Post-Dive Headaches ?

[MooreaMike]

I just failed a cardio stress test, not because of my heart function but because I got dizzy with a strong headaches and very short of breath before they could get my heart rate high enough. Actually everything looked fine until that point.

Discussing with my doctor, I thought everyone got headaches just after exercising. Since some of the most strenuous exercise I get is diving (especially in currents), he suggested I check to see if others experience headaches after nearly every dive. Not just annoying little sore, but sit by myself quiet and try not to throw up headaches. They are present after other exercise, but not as intense. Interesting thing is they go away when I get back to some depth (30-40 feet), although the nausea takes longer to dissipate.

Any input on this or where I should ask the question is very welcome. I'm going to try DAN also, but thought some real-life input would be welcome also.

 

[sander8]

I'm just a laymen and not a medical professional, but it seems that your main problem is the strong headaches and shortness of breath after exercise on the surface, not diving. Get to the bottom of that first. From your post, your doctor has not explained that. You need more thorough investigation of that problem. You need more medical attention and expertise. Get a specialist. Change doctors. Once you find the right medical care and diagnosis, you can ask questions about fitness to dive.

I would not dive with the symptoms you describe until I had trustworthy medical clearance.

 

[warmwaterturner]

The statement that "everyone got headaches just after exercising" should be concerning and explored further. If anything, endorfin release at peak exercise should give a relaxed euphoric state. I kickbox, do weights and lots of cardio and have never experienced a headache after exercise. I would seek a ct scan if I were experiencing this on a regular basis.

 

[Bubbletrubble]

No, post-dive headaches are not normal. Someone with your experience level should not be experiencing severe headaches and nausea post-dive. It's an indication that something is wrong.

Be patient. Work with your physician on this. The issue might be related to carbon dioxide retention, aerobic fitness, cardiovascular, or neurological issues. Since you would like to continue to dive (I'm assuming), it will be worth the time, money, and effort to figure out what's going on.

Since the bad headaches also occur after other types of exercise, the pressure changes experienced during diving might not be playing a predominant factor here. Exercise headaches can be divided into two categories: primary and secondary. Primary exercise headaches are kind of a mystery. It's possible that exercise causes vascular dilation inside your skull and this somehow causes pain. If this is the issue, there are a couple of different medications (indomethacin or propranolol) which you might take prophylactically. Secondary exercise headaches can be caused by a lot of different medical conditions, some more serious than others: cerebral hemorrhage, cerebral vascular abnormalities, sinus infection, atherosclerosis, obstruction of the flow of cerebrospinal fluid, or some kind of tumor. (This is not a comprehensive list BTW.) Obviously, you'd want to address the underlying medical condition if this is the case. I don't want to get you unnecessarily worried about this...but you should take some time to figure out what's going on. Get together with your primary care physician and figure out an action plan which will likely include some specialists.

Good luck and keep us posted on any progress when you get the chance.

 

[DandyDon]

I thought everyone got headaches just after exercising. Nope! I used to get headaches during high school football practice but never learned why; oddly I never got them on games - nor other exercises, or strenuous work on the farm or wrestling cattle that outweighed me.

he suggested I check to see if others experience headaches after nearly every dive. Never

I'm glad that Bubbletrubble knows something about this as it sounds odd to me.

 

[MooreaMike]

Thanks so much for al of the input. I definitely realize there might be something going that is not normal. The diving headaches and nausea have been for a few years, the other exercise for just a few months. I just assumed that others had the same issues with diving. Very often, everyone is fairly quiet for a few minutes right after surfacing, even on liveaboards I have been on. So I assumed everyone had the same issues.

Since this just happened Friday afternoon, I have heard from my primary care physician (specialist in sports medicine and an infrequent diver, also) and we are going to schedule some more tests, including a 'look inside my head' over the next week or so. Just don't have them scheduled yet.

Still interested to know if anyone else experiences similar symptoms diving....It could be that I initially experienced the headaches diving since swimming in currents would be the most strenuous exercise I would get at the time.

 

[OBXDIVEGUY]

I used to get headaches on particularly strenuous dives, like fighting a current or something. I'm sure it was CO2 buildup. Not to mention, sometimes I would have a death grip on my regulator mouthpiece. With more experience now, I can remain relaxed and not have any problems at all.

But no, a headache after every dive is definitely not normal.

 

[textilet]

I have read that PFO (Patent Foramen Ovale) is linked to migraine headache, as well as increased risk for DCS and DCI symptoms when diving. Not sure if a PFO related headaches are brought on by excercise but I know that negative side effects of diving+PFO generally happen when the dive (or hike back to the car) is strenuous physically. Also a PFO/DCS related cause for your headache would help explain why your symptoms go away at depth. Just a thought. I am in no way educated on the subject.

 

[oddible]

What about hypoglycemia? Try drinking an orange juice right after your workout (or maybe better, drinking some fruit juice that is maybe less acidic right before you work out). Have you had any issues with blood sugar?

 

[cutlass]

IMO, the report of breathlessness makes exercise-induced hypoglycemia a front-running possibility.

Of course, we must first respect the possibilites of a serious condition (but subacute while not exercising) such as those mentioned by BubbleTrubble: space-occupying brain lesions such as cysts (maybe parasitic!) or tumors, swelling or inflammation, or pooling fluids such as from hemorrhage, aneurysms, or drainage defects (of cerebrospinal fluid).

After that, presumably a routine blood test has been done and red cell counts (hematocrit or "crit"), hemoglobin (key gas exchange protein), bicarbonate, chloride, and phosphorous electrolytes (acid control/buffering), glucose (cellular nutrition), and blood-urea-nitrogen (BUN), creatinine, uric acid, and proteins (kidney health) are all within normal limits. If decided to be necessary, arterial blood gas (ABG) measurements at rest and during exercise might be informative.

The stress-test was reported stopped for reasons other than an EKG-detected heart abnormality. This suggests that at least the heart's electrical and muscular system seemed to be adapting to exertion up to the point of termination. However, this doesn't exclude other abnormalities which may be reducing pump efficiency and thus allow acid build-up*.

Certainly, lung function tests may be worthwhile to check for impediments to adequate gas exhange. Besides the usual spirometric testing, one must be alert to changes in breathing mechanics (rhythm, depth) which may indicate neurologic (possibly brainstem) or chest structure problems.

Hopefully, the condition will be found to be simply relieved without the expense, inconvenience, discomfort, or pain of too much further testing.


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*Acid? Rising acidity (especially as CO₂) is a signal of rising metabolic waste (and implied decrease of available O₂) which must be flushed. The reaction is to increase flow by increasing blood vessel caliber. This puts pressure on surrounding tissue, resulting in headache. Acidity is principally controlled by the kidneys and lungs. But reaction by the kidneys is relatively slow (hours to a few days) while respiratory mechanisms react in minutes. Thus in this case, we should take a closer look at the pulmonary circuit -- the gas bags and associated pump, pipes, and transport fluids (i.e. blood components).