Diving Accident, Self-Responsibility and Balance

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razorbackdiver, you should DEFINITELY have been taught some kind of pre-dive buddy check, no matter what agency's class you took. Failure to do that would be a breach of standards. But even for people who are taught such a check, it seems to be one of the first things people STOP doing, at least until some easily preventable problem reminds them that it's a lot easier to fix things on the boat or on shore than it is underwater.
 
There is absolutely no doubt that the fight or flight response has been an advantage to human survival and we can find actual examples where the panic response gave a person what they needed to survive a specific situation.

However, in the early 1990's tech diving, one of my buddies divined what we took then to be the #1 rule for tech diving:

Tech Diving Rule #1 "You Panic, you die."

Which gave rise to the 2nd rule:

Tech Diving Rule #2 "In case of extreme emergency during a tech dive, see rule #1."


Yes... it's harsh but it was the days of Aquacorps.


One could argue that there is a time and place for panic, but there is also a time and place to not panic.

Thea was not Tec diving... which helped.

You seem like many others to dissociate fear and panic from the fight or flight response.

The emotional response is an inevitable part when the amigdala fires triggering the fight or flight response.

You also seem to believe that panic is the root cause of fatalities.

The root cause is the trigger of the panic and precedes the panic and the panic is an interim event usually in Tec diving preceding death.

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you should retake OW from a better instructor. Your instructor probably missed other things as well, and if it was relatively recent, I would fill out a report to PADI (I am assuming PADI because of the reference to the pre-dive check acronym).

By the way, if you use "begin with review friend" for your pre-dive check, you will likely find one day that you forgot to turn your air on :)
You are correct about other things being missed. My original training agency was not Padi but rather SSI. I don't say that to promote Padi or to knock SSI. It's all about the instructors. Not the agency.
 
I am posting here, frankly, for my own mental health. Since this incident 5 days ago, I am unable to focus, think about it constantly, try and pinpoint exactly where I screwed up, what should I have done differently.
I feel shocky, disoriented, we have been home for two days and still I cannot let this go. I need to talk, de-brief, I feel alone, and stressed and need to talk. And having few other friends who have ever dived, I thought I would ask for your indulgence and allow me to share this incident here.

My husband (non-diver) and I just returned from a 2 week vacation in Eleuthra, Bahamas (2/21/2014). I am a 49 year old attorney from Missouri and essentially a vacation diver, certified, with about 60 dives under my belt. About half of those dives were in Hawaii, the rest off of various islands in the Bahamas. I was certified about 2 years ago.


I have visited this forum hundreds of times over the years for informational purposes. Last night, I joined for emotional reasons. Something really bad happened. I am not sure why. I have always been a strong, capable woman, worked in a trauma center for years, (before going to law school). I took every moment of my PADI training extremely seriously. I have watched and read every account of a scuba accident I could find prior to every dive. Safety is what I specialize in.

But for the last 5 days, I have re-lived this incident a hundred times in my head. I can't sleep, I feel physically weak, I am irritable and angry and shocked and... Just in disbelief that this perfect vacation almost, and I mean seriously almost, ended in my death.

There is no one to blame. I take full responsibility for what happened here. I just cannot figure out the WHY of it. I can't make sense of it, and I am asking for help, here, in doing so. My mental health has taken a big hit, and I have no other experienced divers to de-brief with (I live in Missouri). Any thoughts totally appreciated.

This last Wednesday, February 19, 2014, we went on a one tank wreck dive at Devils Backbone off of Harbor Island, Bahamas. I had already dived a few times during this vacation, and had a blast. It was a 1:00PM dive, there were 3 Dive Masters, and a Master in training on board, all under 30 years old. We had 4 certified divers, including me, and 3-4 discovery divers.

S (head Master) gave us our briefing. He and the Master in training (a pretty girl around 22) would take the certified divers over the reef to the wreck, we would descend and explore, then return through a small swim through (a huge iron pipe about 20 feet across and 15 feet wide). S stated that there would be a little current on the way back, and we should feel free to grab the dead coral to ascend the shallow reef after the swim through if needed.

We swam over the shallow reef and down to the wreck. My videos show the surge tossing us around after we reached the wreck. I had some trouble with my weight belt slipping, and had to fuss with that a bit. I remember being unable to hover to get a decent pic of anything. I had my flash light, and was and was checking out nooks and crannies, but the surge was just... too swift to stabilize long enough to really get a look at anything.

It is likely, looking back, I think I was exerting myself more than I realized. You guys know how cool it is down there, how easy it is to focus on the environment around you and not how you are physically feeling. Between getting that damn weight belt right and fighting the surge, I was likely getting winded.

S turned us around as the dive wound down. I waited my turn to enter the swim through, the only other diver behind me was the Master in training. Still, I was having a blast. I swam though the huge pipe, and began to ascend the reef on the other side. I tried to grab the "dead coral" to pull myself up and over the reef, but couldn't get to it. Every time I reached out, the surge grabbed me and dragged me up and away. Swimming hard, I would go forward two feet, then get pulled back ten feet.

And suddenly, I was tossed to the surface and all hell broke loose. The Master in training was gone, the Dive Master was gone, I was alone. And breathing way harder than I knew I should be. 2-3 foot waves were washing over me, at some point, I topped a wave and saw the boat looking smaller than it should have been. Somehow, right about now, my camera turned on and began recording. Purely incidental, I had no idea it was recording. The first think I hear on the video is myself, shouting "help!"

And I was panting. Remembering my training, I immediately gave the distress signal, waving my arm, and could see that the third diver master, who had stayed on the boat, saw me (I hoped anyway). I forced myself to stop, rest, catch my breath. But I could not catch my breath. My breathing was SO hard and SO shallow, I couldn't get my breath. I dropped my weight belt, trying to calm myself, "never panic, never panic" I chanted to myself. Suddenly, a diver surfaced in front of me. I said "are you a dive master?" he said no, just a diver.

He told me to inflate my BCD, but by this point, I was disoriented, I couldn't find it. I think the other diver inflated it but don't remember. At this point, my breathing was out of control, I was getting no air, I took my reg out, it didn't help. S suddenly appears as well, inflates my BCD, speaks to the other diver. I remember he said "keep your reg in", I told him I can't breath.

I remember, deep in my head, that I knew I was dieing. "Stay calm, don't struggle, deep slow breaths" I repeated deep in my head over and over again. I recall the other diver trying to push against my feet, while S, the dive master, had my BCD, trying to tow me in.

My video shows he was kicking hard, on his stomach, then having to flip over onto his back, kicking even harder. The waves washed over us. I remember looking over my shoulder, thinking we were near the boat. We were not near the boat, the boat was getting SMALLER. Later, my husband and the other non-diver, who had no idea it was me they were towing, confirmed that we were being pulled out and away from the boat.

In the meantime, the dive master who had stayed on the boat, put on his wet suit and stood watching us. My husband has no idea what he was waiting for, he had a yellow bouy in his hand attached to a thick rope, but took no action.

My video shows from the moment I shouted help and signaled, to the moment I saw that yellow buoy, 15 minutes had passed. The video also shows that we were suddenly being pulled hard and fast through the water, the dive masters kicking slowed, and within 5 minutes or so we were at the boat.

My breathing had gotten faster and even more shallow. I pulled myself on the boat, telling them I couldn't breath, help me, I need air, I need air, and collapsed. Unable to move, onto the deck. I have never been sick a day in my life, I was shocked and terrified that I could not even lift my hand, or move a finger. "Air", "Help", I think I gasped. Someone said "get the oxygen!"

Still laying at the back end of the boat, I was also inhaling exhaust fumes from the motor. "Pull me up, exhaust" I said maybe 3 times. Finally they dragged my away from the exhaust.

Later, my husband told me that the dive master who had finally swum out and pulled us in produced and O2 tank from somewhere. But he couldn't figure out how to attached the mask. I could here the tank clanging, knew it was coming, felt some smidge of relief. But it didn't come. It took almost 5 minutes to get the mask on my face. Someone just stuck it on my face and let go. The mask was not on right, the O2 was flowing up my cheek. I grabbed it and tried to get it on right, and finally got a whiff of the golden oxygen.

Then suddenly they took the damn mask AWAY, I could hear more clanking, I am panting SO HARD, and SO FAST and forcing myself not to pass out. "AIR, HELP" I think I said again. Finally, another mask was stuck on my face. My husband later told me they had put the wrong O2 mask on me and had to switch it out for another one.

But no one positioned it. I grabbed it and moved it around until I got the fricking air that I knew somehow I had to have or I was going to die..

We raced back to shore, I am still gasping but getting air. S said, "it's ok, the nurse will be at the dock when we get there", I remember being relieved. As we approached the dock, S said, "ok, they aren't coming, the nurse isn't coming". Then he said "you're out of air but we are almost there" (the emergency O2 tank ran out of air in less than ten minutes.)

We get to the dock, I was able to climb the steps, they sat me in a golf cart (more exhaust, still panting bad, still can't get air.)
They drove me the 3-4 minutes to the clinic. I am in severe respitory distress. We pull up in front of the clinic. Someone shouts "go around back, that door is broken". We drive around back, and a tiny Asian nurse sits me in a wheel chair, but can't get me over the poor stop (she was about 90 pounds, I am about 5'9, 180).

I reached for the door and pulled myself to my feet (I do not know how), and stumbled into the small clinic. But no one was there. NO one was in the hall, I just kept walking, I said "****, help, please, please help". And some lady in a blue jacket saunters up and takes me into a room, I got on the gurney, they put the O2 mask on.

By now, 40 minutes had passed since I signaled for help. It was a 15 minute boat ride to the dive site. My feet were blue, BP 180/140, O2 at 85 (even after the O2 I got on the boat). One of the nurses shouted, "get the doctor!" They start some sort of breathing treatment along with the O2, and within 5 minutes or so, I took a deep breath and smiled. Pure, unadulterated joy, relief, my mind started working, my head stopped exploding with pain, my breathing slowed and BP dropped down to 140/80, all within about 20 minutes.

Later, I learned that S, our dive master, had stopped the Discovery divers from crossing the reef and diving the wreck because the surge was too bad. Later, when the shop owner spoke to us, S told him the current was "much stronger than I thgout it would be". Later, my husband told me about the dive master on the boat, putting on his wet suit yet waiting more than 10 minutes to get in the water and pull us in. Later, the other non-diver said she was confused why he didn't jump in when it was obvious we were drifting AWAY from the boat.

This all happened just 5 days ago. I have no pre-existing health problems. I am about 40 pounds over weight (but a long distance runner up until about 5 years ago). I lead a far too sedentary lifestyle. I was likely dehydrated and had been drinking the night before. I believe that I experienced what is called "exercise induced bronchospasms (EIB)".

Being out of shape, partying on vacation, being a smoker, being dehydrated before diving, all these factors were and are within my sole control. I am fully responsible for pre-disposing myself to physical limitations that can make diving dangerous. I know that. Being aware of these factors, I only go on shallow dives (this one was 27 feet at its deepest), where the water is calm and clear. I don't take risks, I stay with the group, am careful to check my O2 constantly.

This was my fault. I screwed up and could have died from this. I believe it may have damaged other organs as well, I have been having bad headaches and mild chest pain since this happened (going to doctor tomorrow).


There is no doubt I came very near to death because I did not stay on the boat when the Master said "some current". I felt it in my gut and ignored it. My over-estimation of my physical abilities and failure to listen to my gut came very, very close to killing me.

What I do not understand are the following factors I did not have control over, and am aski1. How did I end up out there alone, whng for thoughts on, are the following questions:
en the Master in training was bringing up the rear?;

1. Why was the emergency O2 so difficult to access, then correctly administer (the hole where the air flows from should be under your nose, not askew on your cheek.)?
2. Is emergency O2 supposed to "run out" in 10 minutes?

Again, these are questions. This was an unforeseeable incident for which responsibility lies directly on my shoulders. I just can't figure this out. I am confused and depressed, doubting myself, devastated really. My head still hurts. The dive staff did everything they could to help me. I just don't understand the "why".
Any thoughts appreciated.

you had a crap dive because you had neither the fitness nor the experience for the dive.
Partly the blame should lie with the dm's whose decision it was to plan the dive and decide who does what.

Learn and keep diving just like the rest of us.
 
It's funny when someone just enters the room and joins in a heated conversation! :wink:


More seriously though:
ACTH, adrenaline, noradrenaline.... helped Theas' luck that dive that day.

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Just want to widen the thinking on this. The natural fight or flight physiological response is also that which underlies 'having a blast!'. It is the same basis as the kick that adrenalin-junkies have in extreme sports.

Once the amygdala has pulled the trigger and the adrenal glands have dumped their load, it is not something that can be just switched off. The effect may last some time depending on the amount and manner of catecholamine release, perhaps even up till having a BP of 180/140, 40 minutes later.

But a physiological response is all that it is, no more and no less. Controlling its release is one element of training, managing it after release is another. The individual needs to harness the good elements, like heightened arousal and quick reflexes, and suppress the bad elements, tunnel vision.
 
It's funny when someone just enters the room and joins in a heated conversation! :wink:


More seriously though:


Just want to widen the thinking on this. The natural fight or flight physiological response is also that which underlies 'having a blast!'. It is the same basis as the kick that adrenalin-junkies have in extreme sports.

Once the amygdala has pulled the trigger and the adrenal glands have dumped their load, it is not something that can be just switched off. The effect may last some time depending on the amount and manner of catecholamine release, perhaps even up till having a BP of 180/140, 40 minutes later.

But a physiological response is all that it is, no more and no less. Controlling its release is one element of training, managing it after release is another. The individual needs to harness the good elements, like heightened arousal and quick reflexes, and suppress the bad elements, tunnel vision.

I could not suppress tunnel vision during the incident after I went into tunnel vision on one of my incidents.

How do you do that?

After the incident ended (6 minutes in total) all reverted to normal.

Thea did not mention tunnel vision and was able to talk during her incident which has been puzzling me...

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razorbackdiver, you should DEFINITELY have been taught some kind of pre-dive buddy check, no matter what agency's class you took. Failure to do that would be a breach of standards. But even for people who are taught such a check, it seems to be one of the first things people STOP doing, at least until some easily preventable problem reminds them that it's a lot easier to fix things on the boat or on shore than it is underwater.

TSandM
I agree, I defintely should have been and yes I believe a large number of divers stop doing predive checks and that is my point. The bulk of this thread seems to me to be dealing with Thea's actions, reactions, and inactions once she is in the incident pit. I believe that is a valid discussion to have, but it also seems to me that not disscussing issues that landed her in the incident pit in the first place would be irresponsible.

Thea states she had to fuss with her weight belt several times before she was in the incident pit. She also states she tried to ditch her weights once she is in trouble but it got hung up on something. In the video I am not sure who is attempting to remove her weight belt but it seems to take longer than should have and more than one attempt. Now maybe the outcome would have been the same if there had not been any trouble with weight belt, but it certainly didn't help anything.
 
I could not suppress tunnel vision during the incident after I went into tunnel vision on one of my incidents.

How do you do that?

A stress management course might be the best source of such advice.

There is one theory that it is the result of cerebral vasoconstriction resulting from respiratory alkalosis, in which case breathing into a paper bag might help, as it does with tetany.

The point I was trying to make was that in any enjoyable and challenging sport, individuals do squirt the catecholamines you listed in your post into their bloodstreams. The trigger is from the part of the brain that is involuntary (instinctive). I think you described it like having two brains. The voluntary or thinking part is the one that can give you awareness and allow one to control and manage those potential external stressors, the involuntary reactions to them and therefore the individual's performance during those sports.


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---------- Post added February 28th, 2014 at 11:55 PM ----------

I believe that is a valid discussion to have, but it also seems to me that not disscussing issues that landed her in the incident pit in the first place would be irresponsible.

I agree that is a valid point. An assumption has been made that her performance was impaired by a panic (fight or flight) response. If indeed the inability to perform those skills when called upon was due to poor training or lack of practice, it would have an impact on the analysis of events and future prevention.

Advice has already been given about getting her own equipment. The full benefit of this can only be realised once the new kit has been used over and over until it becomes instinctive and no longer stress provoking.


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---------- Post added March 1st, 2014 at 12:12 AM ----------

I am scared to death of what all these tests may reveal about my physical health.
Try not to get into a panic about your upcoming medical! This could give falsely high BP readings. But even if you do, try to avoid thinking it stupid - to some extent it would have been involuntary.



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Ugh. My views and understanding of what happened have changed SO MUCH since I posted the above. I thought about deleting, it is so embarrassing. But that would be a bit disingenuous of me, so, I left it up.
I respectfully disagree that I was unfit and too inexperienced for this dive. It was an easy, shallow dive. I had a wonderful time for the most part. It was just that last few minutes that things went nuts. The DM's have no blame whatsoever here. In fact, they went above and beyond in assisting me. I will be forever grateful.
I had already dived a few times just days before, and was fine. In the Exumas last April, I dived in silty water, the DM and I lost track of eachother. I wait 60 seconds, didn't see anyone, and immediately surfaced. The boat was a bit far off and there were other divers in the water, so I inflated my BCD, and my sausage, laid back, and watched the clouds float by until the boat came over and grabbed me. The water conditions were similar, but I was not panicky or worried.
When I say "out of shape" I mean I stopped long distance running and weight lifting, which I have done all my life, about 5 years ago. But I am quite active, I built stairs off our second story deck over the summer, built a deck around our pool, dug a 40 yard ditch, carried hundreds of pounds of gravel to fill it after I installed the drainage hose and fabric (our house is on a slope!). I just got done finishing the basement, and carried most of the lumber, insulation, and carpeting down myself.
Right before we left, I remodeled our wet bar, carried in all the materials myself, installed all the tile, tore out and replaced parts of the dry wall.
For me, as an athlete all my life, I am out of shape. For the average 50 year old woman, I am, not. I do though, understand and appreciate your time in reading my post and posting your thoughts. It is impossible to know who people are online.
Being fit and knowing your limits are essential in diving.

I have read "The Last Dive". Twice. Two experienced tech divers died, horribly. I am hoping that some here will understand that sometimes, sh*t happens that is unpredictable. I have read MANY accounts of otherwise extremely experienced and fit divers dieing or coming close to it. I hope you guys have some understanding that you too, could run into trouble. And I hope as well, you will understand that sometimes, we need eachother. And no one is to blame.

---------- Post added February 28th, 2014 at 07:21 PM ----------

I am good, and take none of it personally. Thank you so much though, I appreciate it.

---------- Post added February 28th, 2014 at 07:47 PM ----------

I did have tunnel vision. All I could think about was AIR, I was starving for AIR. Here are the unadulterated facts, as I have weeded them out from my own rather dramatic original post and integrated all the thoughts expressed here:
1) I had no fear on the dive, my fear didn't come until I suddenly was on the surface and could not breath, nor have the strength to keep my head above the water;
2) I immediately signaled for help and two divers immediately responded;
3) It took 10-15 minutes to get me back to the boat. The DM and other diver did exactly as they were trained to do. Remind me to keep my reg in, start pulling me by my BCD and pushing my feet towards the boat;
4) After 10 minutes or so, the DM on the boat leapt into the ocean, swam to us, and a staff member pulled us to the boat. The surf was too strong to do it on their own;
5) I do not remember most of that 10-15 minutes, accept for releasing my weight belt and having trouble, being unable to inflate my BCD and chanting deep in my head, "do not panic, do not panic". Both the DM and my husband said I was completely still as we approached the boat;
6) I remember it took 3-5 minutes for the boat staff to get the O2 hooked up. I remember they put the mask on wrong, I remember they took that mask away, and replaced it with a bigger one, but still, it was not on correctly. I fixed that somehow;
7) I remember the DM banging on a tank shouting "surface! we have a medical emergency!:
8) I remember the DM saying the nurse would be at the dock, then later hearing him, distraught, say "the nurse won't be at the dock!", he was not talking to me;
9) I remember getting into the golf cart, rushing to the clinic, still air starved and panting;
10) I remember the front door to the clinic was broken, I remember the DM being REALLY PISSED that no one came out to meet us;
11) I remember the DM shouting "She could have bled to death by now! Where is the nurse!";
12) I remember they called for the doctor after seeing my BP was 140/180 and O2 was at 85%.
13) I remember the doctor coming in and repeatedly asking if I had asthma;
14) I remember my husband telling me later that the nurse freaked a little when she saw how blue my feet were;
15) I remember suddenly being able to breath again, and telling my husband "I am ok, it's ok!"

These are just facts. My husband, a wonderful, intelligent, no nonsense man with a memory like a steel trap.

I remember discussing all these things with the DM who saved me, other divers on the boat and the owner of the shop as we waited for our water taxi.
I remember crying. I remember my gratitude and shame at having caused all this fuss. I remember being so weak when we got back to our beach house that for the first time in my life, I needed help sitting up.
I have no motivation to lie. None of THESE facts are exagerated (again, my original post is embarrassing. Ugh).

ALL I hope for is that staff on a dive boat are comfy hooking up O2. It is so simple so inexpensive and even with the issues that day, life saving.
Gianaameri, you are incredible. You have actually read and thought about and analyzed a complete strangers terrifying incident and made remarkably accurate observations about MY OWN INCIDENT, I had not thought of before. Thank you so much, you have no idea how grateful I am.

I do though, also understand that divers MUST be responsible for themselves. So much is at stake when the **** hits the fan. I would rather die myself than have someone die trying to save me. I have learned A LOT here. Thanks all.
 
The average 50 year old man or woman doesn't dive, so you are above average. Every diver I know has had an episode or episodes. Keep diving, and come to Brac where the water is calm and clear, and everyone is happy. I wouldn't over analyze the dive, get your physical and move on. You don't have to prep for a dive like a military operation, but the basic predive routine should be a habit. Self check, equipment check, site check and buddy check. I think getting your own kit and learning how to use it is much better than the rental gear, so consider that.

Thanks for the write-up. I was surprised it was such a volatile subject. Stay safe.
 

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