Decompression Accident in North Sulawesi

[outofofficebrb]

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.

Hey, you never mentioned this before! Hm.....So that is how I get a business class ticket home from Indonesia. Glad all is well now!

 

[rsingler]

My days as a hyperbaric doc are long gone, and I mostly follow along with @Dr Simon Mitchell and @Duke Dive Medicine .
But attitude toward In-water Recompression is shifting a little.
My initial thought was that Freewillow was asking about a recreational dive to continue the fun on his trip, and of course that would be ill advised.
But continued symptoms after surface oxygen with no nearby chamber? While I won't advocate it for anyone, especially on this forum, I can't say that sitting at 20 ft on oxygen with a buddy isn't something that I might think about. 1.6 atmospheres and no inspired nitrogen? Hmmm.
I'm watching the IWR discussions with much interest.
It's all about risk/benefit, and if I were far, far away and in trouble, who's to say what the best course might be? We have plenty of warnings about the risk of IWR, and going to 20' on O2 doesn't even begin to approach the USN IWR table. So perhaps others will weigh in on the risk/benefit issues with a Type I hit. In any case, though, in a faraway place...

 

[Dan]

Hey, you never mentioned this before! Hm.....So that is how I get a business class ticket home from Indonesia. Glad all is well now!

Yep. 100% Thanks.

6 months after the surgery I was back in Raja Ampat.

 

[scubadada]

Hi @Freewillow

Thank you very much for sharing your story. I have nearly 1500 DCS free dives but am aware it could always be me. Your episode illustrates the importance of a means of effective communication, dive insurance, and an ample supply of oxygen.

 

[Kevrumbo]

...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?

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.
,

Have you ever had a PFO screening test before @Freewillow ? The cutis marmorata/skin marbling symptoms you had are a troubling sign, especially if you have had a history of this condition before on post-dive. . . Read decompression diver Ken Sallot's account (@kensuf here on SB).

Things to consider when you are cleared to dive again, and want to travel abroad to remote divesites:

• Take a day-off after three consecutive days of multiple dives per day at a resort or liveaboard.
• Since you are Advanced Nitrox Certified, consider doing recreational safety stops on 100% Oxygen on the last day of consecutive multi-dive days before taking a day-off.
• And perhaps the most controversial contingency: suggest putting together an In-Water-Recompression kit -full face mask, O2 clean reg, wetsuit heater etc- and a modified Australian method O2 IWR profile, along with a dive operation that can reliably supply you with 11L Alu cylinders of Oxygen. (Not sanctioned or recommended by DAN, so don't even tell them you're thinking of attempting this).

 

[Freewillow]

Thanks Kevrumbo for your suggestion. I read @kensurf piece of material. Very interesting.

I have sold hearth valves during 5 years of my professional life, so PFO stories are not unknown to me, but I have never been screened for this, since this is my first hit after 850+ dives, among them over 200 deco dives.

As I said, I have a medical appointment with Dr. P. Germonpré in Brussels. He is well known in the field an is taking part, as far as I know, in a DAN(?) study on PFO and DCS. So I believe that I am going to the right place, by paying him a visit next week.

It goes without saying that I will report after my meeting with him. I am 69 years old and I guess my experience could benefit other - old - divers.

Finally, I do not understand the end of your sentance: "The cutis marmorata/skin marbling symptoms you had are a troubling sign, especially if you have had a history of this condition before on post-dive"

Best regards.

 

[Kevrumbo]

Finally, I do not understand the end of your sentance: "The cutis marmorata/skin marbling symptoms you had are a troubling sign, especially if you have had a history of this condition before on post-dive"

Meaning, "Have you ever had this skin marbling anytime before this incident?" -Just discuss it with the Physician on your medical appointment.

 

[Freewillow]

The answer is no. To tell you the truth, I have not seen the spots. My wife said "marbling red spots" . But I do not know for sure if they were separated red spots or a network of red filament like you see on cutis marmora pictures. Does it make a différence?

 

[Kevrumbo]

The answer is no. To tell you the truth, I have not seen the spots. My wife said "marbling red spots" . But I do not know for sure if they were separated red spots or a network of red filament like you see on cutis marmora pictures. Does it make a différence?

Cutis Marmorata skin decompression sickness is a manifestation of brainstem bubble embolization, not of local skin bubbles. - PubMed - NCBI

Definitely discuss it with the author of the above abstract (Germonpre P.), which coincidentally is the name of the Physician/Hyperbaric Specialist you will be seeing (?)

 

[Freewillow]

Thanks Kevrumbo, I read the abstract, does not sound like a good news to me