DCS in Cozumel

[uncfnp]

Sorry to hear about your hits. I have dealt with skin bends for many years and have researched, spoke with multiple fellow sufferers and professionals and adapted my dives and profiles accordingly. Cozumel dives are very adaptable to conservative dives without any need for private DMs if you chose the right dive ops, especially if you are experienced and can manage your own dive profiles. If there is anything I can help you with please let me know.

Lisa

 

[mcohen1021]

Where do you jump from he suffered DCS to he ruined the day twice for a lot of people? Pretty HUGE jump and accusation for not knowing all of the details or circumstances. We're not talking about a liveaboard that had to turn around to go back to port - we're talking about day boats - it's very likely that his symptoms didn't even present until he was back at his hotel.

With all due respect, he most probably did if the signs showed up prior finishing the day out. And continuing to dive knowing he has this condition that makes him more susceptible to DCS puts him and all others around him at risk. He should have taken the proper precautions after the 1st bout rather than risk it. Again, if his decision is to continue to dive (which it is) and to do nothing about his medical condition (which it is), he needs a private charter, a private DM and lots of insurance – he is obviously going to need it. That or quit.

 

[uncfnp]

You've ruined the day twice for alot of people. If your goal is to manage the risk, then you should be on a private boat with a private DM and an air ambulance on the ready.

I’m sorry but this is nonsense.

 

[Christi]

With all due respect, he most probably did if the signs showed up prior finishing the day out. And continuing to dive knowing he has this condition that makes him more susceptible to DCS puts him and all others around him at risk. He should have taken the proper precautions after the 1st bout rather than risk it. Again, if his decision is to continue to dive (which it is) and to do nothing about his medical condition (which it is), he needs a private charter, a private DM and lots of insurance – he is obviously going to need it. That or quit.

With all due respect - again - you DO NOT know that! How do you know he continued to dive presenting symptoms? How do you know that his symptoms presented on the boat before the dive day was over? It's often not until divers are back in the room and have showered, or sitting at lunch or dinner that symptoms present. Sometimes the symptoms are so subtle the diver doesn't even realize something is wrong until the evening, several hours after the dive. Have you dove Cozumel and are you familiar with how close to shore we dive and how close to medical facilities we are? I don't know, that is why I am asking.

Curious, have you ever been bent? Have you actually done the research and heard Dr.s opinions and advice on the matter? DCS is not a "pre-existing" condition and there is no evidence that having one hit means you are more susceptible to a subsequent hit, especially 5 years down the road. There is a lot of OLD information out there that divers spread around without really knowing what they are talking about with regards to DCS. It does not just happen from diving too deep or too long or being dehydrated - there are sooo many variables and no certainty.

Truth be told - the ONLY way to prevent DCS for ANYONE is not to dive (or as Dr. Piccolo says "or not to come up).

 

[KenGordon]

Well, I suffered round 2 of DCS in Cozumel last week. (First one was five years earlier, also in Cozumel.) I've spoken with two doctors and DAN since; they agree on using EAN 36 in the future, watching hydration, using air tables to plan dives, avoiding exertion, and planning for long surface intervals, although they offered three different recommendations for dive profiles. I can't dictate the dives to an entire boatload of divers but I don't want another session of Navy Level 6 treatment either, so I'm wondering how to arrange future dive trips - specifically how to accommodate the restricted depth and long surface interval.
For clarity, one doctor said 80 feet on the first dive and no deeper than 45 on the second; the second doctor advised no deeper than 60 feet and diving on alternate days only (which really doesn't make a dive trip worth doing), and the third (DAN) did not recommend a specific profile but advised me to plan the dives conservatively.

Maybe choose a destination with decent shore diving. Then you are not diving to the rushed schedule of the operator with an inadequate SI. You will also get to have more choice of profile.

It is not uncommon to discover a PFO after many years diving. The question is not so much as why did I get a hit now a second why not before?

 

[rsingler]

PFO (of any size) is significant if right atrial pressures exceed the left, resulting in brief right to left shunt.
You didn't describe your symptoms, but since exertion is very highly correlated with microbubbles, and you note "sneezing three times", you have described exactly the sort of setup for a brief right to left shunt of existing bubbles.

There are catheter methods of closing small PFOs that are not as invasive. If you want to still dive and you have had two DCS hits, it's pretty straightforward - you should close your PFO.
Changing SI or nitrogen loading will only decrease, not eliminate your microbubble formation, especially with exertion.

I would suggest you need to eliminate your demonstrated occurrence of R to L shunt.

All the above based on grossly inadequate data and some speculation.

Diving Doc

 

[Christi]

PFO (of any size) is significant if right atrial pressures exceed the left, resulting in brief right to left shunt.
You didn't describe your symptoms, but since exertion is very highly correlated with microbubbles, and you note "sneezing three times", you have described exactly the sort of setup for a brief right to left shunt of existing bubbles.

There are catheter methods of closing small PFOs that are not as invasive. If you want to still dive and you have had two DCS hits, it's pretty straightforward - you should close your PFO.
Changing SI or nitrogen loading will only decrease, not eliminate your microbubble formation, especially with exertion.

I would suggest you need to eliminate your demonstrated occurrence of R to L shunt.

All the above based on grossly inadequate data and some speculation.

Diving Doc

THANK YOU - this is excellent information and a much more precise explanation than my "layman" explanation.

 

[mmmbelows]

You might want to consider getting a second opinion. Just sayin'.

^^^ this makes a lot of sense for something this serious and detrimental to your diving future if you haven't gotten one yet

Hate to say it but have you considered that Cozumel might just not be the right place for you to dive anymore? Fully understand trying to figure out if you can find a way to continue diving there, but if not, I think it will be easier to fit the dive location to your diving limitations then the other way around. Just to come up with one example real quick -Switching to shore diving and making Bonaire your next favorite dive destination would give you back full control of your diving profile and may extend your diving career

 

[Brodydog]

I always appreciate these DCS threads. I learn something new every time. Thanks for sharing your experience Butch Fries. A good reminder for me to be more conservative.

 

[Butch Fries]

Where do you jump from he suffered DCS to he ruined the day twice for a lot of people? Pretty HUGE jump and accusation for not knowing all of the details or circumstances. We're not talking about a liveaboard that had to turn around to go back to port - we're talking about day boats - it's very likely that his symptoms didn't even present until he was back at his hotel.

Thank you. The symptoms presented well after I was off the boat on both occasions. I didn't ruin anyone's day. I really appreciate all the great advice from Christi, but once again I'm kinda sorry I posted at Scubaboard. I won't do it again.