DCS

[DameDykker]

Two weeks ago on my summer dive vacation with my dive club my budy and I made a dive to 24 m, 20 min. It was a night dive in waters at ca. 12 deg. C at the bottom and very butiful. After a slow acent and 3 minuts safety stop. We was picked up by the boat and my budy had a mayor DSC hit with loss of feeling and movement in the legs followed by difficulties in breathing.

The oxygen helped very fast and we drove him to the nearest hospital where they put him on permanent oxygen. A few minuts later the ambulance picked him up and drowe him to the pressure chamber. Now two weeks later he still in the hospital and has recieved some 10-12 treatments and there is only slight problems left, which we hope will clear up with training and time. He probably get a 3 month ban from diving.

The lesson is that it was completly undeserved. I had a slight nitrogen load (SI >9 hours) and my budy non. And I am not in as good shape as he. No drinking involved, no dehydration, no other sickness. So everybody can get hit even well within the limits. Check your oxybox and your safety procedures.

 

[exnewwavedivers]

It only shows that even if diving within limits, the risk of DCS is present and as divers, we have come to accept this risk.

PADI, a big agency as it is, will only allow that the dive tables they produced have been shown to work only as far as it has been field tested.

What seems to be forgotten by some divers is that activities prior to and after diving, and not just the actual dive itself, can predispose a diver to DCS.

An example is: A diver did one dive, assuming that this diver did the dive conservatively and stayed within limits, BUT, at some point after the dive, decided to eat somewhere and had diarrhea causing the diver to have dehydration. That can lead to DCS.

 

[scubakat]

Hi DD, I hope that you & your buddy are back in the water soon!

See http://www.h2okinawa.com/mishaps/mishaps.htm for some interesting reading about some deservered & not deserved DCI incidents...

-kate

 

[rcohn]

Sorry to hear about your Buddy. Was he checked for a Patent Foramen Ovale (PFO)? This can provide an explanation for some unexplained hits.

For more info on PFOs see:
http://maths.uwa.edu.au/~adrian/scuba/pfoajb.html
http://www.scuba-doc.com/pfo.htm

Ralph

 

[WetDane]

Hi DD,

Thanks for posting this - I hope he is going to be well and will keep diving.

Dane

 

[DameDykker]

Nice stories scubakat. But if you compare these incidents to our profile and the severe hit my body had it really stresses how undeserved it was.

I know the theory about PFO and I don't know if he was checked for that. But I know they went throug all his resent medical story and even got the downloaded profile from my computer.

By the way he will be released today!

I made my first dive two days after the insident. I didn't really enjoy it - but back on the horse again.

Thank you for your concern.

DSAO

 

[Dr Deco]

Dear readers:

It must be remembered that “deserved” and “undeserved” apply only to table limits. They do not apply to physiology or to “acts of God.” There are always reasons for what occurs in nature even though we may not be aware of them.

When discussing the physiology of decompression, the case of a well-ordered system is always understood to be operating. This is not to say however that some unusual perturbation of the system may not occur at a very local level. We see this most easily in meteorology when a tornado forms in a very limited section of a storm from. The conditions are right in a very small microregion. Even if you could saw that the conditions are right for a funnel to form, you would have a very hard time describing in advance exactly where this would occur on the ground. It is often a “chaotic system” with “sensitive dependence on initial conditions.”

In diving, we can have the same thing, mutatis mutandi.

[sp]--- The flexing of the spinal column at an inopportune time during the off gassing (supersaturation) phase of the dive will result in micronuclei formation.
[sp]--- The reduction of blood flow will result in this nucleus growing and compressing the neural tissue of the cord.

The result is paralysis of both legs. In general, small movements of tissue are not very deleterious, but sometimes, bad things happen. All divers must be cognizant of such a contingency.

Certainly, the real culprits would be lift heavy objects and nucleating the spinal cord. I would think that moving heavy scuba tanks would definitely be a bad idea during the surface interval.

Dr Deco

 

[devjr]

Dr Deco, I was lifting and stowing my diving gear moments before the hit which I described and which you replied to on "DCS, it does happen" thread. My right leg and hip were paralyzed, gut wrenching pain. The paralysis remitted completely after an hour and without treatment other than aspirin and water, only to gradually return(but without pain) a few hours later. As I previously recounted, spent week in hospital, eventually recovered.

Lately, the medical community has taken to blaming certain kinds of stroke on the foramen ovale problem. Seems that a blood clot formed in the leg can be carried to the brain by this heart defect.

 

[Dr Deco]

Dear devjr:

It certainly is true that most problems involving the PFO do not arise in scuba divers. This passage of a clot from the veins to the brain though the PFO is termed a “crytogenic stroke” when a cause cannot otherwise be found. The most common cause of an embolic stroke would be from a clot that forms in the carotid artery, although it can also form in the heart.

If one has a clot in the legs, one might experience a vein-to-artery stroke, or paradoxical stroke, as the clot embolizes the brain. This type of activity often occurs to individuals who have been straining with Valsalva-like maneuvers. Among these are lifting boxes, moving furniture, pulling up bushes, coughing, etc. It is for this reason that I have begun to counsel divers against straining maneuvers when on the surface following a dive. :nono:

Not only does it promote nucleation, but it also increases the possibility of PFO-related DCS.

Dr Deco