DCS hits: "deserved" vs. "explained"

[jazzymusicman]

The terms deserved and undeserved definitely suck. I had a type 2 hit a few weeks ago and when it felt like I was a Mike Tyson's punching bag and I couldn't feel/move my legs for a few minutes, the last thing I was thinking about was what Scubaboard or anyone else would think. At the time, I felt the hit was totally undeserved because I was within NDC limits on my computer. After I was treated and had a full recovery, I thoroughly discussed everything that happened amongst my dive buddies, instructor, and instructor friends and came to the conclusion that I probably did deserve it. I never posted the event in the A&I thread because I've always felt that the criticism received there for DCS hits was way more judgmental than constructive. Whether that was based on terminology or not, I can't say. Would it have prevented me from going to the hospital? Never. I think that victims that refuse treatment are being influenced more by denial than what they expect everyone else's opinion to be.

 

[TSandM]

As a physician, I think the OP has a real point. One of the problems with controlling sexually transmitted disease has always been the patient's reluctance to seek care, because of the stigma of having "the clap". It's the same way with anything where embarrassment is involved.

When the diver feels that mentioning symptoms is equivalent to admitting to being incompetent or having been an idiot, he will wait longer and be more reluctant to seek treatment. It's human nature. Getting rid of the stigma of DCS being something you "deserve" would almost certainly make people more willing to consider the diagnosis. However, no matter what you do with the stigma, there are still the issues of inconveniencing other people on a boat, difficult access and cost, that will impede diagnosis and treatment.

 

[Akimbo]

As a physician, I think the OP has a real point. One of the problems with controlling sexually transmitted disease has always been the patient's reluctance to seek care, because of the stigma of having "the clap". It's the same way with anything where embarrassment is involved...

I have the cure for that problem. Instructors should ask every student: What is more embarrassing, getting bent and treated or living in a wheelchair with a colostomy bag because you chose to hide your symptoms?

I don't see a useful purpose in differentiating between hits that occur while following all the rules or because you screwed up. The treatment is the same.

 

[PfcAJ]

All DCS hits are deserved.

All tables have a non-zero chance of DCS. The only way to be sure you can't get bent is to not dive.

Its a sports injury. Sport long enough, and you'll get hurt, even if you try and avoid it.

 

[victorzamora]

Akimbo & AJ:

I'm very close to agreeing with you. I totally understand what you mean. Whether they're deserved or not, the wording is referring to whether or not deco algorithms predicted safety or not. However, I think one reason to separate them is that they teach us separate lessons. "Deserved" hits teach people to be more vigilant. We all know to stay within our algorithm's limits (or NDLs or whatever), so WHY we violated that teaches us something. Did they ascend too fast? Loss/lack of buoyancy control? Poor gas management? Was it just a better bent than dead situation? How can we mitigate that? Is it the diver's fault, or is it just a freak of nature, or is it directly poor technique on the diver? If it's an "undeserved" (or unaccounted for, unexplained, un-whatever) hit, it might teach us about a certain algorithm. If several people are getting hit using GF15/85 and they all happened to be diving long exposures at relatively shallow depths (square profile, NC wreck dive, for example) then maybe gradient factors should be changed for those circumstances. Maybe a different algorithm should be used.

Patterns might evolve with enough reported "undeserved" hits, regardless of whether you consider it a sports injury or not. For example, playing in the NFL is likely to get you a concussion....but QBs get it more often than average players, so their vulnerable position makes them more likely to get "hit" with a concussion. Maybe that's something we should protect. In MX, falls are likely....but if this triple-triple-double is having a lot of people shorting the second triple, maybe they should shorten the gap a little bit. When patterns emerge, you can make changes to the way you play the sport to allow for greater safety.

Maybe we need an A&I forum where the OP can be anonymous and just identified as the OP, and give him full control to edit/delete/remove comments from the thread. The OP can post what happened, and clarification questions can be asked/answered but judgemental/tangiential discussions can be deleted. Jazzy, would you post more details in A&I if that were the case?

 

[mala]

All DCS hits are deserved.

All tables have a non-zero chance of DCS. The only way to be sure you can't get bent is to not dive.

Its a sports injury. Sport long enough, and you'll get hurt, even if you try and avoid it.

its not boxing.

its diving

And yes all hits are deserved.

 

[PfcAJ]

If you violate the your ascent parameters, you definitely deserve it. But "underserved" and "unexplained" etc etc simply don't exist.

 

[Wolfie_47]

I guess I'm curious; is it the medical community that are applying these labels or the dive community? Perhaps both?

 

[victorzamora]

Wolfie: It's mostly the dive community.

AJ: What do you mean by that statement? Who were you replying to? I think I disagree with part of it, but it's so random I'm not sure what you mean.

 

[Wookie]

I think divers use the terms to explain that they know why they took a hit, or they don't know why they took a hit. The problem with any of the terms is that there is some chance, no matter how small, of getting a bubble somewhere that will cause a problem, regardless of the circumstances of the dive. In that case, if the diver chose to dive, there is a small but very real chance of taking a hit.

It's interesting. When we have a diver take a hit, we don't review dive computers, we don't ask for profiles, we ask no questions that would assign blame to the diver or not assign blame to the diver. We take first aid actions, and if first aid doesn't solve the problem, we go to higher medical authority. I've only seen "blame" assigned by chamber techs and Monday morning quarterbacks.

Also, I am far more likely to suspect something is wrong with a diver then they are themselves. What I mean is that a diver will shrug off a symptom that I will see as a sign later, rubbing of shoulder, dead foot while walking, extreme fatigue. Since I have come to understand that oxygen is first aid for diving accidents, I am way quicker to put someone on O2 and see if they improve (a sure sign that something is wrong) then I used to be when I ran this boat for someone else, when the protocol was, if you put them on oxygen they were going to a chamber to be evaluated by the doc. Sometimes folks really are tired, and sometimes they did wrench their shoulder coming up the ladder. Oxygen is a very valuable diagnostic tool.