Close Call; Glad I could write this incident report.

[InTheDrink]

Would TSandM, Duke Dive Medicine, Debersole or any other medical practitioner be able to answer Skydiver1's question? Thanks!

They might be able to but from what I've read so far there's nothing terribly helpful or conclusive. Some ppl, myself included, believe blood pressure is a factor, others don't. I'll try up post a bunch of links when I get home. High BP would appear to be a common factor but there again many middle aged men have slightly elevated BP. So it is not clear.

This is why I'm interested in not just why it occurs but also early warning signs. If we can't get a handle on the former maybe we can at least get some handle on the latter. Not perfect for sure but I do think that if there are early precursors to full blown PE then being aware of these might allow us to take evasive action early. And from my experience every minute does count.

Likewise I'm increasingly aghast at how frequently this might be happening but not reported. I might be being a bit dramatic here.

My final advice to any diver is: don't work too hard underwater. Struggling to keep up with guide? Blank it. Struggling against current? Blank it and go with flow. Strangely anxious? Get with bud ascent slightly. Or thumb dive.

Diving should be like yoga IMO. When its not then don't be worried to call it.

Apologies for blathering on but like I said I'm increasingly worried that this 'rare' phenomenon isn't quite so rare.

John

John

 

[Barracuda2]

IPE = Scary stuff. Excellent job by the surface support, and I'm glad you're okay. Any chance you'd be able/willing to share the dive profiles from the computer?

I don't have a computer cable for the Suunto Viper; I would share if I could; maybe I'll see if I can borrow one.

---------- Post added February 24th, 2013 at 04:00 PM ----------

Glad you are O.K !



Can you explain the above statement. Why would the pO2 setting "make" you do a deco stop?

Not really sure. The dive op told me the first dive was to be max 110'. When I set my Suunto Viper at 33% and a po2 1.4, max depth was 102'. i questioned this of course and the DM said set it at 33% with a po2 of 1.5. That allowed a 112' max; ok, that made sense. Then he said (as if it was common knowledge) that the only drawback is I will be required to do a 2 min. deco stop at around 18-20'; He was right. On both dives, my computer told me to stop for 2 min. deco, then shifted to a 3 min. safety stop. All divers on board were diving 1.5 po2. I'm sure someone else on this thread can explain the physics behind this. I'm not that guy.

---------- Post added February 24th, 2013 at 04:08 PM ----------

Well done mate. I've been there and got the t-short and its not a lot of fun. PM me if you want to chat: took me 9 months to get back in the water and every first dive I do I still get scary anxious. Then it's back to being awesome again ;-)

John

Thanks, John. My next dive will be in April in a very controlled environment: a quarry, and no more than 60'. I'm going to ask one of my buddies to stay behind me (ride my donkey) and keep an eye out for me. You and I both know that even though you're with buddies, most dives are really solo unless a buddy is right behind you or directly beside you. It takes only a few seconds for things to go sideways, and only a few seconds to get help.

---------- Post added February 24th, 2013 at 04:09 PM ----------

Glad you are ok, really scary stuff. I dive nitrox often but have never had any deco obligations. For my edification what bearing does having your 1.5 pO2 setting have on any deco obligations? Thanks.

Sorry, just saw that this was asked two posts ago. Read all the posts next time..........................

I answered on page 3

---------- Post added February 24th, 2013 at 04:10 PM ----------

Given the severity of your symptoms, I am somewhat surprised the dive boat didn't place you on o2 (on many boats that's automatic ER evaluation) and arrange transport to the hospital.

Glad it all turned out well and well wishes on future dives.

I was too "out of it" at that point to remember whether they did or not....not sure.

 

[openmindOW]

Barracud2, thank you for posting. Like the others, I am happy that you are okay.

It sounds like you handled everything well.

If I may ask, how ol are you?

Do you have anyithing in your history that might be relevant?

It take it that this was a solo dive. correct? (I'm not judging, just asking. for clarification.)

DukeMedicine seems to really know what he's talking about; please contact him.

 

[DandyDon]

Not really sure. The dive op told me the first dive was to be max 110'. When I set my Suunto Viper at 33% and a po2 1.4, max depth was 102'. i questioned this of course and the DM said set it at 33% with a po2 of 1.5. That allowed a 112' max; ok, that made sense. Then he said (as if it was common knowledge) that the only drawback is I will be required to do a 2 min. deco stop at around 18-20'; He was right. On both dives, my computer told me to stop for 2 min. deco, then shifted to a 3 min. safety stop. All divers on board were diving 1.5 po2. I'm sure someone else on this thread can explain the physics behind this. I'm not that guy.

Ok, well - with your 54 years of diving, I respect that you must be a well seasoned veteran - but your reply surprised me. Changing to 1.5 did not directly cause your deco. Let's discuss that on another thread tho...

 

[Barracuda2]

To the OP - what signals did you get, if any, prior to the event? I got wheezy/rattling breathing and cold. I then got tingly lips (presumably start of hypoxia) then feeling of going to pass out. I know from your post you got some of thee things but can you provide any more detail? If there's any commonality to the onset of symptoms we might be able to work out mitigating strategies.

John

First, slight need to clear throat
Second, more clearing of throat, and more intense (stuff coming up)
Third, labored breathing; severe rattling in my chest; some wheezing.
Fourth, Very labored breathing; a feeling of suffocating which led to light-headedness; the next step would be passing out.

 

[rongoodman]

Not really sure. The dive op told me the first dive was to be max 110'. When I set my Suunto Viper at 33% and a po2 1.4, max depth was 102'. i questioned this of course and the DM said set it at 33% with a po2 of 1.5. That allowed a 112' max; ok, that made sense. Then he said (as if it was common knowledge) that the only drawback is I will be required to do a 2 min. deco stop at around 18-20'; He was right. On both dives, my computer told me to stop for 2 min. deco, then shifted to a 3 min. safety stop. All divers on board were diving 1.5 po2. I'm sure someone else on this thread can explain the physics behind this. I'm not that guy.

It looks like your Suunto was adding some extra conservatism to the depth/pO2 calculations by using 34% instead of 33%, no physics involved. (Doing the arithmetic gives me 107' for a p02 of 1.4 and 117' for a pO2 of 1.5 with 33%.) This was just an exercise to keep your computer happy--it didn't change the amount of O2 you were exposed to. You can't say much about the added deco stop without knowing how long the dive was or how the Suunto is calculating deco obligations.

 

[Barracuda2]

Barracuda, Like all the others: I'm glad you are OK and thanks for sharing. This helps us all understand the dangers of diving and helps make us safer. I do have a few non-medical questions. These are to help us all and NOT to assign blame (there isn't any) or criticize anyone. You were obviously in very deep distress, and it is also obvious you are an extremely experienced diver...

When you surfaced what steps did you take to remain on the surface? Do you feel in retrospect that they were adequate? In retrospect can you think of anything you would do differently in the ascent? in the surface time before rescue? Lastly, were you solo diving? (no criticism here - I also solo dive) and if you weren't what did your buddy do to help? If you were, do you think an average buddy would have been a help?

Great questions, raftingtiggr. When I surfaced, I first located the boat. I had enough sense to keep the reg in my mouth even though my body desperately wanted to take it out thinking I would get more air but I was in some swells and chop. I took it out briefly once to spit so I could see what was coming up. I began waving my right arm in arcs as a distress signal, and the capt. reacted quickly. (fortunately, he was not engaged in picking up other divers) Because of the swells, it took him a few minutes to maneuver the stern to me. (to me it seemed like an eternity) My BC was adequately inflated; I let a little air out so I could roll more on my back which seemed to bring some relief for a while. There was nothing I could do more on the surface to help my situation. I prayed a lot. In retrospect, on the ascent, I may have skipped the 3 min. safety stop. Everything happened so fast, (within 8-10 min.) I would have gained an extra 3 min. to communicate my distress and get help. I was diving with a group, but in drift diving, sometimes you just get separated; so, yes, I was solo. Had I had a buddy with me, there would be nothing he could do for me but give me words of encouragement. Even if the buddy was a rescue certified diver, under the conditions, I don't think he would have been able to help me if I passed out other than get me to the stern ladder once the boat got to us. Hope this helps.

---------- Post added February 24th, 2013 at 05:12 PM ----------

Ok, well - with your 54 years of diving, I respect that you must be a well seasoned veteran - but your reply surprised me. Changing to 1.5 did not directly cause your deco. Let's discuss that on another thread tho...

Don't know, Don; when diving deeper, I monitor my computer closely. I know for sure that I did not take it into deco before my ascent. My NDL was always in the double digits or close; no more that 8 or 9 min. out. I know my Suunto is more conservative than most computers and maybe that had something to due with it. The DM told me it would command deco time even if I didn't take it into deco, and it did. Go figure.

---------- Post added February 24th, 2013 at 05:25 PM ----------

Barracud2, thank you for posting. Like the others, I am happy that you are okay.

It sounds like you handled everything well.

If I may ask, how ol are you?


Do you have anyithing in your history that might be relevant?

It take it that this was a solo dive. correct? (I'm not judging, just asking. for clarification.)

DukeMedicine seems to really know what he's talking about; please contact him.

I just turned 70 on the 9th of this month. I do work out cardio and muscle on a regular basis. (I have to, to stay up with my younger dive friends) I recently went on two meds related to A-Fib, but DAN nor my cardiologist can confirm that they had anything to do with the IPE hit. (Personally, I think they did) I'll be talking to a DAN cardiologist soon to get more info on this. Recently, I've done a lot tougher dives than this in the Great Lakes and had no problems at all. I was not on those meds at that time. I was diving with a group, but in drift dives, sometimes divers get separated; yes I was solo. I am solo certified if that means anything. I PM DukeMedicine and am waiting for their response.

 

[raftingtigger]

Barracuda2. Thanks for the info. IMHO your skipping the safety stop might have saved your life. Certainly got you to help 3 min faster.

I wonder if anyone knows if IPE progression slows or even stops with ascent, or does it take removal from the water and maybe even positive pressure breathing.

Sounds like if a diver feels like they need to "clear their lungs" it is time to thumb the dive, NOW. It would be interesting if anyone else who has suffered an IPE episode can chime in with their initial symptoms.

 

[Barracuda2]

Barracuda2. Thanks for the info. IMHO your skipping the safety stop might have saved your life. Certainly got you to help 3 min faster.

I wonder if anyone knows if IPE progression slows or even stops with ascent, or does it take removal from the water and maybe even positive pressure breathing.

Sounds like if a diver feels like they need to "clear their lungs" it is time to thumb the dive, NOW. It would be interesting if anyone else who has suffered an IPE episode can chime in with their initial symptoms.

For me, one of my pre-dive safety checks from now on will be to cough or clear my throat just to see if I get anything up; If not, I dive, and if I feel the need to clear just once, and stuff comes up, the dive is over and I'm heading to the surface with no safety stop. Back in the late 50's, 60'a and 70's safety stops were unheard of and I got by ok without them. However, if my dive is uneventful, I will safety stop.

 

[Ayisha]

I wonder if anyone knows if IPE progression slows or even stops with ascent, or does it take removal from the water and maybe even positive pressure breathing.

Breathing often does not improve upon ascent. The person's lungs are filling with liquid and less and less oxygen is getting to the brain. Sometimes it resolves on the surface but sometimes it does not. The protocol is to administer O2 right away (even if symptoms diminish), possibly with a CPAP, and then seek medical attention.