Pool Session Incident

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ascully88

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Hi all,

I had my first pool session about a week ago and panicked at 10 feet during a mask clearing exercise and went up fast to surface possibly holding my breath. A big no-no I know... I did well the rest of the session and did the mask clearing as well. The next day I had chest pains up and down my sternum. I went to the ER out of fear of the bends. They did and EKG and a chest x-ray and said I was fine but they can't say for sure what the pain is from. I can still move around fine, its just an annoying aching that sometimes makes it feel a little weird when breathing.
Does this chest pain sound normal for what I did underwater? Also keep in mind that it was my first time scuba diving and though I am moderately active it was my first time in a while being that active in water.
Should I wait til the pain is gone to do my second pool session or just do it tomorrow?

Thanks.
 
Did you tell the ER doc about the events leading up to your chest pain?? Have you contacted DAN (800-446-2671)?? It's not the "bends" I would be concerned about but rather a "lung-overexpansion injury" (due to the possibility of holding your breath and surfacing, with the air further expanding thereby causing macro- or micro-trauma to the lungs). I would at least call DAN and discuss with them............Best wishes
 
The symptoms you describe point to a likely case of mediastinal emphysema, air in the space around the heart. As long as you did not also suffer an air embolism, your chances of recovery without additional problems are good. You should not dive untill fully recovered and you should be further evaluated by a physician familiar with diving and barotrauma.
 
If it was the first time wearing a BC and tank, it is more than likely muscular. You were stretching muscles you have never used. Does it hurt more when you press on it. Is it positional? You were already seen by the ED and cleared. Continue on your diving training and enjoy but learn to relax.
 
Should I wait til the pain is gone to do my second pool session or just do it tomorrow?

No and no. You need to get this looked at and possibly attended to NOW to rule out some things:

1. The greatest concern would be an embolism due to the breath-holding ascent. (Yes, they can occur from that shallow depth.)
2. Embolism will manifest itself fairly quickly (usually within 10 minutes of surfacing) and can/might be some combinantion of lung-related injuries such as "heavy" chest, pain in the chest, trouble breathing, coughing up blood, etc. What you're describing certainly IMHO fits into that category of symptoms.
3. Embolisms are frequently life-threatening and require immediate medical attention so the fact that this happened a week ago and you're still around to ask about it may mean it's not an embolism. But that doesn't mean you didn't do some tissue damage, bruising, etc.
4. You didn't mention where you are. If you're in Los Angeles County (CA), call the LA County Medicial Alert System at 866/940-4401, then push "8". You'll be connected to the hyperbaric section. Tell them right off the bat you may have suffered a scuba diving injury in the pool and give the details. They will put you in touch with the hyperbaric doctor on 24-hour call and you'll go from there.
5. If you are outside of Los Angeles, contact the DAN Emergency Line instead at 919/684-8111. You can call collect if you need to. Tell them you may have a scuba diving emergency. You'll be connected with a tech to whom you'll tell your story and who will advise and help you from there.
6. If you do need to be treated in a recompression chamber, and if your instruictor registered you and his other students with DAN at the start of the course, you will automatically be covered under a DAN Student Insuarance policy fopr any chamber-related costs resulting from an accident during dive training (which this would certainly be).
7. If your instructor didn't do that and if you didn't purchase your own DAN policy prior to the pool session, then your own insurance will likely/possibly/hopefully cover most of your chamber expenses, if any.
8. DO NOT GO BACK INTO THE POOL UNTIL YOU'VE BEEN EVALUATED BY A DIVING DOCTOR (NOT JUST A GP).

If, as you're reading this, you have not yet contacted anyone about this, pick up the phone RIGHT NOWand make one of the calls indicated above. And when the dust all settles on this, come back to this forum and let us know how you are and what happened.

Good luck and good wishes.

- Ken

---------- Post Merged at 11:11 AM ---------- Previous Post was at 10:41 AM ----------

I can still move around fine, its just an annoying aching that sometimes makes it feel a little weird when breathing.

After I made my initial post, I called one of our local hyperbaric people and discussed what you had posted. He pointed out that another possibility would be pneumothorax which might not have shown up on x-ray. (Plus there are a couple of other "pneumos" it could be that might involved a lung injury releasing air, but not into the bloodstream.) You really need to consider the possibility that this is more than just muscle pain. Better to over-react and rule things out than under-react and see a small treatable problem become a much bigger issue.

- Ken
 
Concur with Ken's recommendation above in that you should be re-evaluated before going back in the pool. This is unlikely to be a gas embolism but could be some mediastinal air as captndale noted, though that should have been picked up on your xray.

Of note: the local number for DAN is (919) 684-9111 as opposed to -8111. -8111 will get you the Duke Hospital switchboard.
 
I called DAN and they said that if anything was wrong with my lungs it would have been seen on the chest x-ray. They also said to see my general physician. Sooo I don't know what to think. They didn't seem like it was a big deal. The hospital doctor didn't seem concerned either. He gave me some pain medications.
For the past few days I have been doing my regular job which can be a little strenous. Breathing itself isn't hard or hurtful but if I fully expand my lungs it sometimes hurts a little more up my breastbone. It just feel like its at the very front of my chest, especially if I lean forward its hard to explain. The worst part about this is just not knowing if I pulled my muscles. Maybe my instructor pulled my BC too tight or what.
I won't scuba dive anymore and I'll see my doctor but now I don't know who to trust. I highly doubt my regular doctor will know anymore about this than the er doc will. I'm really scared that I'm going to drop dead in a few moments from some bubble traveling in me that no one saw...
 
I called DAN and they said that if anything was wrong with my lungs it would have been seen on the chest x-ray. They also said to see my general physician. Sooo I don't know what to think. They didn't seem like it was a big deal. The hospital doctor didn't seem concerned either. He gave me some pain medications.

Couple of questions (and I will put you mind at ease at the end of this reply):

1. Did they specifically look for pneumothorax, which is basically a collapsed lung?
2. When you say "the hospital doctor didn't seem concerned" is that someone you saw today, or the original doctor?
3. My concern is that if you're still in this kind of discomfort after a week, did they miss something because they were looking elsewhere?
4. I think you can call them, ask specifically about pneumothorax and any other lung over-expansion injuries, to make sure that they were aware they should look for that.

Breathing itself isn't hard or hurtful but if I fully expand my lungs it sometimes hurts a little more up my breastbone. It just feel like its at the very front of my chest, especially if I lean forward its hard to explain. The worst part about this is just not knowing if I pulled my muscles.

That's a possibility but that's something they ought to specifically be checking for. Again, if you didn't see a doctor TODAY, I think you need to do that ASAP. If nothing else, it will put your mind at ease as to what this is not (or wha it is). Also, tyour doctor can call DAN and do a phone consult with a DAN doc while they're examining you.

Maybe my instructor pulled my BC too tight or what.

The joke about the bends is that the first symptom is denial. Don't try to rationalize this away. Get a second look-see (if you didn't today) with a specific goal of ruling out or confirming the dive-related things that have been mentioned throughout this thread.

I won't scuba dive anymore and I'll see my doctor . . .

Excellent choice for now. This doesn't rule out returning to diving later. But it does mean find out NOW what's wrong to insure that continued diving won't make it worse.

. . . I highly doubt my regular doctor will know anymore about this than the er doc will.

Where do you live? Is there a DAN-recommended hyperbaric doc in your general vicinity?

I'm really scared that I'm going to drop dead in a few moments from some bubble traveling in me that no one saw...

This is the part that should make you feel better about that statement. My purely layman non-medically-qualified opinion is that if there was a bubble or bubbles running around in your system waiting to kill you, they would have done so already. So while all of this may be scary, you're still here. What you need to do is get some further examination instead of just hoping it will all go away on its own. Which it might. But why take that chance?

- Ken
 
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