Abdominal Pain from Packing? - Help?

[wes]

I have been waking up with abdominal pains at night since I came home from Grand Cayman Comp Deja Blue III 4 weeks ago. It happens severely two to three times a week, sometimes many nights in a row and sometimes one night than not for a few nights.

I have been under alot of stress since I got back so that may be related too. It feels like the kind of pain I get in the lower abdomin (below my belly button) that I have gotten from getting food poisoning. When this happens, and to me it happens only1 day every 2 or 3 years, I get intense pain like I have now, except there is alot of belching and burping and it slowly gets worse maybe 3-6 hours after I ate the bad food and then goes away. I have never had abdominal pain from food poisoning two night in a row, especially when I don't feel sick or any pain during the day.

The reason I think it may be from packing, and maybe air getting "stuck" down in my stomach then somehow "pushed" into my lower intestine and then causing pain at night is because I haven't have any pain at all for 5-6 days and haven't been to the pool either, and then yesterday I went to the pool and tonight I had the abdominal pain again so think maybe is connection.

I was training for dynamic apnea in the pool for the comp so set up my weights so I would pack 20-25 times when practicing dynamics. I haven't changed my weights back so have been still packing like this at the pool when I swim, not because I normally pack like that, just because my neck weight is set at 9 lbs so if I don't pack I will sink too much.

Normally when I do pool train in dynamics I don't pack or pack maybe 5 times only.

This time I packed 20-25 times for dynamic practice every time I went to pool to train 2-3 times per week for maybe 3 months before the comp then at the comp (was 19 days) was packing like this for depth and pool dives. I didn't have any pain like this before training or at the comp, only now that I got home.

The other things I can think of is stress or some parasite I got from traveling to Cayman.

Would be great to hear any ideas or anyone who has had similar issues.

For sure is not pain in my chest or pain while breathing. Is steady pain from my abdomin below my belly button, that is constant whether I breathe or not.

I will change weights and not pack at pool for a couple weeks and see if goes away to test this theory anyway.

Thanks and Cheers - Wes Lapp

 

[Simos]

I am only a beginner Wes but if I were you I'd definitely stop all freediving/exercise until I get it checked out by a doctor - it could be so many things it would be really hard for anyone to guess and be 100% and some abdominal pains are more urgent to check out than others. Better to be safe than sorry with these things in my opinion.

 

[wes]

Simos,

Thanks and your advice that abdominal pain can be really serious is true. At age 10 I had strong side ache for about 1 week and finally I agreed to go see the doctor and he said it was my appendix, my dad said when should we have it out and the doc said "right now!".

As you gain more experience with freediving you will probably find like I have that anything that is freediving related to get help from "regular" docs is almost worthless. At same time there are really good docs and individuals with tons of freediving type experience and this kind of advice is very precious.

Cheers Wes

 

[Simos]

I know exactly what you mean Wes - still worth a visit I'd say, they sometimes get what it is, depends on the case (sometimes way off the mark though!). And at least if it's something odd and non-freediving related like a parasite they might find it.

Could be anything really. About 10 years ago I did an open water SCUBA course - after consecutive daily dives and some snorkelling, I went back to my house and felt an odd abdominal pain. I gave it a rest, it felt better and after a few days I tried diving again, got the pain again.

I thought it was something from the pressure etc but turned out to be the start of an inguinal hernia. I can only guess that lots of hours finning or something must have triggered it - managed to get away without having to fix it in the end.

I don't know your dive profiles, but apart from the obvious thing to consider (i.e. that it must be related to packing), abdominal pain can also be linked to DCS. Do you have any other symptoms? It might be worth checking it out with a diving doctor...

 

[Simos]

The other thing that I can think of (that might be related to packing too) is some kind of alveolar tearing (maybe because of packing or some lung squeeze or combination of the two) allowing air to escape into lung tissue and from there elsewhere, like the abdomen.

Whatever it is, I definitely don't think it's worth packing at all or even freediving until you've checked/sorted it out. If it is some kind of injury like this I think it needs to heal properly, otherwise it might start re-occurring often.

Sorry don't mean to stress you out in any way - just a few things that come to my head since you asked for ideas of what it could be!

I know you have a lot of experience and I'm fan of some of your awesome swims like the recent DYN record, so I'm writing the above in full knowledge that it's most probably newbie rubbish going to an expert

 

[Simos]

I did a quick search for anything else that might be the culprit Wes, found this too:

http://forums.deeperblue.com/freediving-science/89084-median-arcuate-ligament-syndrome.html

Maybe packing aggressively can in some way cause this but from that thread, it doesn't seem to be related to freediving at all.

Anyway I'm just wasting time until Trux jumps on the thread and tells you exactly what the cause is

 

[BennyB]

I did a quick search for anything else that might be the culprit Wes, found this too:

http://forums.deeperblue.com/freediving-science/89084-median-arcuate-ligament-syndrome.html

You beat me to this Simos. I was diagnosed with MALS in late 2010. I'll get to that in a sec.

First question to you Wes - have you noticed that the pain is triggered not long after eating? And if so, have you noticed if eating fatty foods specifically triggers it?

Second question - do you still have your gall bladder and have the doctors checked for a gall bladder infection? I can't recall the name of the test but the Dr presses down in the quadrants of your belly, releases and listens for an audible sound (and signs of pain).

My experience back in 2010 sounds a bit similar to yours. The abdominal pain was close to crippling, always after food and would last an hour or so then just disappear - a bit gassy as well and associated gas pain. After 3 mis-diagnoses (all from out of hours medical centres where my wife took me when the pain got too bad) I got to my regular doctor who tested for gall bladder and I had a positive response. An ultrasound was taken as an extra check and that's when the MALS was identified. So rather than taking my gall bladder out I had more tests was sent to an specialist who confirmed it and gave me the option of waiting for it to go away or keyhole surgery to repair. I waited and it went away. Since then I have had maybe 2 or 3 unexplained abdominal episodes in the proceeding 2 years but nothing remotely near what I had then.

MALS is quite rare and is essentially one of the ligaments that wraps around the Aorta and moves up and down with your breathing (it's attached to the diaphragm. Upon exhale it moves up and contracts, it looks identical to your index finger curling up. This cuts off the blood supply momentarily from one of the upper branches off the Aorta which supplies the abdominal area, which causes the pain.

MALS symptoms are very close to Gall Bladder infection symptoms and have similar triggers (fatty food). I suspect in my case I had a Gall Bladder infection and it was by chance that MALS was identified.

This is, of course only two possibilites and you should definitely see a Dr to rule them out - they are both very simple to diagnose (pressure test from Dr for Gall Bladder and ultrasound for MALS). Gall Bladder would be the worse of the two as there is infection involved. But, i'm not a doctor and my knowledge of this is limited. But, from what i've seen many doctors don't know MALS either (10% of the population have the condition and 1% of those have problems with it - my doctor had to look it up on Wikipedia!).

I don't really have any issues with freediving and MALS - I thought as the condition is brought on by exhaling then it would be a depth-triggered event, but since diagnosed i've been past 50m a few times with no recurrance. Packing does not seem to influence it. The only thing I would maybe suggest is that I have an absolute hatred of negative dives, i'm not sure if this is caused by MALS or me just being a bit of a girl

I hope some of that helps, let me know if you've got any specific questions and i'll try to answer them.

Cheers,
Ben

ps I just realised Simos' link was my original posting - I thought it was the wikipedia article. Wikipedia has good info on MALS, just ask my doctor...

 

[wes]

I think the abdominal pain is an alergic reaction to shell fish. I have been eating smoked canned baby clams and oysters quite frequently and do it when I am super busy as its an easy dinner with salad and vegetables. I also tend to do pool training when I am stressed in life as this is the best way for me to relax, so heavy packing with pool training overlapped with shellfish consumption. I stopped heavy packing (only 5-10 packs to "top off" lungs) and stopped eating shellfish too and no abdominal pain for 3 weeks or so. Then last night up at midnight and couldn't sleep and had a can of oysters and got the abdominal pains about 5 hours later which callibrates with internet symptoms.

Thanks for all your help and I will pay more attention to figure this our more exactly - Cheers Wes