Humbly Requesting Advice

[Ntrik]

Hello

Great forum.

I get an overwhelming vomiting sensation after about a minute underwater. I am a spearo and ever since I got this really bad cold with coughing fits 2 years ago I suffer from this problem. The deal is that I can easily do 3min static out of water and was accustomed to great ease in holding my breath underwater. Today there are days that I have to break of my dive cause I feel like vomiting or dizy or even cause I feel as if I will start coughing.

I have been to countless doctors, have had x-rays, been on medication to kill alleged bacteria colonies in my bronchi but no luck. I dont smoke, I work out and still cannot get back to diving in peace.

Its forever been pissing me off.

Advise please

 

[Erik]

Have you had your ears checked out? Maybe something happened to mess up your balance mechanism when you got the cold....sounds like vertigo to me, which is usually caused by ear problems.
best of luck,
Erik Y.

 

[DeepThought]

Does it happen in warm water as well?
since you live in the UK, my definition of warm water is 25c and warmer....
Has doctors tried to examine your Inner ear thoroughly? I'm not sure x-ray would show all the delicate tissues....

The only advise I can think of for now is to not give up on this!

 

[Ntrik]

Eric

I must confess that I have not thought that maybe my ears are to blame...perhaps cause I have no problem compensating. But it is a good point nonetheless and well worth checking out. Problem is that when I tell doctors that I want to be ok to dive deep they look at me as if I am from another planet. Id really like to see a specialist in dive physiology at some point but cant find one here in the UK.

Michael
Thanks for the encouragement.
It happens primarily in the warmer waters of cyprus and the aegean sea where I dive deeper in summers. Here in the UK the sea bottom and the vis is very "uninspiring" so I seldom go beyond 7-8 meters for speargunning. So I sort of avoid the problem by decreasing the bottom time so as not to irritate my lungs and start coughing. More specifically when it "hits" as soon as I get a contraction I either feel like vomiting or really need to cough and when I get to the surface I feel very disoriented for a while.

Regards

Nikos

 

[LioKai]

Aloha Ntrik!
My question is specific:
Does the problem occur while going deeper, or does it occur at the beginning of the return to shallower depths? Or after a certain period of time underwater?
I get a similar problem at the start of the return to the surface.

Matthew

 

[Ntrik]

Hello LioKai

It occurs after I have been underwater for some time. Depending on whether the day is a "good" or "bad" one it could be in the middle or towards the end of my apnea. In the past even in extreme cases where I had gone too far and felt in the ascent a potential samba coming on I was always disciplined enough to stay relaxed and keep my pace.

Now occasionally out of the blue I have to break off the dive and ascend like a madman cause I feel im going to vomit. It does not always happen but I can always make it come on if i employ a spearo technique where I have to increase my usual bottom time.

Yes the problem becomes more intense as I get to the surface (perhaps the expansion of the lungs) and sometimes end up vomiting out of the snorkel.

To be honest it has been getting milder over the past 2 years, but has limited my bottom time and prevents me from going deeper as I get paranoid that I will not be able to make it to the surface before I vomit.

Salutations to Hawaii

Nikos

 

[LioKai]

Sure sounds like a gas expansion problem in the middle ear.

You could have scar tissue deep in your ear that is causing a mild blockage of proper gas flow and expansion. The fact that you can control the effects of the problem by remaining relaxed is resulting in a controled slower ascent. The slower ascent is allowing the air in your middle ear to equalize to some degree. Correct me if I am wrong here but are the vomitious sensations more intense with a faster ascent? If so then you might want to go to a doctor who specializes in the ear nose and throat catagory.

Something else to consider for help is an accupuncturist and a person who specializes in food disorders and food alergies. Naturalpathic medicine is growing in popularity here in Hawaii. Accupuncture treatments are now covered by my health insurance plan.

Many of my so-called diving related problems are in fact diet related issues. My NP doctor gave me a list of specific foods that I should eat, and a list that I need to avoid. I realized that I have an alergy to eggplant, it causes my tongue and throat to swell. Once I began eliminating certain foods from my diet I became a much happier diver and human being.

You must really love to dive if you continue to deal with the probability of blowing chunk through your snorkle.

Matthew J D'Avella

 

[aydin]

hiatus hernia??reflux??

Hello Ntrik,
I am a pediatric surgeon and a spearo as you.I think your problem can be gastroesophageal reflux?? Because at the end of your dive sometimes after the first contraction of diapragm,if you have hiatus hernia or gastroesophageal reflux it triggers the whole event ,choking,vomiting,etc... The problem can be in your lower esophageal spinchter not in your ears I think,Consult to your doctor again...
Hope to meet you in the Aegean sea
Aydýn

 

[DeepThought]

Well, I see that people have thought up a few possible causes.
could you try to trigger this feeling on land?
can you try do a head stand or laying on your bed with head down (less efficient) for a duration of a dive that triggers this thing, and see if you get this feeling?
if not, you might also try doing that with apnea, and see if the contractions while head down trigger it. if not, my guess is that maybe it's not related to stuff escaping out of your stomach, if I understood Aydn's proposel. on the other hand, if you turn slower from descend to ascend, and ascend slowly, maybe it would solve it if it's a pressure problem.

Is there any chance that you're swallow air while doing your breath-up? either by packing or conventional methods? I guess that could triger a reflux as well...

Maybe you can contact DAN and see if they can refer you to a specialist....
keep us updated.

 

[Ntrik]

Thanks for your responses.

LioKai

I am definitely seeking a specialist for the inner/middle ear scenario.

Yes the vomiting sensation escalates the faster I ascend but it comes on sometimes when i lie absolutely still on the bottom in ambush.

I am quite interested in what u mention about accupuncture as I have heard accounts of some remarkable results. Quite surprised it is actually included in your health plan. Very progressive health care u have there.
You Hawaians have got it made what with the deep blue sea, volcanic cliffs, and free accupuncture.
These are good treatments u mention but I have yet to be certain of the cause. I appreciate your thoughts on the matter.

Regards

Nikos

 

[Ntrik]

Hello Aydun

How exactly and from whom can I get a proper diagnosis for what is affecting me? You are absolutely right in identifying these symptoms but what tests would have to be conducted to physically diagnose such a condition.
What sort of doctor specialist do I look for? I say this because doctors here in the UK are very dismissive of any condition that falls outside their "scope of expertise".

Thank you for contributing your thoughts.

Regards

Nikos

 

[Ntrik]

Thanks DeepThought

Yes I can trigger it on land. If I hold my breath long enough once I feel the first contraction I get the vomit choking sensation that Aydun described. I can tell u that much now.

About the other tests you described ill try them later in the evening and let u know, although since the apnea test provokes the condition it already proves aydun's point.

I dont think it is an issue of my diving or breathing technique because I was diving deep 25+ without problems for about 4 years before the condition overtook me (after a bad cold).

What is DAN?

Cheers

Nikos

 

[aydin]

reflux

Hello Nikos,
Do you have a feeling like an acidic taste in your mouth or pharynx,before the other symtoms.I ask this because after a long dive 4-5 hr.,i have too this acidic taste due to reflux .And this acidic reflux can trigger your coughing,etc..
After an contact with your family doctor,I think ,you can admit to an gastroenterologist.A special test,24 hr. esophageal pH monitoring could be made(a little probe will inserted to your esophagus,through your nostril,and will attach to an walkman like apparatus 24 hours and the result will show the pathologic pattern of reflux number,duration ,etc),
do not afraid ,I am using this non invasive test to the children as well.
Aydin

 

[Ntrik]

Hello Aydun

I dont have an acidic taste in my mouth to begin with, However if it comes to vomiting, it comes out very acidic to a degree that I burnt the taste off my tongue for days once. The problem has got milder.

Right after I had had this cold I would have the same vomiting sensation after I exerted myself in some way on land while in the water I vomited after almost every dive until I could not produce anymore of it (Very good way of attracting AJ).

Today like I have already said it happens when I want extra bottom time like in an aspetto for instance or if I dont take a long recovery between dives.

I have no problem with contacting a gastroenterologist and having this test (although id look great in court with a tube up my nose).

Anything to get to the bottom of whats causing this.

Thank you very much.

Nikos

 

[DeepThought]

So you can get this feeling just from sitting infront of your computer holding your breath? with no real connection to diving at all? do I get it right?

Maybe you should take some anti-acid next time before diving, to see if the affect is weaken. I have no clue how those things work, and if they have a drugging affect, so be aware of that.

Hmm, I asked about your breath-up, because in theory, it is possible that you'll change it in small changes during time, and such things can happen... I guess that you're not hyperventilating before holding your breath? (I know someone that gets nausia if he does).

DAN=Diver Alert Network. I have no specifc clue what they are exactly, my impression is that they are a bunch of physicians that deal with diving physiology.
Here are some links:
http://www.deeperblue.net/bio.php/83
http://www.diversalertnetwork.org/

besides that, maybe you should find out if there is some hyperbaric medicine center in the UK. I know that in my country they deal with more than just decompression sickness.

About doctors being insensitive to unusal needs of their patients, it happens here as well. I have a friend who is convinced he can't dive because an MD told him saw, even though I'm certian he didn't bother checking the issue thoroughly. and that was a dive doctor.

I say that if a doctor is insensitive to your problems, than he is not a good doctor.

By the way, if it's attracting AJ's, than what are you complaning about?

 

[aydin]

Micheal is right,maybe I can try the Nikos calling technique of AJ,just kidding..
Micheal is also right in the antacid issue Nikos.You can trybefore your dive maybe instead of other investigations.The antacids have no drugging effect,they only can the pH of your gastric content,the nonacidic reflux may not cause the other symtoms..
Aydin

 

[Ntrik]

Hello Michael & Aydun

Im going to do this test with the antacid's later on today. If I see a marked difference I am seriously going to go out and party.

The links you supply are very useful and will send the doctors team a comprehensive email with my condition.

I did a little research on the hyperbaric medicine you mentioned Michael.
Interestingly, one of the world leading authorities on this subject and the great Jacques Mayol's personal doctor, is a man named Nikolas S. Trikilis.
We have exactly the same name and last name (middle initial also)!!!!
So I figured this is a sign and have already emailed him with my situation and questions of whether we are related.

About my breath up routine its very basic. One minute of 6-8 deep inhalation exhalations followed by another minute of max 3 slower and deeper inhalation exhalations where at the 4th inhalation i dive. Tell me your opinion on this.

Aydun I seriously had to shoot an amberjack this one time on the surface in the middle of a vomiting crisis. I looked very professional as I was tracking the 8kg AJ while I was vomiting out of my snorkel.

Ill let u guys know about the replies I get from the doctors as well as the results of the antacid "experiment".

Grateful for your Help

Nikos

 

[DeepThought]

Hey, that's an amazing coincidence. He can't refuse helping a suspected relative.

About your breath-up, it sounds good to me. do you also pack on that last breath?

About your AJ technic, I really don't know where that puts you on the food chain, eating fish that eat your.... I think that's definitely new to predatory technics, and estreamly cool!