Patoloco
Registered
Please bear with me, this is a nicely detailed history from a friend and I want Dr. Decompression to have a chance to weigh in on the full story. If anyone has additional diagnostic test suggestions (MRI of neck was one idea i had), or treatment ideas, please chime in.
Demographics: 40 yr old fit captain who runs a live aboard dive/education business in the summer and skis in the winter. No smoking, social drinking. No history of pulmonary/cardiac problems. No family history either. Positive history of decompression sickness (the bends), treated in a chamber at least once in the past.
Tests done so far (all neg):
1. esophageal echo
2. CT chest with contrast
His story:
....I have mostly stopped diving completely.This summer, I had a real need for making a video this past summer of divers in training for marketing purposes. I decided to allow myself one dive this summer, to 10 feet of water, for 15 minutes, and with a 5 minute safety stop at 5 feet and a really slow ascent.
With all these precautions, I still had DCS type symptoms several days later (not within the first 24 hours). My symptoms were:
1. pain in my chest on the right side,
2. pain and unusual sensation in my neck and arm
3. sense of fullness in neck.
Due to logistics, I choose not to seek hyperbaric treatment for the symptoms;they eventually mostly subsided in a few days and NSAIDS worked well. This was the ONLY dive done in over a year, including any free dives greater than 6 feet in depth.
In the last 1-2 years, I have had several within-limits DCS hits and I suspect there is some other problem than lack of decompressing that is going on.
Disturbingly, the symptoms occur without diving. When lecturing or if I speak loudly for a period of time, I notice pain for a few days in my chest and neck. After one lecture, I looked in the mirror and the right side of my neck was visibly swollen. It creates pain in a specific spot on the right side of my chest, my arm can go numb, and in general it sucks.
Other inciting events:
1. blow into the didgeridoo
2. holding my breathe. I have found that I can only free dive if I let a significant bit of the air out of my lungs before descending. Last year I got seriously “bent” with skin bruising, severe chest pain, and numbness from a breath hold dive to 60 feet. Although theoretically possible, it should not have happened since it was 1 dive without compressed air or anything.
3. If I drink several fizzy soda drinks, it seems to increase the discomfort in my neck.
Worse, in August I went snorkeling for a couple of hours and used extreme self discipline in not doing any free dives, not even to a couple of feet, just breathing through the snorkel at the surface. A short time after leaving the water, I thought that I was coming down with a cold, I had a terrible time swallowing and my neck and throat hurt. I subsequently never developed a cold though.
Last Winter, while living in Aspen, I had a cold and was coughing a lot. I went out skiing upon feeling better and went up to the top of the cirque in snowmass (11,000 feet). I coughed in the cold air and my chest started to feel funny (numbness in my arm, chest pain). Upon returning home with ongoing chest pain, I went to the emergency room. They ran a battery of tests (yet another chest x-ray, blood work, ecg) and no sign of any cardiac problems.It all resolved in a few days. Even an esophageal echo was normal.
Last December I had a full CT scan with contrast done of my chest; it came back with a clear bill of health. The pulmanologist said that I was the healthiest lung patient he had ever treated...
I feel what I develop is subcutaneous emphysema. The signs and symptoms all seem to match wikipedia references, except there are no crunchy or pop sensations. I currently have symptoms (chest pain on right side, fatigue feeling in arm, fullness in neck) to a slight degree that I can exacerbate by simply talking loudly for 15 minutes.
Demographics: 40 yr old fit captain who runs a live aboard dive/education business in the summer and skis in the winter. No smoking, social drinking. No history of pulmonary/cardiac problems. No family history either. Positive history of decompression sickness (the bends), treated in a chamber at least once in the past.
Tests done so far (all neg):
1. esophageal echo
2. CT chest with contrast
His story:
....I have mostly stopped diving completely.This summer, I had a real need for making a video this past summer of divers in training for marketing purposes. I decided to allow myself one dive this summer, to 10 feet of water, for 15 minutes, and with a 5 minute safety stop at 5 feet and a really slow ascent.
With all these precautions, I still had DCS type symptoms several days later (not within the first 24 hours). My symptoms were:
1. pain in my chest on the right side,
2. pain and unusual sensation in my neck and arm
3. sense of fullness in neck.
Due to logistics, I choose not to seek hyperbaric treatment for the symptoms;they eventually mostly subsided in a few days and NSAIDS worked well. This was the ONLY dive done in over a year, including any free dives greater than 6 feet in depth.
In the last 1-2 years, I have had several within-limits DCS hits and I suspect there is some other problem than lack of decompressing that is going on.
Disturbingly, the symptoms occur without diving. When lecturing or if I speak loudly for a period of time, I notice pain for a few days in my chest and neck. After one lecture, I looked in the mirror and the right side of my neck was visibly swollen. It creates pain in a specific spot on the right side of my chest, my arm can go numb, and in general it sucks.
Other inciting events:
1. blow into the didgeridoo
2. holding my breathe. I have found that I can only free dive if I let a significant bit of the air out of my lungs before descending. Last year I got seriously “bent” with skin bruising, severe chest pain, and numbness from a breath hold dive to 60 feet. Although theoretically possible, it should not have happened since it was 1 dive without compressed air or anything.
3. If I drink several fizzy soda drinks, it seems to increase the discomfort in my neck.
Worse, in August I went snorkeling for a couple of hours and used extreme self discipline in not doing any free dives, not even to a couple of feet, just breathing through the snorkel at the surface. A short time after leaving the water, I thought that I was coming down with a cold, I had a terrible time swallowing and my neck and throat hurt. I subsequently never developed a cold though.
Last Winter, while living in Aspen, I had a cold and was coughing a lot. I went out skiing upon feeling better and went up to the top of the cirque in snowmass (11,000 feet). I coughed in the cold air and my chest started to feel funny (numbness in my arm, chest pain). Upon returning home with ongoing chest pain, I went to the emergency room. They ran a battery of tests (yet another chest x-ray, blood work, ecg) and no sign of any cardiac problems.It all resolved in a few days. Even an esophageal echo was normal.
Last December I had a full CT scan with contrast done of my chest; it came back with a clear bill of health. The pulmanologist said that I was the healthiest lung patient he had ever treated...
I feel what I develop is subcutaneous emphysema. The signs and symptoms all seem to match wikipedia references, except there are no crunchy or pop sensations. I currently have symptoms (chest pain on right side, fatigue feeling in arm, fullness in neck) to a slight degree that I can exacerbate by simply talking loudly for 15 minutes.