Advice/Help required please

[charlieg]

Hello Everyone,

This is my first post. I am not normally one for placing posts on forums such as these, but needs must.

I have been freediving for about 9 months now and train 3-4 times a week. Unfortunately, freediving affects me in a number of ways which I feel are getting worse instead of better.

The first is nausea. Lately, I have been doing 75m-100m repeats with 1 min 30 - 2mins recovery. After about two swims, I feel extremely nauseous and need to be sick.

The second is much more embarrassing for me and is a gastro-intestinal problem which I feel is similar to that which is known in running circles as "runners trots"/"runners diarrhoea". Sometimes, I can suffer from this 3-4 times in one session. I find it extremely worrisome in case I cannot make it to the bathroom in time. I also find it very embarrassing running to the toilet so often in an one hour session. Often, I have to abort a long swim to run to the toilet even though I feel fine breath hold wise. I have tried not eating anything before training. I normally train in the evening. However, I then feel sick and extremely low in energy and get cold much quicker.

Does anyone suffer from this or suffered from it in the past that can give me some advice? These things happen when I/and my body feels stressed. However, I really believe that to improve, you must stress the body so it will adapt.

Conversely though, I believe these problems (especially the latter) are hampering my progress in and enjoyment of the sport.
I would sincerely appreciate if anyone could give me some advice or at least reassure me that there are some other people who suffer from this and that it can indeed be overcome.
Thanks

[Tony Babowicz]

Charlieg,
I suffer the same as you,except maybe not as extreme. If I do more than one 75-100m dynamic with just a minimal rest interval, you will see me running to the bathroom everytime regardless of what I eat or time of day. Last Sunday, I was doing some statics. 2min breath, 2min hold. 3min breath, 3min hold.4min. breath, 4min hold. 5min breath, 5'30" hold. I surfaced in a panic as I thought I would not make it to the bathroom. My safety buddy asked me why I had surfaced so soon (I was really having a good static) and I had to explain to her that duty was calling. She has done dynamic with me in the past, so she understood and we had a good laugh.
What I have noticed is that after I do my business and get back in the water, my reflex comes back really quick and my second dynamic after is usually really good. It must have something to do with high CO2 buildup and strong contractions. That is just my opinion and I haven't had an expert opinion on this but it makes sense.
As far as the nausea goes, I'm sure it has something to do with lactic acid buildup. I have actually vomited once from this. We were doing 25m underwater sprints. Our rest interval comprised of dolphin kicking on our back 25m and immediately start the next 25m sprint. By the sixth one, I was leaning over the pool deck vomiting my guts out. I've have been told by some very knowledgable people that this is not uncommon for intense lactic acid buildup. Your body is merely trying to flush it out. I'm starting to believe that this is the price you pay to improve. I don't workout like this more than once per week. The other days that I am in the pool, I cut my distances considerably and try to make it relaxing and fun.
It would be nice to have an expert in dive physiology make sense of this for us and maybe help us to better design our workouts... anybody,anybody?...

[trux]

Well, I am not an expert, but it is an interesting topic so I googled it up, and found indeed some interesting information.

Tony is certainly right that the nausea and diarrhea are primarily caused by the lactic acidosis. Blood shift (hence reduced blood flow in the digestive tract), and strong diaphragmatic contractions during prolonged apnea likely aggravate the situation further.

The tolerance to lactic acid increases with training, but if you experience such problems since a long time with no improvement, there may be some additional factors involved. Dehydration or over-hydration are the most obvious ones (more about it for example here: Puking After Working Out).

You can also ask your physician to test your liver - it is the liver that breaks down acid lactic, so if it is not all right, you can indeed have more problems than others do. You can also ask the doctor to do a resting lactic acid test, to see if the resting level is not pathologically increased. More about it here: Lactic Acid

I found some excellent threads in a martial art forum. Read through them, there is some excellent info and good advices. Especially the guy with the nick MikeMartial posts excellent information:
Why Do We Puke When Exhausted? - Sherdog Mixed Martial Arts Forums
Anything to reduce WO nausea? - Sherdog Mixed Martial Arts Forums

Some quotes from the threads:

The Gastrointestinal System and Exercise
It's well established that intense exercise (e.g., >85% VO2 max) shunts blood away from the GI tract and slows down digestion and absorption. However, at exercise intensities that ultra cyclists use, digestion is not impaired, provided hydration is maintained.
...
The sensation of nausea and subsequent retching/vomiting is controlled by the vomiting centers in the reticular formations of the medulla (in your brainstem). It receives signals from four sources:
1. the chemoreceptor trigger zone (see below)
2. visceral nerves from the GI tract (ate something bad, stomach flu, food poisoning, etc)
3. visceral nerves from outside the GI tract (e.g. gall bladder stone causing you to vomit, heart attack causing intense nausea, etc)
4. nerves from the extramedullary centers in the brain (e.g. bad odors, fear, motion sickness, brain injury)

What I want to focus on is #1, the chemoreceptor trigger zone. This "zone" is located in your brainstem and gets activated whenever an abnormal systemic, whole-body event is happening, like hypoxia, diabetic ketoacidosis, uremia, vomit-inducing drugs, AND IN THIS CASE, lactic acidosis.
...
"The anaerobic threshold (AT) is the exercise intensity at which lactate starts to accumulate in the blood stream. This happens when it is produced faster than it can be removed (****bolized). This point is sometimes referred to as the lactate threshold, or the onset of blood lactate accumulation (OBLA). When exercising below the AT intensity any lactate produced by the muscles is removed by the body without it building up.

The anaerobic threshold is a useful measure for deciding exercise intensity for training and racing in endurance sports (e.g. distance running, cycling, rowing, swimming and cross country skiing), and can be increased greatly with training."

They contain also some advices how to reduce the nausea:

Hydrating might have a slight effect in prolonging the duration of exercise time before experiencing nausea (fluid increase may reduce concentration of lactic acid in the bloodstream slightly), but if you're exercising past your anaerobic threshold, hydration will only be a temporary measure before the inevitable happens.
...
NaHCO3. I can sell you some, but it'll cost you, and I have to disguise it in the mail....

Seriously, try some sodium bicarb, aka baking soda. There's a few things floating around on it, and for something like 20 rep hell programs, it just may do the trick to buffer that excess lactic acid.

More files on the topic are for example here:
Ultracycling: The Puke Files
Puking After Working Out
Post Workout Nausea - MESO-Rx
lactic acid nausea OR diarrhea - Google Search
puking exercise - Google Search


PS: could someone click below on the link "add tags" and add the tags "nausea" and "diarrhea"? I already exhausted my limit of 2 tags for this thread. Also, moderators should consider changing the thread title to something more describing the topic. I think it is an important topic, and many freedivers may be interested in it. The current title won't attract a lot of attention among most people. Something like "nausea & diarrhea during training" may be better suitable. And moving it to the Freediving Science subforum may be a good idea too.

[Tony Babowicz]

some great reads there Trux, thanks.
One concern about sodium bicarb, I regularly feed it to my horses before intense workouts with the intent to help absorb lactic acid. (Its common for a high spirited performance horse to cramp up or as we say "tie-up" near the end of their workout.) It has been brought to my attention that the absorbing of lactic acid by sodium bicarb builds CO2 in the body, and if we are training while in apnea, this might pose a problem for us. What are your thoughts on this? Thanks.... Tony

[trux]

You can read about the effect of sodium bicarbonate on breath-hold diving here:
sodium @ APNEA.cz

(Basically it is rather positive)

[charlieg]

Hello,

Thank you for replying. It reassures me to hear that some other people do in fact suffer from these problems. The reason for the vague title was because I felt somewhat embarassed about this problem. When I am training with a group of people, I am the only person who suffers form these problems and therefore I find it difficult to say..."excuse me, but I get very bad diarrhea", while I make for the toilet at a sprint. The sickness I don't mind so much. I can control it and if you need to be sick no-one really gets offended if you puke at the side of the pool or in a bin. The other though...well…

[trux]

Frankly told the above mentioned documents or threads spoke more about nausea than diarrhea. Till now I got only little information when searching for diarrhea and lactic acid, and most of it speaks about the positive effect of the lactic acid bacteria.

I suspect the diarrhea may be caused by the diaphragmatic contractions and vasoconstriction. I did not look up the search results closely, but see some hits for the term diarrhea here in the forum search, and there are some documents for the expression "apnea diarrhea" in Google. I just head to bed so won't research it now, but hope you or someone else can look at it closer in the meantime.

[trux]

BTW, although the sodium bicarbonate may help with lactic acid, it would actually make the diarrhea problem worse, not better. Eric Fattah wrote about it more than once here on DB: check out for example the following threads. And unlike the above mentioned research he also denies positive effect on the breath-hold time:

http://forums.deeperblue.net/freediv...tml#post215994
http://forums.deeperblue.net/freediv...rch-study.html
http://forums.deeperblue.net/general...rformance.html

[charlieg]

Thank you for these links. I googled apnea/ diarrhoea like you suggested, but I could not really find anything really of interest. It was only a very brief search though as I was at work.
Yes, from experience, I feel the nausea is caused by lactic acid build up. Often, my legs just will not work and are painful after a number of sprints or long repeats. I do seem to be less tolerant to lactic acid than the other people in the group as they can go a entire session and not feel sick whereas I can only do a few repeats and feel extremely unwell. Maybe, I will just have to do a number of lengths normal swimming to dissipate the lactic acid between each dive. I do not want to do this as it will remove the stress that was placed on the system that the previous dive created i.e. the rest period will be greatly increased.
I also agree that the diarrhoea is more likely to be caused by contractions. However, in the water, the contractions I have are on the whole quite mild. Sometimes, though I can get contractions very early in a dive (after 30m) and early in a session. Therefore, the entire training session is ruined or interrupted. It has been suggested that this may just be part of my dive reflex - I am not sure. I really just wanted to find out if other people had experienced this, and if maybe it will go away with time.
Maybe, I should just learn to accept that both these issues will be part of my diving experience. Maybe then, the psychological
element of the anxiety that is causes will lesson and in turn reduce the problems.

[trux]

You should try making an intensive session of hypocapnic static training to see if it has diarrheal effects too. At such training, you do not really achieve any deep or prolonged hypoxemia, and do not use muscles, so the lactic acid build is rather limited. In contrary CO2 will be high and you will likely experience strong and long contractions. That should help isolating the culprit of the diarrhea - if such training has the same effects, then the contractions and blood shift are likely at its origin. If it has no or a weak diarrheal effect, then lactic acid may be the reason. In that case testing your liver and resting lactic acid level may be wise to exclude some pathologic factors.

Such a session of about an hour may look like follows:
1) warm up (i.e. 3-4 easy apneas of 1-2 min slowly exhaling underwater until empty lungs)
2) 2-3 moderate empty lung apneas with relatively short recovery (30s)
3) 10 minutes of same length apneas (i.e. 1 min) with only a single exhale/inhale cycle between them. Try keeping the breath-hold length same or longer as you progress, do not decrease the time. So you better start quite easy - it will become hard at the end.
4) Classical hypercapnic table - i.e. apnea of 2 min + rest 1:30, 2 min + 1:15, 2 min + 1:00, 2 min + 0:45, 2 min + 0:30, 2 min + 0:15, 2 min + 0:15, 2min + 0:15, and the last 2 min apnea (increase the 2 min apnea accordingly to your level - usually around 50% of your PB is OK)

Also try comparing dry and wet training - possibly water getting accidentally into your mouth and gastrointestinal tract may be a factor too, or it may be the temperature that play a role too.

You can also try changing your diet - i.e. eating rice, but early in the day, not directly before the training.

[naiad]

Charlie, you are much braver than me, I would have given up if that happened to me!

Seriously, if you are experiencing actual vomiting or diarrhoea during training sessions, I think you should reduce how hard you train, at least until you have found some sort of solution to the problem. It doesn't sound like a healthy thing to be doing.