Nausea underwater/after getting out of water

[scubarat]

Does anyone know what is going on here:


I have done about 20 dives in total and the last few dives have been giving me issues with nausea. I find that on the first dive, I am fine underwater, but as soon as I surface and am getting back on the boat (or shore) I get hit with this crazy wave of nausea. Then during the break before the second tank, the nausea remains and slowly dissipates but not completely.

On my last dive, I had to cancel the second tank b/c not only was I nauseous during the first tank dive while underwater (first time for this), but I was not recovering from it after I got out of the water. I have taken dramamine and am usually not prone to motion sickness.

I'm not sure if I need to see a dive medicine doc, an ear doc, no doc...anyone have an idea on what may be causing this weird nausea?

 

[ECPaul]

While I never have any problem with nausea when I'm underwater, I do occasionally get very nauseous after a dive when I'm bobbing around on the surface after a dive awaiting my turn to get back into the dive boat - especially when there is some surface chop. This can be so significant that I'll actually just lean over the side of the boat after a dive and toss my cookies before the next dive.

But then I'm good to go!

So here are a few things that I do to avoid have a day of nausea versus a great day of boat diving:

1. On the ride out to the dive site try to distract your brain so that it does not focus on the rolling motion of the boat. The best way to do this is to engage others in conversation, especially fellow divers that you may be meeting for the first time.

2. If you are not going to follow recommendation #1, then at least pick out some point on the horizon and focus on this. It might be a boat in the distance or some point of reference on the shoreline, but in any case this keeps your vision and mind focused on something that is not rocking and rolling.

3. Stay cool (not cold). Don't get into your wetsuit too fast before it's time to get into the water, otherwise you'll end up getting overheated and more prone to feeling lousy and nauseous. Likewise, get out of your wetsuit as quickly as possible after a dive.

4. Stay hydrated, especially after a dive. Dehydration can frequently lead to nausea.

5. When there is a crowd waiting to get back onto the boat, hang out at you 15' safety stop for a few extra minutes (so long as you are OK on air) instead of waiting those few extra minutes on the surface - this will help to avoid the problem with nausea induced by bobbing on the surface.

6. Stay off the booze the night before - nothing like a stomach looking for revenge on the abuse that you heaped on it with one too many mai-tais.

7. And last, but not least, once the nausea sets in, it is pretty hard to make it go away unless you just give into it, get it over with quickly, and then get on with a great day of diving. Frankly, anticipation of vomiting is far worse than the act itself, and you'll immediately feel better afterwards.

8. BTW - I don't advise the dramamine - I know some people are big fans but I don't like taking sedatives when diving.

 

[DocVikingo]

Hi Scubarat,

How unpleasant.

A few questions:

1. Any problems equalizing or issues with the ears?

2. Any prior history of motion sickness on land or water?

3. Any gastrointestinal, neurological or other medical conditions which might account for the nausea?

4. Is a large meal or anything out of the ordinary eaten prior to diving?

Some divers will develop nausea during a dive due to the vestibular stimulation from surge, current, kelp and other marine life waving back and forth, and the like. When this is the case, motion sickness preparations may be of benefit. Less drowsy formulas, such as those containing meclizine (e.g., Bonine, Dramamine II), are preferable to those containing dimenhydrinate (e.g., Dramamine Original Formula, Triptone), a drug with demonstrated adverse effects upon alertness and performance both topside and at depth. These are to be taken an hour prior to diving.

Nausea with onset during or shortly after a dive also can be brought on by swallowing sea water or air. New divers seem prone to this phenomenon and it can be prevented by breathing regularly, slowly and easily off a properly serviced reg, taking care not to gulp down water or air.

This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice to you or any other individual, and should not be construed as such.

Helpful?

Regards,

DocVikingo

 

[DocVikingo]

Addendum:

Given that the original post inquired regarding "Nausea underwater/after getting out of water," I limited my response to factors that may contribute to the development of nausea during or shortly after a dive.

If the thread is going to be expanded to the prevention of motion sickness (which typically includes symptoms other than just nausea alone, e.g., vomiting, dizziness/vertigo, sweating and a general feeling of malaise) while on the boat, the following may prove informative:

Tame the Technicolor Yodel: Managing Mal de Mer
http://www.awoosh.com/Doc Vikingo's Resource Page/Sea_sickness_remedies.htm

This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice to you or any other individual, and should not be construed as such.

Helpful?

Regards,

DocVikingo

 

[scubarat]

Doc,

1. Usually equalizing is not a problem...but I have had a few times where it wasn't going smoothly. I have had issues with my ears being "internally irritated/itch"...ie, it feels like someone is tickling the inner ear with a feather! Eustachian tube irritation? I've been to ear docs who say all looks well and to use hydrocortisone in the ear if the irritation occurs.
2. Motion sickness only when someone is driving fast along curvy mountain roads.
3. No medical conditions that would account for this.
4. Hmmmm, large meal...that one I can't remember....but I don't recall anything like that.

Yes, I did take the less drowsy formulations of motion sickness pills but it didn't seem to help.

Thanks for the other tips!

 

[scubarat]

Thanks for the reply!

I never actually feel the need to vomit...I just feel sick but it's not like I'm holding back.

I DO tend to get cold in the water so I end up needing to wear TWO wetsuits to stay warm. Not sure if maybe that's adding to the problem...but if I don't, I freeze!

 

[DocVikingo]

Hi scubarat,

Dooes wearing two wetsuits result in significant constriction, particularly around the midsection?

Do you ever become overheated, either topside or u/w, as result of so much neoprene?

Do either the motion underwater or swallowing air/water hypotheses strike you as plausible?

Regards,

DocVikingo

 

[fisherdvm]

There are so many causes of nausea, I wonder if you would have to do some sort of process of elimination. First, I would wonder about the tightness of your wet suit, whether it might be impinging upon your digestive system. Second, hypothermia can certainly cause nausea. Third, anxiety can trigger nause, if you are not comfortable with the environment. Then, fourth, you would look at how rough the sea is on your last few dives, as compared to the previous dives, as it could just be a case of sea sickness. And fifth, were you in close proximity to the exhaust, or that the wind blew the exhaust back to you.

I know that I was more prone to nausea when diving in cooler water, and certainly during rough sea. Maybe we can have more information on the temperature of the water and sea condition of the dives you had with the nausea problem.

 

[diverrick]

Salt water poisoning. It happened to my wife. no one knew what it was including DAN and the LOcal MD. We only found out as a result with the daughter of a resort owner who had seen it before. WE got her a rentL REG, AND THE PROBLEM WENT RIGHT away. Needless to say we bought her a new setup as soon as she got home. and she has never had any further problems.

 

[diverrick]

change out your regulators and see what happens. Let us know how it comes out.
R-