Decompression Accident in North Sulawesi

[rsingler]

You have a point: the presence of "hidden" bubbles that coud create a symptom aftherwards. But for the suggested dive, just make the math. Nitrox @ 80% O2 gives you at 12 m a PPN2 of : 2,2 bar x 0,2 = 0,44 bar. Since the PPN2 on the surface is 0,8 bar, there is NO POSSIBILITY of further N2 bubble formation, on the contrary. Am I crasy, do I miss something?

Lol, you have a point! In fact, the extra ambient pressure at a lower ppN2 might actually amount to a little Inwater Recompression!

I'm sure you noted, but the ppO2 of EAN80 at 12m is over 1.6. You really didn't want to dive that deep, did you? My MOD for that gas is 24 ft. You must really love to dive!

 

[doctormike]

you are right 80% oxygen, the opposite is pretty close to air

Hey, since you are willing to try diving immediately after being treated for decompression sickness, you could also see if the conventional wisdom about the Paul Bert effect is wrong as well...

Ask your doctor friends if they agree that doing a dive with a PO2 of 1.76 is safe. At least if you have a seizure, you will be in pretty shallow water.

 

[Freewillow]

Can you please explain what you mean by having to rely on Murex to communicate with DAN and what is meant by lines of communication being cut quite frequently? Are these dropped calls or are you relying on people to relay messages? Given the amount of communication problems that you have slowly let us on to, is it possible that perhaps DAN tried to contact you but because they are going through a middle man (Murex), that the message got lost along the way or there was a miscommunication?

I am also confused about how Anilao comes into play here...I am thinking Anilao in the Philippines. You are closer to Manado or other chambers in Indonesia. The idea of getting worse and not having a chamber is scary. Did they tell you that it would be *24 hours to organize as in arrange logistics-wise* or that it would be *24 hours before you would be in a chamber receiving treatment*..or *24 hours before someone would be there to pick you up*? (I ask because these are all very different and have different implications.)

I feel terrible you got bent and am glad you are okay. I want to understand the whole DAN process a bit more and hope that you don't feel like I'm interrogating you.

No problem at all. Sorry about Anilao, I meant MAnado. I just flew hope yesterday and the 30 hours travel plus jetlag of 7 hours is taking a toll on me.

In order to facilitate communication, when the acute phase was over, this is the following morning, I moved to the restaurant of Murex, wich was very closed to Murex offices. So I was "literraly" less that 10 meter away from the phone. When I say that communication was erratic, it means that phone lines were cut quite frequently. Once it took 3 phone calls from DAN in order to get a 3 minutes discussion covered. The same thing with internet: very slow and cut because - what they told me - the wifi card was getting too hot.

This all is not Murex fault nor DAN, the place is just quite too remote. To give you an example: electricity in the rooms is down from 9 am till 6 pm. However, electricity in the office is kept on, except when lines are cut di to rain or god knows what................

 

[rsingler]

Hey, since you are willing to try diving immediately after being treated for decompression sickness, you could also see if the conventional wisdom about the Paul Bert effect is wrong as well...

Ask your doctor friends if they agree that doing a dive with a PO2 of 1.76 is safe. At least if you have a seizure, you will be in pretty shallow water.

Hey Mike, let's cut him a little slack.
I admire anyone with the strength to share a DCS story on this forum. Talk about opening yourself up to criticism!

 

[Freewillow]

Hey, since you are willing to try diving immediately after being treated for decompression sickness, you could also see if the conventional wisdom about the Paul Bert effect is wrong as well...

Ask your doctor friends if they agree that doing a dive with a PO2 of 1.76 is safe. At least if you have a seizure, you will be in pretty shallow water.

OK, I am tired of a 30 hours flight, jet lagged and.................So you know what I meant: i did not said I would dive immediatelly and even if the numbers do not square with the PPO2 max, you know what I meant. No need to play Dr Smartass. .

If you preffer, I will take the example that I took when I was in Indonesia. It is in French, but I am sure you will understand it.


Fais le calcul toi meme. 12 m soit une pression de 2.2 bars. Nitrox a 70% d oxygene et seulement 30% de N2. Soit une ppn2
2.2 x 0.3 = 0,66 bars. Comme en surface la ppn2 est de 0,8 bars, cela m'etonnerais que mon corps absorbe de l oxygene dans ces condtions"........ Lol

Guy

 

[rsingler]

Ça y est!

 

[doctormike]

You have a point: the presence of "hidden" bubbles that coud create a symptom aftherwards. But for the suggested dive, just make the math. Nitrox @ 80% O2 gives you at 12 m a PPN2 of : 2,2 bar x 0,2 = 0,44 bar. Since the PPN2 on the surface is 0,8 bar, there is NO POSSIBILITY of further N2 bubble formation, on the contrary. Am I crasy, do I miss something?

I don't know if you are crazy or not, I'm not qualified to make that judgement. But what you missed is that those calculations are for planning dives, not for estimating risk AFTER an episode of DCS.

The problem with being very clever about DCS is that there are so many unknowns. Multiple ascents are a risk factor for injury even without violating standard decompression tables - guess how I know that.

If you had some nidus of bubble formation in your shoulder, and you treated it by breathing O2 on the surface, but it hadn't cleared by the time of your next dive, I would think that you could be on an O2 rebreather and still get symptoms from the reduction in ambient pressure on ascent.

Again, I'm just guessing about this stuff, I'm not a hyperbaric doc, maybe one of them will chime in. I personally wouldn't dive a day or so after an episode of DCS, no matter how good my insurance policy was, and no matter how many docs told me what I wanted to hear. But that's of course up to you.

 

[doctormike]

OK, I am tired of a 30 hours flight, jet lagged and.................So you know what I meant: i did not said I would dive immediatelly and even if the numbers do not square with the PPO2 max, you know what I meant. No need to play Dr Smartass. .

You are right, I was being snarky. Sorry...

 

[doctormike]

Hey Mike, let's cut him a little slack.
I admire anyone with the strength to share a DCS story on this forum. Talk about opening yourself up to criticism!

You are right, I was being a bit obnoxious.

But the thing is that this isn't about making mistakes, which we all do. It's about normalization of deviance.

I don't think that it's good to post how it's OK to dive right after an episode of DCS - sorry, I think that needs to be commented on. I don't want new divers taking home the message that even if you have been bent, and a dive doc tells you not to dive (for six weeks or whatever), that it's OK anyway if you have the right insurance or profile or whatever.

 

[Dan]

I won’t say DAN is useless. In fact it’s the opposite. About 2.5 years ago, when I was in Cendrawasih Bay, Papua, Indonesia, I fell off a liveaboard stairs from the upper deck to the main deck, landed on my right knee & split my knee cap into two. Fortunately it was at the end of the trip, so I was able to fly to Jakarta at the scheduled time. I was sent to the hospital in Jakarta for the knee surgery. My medical insurance covered the surgery cost. Since I had to keep my right leg straight during the 24-hour flight home, DAN covered the $5000 one-way business class flight ticket (Jakarta-Houston) so I can lay flat on my back during most of the flight duration.