Vomiting too

[oscul8or]

My wife has known me for almost 28 years, and in all that time she has never known me to vomit - of course until I started diving a few years ago. Don’t get me wrong – I am prone to motion sickness to the point where she’s told me that my skin tone was actually green. But I almost never get sick enough to, well, get sick.

I got my PADI OW in 2008 and we went to Hawaii did a dive in the afternoon and a second at night with manta rays (if you haven’t yet, you gotta do this!). This was one of the highlights of my life, despite the fact that 5 minutes after the dive, I was back on board chumming the waters. This was the very first time my wife knew me to vomit.
The second time was last week after 2 shallow dives in Venice, FL (hunting for meg/shark teeth). Same thing – after the 2nd dive (which I cut a little short b/c of how I was starting to feel) I got sick right away. Both times the seas were fairly calm.

I have wanted to learn to dive ever since I was small and I saw my first Jacques Cousteau special back in the 60’s. I’ve got lot of dives on my bucket list, but I’m worried that motion sickness is going to cut that list short! I have tried the standard meds (although not trandsderm scop yet), ginger, avoiding the wrong foods, the wrist bands, eyes on the horizon, etc.

BUT something occurred to me after my last experience. During both dives in HI and FL, I distinctly remember the sensation of water slowly trickling into my ear sometime after descending (i.e. not during descent, but after being down for 5 – 20 minutes). I know that there is a phenomenon where cold water in the ear can cause vertigo, nausea and the like. So my current theory is that if I can keep the water from trickling in, I’ll be less prone to feeding the fish after (or even while) diving. I’ve read a little on vented ear plugs as well as the ProEar 2000 masks. I’m wondering if anyone else has tried to combat nausea by keeping water out of the ear. Did it help, what products worked? I’ve been thinking that just stuffing some lambs wool in there might do the trick. I don’t think I need a solid barrier, just something with enough surface tension to keep the water from slowly trickling in.

Then again, I may just be prone to motion sickness and it’s just going to happen. (still, I’d do the night manta dive again in a heartbeat!)

Also, I saw Ed's post (http://www.scubaboard.com/forums/diving-medicine/399825-vomiting-vertigo.html) about his son and wonder if he's experiencing something similar.

I will say I have experienced some light nausea during/after shore diving (i.e. removing the motion of the boat from the equation), at our local quarry, but it was less intense and I was able to keep my lunch down.

 

[knowone]

http://www.scubaboard.com/forums/ba...-sea-sickness-while-diving-3.html#post5680371

 

[Duke Dive Medicine]

Oscul8or,
Have you ruled out bad gas? Also, are you experiencing any true vertigo (a sensation of movement), or just nausea and vomiting?

The vertigo that's caused by cold water in the ear is known as caloric vertigo. It's typically transient and goes away as soon as the fluid in the inner ear warms to a consistent temperature. The way to avoid it, or at least minimize its effects, is to let water into your hood and your external ear on the surface vice allowing it to seep in at depth.

Have you had your ears examined by a physician? If you have a fistula in your tympanic membrane, that could cause the water-trickling sensation and bring about vertigo when the water cooled off the vestibular apparatus. The water wouldn't necessarily have to be cold.

You may be experiencing alternobaric vertigo, which happens when one ear clears before the other. It usually occurs on ascent, and clears up when the affected ear equalizes. You may also be retaining CO2 (the subject of another current thread). Textbook CO2 toxicity also involves a headache, but it wouldn't be entirely out of the realm of possibility.

Hope this helps.
Best Regards,
DDM

 

[krawdady]

You should probably get your ears checked out just to be safe. I had a similar experience to to Ed's post. In my case I did something dumb after making a couple hundred very careful dives. I went diving with a cold, had trouble clearing and forced it inside Ginnie Springs. I felt pain and a sensation of water flooding my ear. What followed was almost 24 hours of not being able to stand up straight, extreme nausea, shaking and shivering. I took a month off and tried again in the caymans. This time the vomiting started underwater during the dive and then another 24 hours of throwing up. I finally saw an ear surgeon who said he thought I had an inner ear injury (I guess they can't tell for sure without lifting the ear drum) and that since I didn't seem to have permanent hearing loss in that ear, the tear was probably small enough to heal on it's own without surgery if I took at least 6 months off. After reading about what could have happened I can tell you that it is nothing to mess with and some people have horrible repercussions from inner ear hits. I am not qualified to give medical advice but I can tell you from my own experience that you should not take chances with possible ear injuries. If it turns out to be related to sea sickness I have known some people who have had great luck taking ginger tablets a couple hours before a dive. Maybe it's all in their head but it seems to work nonetheless.

 

[bleeb]

What kind of exposure protection were you wearing? In particular, how tight around the neck was it? How many dives have you done with the same suit without throwing up? Would any medical types out there be able to comment on whether there's any truth to the story that a small fraction of divers can get sick from a tight neck seal creating pressure either on particular nerves or on neck veins?

 

[PatW]

It sounds as if you get sea sick during the dive, if I read you correctly. I can get sick on a boat, but generally when I am in the water, I am OK even if it is rough. In facts, on one trip, I did most of my safety stops in the water to avoid the pitching in the boat. I seem to be getting more resistant now though. But it is not something that one necessarily out grows with exposure.

If it is water in your ear that is causing the problem, you can get fitted ear cover which keep most of the water out. I forget their name but many scuba shops carry them. My wife is prone to ear infections from water in the ear and she uses them with good results.

It would make sense that water in your ears could cause "sea sickness". Sea sickness is generally caused by motion. Water in your ear could disrupt your ears inputs on your balance which could mimic irregular motion and trigger sea sickness.

 

[oscul8or]

Wow, lots of great info and questions! Thanks everyone.
Regarding reference to http://www.scubaboard.com/forums/ba...-sea-sickness-while-diving-3.html#post5680371: I'm a strong believer in the mind/body connection and how the mind can have significant physical effects on the body. I will definitely practice those techniques.
I’m not sure that’s a solution to my diving nausea though. Both times that I’ve gotten sick, the boat was in very calm waters. I’ve been on an 80 foot vessel in the open Pacific in Alaska in huge seas where more than ½ have of the people on the boat were getting sick (like 20 people including crew). While I felt VERY nauseous, I never lost it (even after some of the cool sea spray that was helping me feel better suddenly felt warm, and I realized I was downwind from another passenger whose stomach wasn’t as strong ).
And the fact that I’ve still felt nauseous (although not as bad) quarry diving, makes me think it’s more about the dive than the boat.

Bad air? So far all my dives have been with several other folks who got their air from the same source, so I’d rule that out.
I’ve seen true vertigo (my wife had it from labyrinthitis a while back). I’d say I get a little woozy, but nowhere near having to hug the earth to keep from falling off. So maybe, maybe not.
Ear exams – I’m one of the few people I know who gets a full physical every year. The Dr looks in there, but not for very long and he may not be looking for something like that (or would it be completely obvious? If so, he’s never mentioned it). BTW, since you’re a Dr, and I’m very close to Durham – maybe I should make an appointment so you can look yourself ;-).

Alternobaric vertigo – possible. Although both times I started feeling bad before ascending and I specifically cut those dives a little short with plenty of air in my tank b/c of how I felt. I was also getting cold both times.

Exposure protection – in HI I was wearing my own 3mm full body suit. Same with the quarry dives. In FL I had a rental 5/3mm with a hood. Constriction around the neck is something I’ll pay attention to.

I guess I should have mentioned I don’t have too many dives logged yet so it’s hard rule things in/out statistically. Prior to getting my OW, I’d done 5 Caribbean ‘resort’ dives – all of which were single tanks, warm(er) water with great vis. (yeah, I should have just got my cert before those….long story). Did my 4 check out dives in a local quarry, the 2 in HI, 2 more in the quarry, and these last 2 in FL.

From all I’m reading and hearing from y’all, this is complex and lots of things can be the trigger. Or I may just be prone to (under)sea sickness. I guess I’ll just have to do a lot more dives to figure it out! (but I’ll get my ears checked first!)

 

[Duke Dive Medicine]

oscul8or,
Sent you a PM.
Best,
DDM