Feelling sick after diving...

[condor13090]

Anyone ever feel sick after your dive? While diving in Bermuda I got really sick and I think it's because my instructor and I came up too quickly. We didn't stop at 15 ft. for 3 to 5 min. after being at 35 ft. for 45 minutes which I was taught to always do. Also we came up pretty fast.
I noticed this the other day too after a 30 ft. dive even with the required stop. As I headed for the surface I had a little trouble releasing some air from my BC and I surfaced a bit faster than normal...then while swimming to the boat I felt sick to my stomach and decided to call the next dive off.
It may be an inner ear problem, as I noticed riding in a car also gave me a simular feeling.
What do you think? George

[MiddletonMark]

The inner ear is a good thought, don't know enough to say more on that.

Are you getting some water, just a tiny bit, in the mouthpiece? My wife struggled for a few dives in Bonaire, until we had her regulator/etc checked ... and some sand/gunk cleaned out. Seems like just a tiny bit of water was coming in when breathing, no big issue until she surfaced ... but she felt/was quite sick on surfacing until we had this addressed.

Just a thought, probably far more experienced folks will jump in and have better ideas ... but that's my guess

Sure doesn't sound like fun at all, though.

[luminary]

There are lots of reasons why you can feel a little sick after diving. Sometimes you're just a bit dehydrated. Sometimes it's motion sickness (which would be related to your inner ear). But sometimes it's more severe like a bad gas mix or a DCS hit. Since it happened in two completely different places it's most likely not bad gas.

Did you have any other symptoms? Skin rash? Sore limbs/joints? Headache? Chills? Anything other than usual? If so, I'd be more inclined to think it was DCS. If not, that doesn't mean it wasn't. The very easy going dive profile also makes DCS unlikely.

The absolute first thing is that you stated in both cases your ascent was not correct. That needs to be corrected immediately. In my opinion the majority of recreational divers do not ascend properly and it's the most dangerous thing I witness on a regular basis. Was the dive with your instructor a cert dive? If not, let him go. If your dive buddy insists on doing something you know to be wrong (either in principle or just for you specifically), don't make the situation worse by doing it anyway.

The safety stop at 15 feet is just that, a safety stop. Most people would be perfectly fine diving 45 minutes at only 35 feet and not doing a safety stop. However, coming up too quickly is dangerous no matter what the depth. Keep in mind that everyones physiology is different and you just may be more sensitive to quick ascents.

I'd try one or two dives in perfect conditions. Go slow, do a safety stop, don't push the bottom time, make sure you're well rested and hydrated before hand and that the water isn't rough. See if you feel sick. If you do, IMO you should stop diving until you discuss it with a knowledgable doctor. DAN would be a good place to start looking for one. I know that may sound extreme but being sick after diving is not normal and you need to figure it out so you can continue to dive safely. It may be something as simple as what Mark said, but it may be more serious.

[gregt]

Good post Matt. I have nothing to add except to provide a link to the DAN website

[condor13090]

The guy in Bermuda wasn't my regular instructor and it was for my certification. He did alot of things different from what I was taught. I would never recommened changing instructors because being in an open ocean is not the place to have something new or different asked of you. I did my pool time in the USA under the SSI program and decided to finish down there in the PADI program. We hardly talked before we went out...but he was busy driving the boat which is like going through a maze with all of the reefs out there. So alot more communication would have helped.
As far as the dive, I would be more comfortable going to depth and as part of the assent plan, swimming back to the boat following the bottom to the shore since the boat was parked there anyways. This way you come would up slow and do alot of breathing over 10 or 15 minutes instead of bobbing in the waves to get back.

[luminary]

One of the goals of any dive should be for your ascension to end at the boat. Swimming on the surface sucks. Did both of the dives where you got sick have an extended surface swim? Was the water rough? Do you normally get sea sick? Based on this post and your post about getting sick from holding the weights on the surface, I'd guess that you do get sea sick.

I get motion sickness all the time. An extended surface swim will almost always make me sick. I can't count the number of times I've puked through my regulator .

Getting sick from being on the surface is a much different situation than getting sick because of your dive. Which one was it?

[MiddletonMark]

Great point about ascent, Matt.

[Tech Diver]

It is rather unlikely to get a DCS hit from a 45 min dive at 35 ft after missing your safety stop. Even if you did have sub-clinical DCS, which is possible if you have a PFO (Patent Foreman Ovulae - hole in the heart), the classic symptom is fatigue. More likely you have motion sickness. Generally, if you start the dive with some nausea/discomfort, it will usually disappear while underwater, then reappear in a stronger form as soon as you reach the surface. I am very sensitive to motion sickness and a boat ride, or bobbing in the waves, is a sure way to get me sick. As a result, I always use a Scopolamine patch. It is the only anti-nausea medication that is approved by the Navy for use in diving and is available by prescription only.

Safety stops are a very important part of the dive plan. Even though they are called Safety stops, they are in reality Deco stops, as EVERY dive is actually a decompression dive. Divers that miss safety stops do actually experience some form of sub-clinical DCS. However, it may be so minor as to be completely unnoticeable. Other times it is not.

The exchange of gasses by your lungs is the only way that Nitrogen is rapidly purged from your system. To do a proper safety stop you should be oriented in a HORIZONTAL position. If you are vertical, the difference in hydrostatic pressure between the top and bottom of your lungs makes your lungs less than 50% efficient. That is because the capillaries are only fully expanded at the bottom and contracted at the top. It absolutely amazes me how this fact is never taught in recreational diving.

Another very important thing is to remain very well hydrated, as this increases the blood volume, significantly aiding the efficiency of you lungs gas exchange during the safety/deco stop.

[luminary]

Unlikely, sure like I said. Possible, yes. I too think that George just got motion sickness but if he does not regularly get sick, and the only time he did was during two dives that both had accelerated ascents, the conservative approach is too look beyond just motion sickness. IMO, better safe than sorry.

And on a side note, I also use scopolamine. Within the past few years a pill form has been made available (by prescription). The brand name is Scopace. I have found it to be more convenient than the patch. I don't go anywhere near a boat without having popped my little pill . I haven't gotten sick once since I started using it.

[luminary]

Just as another comment on using scopolamine, at least the pill form...It does have some side affects. I get cotton mouth from the dose that I take. Too strong a dose and I get slightly loopy (kinda like a mild wine buzz). If anyone reading this does decide to give it a go, it is imperative that you test your prescribed dosage on land, at home (no driving) before using it under water.

[Tech Diver]

I fully concur with Luminary about testing it first before you dive. Scopolamine is a narcotic and works by suppressing some sensory systems, so you need to first see how your body reacts in a controlled environment (at home on dry land).

I have only used the behind-the-ear patch and never the pill form. I usually apply the patch about 3 hours before the dive. The strange thing after I removed it is that the room on dry land begins to sway like a boat several hours later (has anyone else felt this?). I understand there is also a cream form that you rub on your wrists. It is supposed to be very fast acting.

[condor13090]

I just drove an hour to go diving and when I got there I felt a little sick to my stomach...so I opted not to dive. This sucks...it takes all the fun out of it. I think I'll try the sea sick pills and hopefully it will help.
I'm a hang glider pilot and Iv'e been flying for 28 years and only once did I ever feel sick and that was after some beers the night before and doing some high speed aerobatics. Of course being the driver of anything is better than being a passenger when it come to getting sick.
I've been on Lake Ontario in 15 ft. swells and was fine but another time I was sick for 3 days on the ocean during a fishing trip.
My brother gave up scuba because he got sick diving in a surf area where everything is moving all directions...and it doesn't seem to bother me at all.
One time in the pool I came up pretty quick and I got light headed...could be due to the blood pressure medicine I'm taking...oh forgot to mention I do take alot of pills for my heart. Asprin, Toprol, Lipitor and Plavix...and I did check with my Cardiologist before I learned to dive.

[luminary]

First thing, my hat's off to you for making the correct decision. After putting in some effort (like driving an hour) to get to a dive destination, many people are inclined to ignore certain things and dive anyway. Calling the dive, whether or not absolutely necessary, because you didn't feel right is definitely the responsible thing to do.

Honestly, based on everything you've said, the only path I'm comfortable suggesting is that you talk to a doctor that is knowledgable about diving and it's affects (I always recommend DAN as a source but there are probably others). You said you don't normally get motion sickness, but you have had some incidents where you did. I think that you should discuss your specific medical history (such as the facters around taking heart medication) with an experienced doctor.

Best case, the doctor will just tell you that it's motion sickness and you might be out a couple of bucks for the consultation. But it could be something more significant.

You might as well try and find out for sure if you really need to call a dive because of a little nausea.

[condor13090]

It's nice to hear others have problems too....and have found a way to deal with it. When I first started diving it bothered my ears quite a bit. They seemed plugged and it took weeks to clear. It's not as much of a problem recently...maybe I did something to them?
I did have heart surgery 2 years ago, a bypass and I'm not limited in any way because of it...I'm one of the lucky ones...no damage.

[Bomber]

condor, you're not hyperventilating are you? that's common with new divers.

[condor13090]

When I dove in Bermuda I may have...wrestling the 26 lb. weight belt for a few minutes, choking on saltwater and a new wet suit compressing my chest and I just couldn't catch my breath. It's so easy to over due anything with all that equipment on. So now I just go slow and calmly and dive in a relaxed manor.
Thanks for all the input guys...George

[condor13090]

Tried the sea sick pills and did 2 long dives and had no problems! I did somehow get water inside my ear...kind of annoying until it clears up, anyone ever have this happen?

[2004jeepoutlander]

isnt the a decompresion sickiness called the bends or something?

[luminary]

Yes, the "Bends" is the common name for decompression sickness. It's called that because it commonly affects the joints first causing the victim to curl up, or bend.

[condor13090]

No it's not the bends...I wasn't deep enough or down long enough. I think it's an ear problem. It may have something to do do with breating too hard...which is easy to do...so now I try to take it easy and everything seems to be fine.

[luminary]

Originally posted by condor13090
No it's not the bends...I wasn't deep enough or down long enough. I think it's an ear problem. It may have something to do do with breating too hard...which is easy to do...so now I try to take it easy and everything seems to be fine.

Just to comment on this for new divers who might be reading this thread...I think we've all pretty much agreed that it wasn't a DCS hit, however Condors statement is not correct. There are many more circumstances besides just depth and time that can affect the occurance of DCS. Given the right (wrong?) circumstances, you very well could have an onset of decompression sickness at that profile. Of course it's extremely unlikely, but is still possible.

[kraphtymac]

Not to address the question, but how much have you worked with your bouyancy? To me, 26 lbs. sounds like quite a bit of weight... not saying you don't need it, because some people do. However, many new divers use WAY too much weight... this causes a hard time getting neutral buoyancy, hard ascents, etc., which could all lead to motion sickness, blood gas problems, etc. If need be, get in some shallow salt water and check your weight belt with gear... it could help your problem, but will undoubtedly make your diving much more fun.

[drgabe]

Lots of awesome stuff in this thread about decomp, safe diving, motion sickness. I'll kick into the motion sickness since the rest has been well covered and MS is my speciality (so to speak).

Scopolamine is not a narcotic, its an anticholinergic agent. As such it calms the inner-ear down so that it doesn't notice differences in position as it would normally. That is why it works so well for people prone to MS. However, all anticholinergic in a since "dry you out". Thus the dry mouth, dry eyes, drowsiness, and constipation which many users will often notice. However if the choice is the above versus hanging over the side of the boat... I have my answer already!

Things to remember, any anti motion sickness med needs to be taken at least one hour before getting on the boat (or whatever). And of course, always use as directed.

Tips that save me from throwing up on all over my BC:
one... get in the water quick on wavey days (be organized and ready to hit water)

two... learn to breath underwater to extend bottom times (for me it ment being in "shape" and extra time in the pool to learn how to scuba breath"

three... always ascend slowly and controlled allowing me to stay under the water, especially while waiting on other to board the boat. I usually bob on the water for about 10 seconds, the time need to scurry up the ladder (even then I feel the green gills coming some times)

[condor13090]

I used Bonine for sea sickness and it worked great. Also this was my second dive for my certification and I ASSUMED the instructor was going to go down with me but after 15 minutes of fighting the waves and getting the weight belt on he wasn't even dressed! We never discussed what we were going to do after I put on the belt. They said I would be fine after I went down...but that would mean I would be going down by myself or wait for him...and I felt there was no way I was going to slosh around for another 15 minutes in 5 to 6 ft. seas so I don't know what he was thinking. I really think he was trying to put me to the test and wanted me to screw up.
I would suggest that anyone wanting to change instructors half way through their certification to not do it.
When I got home and finished my open water dives it was a piece of cake...they explained EVERYTHING before we went in...I guess thats why this school has never had an accident while teaching and thats quite a record.
As for using 26 pounds of weight...it was a guess...I had a new wet suit and never tried it out before...and I told him I seemed heavy because I was adding quite of bit of air to the BC at 35 ft. and he said better to be heavy than too light. But it was a real pain if I changed my depth even by 5 ft. I'm a new diver and even I know the importance of getting it right otherwise you have to deal with the expansion of the BC air all of the time. Now I dive with 19 pounds in fresh and probaly 22 in salt.

[Tech Diver]

I was curious just how much of a DCS risk was incurred by Condor on his 45 min dive to 35 ft, so I decided to run a full computer analysis using the GUE decompression program developed by Eric Baker. I apologize if I am getting too technically detailed here, but I think that some people might find this interesting.

Before anyone starts to panic at the thought of a bunch of numbers and mathematical formulas, the principle behind decompression modeling is really not that complicated. Different tissues in your body take-on or release gas at different rates whenever the pressure of your surrounding environment changes. Skin cells absorb and release gases quickly, while bone does so very slowly. Nerve cells are somewhere in between. The mathematicial model for how cells absorb or release gas are based on exponential equations and are just like those applied to how a hot cup of coffee cools off.

The software I use breaks the body up into 16 different "rate" groups known as Tissue Compartments. Each tissue compartment is given a maximum value (M-Value) of gas that it can safely hold before it begins to release bubbles after a pressure drop. These bubbles are the cause of DCS.

The analysis is based on M-Values in Buhlman's ZHL16B tables. This set of tables models 16 tissue compartments and is denoted as set "B", which is more conservative and makes it safer than the set "A" tables.

I ran a three-segment dive profile based on breathing air:
Segment 1 - A descent from 0 ft to 35 ft at the rate of 99 ft/sec
Segment 2 - A 45 stay at 35 ft
Segment 3 - A fast ascent from 35 ft to 0 ft at the rate of 60 ft/sec

It is segment 3 that is of interest to us since we want to know if any of Condor's tissue compartments were releasing bubbles after he surfaced. In the following data I have supplied three values for each of the 16 tissue compartments:

PN2
The tissue compartment pressure of Nitrogen
(absolute Ft of sea water)

M-Value
The maximum allowed tissue compartment pressure
(absolute Ft of sea water)

%M-Value
The percentage of the M value reached by the compartment.
A value of 100 would mean that the compartment
pressure has reached it’s maximum possible theoretical
tolerance


__________Cpt 1__Cpt 2__Cpt 3__Cpt 4
PN2________51.0___50.9___49.4__46.8
M-Value____97.3___83.2___73.8__66.8
%M-Value__52.4___61.1___67.0__70.0


__________Cpt 5__Cpt 6__Cpt 7__Cpt 8
PN2________43.3___39.8___36.5__33.7
M-Value____62.3___57.4___54.1__51.7
%M-Value__69.4___69.4___67.5__65.1


__________Cpt 9_Cpt 10_Cpt 11_Cpt 12
PN2________31.3___29.8___28.7__27.8
M-Value____49.9___48.2___46.8__45.6
%M-Value__62.8___61.8___61.3__61.1


_________Cpt 13_Cpt 14_Cpt 15_Cpt 16
PN2________27.1___26.6___26.1__25.8
M-Value____44.1___43.5___42.6__41.8
%M-Value__61.6___61.1___61.4__61.7

Sorry about all the underscores but I could not set the Courier font in this posting.

Let's look at the bottom number (%M-Value) in each of the tissue compartments and find the largest value. Notice that in compartment number 4 the tissue reached 70% of the allowable Maximum Value. It is generally accepted that if this value were 90%, Condor would have needed a deco stop before reaching the surface. If you want to be really ultra conservative you would do a deco stop if the tissue compartment saturation was greater than 70%. But with Condors's value of 70%, it is virtually impossible (if not absolutely impossible) to have even sub-clinical DCS with this particular profile even if he was dehydrated, overweight, and had a PFO (hole in his heart).

Even if he doubled his dive time to 90 minutes, the highest %M-value that he would reach is only 81%. In fact, a 240 min (4 hours) dive at that depth, would only require a 1 minute decompression stop at 20 ft (of course it is better to stop for at least 3 minutes). Since we would need 300 cu-ft of gas to complete such a dive, the limiting factor at this depth is clearly tank capacity and not nitrogen on-gassing by the tissues.

In conclusion, we can completely rule out DCS as a cause of Condor's physical discomfort.