Bizarre effects after diving - reasons?

[lemon]

the hallmark of AGE is the abrupt onset of symptoms after a dive. it can be delayed somewhat, however, it wouldn't begin 2 hours after a dive. AGE is the result of a rupture in the membranes that separate the pulmonary vasculature from the alveolar air space. the gas bubbles are introduced relatively abruptly into the circulation, embolize and cause rapid onset of clinical symptoms.

With DCS the bubbles that are causing you trouble are coming out of solution as the pressure decreases with ascent to the surface. As we all know, these gases continue to diffuse out of their dissolved state for hours after a dive is completed. This is why DCS can have a much more insidious onset.

 

[bleeb]

There have been a few references to the symptoms starting two hours after the end of the second dive. This has been nagging me and in re-reading the original posting, it's not clear whether or not this is necessarily accurate.

To paraphrase, the OP completed the dive, packed up, and then took a nap. The ride back to the dock was 2-2.5 hours. Symptoms were showing "by the time we got back to the dock". It wasn't clear how much time passed between the end of the dive and the time the OP was asleep, or how long the nap lasted. If it was a two hour nap, it's possible symptoms were showing quite soon after the dive, but since the OP was asleep, he/she wouldn't have been conscious to recognize them.

gcs118, if you're able to clarify this, it might slightly modify how people are interpreting the situation.

 

[lemon]

you make a good point, however, AGE would be felt within 10 minutes of ending a dive. i doubt he was asleep within this time frame. nevertheless, you are absolutely correct in seeking to clarify the history.

 

[Diver003]

There have been a few references to the symptoms starting two hours after the end of the second dive. This has been nagging me and in re-reading the original posting, it's not clear whether or not this is necessarily accurate.

To paraphrase, the OP completed the dive, packed up, and then took a nap. The ride back to the dock was 2-2.5 hours. Symptoms were showing "by the time we got back to the dock". It wasn't clear how much time passed between the end of the dive and the time the OP was asleep, or how long the nap lasted. If it was a two hour nap, it's possible symptoms were showing quite soon after the dive, but since the OP was asleep, he/she wouldn't have been conscious to recognize them.

gcs118, if you're able to clarify this, it might slightly modify how people are interpreting the situation.

As to the napping/sleeping, my best guess is about 45 min. - 1 hr. after ending the dive. I packed all my gear up and let my neighbor do it first, plus had some water, had a light snack and chatted with people. I really was getting drowsy and from being on the upper deck in the direct sun I went under to the bench to lean against the tanks and doze in and out of sleep for the rest of the time back in (1 - 1.5 hours I believe). I would periodically look around during this "nap" and didn't notice anything odd - just the out-of-it from dozing.

 

[Diver003]

One thing that has been on my mind is that if this were DCS/AGE (assuming from Saturday's dives), wouldn't the dives I did on Sunday have aggravated my situation as opposed to alleviated my symtoms/had no worsening effect? The dives the next day were very similar profiles, even a bit deeper really.

 

[Cruisin Home]

Thanks Bleeb for making the point I was trying to make about "time of onset". In my world of stroke it is the fuzziest thing to pinpoint yet so critical to therapeutic course. It often involves people who are sleeping/napping. Despite Lemon's sarcasm re TPA, I witness on a regular basis the power of re-perfusing (restoring blood flow) a patients brain, they don't call it the Lazarus syndrome for nothing.

After listening to your last account gcs118, I think you were very fatigued, and perhaps a little touch of motion sickness (happens to my wife periodically when we go on dry land she gets vertigo, headaches, tingling).

You will likely never know, still good to have a neuro exam. Hopefully this will make you and your buddies better divers to be pre-armed with the necessary info ahead of time.

 

[Diver003]

I just received my official response from a DAN medic, and it looks good. I have copied and pasted their email below. I am not including my original message because it essentially parallels what I have posted here.



Dear Greg,

Thank you for your e-mail and membership support. We cannot rule out the possibility of DCS entirely but in reference to the thorough information you provided DCS seems unlikely. The most compelling information that reduces suspicion is the fact that you dove the very next day without any return of symptoms. Historically this is not consistent with what is experienced with DCS. Divers have had symptoms that resolved without intervention but had worse symptoms when they dove within 24 to 48 hours after the initial onset of symptoms. Also the fact that your symptoms resolved without intervention further reduces the suspicion for DCS.

All oral motion sickness medications are classed as antihistamines. The symptoms you experienced can be attributed to the antihistamine. Although you had not to that point had any side effects from Bonine our susceptibility to side effects can vary with each use and is affected by many variables. All of the cognitive problems you had can be attributed to antihistamine side effects. Your hand being numb after napping is most likely due to the position of your hand while you slept. Your dive profiles are not particularly provocative especially with breathing 31% EAN. Again we cannot rule out DCS entirely but it seems very unlikely. If we can be any further assistance do not hesitate to contact DAN.



Divers Alert Network

 

[lemon]

thats great gcs, hopefully this gives you some peace of mind.

cruisin, as to TPA i wasnt being sarcastic. it is just an over-hyped therapy. as much as we all wish it were better, it has shown mixed results in studies to date. it also has a big downside with some really bad outcomes from time to time. it is still a very controversial therapy with a lot of questions. thats all i was alluding to.

 

[tracydr]

I'm glad everything turned out ok!

 

[Diver003]

I'm glad everything turned out ok!

Me, too. What a relief. It's been a good lesson to practice extra conservatism in the future because now it hits much closer to home that potentially serious things can happen even if you don't do things wrong.