Throwing up under water.

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JessicaDodge

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I just recently did my first set of dives after my open water certification. As I posted on another board (in a subtopic of my main thread) I threw up during three out of 4 dives. On the second dive I felt sick but didn't throw up. I feel fine on the boat, no sea sickness at all. Soon after I get underwater I start feeling sick. Once I throw up I feel fine. I felt sick on my cert dives but the instructor said it was probably a bug of some sort. I was wondering if anyone has had this happen. Or if one of the Drs may know a reason for it. I was kinda thinking it could be the air and maybe getting nitrox certified... but is it too soon for that?

Jessica
 
Hi Jessica,

Sea sickness is a common problem, which is often resistant to any anti-emetic, whether cinnarizine, betahistine or even prochlorperazine (Prescription only).

Clearly neausea and vomiting are seperate problems. So lets take a look at each in turn;

Vomiting
From your post it reads as though you actually vomited underwater. It is vitally important to avoid the inhalation of any vomitus or salt water as this will cause a very nasty pheumonia - a chemical pneumonitis. So it is important for you to take the necessary steps to prevent any contamination your regulator.

In fact vomiting underwater is uncommon. In my experience, all symptoms entirely resolve once the diver hits the water. (As an aside the army use this fact to "encourage" paratroopers to jump out of their aircraft. The appalling symptoms generated by an hour or more of low-level flying immediately disappear once you are floating on the end of a 'chute!).

Nausea is very unpleasant and results from overstimulation of the organ of balance, the labyrinth. The drugs I listed at the start of this thread often help if taken early enough. Some swear by ginger, but common sense also has a role. Sensible eating, physical fitness, fresh air, avoiding fumes from the boat engine. Some are helped by lying down with eyes closed while in others this actually makes the symptoms worse! Concentrating your vision on a distant object on the horizon may also help.

To return to your post, I am not sure if your symptoms started during or at the end of each dive. If this is the case is is highly suggestive of contaminated air, or perhaps as you suggested yourself, a viral labyrinthitis. I am assuming you are not pregnant (hyperemesis gravidarum) and have been cleared as medicall fit to dive, since a chronic middle ear condition, such as a perforated ear drum, could also be the culprit.

The commonest cure of the usual forms of motion sickness is perseverence as anxiety and hyperventilation play a part. In most these symptoms resolve in time as you become more relaxed and your brain "learns" to ignore the crazy information it is being given by the inner ear. However, some are cursed by it. The British Admiral Nelson - The victor at the Battle of Trafalgar - is said to have been sea sick every time he went to sea!

I know one madkeen diver who accepts this as normal for him, sick as a parrot on the boat but absolutely fine underwater.

Needless to say if your symtoms persist and do not fall into what we accept as motion sickness you would be wise to seek the advice of your own doctor or an ENT surgeon.

I hope this helps.
 
Another possibility for some underwater vomiting is that anyone who is prone to esophageal reflux (where food/ stomach fluids slosh back up the esophagus instead of being held in the stomach) is likely to get worse symptoms when diving due to the horizontal or head-down position assumed in diving. This would be a possible trigger for underwater vomiting.

If you ever get a feeling of food rising back up in your throat, ever have frequent heartburn, or do a great deal of unpleasant burping/belching after a big meal, this could be something to investigate.

Anxiety (even good or exciting stress) is a tremendous nausea provoker also..
Witness the number of athletes vomiting before a contest or the number of panicked students vomiting before a test.

Good luck sorting these out. I wouldn't be in a big hurry to blame the air.

John
 
When I started diving, I had a similar problem but in reverse: I'd feel fine underwater but be overwhelmed by nausea as soon as I'd surfaced. At first, I put it down to seasickness but when it was happening on shore dives as well, it was on to looking for another cause.
An instructor on one dive suggested it was air in the stomach and recommended slow and deliberate breathing.
Following this advice helped a great deal and the only time I felt sick since was while diving in very strong current.

I know how unpleasant this sort of thing can be and hope you find a solution.
 
Thank you for your replys. To clarify a little better. Yes I vomit under water. I feel fine once I am back on the boat. Or after I vomit. On my last dive I did it right away just to avoid the nausea while under water and I felt fine. Yes, I have been cleared to dive by my doctor. Though he doesn't dive. Although I have recently started diving, I have been on or around water since I was born and never had any type of sea sickness. On the first dive it was about 15 mins into the dive that I started feeling sick. The second dive it started a little earlier. (though I didn't actually vomit.) Both of the other dives were at the very beginnig... like 3 or 4 mins under. I also felt sick on my certification dives (done with a differant place and differant air) I don't know that there was a problem with the particular air, others breathed it fine. I may have to find a doctor in town that dives. I live in FL it can't be that hard. I don't think it's normal motion sickness, and apparently its not a common thing in diving. Thanks again.


Jessica
 
Was there much surge on your dives? I know in my OW class, the surge was pretty severe on our first dive. Reports came back that the divemaster blew chunks through his regulator! :spew:
 
JessicaDodge once bubbled...
Thank you for your replys. To clarify a little better. Yes I vomit under water. I feel fine once I am back on the boat. Or after I vomit. . . .I don't know that there was a problem with the particular air, others breathed it fine.
Jessica
Sounds like John R was spot on.

It was an intersting exercise for me to look at all the possibilities, though!

I suspect you may be swallowing a lot of air prior to the dive (due to subliminal anxiety?). Jessica, perhaps avoiding any food immediately prior to diving, so you have an empty stomach, might help you.

A real puzzle though.:confused:
 
Have you ever experienced vertigo? One buddy sometimes experiences vertigo if viz is poor and lacking in a reference point (like the bottom). Something about being suspended midwater upsets the inner ear balance. Usually doesn't result in actual vomiting, but I have heard verigo can cause this.
 
If the middle ear is exposed to pressure differences it can cause a type of transient vertigo refered to as alternobaric vertigo. If you notice one ear clearing slower than the other the pressure differential between the two can affect the inner ear and cause temporary (less than a few minutes) vertigo.


If your inner ears have a temperature differential causing the sensation then it is called caloric vertigo. It is most often seen when diving with a tight fitting wetsuit hood when cold water enters one ear before the other causing the temperature difference. It is also transient and will disappear when the ears have equalized.

Both situations can cause feeling of nausea during a dive, please let us know when you figure something out about your problem.

Good Luck and good diving!!!

Jeff Lane
 
You have consistently used the words nausea & vomiting to describe the experiences about which you are inquiring.

Medicine describes nausea as an unpleasant sensation in the stomach usually accompanied by the urge to vomit. It may be accompanied by a cold sweat, salivation & a noticeable disinterest in one's surroundings. Vomiting is bringing up stomach contents through the mouth.

The issue of vertigo has now been raised, a rather different condition. It is described as a sensation of moving or spinning within relatively stable surroundings, sometimes accompanied by loss of balance. It may result in nausea & vomiting, but this is not a defining feature.

Having read this, do you feel that vertigo was involved in these episodes?

Best regards.

DocVikingo
 

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