Light-headedness + Nausea Upon Surfacing on a Beach Dive

[Duke Dive Medicine]

Hi Eli,

It's interesting that this would happen at a specific point on every single dive that you've made. Have you made all of your dives over a short period of time? Did this happen during your certification process as well? Also, have you ever had any other symptoms, e.g. a headache? Have you ever had difficulty equalizing your ears on an airplane or while driving through the mountains?

Best regards,
DDM

 

[MilkAndRelish]

DDM- that's a good point. I suppose this has happened on 3/7 of my dives. My 4 certification dives were <20 minutes each and we only went to about 25ft. What's interesting is that my certification dives had the most surge of any of my dives, and we were just sitting still on the bottom for most of them.

My 3 dives afterwards which were 35-50 minutes this did happen, and I went deeper (35-65 ft).

I don't really have a headache afterwards- if I do, it's really really minor. I have never had problems equalizing my ears.

I recently got certified in the middle of June so all of these dives have happened in the last month or so.

Best,

Eli

Hi Eli,

It's interesting that this would happen at a specific point on every single dive that you've made. Have you made all of your dives over a short period of time? Did this happen during your certification process as well? Also, have you ever had any other symptoms, e.g. a headache? Have you ever had difficulty equalizing your ears on an airplane or while driving through the mountains?

Best regards,
DDM

 

[Duke Dive Medicine]

Hi Eli,

This could be an acute issue with your middle ears that's causing a phenomenon known as alternobaric vertigo (one ear clears before the other on ascent) but if so I'm puzzled as to why you wouldn't have reported difficulty equalizing on descent as well. It's typically a lot easier to clear on ascent than on descent. You may have an anatomic anomaly that inhibits one or both of your middle ears from equalizing properly, so a visit to an ENT is probably advisable as the other posters have recommended. I'm not 100% convinced of it though, so if this happens again after you're cleared by the ENT you'll need further workup. I'm a bit suspicious of CO2 retention, even absent the classic headache.

Best regards,
DDM

 

[tech_diver]

This will sound crazy and the symptoms don't line up exactly but I have actually seen it happen.

Are you biting down hard on your reg mouthpiece? I've seen new divers biting down hard (unconsciously) on their mouthpiece during a dive then experiencing TMJ disorder type symptoms afterwards.

 

[rhwestfall]

Rather than your comment that you didn't get cold, are you overheating (exertion or just being in the water in your exposure protection that may be heavy)?

 

[MilkAndRelish]

Hi Eli,

This could be an acute issue with your middle ears that's causing a phenomenon known as alternobaric vertigo (one ear clears before the other on ascent) but if so I'm puzzled as to why you wouldn't have reported difficulty equalizing on descent as well. It's typically a lot easier to clear on ascent than on descent. You may have an anatomic anomaly that inhibits one or both of your middle ears from equalizing properly, so a visit to an ENT is probably advisable as the other posters have recommended. I'm not 100% convinced of it though, so if this happens again after you're cleared by the ENT you'll need further workup. I'm a bit suspicious of CO2 retention, even absent the classic headache.

Best regards,
DDM

I have my ENT appointment this coming Friday so we'll see. What factors influence CO2 retention apart from duration/depth? Breath holding? I'm going to make an even more conscious effort to breath continuously and to not hold my breath even for a second.

This will sound crazy and the symptoms don't line up exactly but I have actually seen it happen.

Are you biting down hard on your reg mouthpiece? I've seen new divers biting down hard (unconsciously) on their mouthpiece during a dive then experiencing TMJ disorder type symptoms afterwards.

I haven't noticed this necessarily, but I certainly might be. I should try just relaxing my jaw. However, I don't THINK that this is it.

Rather than your comment that you didn't get cold, are you overheating (exertion or just being in the water in your exposure protection that may be heavy)?

I think on two of my dives I overheated while I was getting ready/walking to the ocean but those were the two times it was less severe. I was really a pretty good temperature for most of my most recent dive. I got SLIGHTLY cold while I was underwater, but never to the point of shivering.

Again, thank you guys for your input these are all really helpful things to consider and keep in mind while I am diving.

 

[DandyDon]

This will sound crazy and the symptoms don't line up exactly but I have actually seen it happen.

Are you biting down hard on your reg mouthpiece? I've seen new divers biting down hard (unconsciously) on their mouthpiece during a dive then experiencing TMJ disorder type symptoms afterwards.

My home bud used to do that until he got a Sea Cure mouthpiece, and increased his air time 20%.

 

[Duke Dive Medicine]

I have my ENT appointment this coming Friday so we'll see. What factors influence CO2 retention apart from duration/depth? Breath holding? I'm going to make an even more conscious effort to breath continuously and to not hold my breath even for a second.

Several things: skip breathing and gas density (related to depth) as you've already noted, high external breathing resistance, physical condition, and individual hypercapnic ventilatory response.
http://www.diveassure.com/new/documents/Diving_and_Carbon_Dioxide.pdf

 

[MilkAndRelish]

Thanks for that article, very informative. That VO2 max machine looks quite handy. I'm going to do some more research on CO2 retention, specifically related to skip breathing.

 

[MilkAndRelish]

Okay! So big news... I saw the ENT Doctor/Surgeon and he said that I have a significantly deviated septum that is probably causing uneven equalization. The side that is being blocked is where pressure 'leaked' from the day after diving.

He strongly recommended getting Septoplasty to correct the deviation. However, I said I wanted to think about it (obviously) and he prescribed me Flonase to spray before a dive and also told me to pick up Sudafed and Saline Spray. He said this might not help, but that I should try this to help clear up my nasal passageways.

He said it was OK to try to dive, but that he thinks getting the procedure will be the only way to really get rid of my symptoms and not have to ascend EXTRA slowly.

Any thoughts?