New diver experiencing nausea, vomiting, bloody nose.

[SeaSnooper]

Hello everyone, brand new member here and this is hopefully my first post of many.

I've been certified as an OWD for exactly one year and I've enjoyed the dives I've made so far, but there have been issues I am concerned about and I'm not sure if they're separate issues or related somehow.

1) I still have extreme difficulty equalizing, I begin to equalize almost the moment my head goes under the water and I continue to do it often, but there is still a great deal of pain involved. I often have to ascend slightly, try to equalize then resume my descent many times before I can get my ears comfortable at depth, but i've been told by that time I may have equalized too hard or forced the descent too much.

When you equalize aren't you supposed to hear a little "squeak" or "pop" which indicates the airspace has been equalized? Well I rarely, if ever, get that.

Once I have managed to get my ears comfortable, I have no problems at all when I'm at depth. I usually have a very enjoyable dive. On ascent though it's a different story and other problems occur...

2) Bloody nose and coughing up bloody phlegm (gross I know, sorry but it's happening).

3) Extreme nausea, weakness and on a couple occasions vomiting.

4) Ears feeling like they're stuffed with cotton for a number of days after the dive. On two occasions I had my doctor check them out. The first time he said it looked like my inner eardrum was swollen and that I possibly even sustained a minor rupture. Saw evidence of fluid behind the eardrum.

second time it happened he said he saw a little bit of blood on the eardrum and what looked like a minor infection. Prescribed antibiotics which seemed to help.

I've usually experienced one or all of these symptoms on virtually every dive I've been on so far. I've come to really enjoy diving and have already made some great dive buddies but I worry that I may not be able to continue with it if I can't resolve these issues. Been trying to call DAN last day or so but their medical info line has been extremely busy.

Any insight anyone can offer would be greatly appreciated. Thank You!

 

[Selchie in LB]

1st email DAN. They will respond within a couple days.

2nd there is a video on ears and diving. I don't have the link but search the Board you will find it.

3rd if did have a rupture it can cause the vomitting and other symptoms due to the inner ear imbalance.

4th you may need to find a doctor who specializes in barotrauma issues. The equalization problem may be due to some underlying issue. The problem ascending is squeeze.

 

[t-mac]

I'm sure some of our medical gurus will chime in shortly, but it is difficult to see this as something good for you. Perhaps it is something you are doing, but it may be you have anatomical features or some kind of condition that make equalization difficult. My suggestion is to try to find an otolaryngologist to check you out -- preferably one familiar with diving. Good luck to you.

 

[supergaijin]

I does sound like something directly related to your problems in equalising. Sitting reading this, can you equalise? You may not necessarily hear a pop, but something should move inside your ears.

Some divers with ear problems have found the Pro-Ear mask to work really well. It looks a little Mickey Mouse and takes a good dozen dives to get used to it apparently but many divers and at least 5 instructors I have worked with, use them and swear by them.


I thought this image from Scubatoys was the best to show off the features

 

[TSandM]

All of your symptoms go together. If you are having difficulty equalizing and having to use force (NOTHING in diving should involve pain) you can break capillaries in your nose and sinuses and get bleeding. Further, if your ears equalize unevenly on ascent, you can get dizziness and nausea.

I think you should consult with a diving-savvy ENT doc, and get an evaluation of the patency of your Eustachian tubes, and the technique you are using for equalization. Not only do the symptoms you report reduce your enjoyment of diving, they could put you at risk for permanent hearing loss or vertigo.

 

[Duke Dive Medicine]

SeaSnooper,

Concur with TSandM above. The nausea and vomiting you're having are likely due to a phenomenon known as alternobaric vertigo, where one ear equalizes before the other. This typically happens on ascent and leaves you with different (alterno) pressures (baric) in your middle ears. In turn the inner ears, which hold the organs of hearing and balance, experience differing pressures, which can cause the symptoms you're experiencing.

A bloody nose after diving is often the result of sinus squeeze, which happens if your sinuses don't equalize properly. Blood can be extravasated (pulled out of the blood vessels) in the sinuses on descent. On ascent, the air space that's left in the sinuses expands and forces the blood and mucus out.

If this happens regularly, and it sounds like it does, you're at risk for permanent and debilitating damage, as TSandM has already pointed out. See an ENT physician before you go diving again. Blocked sinuses and Eustachian tubes can be caused by anything from seasonal allergies to anatomic malformations so it's impossible to tell exactly what's going on without examining you, but a good ENT should be able to help. Good luck!

Best regards,
DDM

 

[Mark Derail]

Except for the dizziness / vomiting, it's pretty much the same with me. Or rather was. It's much better now.

1) worse first dive, usually a "deep", after many months of no diving.
2) much easier on second dive.

I've learned to take my sweet time going down. Like 5+ minutes to get to 60-ish feet. Subsequent dives that day/week it drops to just a minute or so.

Comparing last 2 trips - last trip was OK bloodwise (just a bit) because of my very slow descent. Last trip wasn't a cattle boat with a DM at my side asking me every 10 seconds if I was OK, and holding back the entire group at the anchor.
(talk about stressful)

Last trip was just the DM and my buddy/fiancé, and I told him that I take a while to get down and will follow the anchor down to the bottom, never letting go. So the other two circled along the bottom anchor point waiting for me - admiring the view.

No stress, all fun.

Costs a bit more than a cattle boat - but well worth it (private vs cattle).