get worse that it doesn't sound like anything serious.

I rested for an hour, and just decided to try to equalize my ears. I did, and a good amount of pressure was released. I did that about 20 minutes ago and I feel slightly better.

Does this sound like I just need to make sure I equalize better on my ascent and try to go more slowly? Should I see an ENT to make sure everything is OK?

Thank you,

Eli

Doubt the citalopram is the culprit. My guess is you would get symptoms at other times also.

Your ears sound like the problem. Any pressure in the middle ear can irritate the labyrinth - which is your balance organ. When you "popped" your ears you got some relief. Vertigo often has nausea (mild to totally disabling) as an associated symptom. Overall this is pretty solid evidence that middle ear pressure was at least part of the problem.

Couple of suggestions:

1. Get an ENT evaluation, if that is clear then
2. Make sure you clear your ears often, both on the descent, and on the ascent (usually ascent is easier).
3. Ascend from your safety stop slower than any other part of your ascent. This is where the biggest pressure change occurs.
4. If you use any medications to help with clearing (pseudophedrine, afrin, etc) make sure they are the long acting type. It is less likely to wear off during your diving day. TRY any medicine on land before using with diving.
5. Treat any allergies you have before diving. This is where daily use of a nasal steroid spray can help. It keeps the sinuses from getting swollen, but only if used on a daily basis.

Good luck.

 

[Jon_R]

Are you eating regularly before diving? I had a 2.5 hour pool session once and skipped dinner before jumping in. Afterwards felt exactly how you describe for many hours. Didn't notice it when in the water.


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[Duke Dive Medicine]

Eli, can you describe the lightheadedness? Specifically, does it fee like the dizzy feeling that comes from standing up too fast, or is it more like vertigo, where you have a sensation of motion/spinning? Also, am I reading your post correctly in that you are completely without symptoms until you surface and remove your regulator? How soon after you remove the reg do your symptoms begin? Are there any other symptoms at all, e.g. headache?

Along the lines of the questions the other members asked: do you have any difficulty equalizing on descent? Are you aware of both ears equalizing on ascent, and does one ear equalize before the other?

Best regards,
DDM

 

[MilkAndRelish]

Eli, can you describe the lightheadedness? Specifically, does it fee like the dizzy feeling that comes from standing up too fast, or is it more like vertigo, where you have a sensation of motion/spinning? Also, am I reading your post correctly in that you are completely without symptoms until you surface and remove your regulator? How soon after you remove the reg do your symptoms begin? Are there any other symptoms at all, e.g. headache?

Along the lines of the questions the other members asked: do you have any difficulty equalizing on descent? Are you aware of both ears equalizing on ascent, and does one ear equalize before the other?

Best regards,
DDM

Thank you all for your continued responses. This is very helpful.

The lightheadedness doesn't feel like spinning, but maybe a little bit of motion. Everything feels a little delayed- a little bit like a drunk feeling. I'm not sure how to best describe it.

You are correct that I am 100% without symptoms until I surface. I don't think it has anything to do with actually removing the regulator (that was just to make it clear that I am completely on the surface), but then again I don't know that for sure. It's within 10-15 seconds of being on the surface that I start to experience the lightheadedness and then shortly afterwards I experience the nausea.

I haven't had difficulty equalizing on the descent, but I think I may have rushed it a bit and didn't take my time on the descent. The equalization felt more constant than descending a few feet, waiting, equalizing, continuing. I just descended and continually equalized. I think I should take my time on the way up.

On the ascent, I wasn't fully aware or paying attention to my ears equalizing. I think that both were equalizing evenly, but I really don't remember.

Does this information help?