Blebs and coughing blood

[Daryl Wong]

Hi all,

I'm not sure if this is the right section, but I am interested in knowing if there are any studies on the coughing of blood caused by Blebs when doing some deep dives. The reason I ask Is that I have a partner who has gotten this at various depths from 55ft -100ft. each time he came up coughing blood.
Just recently I had the same thing for the first time. I have been freediving for over 40 years and dive from 50-100ft. This was the first time I ever had something like this happen. I couldn't dive at all after it happended and very shallow the next day. Two months later every thing seems fine.
I just talked to another dive buddy and he had the same thing happen last week. He had been diving to 125 ft.
Is this a normal occurance and one of the risks that freedivers put up with while doing constant ballast dives or any type of dives to deep depths? Is there a way to lesson this occurance, and once it happens are you predidsposed for it to occur again?
Is there any literature out there that studies this?

Aloha, Daryl

[naiad]

What are blebs and which part of the body are they found in?

Lucia

[Herbert]

Hi Daryl,

most of the competitive freedivers have at some point been spitting blood. My doctor told me, if it happens on a regular basis, I should be examined to see where that blood comes from. Little amounts now and then is nothing to worry about, in my opinion. Some freedivers reported to be short in breath and spitting blood for several days after the dive. That would make me think.

Concerning depth, I find 100ft quite shallow to spit blood, but on the other hand, there is the theory that it is not only the depth, but a combination with strong contractions.

I started spear fishing 2 years ago, so I know 100 ft is deep for spearing.

From my experience in constant weight, I remember having some troubles when diving in the 200ft range. After that I was surprised, when diving deeper the next season, not having any problems any more. The other season I was diving 6 times to 330ft in 3 days. I was spitting blood on the 1st day, but did not have any problems on the succeeding days. This season I started No-limits (going a lot deeper) without any problems. After a short break I did some constant and spit very little blood on the first day , but not on the other days?

I was looking in a dictionary, but didn’t find what you meant by “blebs”.

Good luck,
Herbert

[DeepThought]

Blebs = bubbles. I still don't know how they are related to this.

This phenomenon of spitting blood after freediving is called 'lung squeeze' in lay terms, assuming the blood is coming from the lungs. From your description of not being able to dive afterwards and diving shallow the next day and spitting blood for more than one day it sounds like a lung squeeze (other options are sinus squeeze and trachea squeeze). Other common symptomes are wheezing sounds at the end of the breath and not being able to inhale/exhale completely. Lung squeeze blood usually tends to look a little different than blood from other sources - small specs of blood, sometimes not completely red.

The old conception about those squeezes are that they are likely to happen only at depths at which the diver exceeds his lung's residual volume - if the residual volume is 25% of the lungs than below 30 meters, if 20% then below 40 meters, as only then enough negative pressure will form in the lungs, and if there is no sufficient pulmonary erection (engorging of pulmonary capillaries with blood to compensate for the negative pressure) some small blood vessels might burst and some blood will get into the lungs.

Lately there are more and more reports of people getting squeezed at much shallower depths, it has happened to me once at 25m, and there are reports of many squeezes in JumbBlue competitions that are being held at only 15m of depth.

The main suspect is strong contractions. Descent speed and sudden movements that affect the rib cage (extending arms/stretches) are also speculated to increase the chance of a squeeze.

There are a few general recommendations to try to avoid those squeezes:
- Doing lung/rib cage relevant stretches before a dive session.
- Increasing relevant area flexibility (especially of the diaphragm, try searching for 'udayanna banda' on these forums).
- Reducing descent speed.
- Getting acclimatized to depth gradually (warming up to target depth and also increasing depth very gradually over a long period if training for depth disciplines). Practicing negative pressure dives - half lung dives to shallow depths, increasing depths from 5 to 20 meters during a practice period of months. Practicing empty lung dives is more risky as you are more likely to get squeezed during.
- Relaxing all unnecessary muscles while diving, especially the diaphragm - using mouthfill frenzel equaliztion isntead of valsava for instance.
- Increasing CO2 tolerance to reduce contractions at depth - might be dangerous for a spearfisher as it might make it easier to exceed his time udnerwater.
- Avoid diving after a squeeze, the minimum recommended rest period is 2 weeks, but I heard of months as well.

Theory says that getting a lung squeeze will leave some scarred tissue in your lungs, the scarred tissue is less flexible, so afterwards you are more prone to get a lung squeeze.

A bad lung squeeze can kill you, either by drowning in your own blood or just by getting you so much more hypoxic from impaired gas exchange that you'll drown from a relatively easy dive.

I think those squeezes should NEVER be accepted as a normal risk of diving, people have dove to amazing depths without suffering them, it's just a matter of training and predisposition.

This issue has been discussed on several threads so doing a search on 'lung squeeze' might generate more info. I tried to sum all that I can think of now in one post as the info is pretty scattered. I think there might also be an article about this on db main page.

Good luck avoiding those permanently.

[Adrian]

Hi Daryl,
I've moved this thread to the safety section and here there's another similar thread with lots of info: http://forums.deeperblue.net/showthread.php?t=60742

Adrian

[Daryl Wong]

Hi Spearos,

Thaks for the great information. Lung squeeze is what I am interested in. That is what I had. I didn't konw that is the term for what I experienced. I'll be checking on the safety section and doing a search now that I have an idea of what to look for. My main concern was to find out how serious this is, how often it can occur, prevention, and how long it takes to heal.
Deep thought Thanks for the great information.
Herbert thankyou too. I will be researching this phenomena, because I am interested in trying just for my own personal quest to get into the sport of freediving. It looks like fun and theres always something new to learn.


ALoha, Daryl

[ezeeverett]

just got some information from my doctor about blebs, which i do have. he said that i should no longer scuba dive because pressure can cause the blebs to break and cause your lung to collapse. this may or may not be part of emphaseyma from smoking. blebs are just air pockets within the lungs and the wall. any information can be found on any websites talking about blebs. i was encourages to no longer scuba dive...just a warning.

everett