Not sure what is wrong, help please

[Jim Lapenta]

You should not be holding that breath for any length of time. It should be a smooth normal.inhale and exhale. Why are you holding the breath before exhaling?

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[spectrum]

in a nutshell, diving has gone from fun and interesting- to making me physically ill over the past year.

Thanks for the followup post. it added some good information.

"Diving" did not change but some thing or things have. Where you have prior good experiences and describe an active lifestyle I will discount there being an underlying medical issue but keep in mind I'm a medical zero. I'm suspecting a combination of balls are in the air.

The drysuit seal when resize helped some you said and that would certainly make for a bad day of diving. A drysuit can be nice but it adds a level of overhead to your diving and mess with your configuration for many dives before you have things felling and working just right. it can be a while before diving becomes that carefree experience you enjoyed while diving wet. Diving in a wetsuit or less is entirely predictable. The process of adaptation to a drysuit can be painstaking. For some it is a love hate relationship and can take the fun out of diving. That can put diving in a different frame of mind leading to a destructive attitude. Don't get me wrong, it can be a nice addition to diving but it can also be a stumbling block. How has your diving dry been overall as a skill & routine?

Someone needs to have the most air at the end of the dive so don't let the power breathers tell you something is wrong for that alone. You mention of "holding breath" is something of a concern. I'll say that I sort of pause but only to say I don't instantly bounce from inhale to exhale. Sort of like the "complete cessation of movement" you learned about in drivers education. Other than that you mention deep and slow. Those are both good words but the slow part can be too much of a good thing. I have had dives where I was especially mellow and relaxed with a good buddy and no wasted effort. Given the lack of exertion my breathing wold become very slow. When diving you are in a hyperbolic state so you body has a glut of oxygen molecules to pick from. CO2 on the other hand can still build up and give you a head ache. When you started diving you were probably a little less mellow and instinctively breathed plenty.

Combine some level of a CO2 headache, perhaps surge, wave action and jet lag with travel food and water and a few bouts of Montezuma's revenge are easy to write off.

The rented wetsuits are also suspect for being tight in the chest or neck. Unless the things were loose and baggy get your self a nice warm water suit to enjoy when warm water traveling. When you future as a dive seems in peril investing may be counter intuitive. Cost of suit/cost of trip, do the math..... One option may be a well fit rental suit that is fit by someone you know and trust.

I'm equally concerned with renting the regulator set and BC. An under performing regulator is probably not too likely (but possible) but the BC rentals have you constantly rejiggering your routine.

Dive gear, at least for me can be a funny thing. When you get a configuration that works, life is good. If I change something for whatever reason it can set up a run of domino's that has me tinkering with a lot of things and diving can be as much a chore as joy until things are dialed in again. Between the drysuit and rentals you may set yourself up for a parade of stress factors that combined with questionable respiration are taking the fun out of things.

 

[Rich Keller]

Before you do anything else you need to rule out medical issues. This could be as simple as very low potassium levels. The fact that you did not feel well on the surface before getting back on the boat suggests it was not seasickness. Having the queasiness and muscle twitching problem before the breathing problem suggests this may be a medical issue. The rental equipment is probably different every time you dive so I do not think that is the problem either. The neck seal could be the problem or using a drysuit is contributing to an overall uneasiness with the amount of equipment you need to deal with. Do you have the neck seal laying flat so the inside part of the seal is against your neck or do you have it making a U turn so the outside part is making the seal against your neck? Forget the breath holding practice, none of that stuff works anyway and it would be my guess that this is causing your problem. Just breath normally, your body knows better then you do how much air it needs and when it needs it. Once you are cleared medically you might want to try shallow, simpler, less complicated dives that require less equipment there by reducing your stress level to see if that makes a difference. Something like a pool dive or a shore dive around 30' or less where you do not need to concern yourself with anything other then looking at your SPG once in a while and try using lighter equipment like a 30 cu/ft tank with a wet suit instead of the drysuit. Weight yourself so that your use of the BCD is minimal or none existent, this is easy to do if you stay shallow.

 

[Greenjuice]

- I make a point of taking a deep breath, holding it for a moment, and breathing out

- when I could talk I spoke with the dr via DAN. He said it sounded like hyperventilation but there was no explanation for it... (He wanted to link it to anxiety but the only problem I was aware of was terrible nausea) Why the nausea, why the rippling face muscles? Both started before I began breathing hard (which led to my hands clenching up and blacking out). Why the nausea in Cozumel and why the queezy feelings after other dives? The constricted feelings I can blame on the drysuit. The rest I am not sure...

What you are describing here sounds like skip breathing, which can contribute to CO2 retention. If you are not breathing enough to get rid of the CO2 your body is producing, by shallow, skip or restricted breathing, your blood can become more acid (hypercapnea) and give symptoms of headache, a feeling of shortness of breath and muscle twitching; which I think holds true for some of your dive stories.

The story you give for the hand clawing on deck afterwards is a strong indicator for hyperventilation (rapid over breathing and without dive gear this time) dropping your blood CO2. Many doctors see this in connection with anxiety attacks, which is likely why the DAN medic responded in that way. It's just a pointer and best for you to explore why you might have have been overbreathing at that time.

If you have carotid sinus hypersensitivity, you might give a story of repeated episodes of dizziness, faints or falls. This can develop as one gets older.

I am embarrassed to admit that as a med student many decades ago, we used to kid around with hyperventilation and carotid sinus massage on each other to see what it felt like! In the safety (and litigation) conscious society of today, it is probably best done under proper supervision!


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---------- Post added March 30th, 2014 at 03:45 PM ----------

As an after thought, another potential contributor to CO2 retention is the WOB (work of breathing) of your regulator. This may influence your choice of reg if you get your own and stop renting.


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[uncfnp]

Some thoughts.

I do not take her description as skip breathing but rather a relaxed style of breathing that I use myself similar to yoga breaths. Slow inhale using diaphragm, brief pause then extended exhalation. In fact, a slight pause at end expiration is normal even with regular respirations. I understand skip breathing is when the diver extends the pause at end expiration to the point that a respiratory cycle is actually "skipped." It doesn't sound like that is what the OP was doing.

Also not convinced this is air or equipment related since it has occurred with a variety of regs and suits and tanks from different locations.

Also not convinced its medical since she is "athletic" and apparently has no symptoms with any other activities.

Surfacing with 1100 psi in 80 (?) cf tank is not unusual after a relatively shallow dive for 40 mins in an experienced female diver so really does not tell us anything about her breathing.

Focusing on the first symptom of the most recent event "I had a moment when I felt air starved," if air and equipment issues have been eliminated, suggests anxiety (sorry) that led to a cascade of events that ended with hyperventilation and possible panic attack...

 

[Pedro Burrito]

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A ScubaBoard Staff Message...

Moved from A&I to Diving Medicine

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[Greenjuice]

I do not take her description as skip breathing but rather a relaxed style of breathing that I use myself similar to yoga breaths. Slow inhale using diaphragm, brief pause then extended exhalation. In fact, a slight pause at end expiration is normal even with regular respirations. I understand skip breathing is when the diver extends the pause at end expiration to the point that a respiratory cycle is actually "skipped." It doesn't sound like that is what the OP was doing.

'Skip breathing' can have a different meanings to different people, but what appears to be in common is the pause between inhalation and exhalation, which is not a normal breathing pattern. There is a description here:

http://en.wikipedia.org/wiki/Hypercapnia

I think it does fit with the OP description, performed consciously or not. Regardless, all pauses or a skips appear to be used in the dive community as a non-provocative ways of describing what is essentially holding the breath (albeit briefly). If you are getting away with it, fine. If you are getting headaches or other discomfort, perhaps time to re-evaluate.

 

[Duke Dive Medicine]

Concur with the other posters in that this sounds like a skip breathing - hypercapnia - anxiety - hyperventilation scenario. For Buttertoes, I would eliminate the pause after inspiration. Breathe in, breathe out.

Focusing on gas consumption is not a bad thing but it must not be at the expense of normal respiration. Reduced gas consumption comes from becoming more relaxed and comfortable under water and eventually normalizing one's breathing to what's physiologically appropriate and necessary.

Best regards,
DDM

 

[Buttertoes]

Thanks for all your thoughts and comments everyone, I think I have been in denial about anxiety but I that has to make the most sense... I will keep your comments on breathing in mind.

Maybe this gives me something to work on... Maybe some short shallow dives in familiar spots is in order.

I'll do a search and see if I can find some posts from people working through things like this

 

[uncfnp]

Sorry, I forgot that TDI calls it "Ideal Breathing". I have attached photos (it would take me forever to type) of the relevant pages from the Advanced Nitrox manual...