Another "Could it be DCS" Case

[dwatts]

I returned from a trip to Grand Cayman on July 25th. The last full day there I did a morning trip and an afternoon dive trip.

The morning trip was a deep dive where I dove a bit deeper than planned. I went through a swim through (as suggested by our guide) that took us to about 130 feet. When we swam out of it my buddy was decending even a bit more so I went to tell him that we need to get back up (on top of the reef). Max depth was 139 feet for only 1 minute. In fact, my computer shows that I was below 120 feet for only 2 minutes.

The 2nd dive of the AM trip was a shallow dive with a max depth of 52 feet.

I then drove to another dive OP for the afternoon trip (more than 2 hours of surface time). Two shallow dives: first to a depth of 42 feet and the second to 52 feet.

Those dives were on July 24th. I felt no symptoms immediately after. Now, on July 31, I noticed that my right elbow is slightly sore. Also, I have a "sensation" in my hips and upper legs. This sensation is best described as how you feel when you've been laying in bed on one side for too long. You feel like you need to roll over to get comfortable. Anyway, my hips and upper legs feel like that all of the time.

QUESTION: Can DCS show up a week later? Does this sound like DCS?

It's the weekend right now so if you gurus suggest that I see a doctor then is waiting until Monday OK?

[edited to add the fact that all dives were on air]

 

[ronbeau]

I returned from a trip to Grand Cayman on July 25th. The last full day there I did a morning trip and an afternoon dive trip.

The morning trip was a deep dive where I dove a bit deeper than planned. I went through a swim through (as suggested by our guide) that took us to about 130 feet. When we swam out of it my buddy was descending even a bit more so I went to tell him that we need to get back up (on top of the reef). Max depth was 139 feet for only 1 minute. In fact, my computer shows that I was below 120 feet for only 2 minutes.

The 2nd dive of the AM trip was a shallow dive with a max depth of 52 feet.

I then drove to another dive OP for the afternoon trip (more than 2 hours of surface time). Two shallow dives: first to a depth of 42 feet and the second to 52 feet.

Those dives were on July 24th. I felt no symptoms immediately after. Now, on July 31, I noticed that my right elbow is slightly sore. Also, I have a "sensation" in my hips and upper legs. This sensation is best described as how you feel when you've been laying in bed on one side for too long. You feel like you need to roll over to get comfortable. Anyway, my hips and upper legs feel like that all of the time.

QUESTION: Can DCS show up a week later? Does this sound like DCS?

It's the weekend right now so if you gurus suggest that I see a doctor then is waiting until Monday OK?

[edited to add the fact that all dives were on air]

I would suggest you call DAN (Divers Alert Network) at 1-919-684-8111 and ask them if you should go to the hospital or not. They are open 24x7x365 and will talk to you and give you advice even if you are not a DAN member (although it would be a good idea to join for $29 per year).

They are the experts regarding DCS and other diving related medical issues.

DAN Divers Alert Network

 

[dwatts]

I would suggest you call DAN (Divers Alert Network) at 1-919-684-8111 and ask them if you should go to the hospital or not. They are open 24x7x365 and will talk to you and give you advice even if you are not a DAN member (although it would be a good idea to join for $29 per year).

They are the experts regarding DCS and other diving related medical issues.

DAN Divers Alert Network

Thanks. I called and spoke with Ryan. Based on the information I told him he felt that my symptoms are not DCS. DCS symptoms should have been most prominent as a result of the flight the day after the deep dive. Since I had no symptoms the day of the flight nor for several days after, Ryan felt that DCS is not likely.

Instead, he suggested that I may still want to see my doctor as other infections can often cause aches. It wouldn't surprise to find out that I have some kind of infection.

I'll make an appointment tomorrow (Monday).

 

[ronbeau]

Thanks. I called and spoke with Ryan. Based on the information I told him he felt that my symptoms are not DCS. DCS symptoms should have been most prominent as a result of the flight the day after the deep dive. Since I had no symptoms the day of the flight nor for several days after, Ryan felt that DCS is not likely.

Instead, he suggested that I may still want to see my doctor as other infections can often cause aches. It wouldn't surprise to find out that I have some kind of infection.

I'll make an appointment tomorrow (Monday).

Based on what you described it didn't seem like DCS to me but I am not a doctor. I felt by calling DAN you would get some piece of mind from people who trained and deal with these types of things all the time.

I have been a member of DAN since I started diving 4 years ago. We have a family members ship (wife, daughter and I) and we each have their DAN preferred insurace plan. We have never had to use it but for $70 per pesron per year it is well worth it.

Hopefully, your doctor can get the problem squared away.

 

[Dr Deco]

Hello dwates:

As DAN and others suggested, the time factor was not realistic for DCS. Additionally, the plane flight back home should have provoked something connected with decompression bubbles.

 

[dwatts]

Hello dwates:

As DAN and others suggested, the time factor was not realistic for DCS. Additionally, the plane flight back home should have provoked something connected with decompression bubbles.

Given some other symptoms that I didnt' mention above, I beginning to suspect a prostate infection. It's just that the symptoms that I did mention are completely new to me so they kinda throw me off a bit.

I did have a prostate infection about a year ago so I suspect I may have another. I am waiting for a call-back from my doctor to schedule an appointment. A simple round of anti-biotics and I should be good as new (well, good as I was before, anyway).

 

[DocVikingo]

Hi dwatts,

I concur with DAN and DrDeco.

As point of information, while it often is a wise idea to inquire of DAN, one needs to appreciate the likely limitations in doing so.

For example, when one contacts DAN they first, and often only, speak with a paraprofessional (e.g., registered nurse, diving EMT). These folks often simply thumb to DAN's medical FAQs (http://www.diversalertnetwork.org/medical/faq/Default.aspx) and read or email a paraphrasing to the individual. They frequently are quite busy and give the briefest possible reply. For understandable reasons, DAN provides very limited direct physician access. As such, the answers received from one of the experts on the Diving Medicine and Ask Dr Deco forums are likely to be longer and more informative than the responses from DAN, even when both are in essence correct. Also, these forums typically afford more opportunity for rapid give and take between participants than is the case with DAN. Finally, links to previous board threads on the topic, professional magazine and journal articles, and other sources are often given on the forum, another nicety not usually provided in a DAN reply.

And, as do our forums, DAN occasionally gives a rather shaky response. For example, DAN's reply to a recent inquiry about the possible effects of massage on divers seems to be quite weak and disappointing (see http://www.scubaboard.com/forums/diving-medicine/244105-pre-post-dive-massage-therapy.html).

Inquire from a range of sources and see how the opinions rank based on the factual and theoretical support given an opinion, the clarity of the response and similar factors.

DAN is a very worthy and valuable organization, but it is not the be all and end all of diving medicine fact and opinion.

Regards,

DocVikingo

 

[dwatts]

...and the winner is.... Prostate Infection! :doctor:

I start anti-biotics tonight for one month. I had this about a year ago but I didn't have that weird "sensation" in my hips and legs. Apparently, a swollen protate can do funny things to the surrounding nerve. Go figure!

I knew not to relay on DAN, or any single source. I've always tried to educate myself..particularly on matters of my own health. I like to be an educated patient BEFORE I walk into the doctor's office. Thanks to you gurus on this board and to Google, I was.

...now...it's time to starting planning my next dive trip...I think I can talk my wife into a quick quarry weekend trip.

 

[DocVikingo]

Hi dwatts,

It is good that a definitive diagnosis has been arrived at and an appropriate course of treatment commenced.

Given a prior history of bacterial prostatitis, it is prudent to follow suggested guidelines for the prevention of infection of the prostate and promotion of overall prostate health. Although most of these are short on scientific validation, they are commonly recommended by urologists and at worst should do no harm.

These include keeping the genital area scrupulously clean; drinking plenty of fluids and not delaying urination any longer than necessary; limiting alcohol, caffeine & spicy foods; engaging in regular, and safe, sexual activity; taking an extract of saw palmetto; and undergoing regular prostate examinations.

Hope you feel better fast.

Regards,

DocVikingo

This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice to you or any other individual, and should not be construed as such

 

[Divingdoc112]

Remember, FAA regards flying and diving as incompatible for 24 hours (regardless of what PADI says), as opposed to "don't fly until the next day." This is because airline cabin pressure is 0.74 atm (8000 ft). Your tissues know only how many hours have passed, not what day it is. The critical supersaturation ratios expressed by Haldane in 1906 are only estimates and are reflected as an algorythm in many dive computers. Haldane was concerned about multiple tissue compartments and their unequal rates of of saturation and desaturation. Waiting a full 24 hours before flying will help prevent DCS, a serious problem.

It is reassuring that the symptoms are related to prostatitis.

This is offered as educational and does not consititute medical advice.