DCS versus Neurological Symptoms

[Jax]

Please advise them in advance so they don't initiate a stressful response.

Absolutely! Just like I warn them I always spew like a shook-up coke can . . .

 

[Cave Diver]

Ewww....

 

[Kevrumbo]

Two questions on this if you'll entertain them Lynne.

1. Do you have an opinion on whether a pre-existing injury such as a compressed disc would pre-dispose someone to DCS by providing a 'starting point'?

2. Do you feel that relief of symptoms after treating with 100% would be enough of a diagnostic differential to conclude DCS?

There is certainly a theoretical concern with any area of tissue damage being a nidus for DCS, due to reduced perfusion (or perhaps activated immunological activity) but I don't think there are any data to show that this actually occurs.

Response to oxygen is only information. The placebo response is pretty well-developed in humans.

The information on complement activation has not been reproducible.

The actual intracellular changes that the NEDU guys were talking about were changes in membrane permeability and thickness, especially in mitochondria, if I am remembering a rather brew-laden evening's discussion correctly. They were beginning to think there was actually some cellular phenomena, in addition to the ischemia and inflammation concepts that have been long-standing.

Just a comment on "Response to oxygen is only information":

That information can be a critical decision point in the field, for electively taking the risk of In-Water-Recompression (IWR) treatment at a remote location.

The Pyle IWR Table and Treatment Flow Chart requires a 10min surface evaluation while breathing Oxygen --(see http://rubicon-foundation.org/graphics/Pyle_IWR_Tx_Alg.jpg)
________
See also:
http://www.scubaboard.com/forums/5758901-post18.html

 

[Bubbletrubble]

Just a comment on "Response to oxygen is only information":

That information can be a critical decision point in the field, for electively taking the risk of In-Water-Recompression (IWR) treatment at a remote location.

The Pyle IWR Table and Treatment Flow Chart requires a 10min surface evaluation while breathing Oxygen --(see http://rubicon-foundation.org/graphics/Pyle_IWR_Tx_Alg.jpg)

The Pyle Treatment Flow Chart notwithstanding, from everything that I've read, presumptive oxygen treatment at 1 ata is of questionable DCS diagnostic utility. And, yeah, I'm aware that the Pyle chart specifies an "evaluation" period at 25 fsw while breathing O₂ as well.

If you're experiencing symptoms that make you wonder whether you have DCS, you should get on O₂ immediately, be evaluated by a dive-savvy medical professional, and undergo hyperbaric treatment if indicated.
If you have a back condition that makes it difficult to distinguish between exacerbation of the back condition and a DCS hit, it would be prudent to avoid diving in a remote location where medical facilities are limited. IWR carries significant risk. How many dive ops in remote locations have the training and equipment (full face mask reg, a trained supervisorial tender, and a means of communication with the surface) to help mitigate that risk? Why put yourself in that situation in the first place?

 

[Kevrumbo]

The Pyle Treatment Flow Chart notwithstanding, from everything that I've read, presumptive oxygen treatment at 1 ata is of questionable DCS diagnostic utility. And, yeah, I'm aware that the Pyle chart specifies an "evaluation" period at 25 fsw while breathing O2 as well.
If you're experiencing symptoms that make you wonder whether you have DCS, you should be evaluated by a dive-savvy medical professional and undergo hyperbaric treatment if indicated.
If you have a back condition that makes it difficult to distinguish between exacerbation of the back condition and a DCS hit, it would be prudent to avoid diving in a remote location where medical facilities are limited. IWR carries significant risk. How many dive ops in remote locations have the training and equipment (full face mask reg, a trained supervisorial tender, and a means of communication with the surface) to help mitigate that risk? Why put yourself in that situation in the first place?

see:
Oh Dear.. You're "bent" and a long way from home.. IWR anyone?

Nevertheless, O2 breathing at 1ATA (IMHO, in light of my own albeit anecdotal experience) --should not be trivialized by allusions to "questionable DCS diagnostic utility" or "the placebo response is pretty well-developed in humans."