Decompression Accident in North Sulawesi

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Freewillow

Contributor
Scuba Instructor
Divemaster
Messages
1,674
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Location
Brussels
# of dives
500 - 999
Firstly, I would like to stress that I have no symptoms left at this stage. My goal is to show that any insurance - DAN in this instance - can show up quite a bit uselesss if you are stuck in the middle of nowhere.

We have left, my spouse and myself, for 2 weeks in Nordern Sulawesi: one week on Bangka Island ( Murex ) and One week in Lembeh ( NAD).

When we arried @ Murex, we got a very friendly reception: nice place, very few divers, good food.... The existence of a recompression chamber in Manado, 60/90 minutes away , was advertised: modern installation with multilingual international staff..........Dive was great 2/3 divers per guide, calm waters, depth between 20 to 25 meters. Very easy diving, 60 to 70 minutes. See in annex, the profile of my last dive there.

Just after my 11th dive in 4 days, I got a pretty violent pain in one shoulder stepping down from the dive boat. The pain diminished quite fast after a massage and lying down. Did I make a "bad move" stepping up the ladder, was my concern. Half an hour later, going to the toilet, I realised that my head was spinning a bit - I am used to that, low blood pressure. Back to the bed, and my wife notice my back full of marbelled red spots: now the Decompression sickness is well confirmed in our minds. CAll to the dive center and oxygen is administered within minutes, with plenty of 02 supply. They are blending their nitrox tanks on the spot. I forgot to mention that , for a few minutes, I got some tingling on the back of the left foot for some 5/10 minutes. Phobia or type 2 deco sickness, I wonder?

What was very frustrating was that I had no phone signal on this island nor could the dive center call emergency@DANeurope. I finally managed to get DAN some 2 long hours later by sending them an email, and they called us. First and largest problem, the chamber in Manado does NOT operate on this Sunday. I found out the next day, that the chamber had been out of work for quite awhile now.............. I was in contact however with an Italian and then a Belgian Doctor from DAN

If I need to go to the chamber, a sanitory evacuation will need to be organised to Bali or Singapore. This will take at least 24 hours. So let's concentrate on Oxygen therapy, that was the DAN message.

Most symptoms had almost dissapeared in less than an hour. I was left, in the following morning with only 2 small red spots on the side and a sense of heavyness in the left shoulder. New contact with DAN's doctors and more 02 with anti-inflammatory drugs. All back to normal at noon, this is roughly 18 hours after the onset. In total: oxygen foer 6+3+2+2 hours and a lot of water. So a happy ending after all.

Next question, is future dives during our vacation. To go to Lembeh from Europe and NOT DIVE is very though.

I got two opinions: the italian doctor said to wait 7 days, but he never put that in writing. The Belgian Dr did not allow any further diving, even very shallow onces with surox gas :(.
So no diving if I am not prepared to dive without any Insurance coverage. So this is what we did: no further diving.

I must say that the owners of NAD, Simon and Zee made a great effort in order to compensate for my loss in this case. They all have been wonderful @ NAD, bringing us left and right for snorkelling, providing good food, poll, jacuzzi etc during the stay at their place. No doubd that, Doctor's permiting, we will pay NAD a visit next year. The place is awesome.


I have an appointment with Dr Germompré in Brussels next week. I am scared to death about my future dive possibilities. Why did I get bent on dive # 862, staying well away from the deco curve, when I have at least 200 deco dives under my belt with no incident whatsoever? I am also nervous about the fact that this Doctor is a medical consultant to DAN. Is he going to have a neutral judgment when he is somehow, paid by DAN?

HAs anyone a qualified judgment on this?

In conclusion. What should one learn from this?

Such stupid accident seems to potentially hit anybody. The second thing is that, whatever insurance you have , there are places in this world that are SO remoted that you may be left on your own.

Best regards.


fetch



,
 
I wouldn't say that DAN was useless. In a pretty remote situation with a broken chamber, they advised the best they could for you.
As for your diving, you made the right decision. With a hit and no recompression, and a possible Type II, not diving again, even shallowly on Nitrox, was absolutely correct.
You need to look carefully at your preceding profiles, to see if this was truly out of the blue unexpected. First, you had been repetitive diving. How many were deep'ish? Second, having successfully done deco diving is irrelevant, sorry to say.
So was there anything that was even close to the edge for you? ANY strenuous activity in first 30 min after diving, even a difficult boat ladder? Were you cold on ascent?
You'll get conflicting advice on continued diving. You might check for a PFO, if you think your hit was truly undeserved, since we know that we ALL bubble, to one degree or another.
But all is not lost, yet.
You may need to crimp your style a bit as you age. That's life.

Good luck to you. I wouldn't think that seeing a DAN consultant will affect your result. I don't think that having been bent will make you uninsurable.

Diving Doc
 
Hi, there.

Sorry to hear you got hit but am so glad you are okay and on the up and up. I don’t get the sense that you were on your own, necessarily, but that they did not deem your case as requiring a medical evacuation immediately (serious enough) and that they thought it was treatable with oxygen. My understanding from attending a couple DAN seminars is that they do not always medically evacuate and do not always bring people to chambers depending on location and severity. Would you say that is a fair assessment or what was communicated to you?

I think your experience shows us how important having cell phone reception and/or a landline is. Maybe it is something we should consider in our future travels. (For LOBs this would be a satellite phone!)

I went muck diving for the first time in Oct and stayed at NAD Lembeh. I loved it there and will be back. It’s a great resort, isn’t it? I hope you will return and have some great diving.

Did you by chance have any dive travel insurance or travel insurance? Or any credit card coverage that would cover some trip insurance? You may be able to recover some trip interruption or trip cancellation depending on the clauses and scope of coverage on any portion that you were not able to get refunded.

@rsingler I don’t imagine being bent will make the OP uninsurable in the future either but I have not combed the fine print in DAN this. I understood it as if OP chose to go diving again after talking to DAN against their recommendation of not diving, it would affect his coverage for that specific occurrence.
 
May I ask what Island you were on to have no phone contact? I've always found Sulawesi to have good Comms - I managed calling Bunaken from Bangka with an indocell sim quite a few years ago. Thanks for the update re manado chamber, all the best.
 
Thank you Diving DOC.

I have the profile of my 11 dives, they are all very comparable.

The only thing that I, in retrospective, can remember, is that I was a bit tired pre dive 3. I felt that the dives had been so relaxing that this would help me relax while diving. This most likely was a "no go " message that I did not take seriously. My mistake.

When it comes to "exercice" during the dive, I must say that they were mostly "muck" dives in very shallow and friendly conditions. Water was 28°C, no current, good visibility.

To give you an idea, my SAC rate is normally around 14/15 L/min ( sorry about the european/metric usage here ) during these last 11 dives, the sac RAte was between 11.5 and 12.5 L/min. So CLEARLY LOWER. This should be a clear indication on the benign conditions of these dives.

Thank you for your help. I keep faith in the future :)
 
Sorry, I don't think that I quite understand. Are you objecting to the fact that you were told not to dive immediately after being treated for probably DCS? Or to the fact that your insurance might not cover you if you dive after being told not to?
 
Hi, there.


@rsingler I don’t imagine being bent will make the OP uninsurable in the future either but I have not combed the fine print in DAN this. I understood it as if OP chose to go diving again after talking to DAN against their recommendation of not diving, it would affect his coverage for that specific occurrence.

Thanks, I have read the fine print and this was clearly explained to me by DAN people. If you dive without DAN's express permission you are on your own. To think about the cost of a medical evacuation to BAli/singapore and the price of the chamber in these 2 countris was WAY enough to make me think twice about diving against their opinion.

May I ask what Island you were on to have no phone contact? I've always found Sulawesi to have good Comms - I managed calling Bunaken from Bangka with an indocell sim quite a few years ago. Thanks for the update re manado chamber, all the best.

Wingy, it was my mistake. There was some "bug" in my smartphone. Somehow my SIM card could not connect. So yes, any call was impossible FOR ME FROM Bangka. I found that out on my return trip in Singapore. Since I had no phone connection , I shut it down and restarted it. Everything was OK, again. So my mistake, I should have found out that I had a problem with my phone in Bangka. The only excuse I have is that I tried to discuss it with the employees from Murex. But in English, it is not always easy.
 
Thanks, I have read the fine print and this was clearly explained to me by DAN people. If you dive without DAN's express permission you are on your own. To think about the cost of a medical evacuation to BAli/singapore and the price of the chamber in these 2 countris was WAY enough to make me think twice about diving against their opinion.

If I had been bent and was told by a dive medicine specialist not to dive right away, thinking about the possibility of permanent neurological injury would be more of a concern than the fine print on my insurance policy and the potential cost of treatment.
 
Hi, @Freewillow. I get the sense that you are feeling like you were left out in the cold and in your words, DAN was useless given where you were diving. Can you please elaborate on this? I think it's an important point to discuss because many of us have DAN, and some don't have DAN that are considering DAN, etc. It's not often that I run into a member who has had to really utilize the services and benefit from their membership and policy so I'd like to understand it more.

I don’t get the sense that you were on your own, necessarily, but that they did not deem your case as requiring a medical evacuation immediately (serious enough) and that they thought it was treatable with oxygen. My understanding from attending a couple DAN seminars is that they do not always medically evacuate and do not always bring people to chambers depending on location and severity. Would you say that is a fair assessment or what was communicated to you? Do you feel like they should have acted differently and if so, how?

Thanks.
 
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