Article in my local paper

[FlipScubaDiver]

I found this article in my local newspaper about a guy that suffered an arterial gas embolism while diving. Is there any way to prevent this kind of serious dive injury? The article doesn't specify which gas he was diving with though....

here's the link to the article:
http://www.sptimes.com/2006/05/07/Tampabay/Disabled_on_scuba_div.shtml

 

[JGibeault]

The first thing is never hold your breath. Also, diving with asthma, or other lung diseases, increases the risk of air getting trapped in your lungs, then getting into your bloodstream.

 

[DeepSeaDan]

I found this article in my local newspaper about a guy that suffered an arterial gas embolism while diving. Is there any way to prevent this kind of serious dive injury? The article doesn't specify which gas he was diving with though....

here's the link to the article:
http://www.sptimes.com/2006/05/07/Tampabay/Disabled_on_scuba_div.shtml

Hey FSD,

Quite an interesting, albeit tragic story.

At first blush I cannot understand how this dive profile could have produced an embolus in the classical sense of the injury - that being lung overexpansion causing alveolar rupture with gas emboli entering the arterial system. A.G.E. clasically presents in the brain ( causing stroke-like symptoms ) or in the lungs ( with resultant chest pain, difficulty breathing, & / or respiratory arrest ). The dive details were minimal in the article, thus it is possible that at some point during the 2nd dive, the gentlemen experienced elevated lung pressure ( perhaps during his exertions attempting to free his speared game fish ), & unwittingly held his breath during a minimal ascent.

The fact that he was symptomatic on bottom during the 2nd dive ( in the sense that he did not feel well / right ) is interesting, as such symptoms suggest possible cns compromise while at depth - symptoms normally associated with ascent or at surface.

I'd speculate that he did in fact bulge or herniate a disc in his back while freeing the boat's anchor, & this injury was affected by circulating gas seeds that blossomed into a full type 2 bend upon surfacing from the 2nd dive. But this scenario would suggest d.c.i. as opposed to the effects of a.g.e.

The only other physiological reason I can think of to explain arterial gas embolism at depth might be through an undiagnosed patent foramen ovale ( pfo ), essentially an unclosed hole between the left & right sides of the heart, & being of congenital origin ( basically, the hole allows a fetus's heart to be oxygenated, & will normally close prior to birth; in a relatively small portion of the population, it doesn't ). You may wish to read further into pfo as my knowledge of the condition is cursory.

I'd be interested in hearing an opinion from one ( or more ) of the learned physicians that contribute to this board - perhaps you could ask this thread to be moved to the physiology section for further input from the experts.

Regards,
DSD

 

[scubapolly]

It seems to me like the slipped or herniated disc might have attributed to his problems.

Sounds like his complaint is how long it took them to get him to a chamber. That is a risk he took upon himself when he decided to dive 80 miles off shore. 5 hours to get him to a chamber doesn't sound "negligent" to me considering the circumstances. Said in the article it took him 20 hours to reach the dive site. The guy is an idiot, and is just trying to get someone to pay for his stupidity/ misfortune. I don't think he has much of a chance of getting anything out of the settlement.

 

[AggieDad]

I am curious as to why having a herniated disc would cause or be a factor in this accident. My Doctor dives and we have discussed this as to my back and he sees no problem. I can see if one developed an AGE - AND - also had a herniated disc but just having a bulging or herniated disc causing this? Someone enlighten me.

 

[MoonWrasse]

I wonder if he was diving EAN.

Hogan was scuba diving 122 feet underwater in the Gulf of Mexico, and something was very wrong.
His vision had gone blurry. When he blinked, he saw flashes of light, like electrical charges.
But 80 miles from the coast of Tampa Bay, Hogan ignored the signs of trouble.

 

[DeepSeaDan]

I am curious as to why having a herniated disc would cause or be a factor in this accident. My Doctor dives and we have discussed this as to my back and he sees no problem. I can see if one developed an AGE - AND - also had a herniated disc but just having a bulging or herniated disc causing this? Someone enlighten me.

...gas bubble nuclei tend to lodge in areas of reduced or compromised circulation - a lower back injury earlier in the day may have set this chap up for circulation impairment in the affected area. His symptoms ( numbness, tingling, progressive lower extremity paralysis etc. ) indicate a spinal cord bend in the area of the spine where the nerves branch out to feed the legs. Of course, this is all purely speculative because we do not have his dive profiles, nor do we have an accurate account of exactly what went on during his exposures, an accurate clinical picture of the progression of his bend, & the details of his physiological response to h.b.o. therapy.

He ( the complaintant ) indicated he felt "fuzzy" on bottom, which may have been the result of minor cerebral impairment due to the presence of circulating arterial emboli, which then migrated through his system, only to accumulate in the area of the lower spinal circulation ( perhaps the lumbar region ). If circulation is reduced or occluded to an area of the cord, it would in time suffer tissue ischemia ( hypoxia / anoxia ), resulting in irreversible damage to the affected area of the spinal cord. Based on the results of the hyperbaric treatments, it would appear he did indeed suffer cord damage to the extent that he lost the use of his legs.

Regards,
D.S.D.

 

[AggieDad]

...gas bubble nuclei tend to lodge in areas of reduced or compromised circulation - a lower back injury earlier in the day may have set this chap up for circulation impairment in the affected area. His symptoms ( numbness, tingling, progressive lower extremity paralysis etc. ) indicate a spinal cord bend in the area of the spine where the nerves branch out to feed the legs. Of course, this is all purely speculative because we do not have his dive profiles, nor do we have an accurate account of exactly what went on during his exposures, an accurate clinical picture of the progression of his bend, & the details of his physiological response to h.b.o. therapy.

He ( the complaintant ) indicated he felt "fuzzy" on bottom, which may have been the result of minor cerebral impairment due to the presence of circulating arterial emboli, which then migrated through his system, only to accumulate in the area of the lower spinal circulation ( perhaps the lumbar region ). If circulation is reduced or occluded to an area of the cord, it would in time suffer tissue ischemia ( hypoxia / anoxia ), resulting in irreversible damage to the affected area of the spinal cord. Based on the results of the hyperbaric treatments, it would appear he did indeed suffer cord damage to the extent that he lost the use of his legs.

Regards,
D.S.D.

I understand and agree with what you have said in this case. The reason that I can see in this case is his reporting a twinge in his back and then straining with the fish (breath holding) could very well cause exactly what you described. My concern was that just because someone has a herniated, bulging disc makes them more susceptible to AGE seemed a little broad. If someone does the things that can cause AGE AND if the had bad discs then I can see it being a problem.
My orthopedic doctor said that most people when given an MRI will show some bulging after a little bit of age and wear. The proper thing is to avoid diving situations that increase the chance of AGE, in other words be very safe. I am going to sit down with my Doctor again and discuss this situation.

 

[DeepSeaDan]

Hey A.G.,

I too suffer from lower back problems ( a wonky disc between the L1 / L2 vertebrae ). At 47, with 33 years of diving in me ( 1000's of exposure hours - alot of it in saturation ), I'm a pretty conservative diver now. If my back is acting up, I WILL NOT dive - just to be safe. I stay very fit & lead a healthy lifestyle for many reasons, not the least of which is to try to minimize my chances of taking a hit.

So far, so good!

Go to www.scubadoc.com & read up on lower back issues as related to diving - it is an excellent overall reference source.

Regards,
D.S.D.

 

[FlipScubaDiver]

Wow, DeepSeeDan, you have a wealth of knowledge. Thanks for the explanation.

I think that health is far more important than trying to capture something in the sea. If I were him, the first notice of something wrong would've triggered me to get to the surface as soon (but as safely) as possible. Then, I would've asked the divemaster to give me 100% oxygen until helped arrived. I wonder if this guy had taken the rescue course....