DCS and Bone Density

[marinediva]

Hi
I have been diving for some years and during that time have had two confirmed cases of DCS Type1 as well as possibly two or three other cases but unconfirmed and not treated.
The first three were working in a commercial situation, and were put down to fatigue.
The fourth case was in 2007 and the last time in March 2009.

During the past three years I have done over 1000 dives. I did not dive from March till just recently. On my second dive I broke two ribs getting into the boat. Then, this week I had a kayak fall and hit my chest cracking my stirnum. From 2006 to now this will make six cracked ribs.

At first I just thought I was accident prone, but I have been doing some reading and suspect it may be more than that. My doctor wishes to do some Bone density testing,
but I am concerned as it will appear on my medical record.

Bottom line, I would rather save for a hip replacement than give up diving.

Is it possible for DCS to have long term effects on the bone structure?
If so, what number of incidents of DCS does it become a problem?
Besides the obvious broken bones, what other risks are involved with diving and brittle bones?
Is it possible for only one part of the body to be affected? ie my chest, ribs,etc.

thanks

 

[kwflfire]

I do not know the answer, but I have a friend that has been bent 5 -6 times and was told that his thigh bone looks like swiss cheese. Bad news he was told that he could never dive again. A year ago he had double hip replacement, don't know if there is a relation.

 

[AzAtty]

Rapid decompression can adversely affect bones. Dysbaric osteonecrosis, for example, may result from a single exposure to rapid decompression.

Aseptic bone necrosis and bone lesions are not uncommon afflictions for commercial divers. In one study published in 1974, nearly 60% of the 450 divers surveyed demonstrated some degree of aseptic bone necrosis. Nearly 20% had bone lesions. The authors recommended that compressed-air workers be frequently monitored for evidence of bone damage.

Therefore, depending upon the OP's compression and decompression profiles over the years, it is not necessarily surprising to see adverse affects on the skeletal system.

 

[rmc77]

All tissues, including bone, are susceptible to DCI. In the case of bones, the real issue is the aseptic bone necrosis, also referred to as avascular necrosis or osteonecrosis.
This is a disease resulting from the temporary or permanent loss of the blood supply to an area of bone and it may be caused from prolonged, repeated exposure to high pressures. The bones become weakened, and can collapse.
Aseptic bone necrosis risk is insignificant for sport divers but it's a well-known disease for commercial and military divers (but not completely understood)... Most commercial divers are required to at least undergo periodic X-Rays exams for early detection of the disease. So... if your doctor is suspecting bone structure damage I would highly recommend you to do what he wants you to do... Just in case. Osteonecrosis is very serious.

Common treatment? Bone replacement, metal resurfacing and bone transplant. Neither of those seem to be very “friendly” treatments…

 

[Gene_Hobbs]

In addition to the comments on dysbaric osteonecrosis above, you might also be interested in reading this:

Cimsit, M; Ilgezdi, S; Cimsit, C; Uzun, G (December 2007). Dysbaric osteonecrosis in experienced dive masters and instructors. Aviation, Space, and Environmental Medicine 78 (12): 1150–4

There is also a very nice report from Lamar on TDS.

And of course, more in the RRR with the term dysbaric osteonecrosis

Good luck!

 

[Dr Deco]

Hello marinediva :

Aseptic bone necrosis [ABN] is found mostly in commercial divers. The shortest ‘dive’’ of which I know – a submarine escape – followed by ABN is one pressurization and ascent. I did speak with one woman who worked as a dive guide [recreational gas loads] and developed ABN after fifteen years. [She was diagnosed by a physician/researcher in Hawaii.]

Diving ABN are associated with lesions in the head of a long bone [typically the femoral bone], and not the shaft.

I would think the tests are better to warn of problems down the line.


Dr Deco :doctor:

 

[marinediva]

Thanks Dr.
Am starting diving again this week so will see how I go.
Have been taking High doses of calcium and spending lots of time in the sun Vit D as well as some other natural remedies.
If anything breaks in the next six months I will be off to the doctor for full scans.