Severe Headaches When Diving Deep

[Dizzi Lizzi]

Smokers are prone to developing COPD, as are those who live in poor air quality areas or are subjected to second hand smoke. Also it seems from you post that you would not be diving while sick (empysema, bronchitis, resp infection) but just to put it out there if you have a lot of mucus in your lungs again it's harder for you to exhale sufficiently and C02 buildup occurs.

 

[stuartv]

I get bad headaches all too often, usually right towards the end of second dive of the day.

I went to my doctor and then to an ENT. I had my sinuses scoped. The ENT said my lower, rear sinuses were pretty full of fluid and it appears to be a somewhat chronic condition for me. Probably in part from having 2 cats and a dog. Anyway, he got me sorted out on using Flonase (allergy medicine) properly (versus the way I had been using it) and also told me to take Afrin on the morning of each dive day. The ENT was a diver himself.

Since I've been regular on the Flonase and using Afrin each dive morning, my headaches occur much less often.

They still do happen sometimes (like, Saturday, for example). I think they happen as a result of me descending too fast. I always ascend pretty slowly. But, sometimes I get excited and let myself drop about as fast as possible to start the dive. I believe there is still usually some fluid in my sinuses and descending that quickly is what stresses those sinuses and ends up giving me a headache.

As you descibed, I don't feel any discomfort in my face area or where you'd usually associate with sinuses. But, there are other sinus cavities lower and towards the back of your head. That's where I had the most fluid when the ENT scoped me. And the pain ends up as you described, central and towards the upper part of my head.

For me, a glass of water and 800mg of ibuprofen generally cures it within 1 to 2 hours. Another sign that suggests to me that my pain is a result of tissue inflammation - I'm guessing sinus tissue.

 

[Billy Northrup]

I don't think it's CO2 because you would working hard at depth and that's where the headache would occur (done it) not after you hit your stop and take a rest for awhile. Additionally C02 is highly narcotic (another topic)

I can do 2 air dives and be pretty good but after the third there will be a massive headache. When I run nitrox nothing I feel better and less tired all the way around. Here how it was explained to me by Dick Rutkowsky, he called it sub clinical bubbling I believe. You are bubbling, not bent.

My O2 cents.

ADD: https://www.diversalertnetwork.org/files/DANnitrox_web.pdf

Good document, starts on page 81 Co2 talk.

ADD:

/snip
There is anecdotal evidence that the use of nitrox reduces post-dive fatigue,[9] particularly in older and or obese divers; however a double-blind study to test this found no statistically significant reduction in reported fatigue.[1][10] There was, however, some suggestion that post dive fatigue is due to sub-clinical decompression sickness (DCS) (i.e. micro bubbles in the blood insufficient to cause symptoms of DCS); the fact that the study mentioned was conducted in a dry chamber with an ideal decompression profile may have been sufficient to reduce sub-clinical DCS and prevent fatigue in both nitrox and air divers. In 2008, a study was published using wet divers at the same depth and confirmed that no statistically significant reduction in reported fatigue is seen.[11]
/snip off

It really depends on who you talk to and anyone within reason could be right. My west coast rough water, cold, kicking against a current in a restrictive wet suit is going magnitudes different than a Florida bathtub.

 

[John C. Ratliff]

If you are diving in a 3rd world location I would be concerned about your gas. Have you checked CO? It has happened in Florida more than once.

I would second getting your air tested for carbon monoxide. At depth, carbon monoxide, even in small quantities, can also result in bad headaches, and on top of that this is just before real problems set in. So even if it is a CO2 problem, get your air checked for CO too!

SeaRat

 

[eelnoraa]

No, it can't be CO. If it is CO, you don't get headache, you become sleepy, fall asleep, and gone. Even if you are off CO before you pass out, sitting around won't recovery from CO. You need to be breathing pure O2 for a while to get rid of the CO in your blood stream.

I think most likely to be CO2 retention. I got this sometime when I work to hard underwater. In my case, mild headache starts toward the end of the dive. It last for 1-2 hours after surface. Then it will go away. Think back, all of these instances were with a relatively strenuous dives, maybe swim a lot, or again strong current, or trying to modulate breath to control buoyancy too much (instead of adjusting the BC). After knowing how dangerous CO2 retention can be, I pay specially attention to my breathing pattern now to avoid that as much as possible.

 

[John C. Ratliff]

No, it can't be CO. If it is CO, you don't get headache, you become sleepy, fall asleep, and gone. Even if you are off CO before you pass out, sitting around won't recovery from CO. You need to be breathing pure O2 for a while to get rid of the CO in your blood stream.

I think most likely to be CO2 retention. I got this sometime when I work to hard underwater. In my case, mild headache starts toward the end of the dive. It last for 1-2 hours after surface. Then it will go away. Think back, all of these instances were with a relatively strenuous dives, maybe swim a lot, or again strong current, or trying to modulate breath to control buoyancy too much (instead of adjusting the BC). After knowing how dangerous CO2 retention can be, I pay specially attention to my breathing pattern now to avoid that as much as possible.

Actually, that is not correct. Headache is the predominant symptom of CO poisoning. Here are the symptoms of CO exposure:

Symptoms

Symptoms of CO poisoning are non specific. In a recent study from Utah (Weaver et al 1998) the commonest were found to be:

• Headache 74%
• Nausea 51%
• Dizziness 46%
• Weakness 24%
• Confusion 24%
• Lethargy 30%
• Vomiting 20%
• Abdominal Pain 6%

Symptoms can easily be attributed to viral illness, but suspicion should be raised when several members of a family are complaining of concurrent, possibly progressive symptoms in the absence of fever. Children present with a higher incidence of "gastrointestinal" symptoms than adults.
Carbon monoxide poisoning | Diver Clinic

It's fairly simple to get the air in a tank analyzed for CO. If this diver is also a smoker, he already has CO in his system, and it doesn't take much more to be symptomatic, especially at depth. Here is a discussion on ScubaBoard about CO testers. Here's another discussion where CO was found at 12 ppm in a scuba tank at Cozumel.

SeaRat

 

[Dhboner]

Might be sinus squeeze...sometimes pressure in the sinus cavity can manifest as a headache.

 

[JRCrab]

The first post is like [reading] in a mirror. I've recently experienced almost the exact same issue and felt the same worrying feeling regarding my future advancement with diving. I think I just figured out what the issue was for me - trying to conserve air. JUST BREATHE!

That was the short version...If your interest is peaked, read on...till you get bored...then just ignore the rest and breathe

I've got 24 logged dives at this point (plus 4 pre-certification). I'm really getting interested in DIR gear and methods and trying to improve my diving. I'm taking a hard look at gear, trim, weighting, finning and...air consumption! I'm somewhat underwhelmed with PADI instruction (AOW + drysuit + nitrox). I have a fairly technical background in outdoor adventure and want to do SCUBA right!

The last 4 days I've done 2 tank dives, I've had bad headaches for about an hour after the 2nd dive (except the most recent day, which I'll describe). Usually, I'm OK until I surface and get out of the water then feel pretty terrible with a bad headache and even some nausea. I've been feeling kind of funky after the first dive too, but not funky enough to abort the 2nd dive (except the last one...which I'll describe!).

I've been at a comfortable temperature for each dive, but each of the last four 2 tank days have been in very different locations ranging from 49 to 84 degree water with the appropriate exposure protection for conditions. Each of these instances has also had a different assortment of rental gear. So I'm left with one controlled variable - me!

On my most recent 2 tank day I was trying to implement a tip that an instructor on my boat gave me for air consumption improvement: "Try to breathe in so slowly that you cant hear your breath." The first tank was a 59ft dive for 52min. After getting back into the boat I got the same symptoms but MUCH more severe. I was really disappointed and a little freaked out. I didn't know what was going on and if I could continue to enjoy diving. It was so bad, that at 40min surface interval when we were supposed to get back in the water, I asked them to give me another 20 minutes which on this day caused some logistical complications. At 60 minutes surface interval I was really on the edge of feeling OK to get back into the water but I had to make the call.

Eager to figure out what in the world was going on (and not believing an instructor who said it was probably the diesel fumes or alcohol consumption), I decided to get back into the water only if I could come up with something to change from the previous dive. Still thinking the problem was me, I recalled learning something about CO2 buildup from not breathing normally. So, I decided that I would at least start the 2nd dive but would completely forget about air consumption and suck down whatever my body requested. Additionally, I tried to maintain the same completely relaxed state that on the boat was helping me feel better.

I reserved the right to abort if I started feeling uncomfortable again...

It worked like a CHARM! I noticed myself continuing to improve from how I was feeling on board especially when I consciously relaxed every muscle in my head and face (a couple of times I imagined I was still on the boat with a headache and tried to relax my head/face in the same way - felt even better!). That dive was 54ft for 50min. I felt fine during the dive, after surfacing and after getting back into the boat. It was very clear to me I had found the source of my recent debilitating headaches.

I'm still going to work to improve specific aspects of my diving with every dive, however, my first two priorities for now are going to be to FORGET about BREATH CONTROL and REMEMBER to RELAX.

 

[Dan]

The first post is like [reading] in a mirror. I've recently experienced almost the exact same issue and felt the same worrying feeling regarding my future advancement with diving. I think I just figured out what the issue was for me - trying to conserve air. JUST BREATHE!

That was the short version...If your interest is peaked, read on...till you get bored...then just ignore the rest and breathe

I've got 24 logged dives at this point (plus 4 pre-certification). I'm really getting interested in DIR gear and methods and trying to improve my diving. I'm taking a hard look at gear, trim, weighting, finning and...air consumption! I'm somewhat underwhelmed with PADI instruction (AOW + drysuit + nitrox). I have a fairly technical background in outdoor adventure and want to do SCUBA right!

The last 4 days I've done 2 tank dives, I've had bad headaches for about an hour after the 2nd dive (except the most recent day, which I'll describe). Usually, I'm OK until I surface and get out of the water then feel pretty terrible with a bad headache and even some nausea. I've been feeling kind of funky after the first dive too, but not funky enough to abort the 2nd dive (except the last one...which I'll describe!).

I've been at a comfortable temperature for each dive, but each of the last four 2 tank days have been in very different locations ranging from 49 to 84 degree water with the appropriate exposure protection for conditions. Each of these instances has also had a different assortment of rental gear. So I'm left with one controlled variable - me!

On my most recent 2 tank day I was trying to implement a tip that an instructor on my boat gave me for air consumption improvement: "Try to breathe in so slowly that you cant hear your breath." The first tank was a 59ft dive for 52min. After getting back into the boat I got the same symptoms but MUCH more severe. I was really disappointed and a little freaked out. I didn't know what was going on and if I could continue to enjoy diving. It was so bad, that at 40min surface interval when we were supposed to get back in the water, I asked them to give me another 20 minutes which on this day caused some logistical complications. At 60 minutes surface interval I was really on the edge of feeling OK to get back into the water but I had to make the call.

Eager to figure out what in the world was going on (and not believing an instructor who said it was probably the diesel fumes or alcohol consumption), I decided to get back into the water only if I could come up with something to change from the previous dive. Still thinking the problem was me, I recalled learning something about CO2 buildup from not breathing normally. So, I decided that I would at least start the 2nd dive but would completely forget about air consumption and suck down whatever my body requested. Additionally, I tried to maintain the same completely relaxed state that on the boat was helping me feel better.

I reserved the right to abort if I started feeling uncomfortable again...

It worked like a CHARM! I noticed myself continuing to improve from how I was feeling on board especially when I consciously relaxed every muscle in my head and face (a couple of times I imagined I was still on the boat with a headache and tried to relax my head/face in the same way - felt even better!). That dive was 54ft for 50min. I felt fine during the dive, after surfacing and after getting back into the boat. It was very clear to me I had found the source of my recent debilitating headaches.

I'm still going to work to improve specific aspects of my diving with every dive, however, my first two priorities for now are going to be to FORGET about BREATH CONTROL and REMEMBER to RELAX.

Glad to hear you figure it out early, before worse thing happens. Experience will improve your air consumption. I had a Scubapro smartCOM dive computer for the 1st 10 years of my dives, logging up to 500 dives with it & monitoring my air consumption. It started with 0.7 cubic foot per minute (cfm) & slowly dropped to 0.4 cfm after 100 dives (2 years) for the same dive profile, i.e., calm water, no current, 80' deep. My bottom time went up from 30 to 60 min from roughly 2850-3000 psig starting pressure in AL80 cubic foot tank to 650-850 psig ending pressure.

Another keys to minimize air consumption, besides being relax & breathing normally, are to get your buoyancy correct when you reach the bottom, instead of keep adjusting it as you go up & down and minimize finning & hand movement, just float. Every time you fill the BCD with air is like taking away the air that you could have used it for breathing. If I don't have a camera to hold, I would actually crossed my arms, instead of flapping them around when swimming. The only time I move my fins is when I need to swim to another underwater location.

 

[JRCrab]

Thanks! I look forward to experiencing the correlation between bottom time and experience.

Now this is an official thread hijack...

I've become quite good leaving the inflator valve alone. I basically add a few puffs on the way down and dont touch it once I get to depth. In fact, I attribute this a little bit to my odd breathing. Part of my strategy for not using the inflator valve is to run a little negative and make it up with lung capacity (I feel like I have huge lungs underwater with big swings in buoyancy during normal breathing). This means I often avoid breathing out fully to keep myself off the bottom.

I'm also proficient at keeping my hands still. Initially I would hold my hands together under me against my lower stomach, now I hold them in front of me grasping my camera.

Finning I can definitely work on quieting down. I fin almost constantly. This is probably mostly related to my negative bias wrt buoyancy, but also because I'm always turning and twisting to look and take photos or video...and because I'm usually on a dive that involves getting somewhere or seeing a larger area.

I've actually been thinking about trying to do a few dives where I'm not trying to go anywhere for just this reason - to practice holding position, minimizing movement and training myself to have more precise control of orientation with minimal translation. Just go down to something interesting and examine every nook and cranny.

Obviously, to practice this, I also need to be a little more diligent about adding enough air to my wing to lose a little more negative bias.

I guess I have the two things to work on during my next dive (after breathing and relaxing!)!

Thanks!