Dear fellow divers, especially the older ones.
I just came back from a visit to the hyperbaric service of Dr Peter Germonpré @ the military Hospital in Brussels, Belgium.
I will try to summarize, with his permission, the 80 minute long discussion we had. The discussion was open and very friendly. Peter is a diver and shares our passion. He has been numereous times in the Asian Gold Triangle and 3 times in Lembeh.
I will not come back on the issue of "deserved" versus "undeserved" hit, for Dr Germonpré, this is a futile question.
From the description of my symptoms - he was not on the spot for the acute phase - I most likely suffered from a neurological/skin DCS. He is pretty sure that a PFO is present. This should be confirmed or not in a few weeks.
These are his recommandations for
myself, whether I have a PFO or not.
- Nitrox dives
- use a dive computor set on air, being aware of the MOD. This should not be an issue considering future profiles.
- Stay in the "security" curve ( even more, start to go up 5 minutes away from the NDL).
- Safety stop of 5 minutes between 3 and 6 meters
- Successive dives are allowed PROVIDED that they do not bring me too fast close to the NDL.
- No Physical exercice within 2 hours following the dives. It can produce a large number of micro-bubles that can go through the PFO or any pulmonary shunt.
We also discussed some points that were raised in this and a french forum. I only relate what I understood from him. So there are no warranty on the accuracy of the information
My dive profile, staying at a certain level ( around 18 meters), followed by a VERY SLOW ascent, is not a great idea, especially for multiple dives. It is much better to do square profiles or a two-levels dive, e.g. 20/25 meters, then half depths and then immediately to the safety stop.
He is not convinced that the photograph's apneae are a major risk factor. He is a photographer himself
He is not in favor of Nitrox dives, using a Nitrox setting even put on a +1 or +2 conservatism. For this the divers have to realise that a dive computor does not know how a particular body behaves. They should therefore dive with wider margins than the computor indicates, especialy if risk factors are present. Moreover for dives with mandatory deco stops, the computor gives only ways and techniques in order to minimise a risk that is way bigger than dives within the NDL.
Interval of 60 minutes between two dives is the norm in a lot of countries. This is sad but difficult sometimes to avoid. It is acceptable but 60 minutes is an absolute minimum.
2 or 3 dives per day is OK, as long as succesive dives do not put the diver too close to the Deco line AND to rest without diving for 24 hours every 4/5 days. The goal, surprisingly, is more to give a chance to the dive computor to "reset" rather to enable the diver to recover. After several days of multi dives, a lot of computors are quite a bit lost, he explained.
He admits that to make a safety stop with enriched nitrox over 70% 02 could be a plus, but not essential for the recommended profiles. Moreover, he believes that when one undertakes to make a risky sport, like diving, even if the risk is quite low but unpredictable, one has to be attentive to first aid care. This means that when a small suspicion of DCS is present, the priority is to get oxygen and ample hydration before seeking advise and diagnosis from a competent doctor on the spot or distant advise from on a help line ( DAN or others).
This sumarises my meeting with a great person, volunteer to DAN Europe . I hope that I was able to reproduce his opinion on the matter.
Hoping that it can help fellow "elderly divers" like myself .
.
