Nausea and Vomiting After Ascent

[Saphires12]

I am a new diver that just completed my Advanced Open Water in Puget Sound (Seattle area). My last 4 dives went well at depth using Nitrox. I have no problems with my decent or ascent. I have been diving anywhere from 40ft to 130ft all with my PADI instructor at my side. After making controlled ascents and the usual safety stop, I have profound nausea, burping, and occasional vomiting at the surface (not cool). There is a slight amount of vertigo but almost not noticeable.

On the surface, my instructor asked me to remove my 8lb weight belt and hand it to him and the symptoms immediately went away. This has worked on the occasions where I have felt nauseated/vomiting at the surface. Any idea what is causing this? It is making me not want to get back in the water. I have been using rental gear but don't want to commit to buying my own gear until I can get this under control.

I am a 28 year old female in good shape. I am 5' 3" 125lbs and diving with 28lbs of weight, an aluminum Nitrox tank, and 7mm wetsuit/hood.

 

[doctormike]

I am a new diver that just completed my Advanced Open Water in Puget Sound (Seattle area)....

On the surface, my instructor asked me to remove my 8lb weight belt and hand it to him and the symptoms immediately went away. This has worked on the occasions where I have felt nauseated/vomiting at the surface. Any idea what is causing this?

OK, a bit out of my ENT comfort zone, but I'll take a shot at this one...!

1) The gas that you breath in at depth (and at pressure) is normally vented from your lungs as you ascend (as long as you keep breathing!). But the gas that you swallow only vents if you burp. And if you don't, then there is a bunch of pressurized gas in your stomach that expands on ascent, causing abdominal distention, pain, nausea, and potentially vomiting.

Solutions would involve (1) trying not to swallow so much gas by breathing easily, slowly and in a relaxed fashion and (2) letting it vent if possible, treating your abdominal gas like middle ear gas in a reverse block (that is, slow your ascent, and maybe drop back a bit if you start having pain). Eventually, the gas pressure will override your lower esophageal sphincter, but until then, it can cause pain and nausea.

2) A tight wet suit can cause similar problems pushing on the trapped abdominal gas even more.

3) A weight belt can also cause pressure and pain, with nausea and vomiting. This is especially true when the following happens:
- you put on your weight belt snugly on the boat
- you descend and your wet suit becomes compressed, and the belt becomes loose
- you tighten your weight belt at depth to keep it from slipping off
- you ascend, the suit expands, and now you have a VERY snug weight belt, causing abdominal discomfort (this explains the improvement when you remove it).

You are wearing a heavy cold-weather wet suit, which will make this even more of a problem. If you are going to be diving a lot in this type of suit, and if you are considering buying your own gear, you might look into a BC with integrated weights to avoid the weight belt altogether...

Best,

Mike