Muscle cramps, nausea and ear pain--don't let
annoying problems like these end your dive.
By Samuel Shelanski, M.D.
We learn
during certification that water magnifies objects. It can also magnify
problems, making minor physical ailments loom large at 60 feet. Identifying
problems and knowing how to deal with them under water can make diving safer
and more enjoyable. So next time one of these problems strikes, stay calm and
use these techniques to end the problem before it ends your dive.
End Ear Pain | Make Cramps Disappear | Beat Seasickness | Reverse the Squeeze | Stay Smooth, Stay Calm
Problem: I get pain in my ears when I'm
descending due to difficulty equalizing. I blow and blow and it doesn't seem to
help.
Diagnosis: Squeeze. Once you feel that pain in
your ears, it's already too late to start equalizing. It only takes a small
pressure difference between the inside of your ear and the outside to squeeze
the eustachian tube shut, preventing you from equalizing no matter how hard you
blow. In fact, blowing too hard at this point can cause damage to your inner
ear.
Quick Fix: Relax, ascend until you no longer
feel any pain and then equalize. Resume your descent, slowly, making sure that
you equalize continuously. If ear squeeze is a problem on every dive, you may
benefit from using a decongestant before diving (see "Equalizing Made Easy").
Problem: Sometimes my leg muscles start to
burn or tense up painfully when swimming against a current or chasing my buddy
around the reef.
Diagnosis: Leg cramps. They occur when exercising muscles use up
oxygen faster than the blood can provide it to them. This change in the muscle
metabolism causes a buildup of lactic acid in muscle tissue that results in
cramping.
Quick Fix: The most important thing to
remember when you have a cramp--whether in the legs, stomach or any other
muscle--is to stay calm and breathe deeply. If the cramps are in your calves,
you can help get rid of them by grabbing your fin tip on the affected side,
straightening your leg and pulling on your fin to stretch the cramping muscles.
To prevent leg cramps in
the first place, many divers find it helpful to switch their kicking styles
when swimming a long distance or against a current. Alternating between a
flutter-kick and a frog-kick is helpful because different muscles are used for
each type of kick. Cramps in the stomach or other muscles will pass in a minute
or two if you remain calm and breathe deeply.
The best way to prevent
cramps is to maintain good physical condition. The better your condition, the
longer it will take for lactic acid to build up in your muscles. Diving is not
usually a strenuous sport, but when you encounter an unexpected current, or
have a longer than expected swim back to the boat, it's best to be fit. You
will be a happier and safer diver for it (see "The Complete Diver Workout").
Problem: Sometimes when I dive I get really
queasy. What should I do?
Diagnosis: Seasickness. If you're prone to mal
de mer, you already expect to get seasick on a moving boat and probably take
medications like scopolamine, bonine or Dramamine. You might be surprised,
however, to find you can even get seasick while diving. Floating on the surface
in swells or chop, or diving in surge can both trigger symptoms.
Quick Fix: If you're feeling seasick, be one
of the first divers in the water. Most people will feel much better once they
get below the surface. Beware of suiting up too soon, however. Wearing a
wetsuit in the blazing sun can lead to overheating and make nausea worse.
Nausea can also occur under
water, most commonly in nearshore surge zones or shallows affected by wave
action. If you are being buffeted by waves or surge, try to drop down to
calmer, deeper water.
And if you have to vomit
while diving? Personally, I favor removing one's regulator, vomiting, and
replacing the reg. Others argue that it's better to vomit through the reg.
Either way, you should purge the reg before inhaling. It really doesn't matter
which method you choose, as long as you stay calm, remember to breathe and
don't inhale water. Most people will feel 100 percent better after vomiting and
can complete their dives. If you still feel nauseated after vomiting, end the
dive immediately (see "Quick Cures for Seasickness").
Problem: I never get squeezes, but sometimes
when I surface at the end of the dive I get pain in my face around my eyes. Why
is that?
Diagnosis: Reverse squeeze. Although more
commonly felt as pain in the ears, a reverse squeeze can also affect sinuses
and cause facial pain. Whether it's your ears or sinuses, the solution is the
same.
Quick Fix: Deal with the situation as you
would a squeeze, but in reverse. Descend until you no longer feel the pain,
then slowly ascend. Yawning, swallowing and moving your jaw side to side may
help equalize your air spaces by opening the eustachian tubes.
If you frequently use a
decongestant before diving, make sure it won't wear off until well after the
dive is over. That 12-hour Sudafed you took before your morning dives may not
last through the night dive and the rebound congestion that can occur after
using some medicines can increase the likelihood of a reverse squeeze.
Problem: I'm an experienced and confident
diver, but I often feel nervous, agitated and paranoid when diving deep.
Diagnosis: Nitrogen narcosis. The so-called
"rapture" of the deep doesn't always make you feel euphoric; it can
also make you paranoid. Other symptoms may include dizziness, ringing in the
ears, reduced motor skills, trouble reading gauges and a sweet or metallic
taste to your air. The effects of narcosis are highly variable but they start
affecting divers at 60 feet and studies show all divers experience some
narcosis at depths greater than 100 feet. While nitrogen narcosis itself isn't
dangerous, a severely narced diver can't be trusted to behave rationally or
safely.
Quick Fix: When symptoms are felt, stay calm
and concentrate on ascending slowly and cautiously. The effects of narcosis
dissipate rapidly at shallower depths and you can resume diving once your head
clears. Avoid diving deep if you are taking prescription or over-the-counter
medications--including decongestants and motion sickness medications, which
have been shown to intensify the effects of narcosis.
Other factors that magnify
the effects of nitrogen narcosis include carbon dioxide buildup due to shallow
breathing (concentrate on exhaling fully if you feel narced) and poorly
performing regulators; fatigue and stress. The fixes here are preventative:
maintain your gear and be physically and mentally prepared for the dive (see
"Your First Deep Dive" and "Narced No More").
As
important as it is to recognize and deal with minor problems under water, it's
even more important to be aware of big problems that you shouldn't try to fix.
As much as you hate to shorten a dive, it's better than shortening your life.
Get to the surface--and a doctor--as soon as safely possible if you experience
any of these symptoms:
Chest pain or pressure
and difficulty breathing. Heart attacks are suspected as a contributing cause in a significant
number of diving deaths. Heart attack pain is classically described as feeling
as though an elephant is sitting on your chest, and the pain frequently
radiates down the left arm and up into the neck. This is usually accompanied by
difficulty breathing. The threat of heart attack is greatest for male divers
over the age of 40 and those in poor physical condition.
Problems that can manifest
themselves as stabbing chest pain include a collapsed lung (pneumothorax),
constriction of the airways (bronchospasm) such as is seen in asthma, and panic
attacks. End the dive immediately if you experience these symptoms.
So what to do if you are
swimming along and develop chest pain? Stay calm, attract your buddy's
attention, and surface slowly. Make sure that your buddy is within arm's
reach--should you lose consciousness, your buddy can ditch your weights and
bring you to the surface.
Seek medical assistance if
the pain persists. Hopefully, you will find that you overreacted, but that's
preferable to winding up as a fatality.
Numbness or tingling in
any part of the body.
This is especially important for nitrox divers. One of the earliest symptoms of
oxygen toxicity is a numbness and tingling in the lips. Symptoms can escalate
rapidly to convulsions, so ascend immediately. Susceptibility to oxygen
toxicity varies from diver to diver, even from dive to dive. Any sensation of
tingling and numbness while diving nitrox--especially within 30 feet of the
depth limit for your particular mix--is a serious warning sign. Ascend
immediately.
