Bilateral digit soreness = DCI?

[Scubadent]

Completed my AOW course about 3 weeks ago.

1st day was open water, max depth 80 feet, 2 dives.

2nd day lake diving, max depth 30 feet , sawtooth profile while performing the many skills necessary for cert. over 3 dives

The day after the 2nd dive, I noticed index fingers of both L and R hands had soreness involving the joint capsules of the 1st and 2nd knuckles (proximal and middle phalanges?). The discomfort is mild but noticeable, and is worst when the tip of the finger is pressed towards the palm with resistance by that finger. No other soreness, rash, etc...

My question is, does this sound like a mild case of DCI? I have been taught that any abnormal sensation 12-24 hours post dive should be considered so. Is the bilateral aspect of these symptoms generally found in DCI cases? FWIW, I also found myself hauling around many tanks using the "split finger" grab of the valves over the two days. Could this be ligament damage?

I have a physicians appt to eval soon, but am afraid that he isnt versed in dive med. Being a dentist, this discomfort is unsettling given that my fingers are my career. Thanks

 

[Rick Murchison]

I doubt it.
Sounds more like you just turned 40.
Rick

 

[Scubadent]

:crest:

Only 30

Cant wait to see 40, though

I'll always think like a 21 yr old. Gotta stay young, if only in the mind!

 

[Genesis]

DCS typically manifests at rest.

If the pain is only on movement, it is less likely to be DCS-related.

If you're manhandling tanks by the usual "two fingered pickup", yes, you can do some harm. I've pulled finger (and arm!) muscles that way myself and KNOW it wasn't DCS, since I wasn't diving that day but WAS moving my tanks around!

 

[DocVikingo]

Hi scubadent,

Just kidding.

Taken in the aggregate, the following factors suggest that your complaints are not related to DCS:

1. When diving air, in ~50% of cases of DCS the first signs/symptoms appear within 30 minutes, in ~90% within 3 hours & in ~99% within 12 hours.

The statistical remoteness of DCS symptom onset the day after the last dive is a consideration in your favor.

2. DCS is far more likely to manifest in large joints, e.g., knees, elbows, shoulders, than in small ones, e.g., phalanges.

3. Bilateral joint discomfort is not unheard of, but certainly is not the expectation.

DCS-related involvement of the same phalanges on each hand would seem to be a very unusual presentation, indeed.

4. You identify a strenuous activity involving the fingers, performed over several days.

While this does not rule out symptomatology based on
gas-phase phenomena, it does provide a logical mechanical explanation for the discomfort.

5. The absence of any other features of possible DCS.

While this one carries little diagnostic weight, it is nonetheless comforting.

I'd be interested in what your physician makes of your situation, if you don't mind posting it later.

Do be aware that both you and your physician are free to seek expert advice from DAN at http://www.diversalertnetwork.org/medical

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.

Best regards.

DocVikingo

 

[Dr Deco]

Dear Scubadent:

Joint Pain versus Bends

This is a common problem for individuals who have performed some special and strenuous activity. I am reminded of a student who had taken a chamber dive in a deco physiology class. He called to say that his arm was sore (one day after the dive). Upon questioning, it appears that he had carried his suitcase for five blocks to go to a bus stop. He did not believe that he had a problem but called just to make sure.

This is similar to your situation - A dive and physical activity. If this had occurred shortly after surfacing, it could have been a bigger concern, as I would have suspected that you formed a gas phase with all of the activity.

Someone did report to me an incident of a surgeon who went scuba diving. He developed neurological DCS, treatment was delayed because of location, and he became paralyzed. He had to quit his surgical practice. Very sad indeed.

Dr Deco :doctor:

 

[Scubadent]

Very helpful and encouraging adviced indeed. I will be sure to post the results of my discussion with my physician and I will be certain to recommend the DAN resource if there is any uncertainty as to the diagnosis.

Hats off to your always prompt and insightful thoughts. Bummer of a story, though, Dr Deco. All that training and hard work out the window now. Very sad indeed. Its just those sorts of incidents that are forefront in my mind during pre dive prep. Safety can never be ignored or taken for granted. As my instructors were fond of saying at the Army Airborne course, Stay Alert - Stay Alive!!

 

[DocVikingo]

How did the eval turn out?

Best regards.

DocVikingo

PS: Ex 101st here.

 

[Scubadent]

Sorry for the late reply, been away from the board for a while!

Actually havent seen the physician yet. I had to cancel the appointment due to some pressing issues but am scheduled on 9/16/02. I'll keep you up to date once the results are in. Thanks.

Screamin' Eagles! One of the most legendary divisions in the Army. My hats off to you. My father was 101 in Nam. '69. Has a 1/2 inch hole in the front of his right shin as a souvenir from an AK. I have no idea how the docs saved his leg. Amazing folks.

 

[DocVikingo]

Hey Scubadent,

Nam '68 & '69. Lower left leg full of holes.

Rak-a-san.

DocVikingo