dive buddy got bent

[flots am]

It is sort of a long story and one that i feel bad about enough already. My long time dive buddy is also my long time girlfriend. She lets me handle all the technical aspects of the diving. I take care of the gear and is usually the person educating/reminding her about any risk and such. End result is that there was no uncontrolled assent or radical deviation from the planned dive.

Your GF was stable with no symptoms in the ER.

This means that as long as the O2 doesn't run out, they're going to treat the guy with the gunshot wound, the old guy with the heart-attack, the person who might be having a stroke and the guy with the infection that might eat all the flesh off his body in a few hours.

When everybody else is all set, then they'll take care of the people who have colds and should have stayed home and the people who had DCS symptoms that resolved on O2.

If you would have cooled your heels for a while, they would have eventually taken care of your GF.

flots.

 

[jimmy71]

How do these discussions get so twisted up?

He expected that they would proactively contact someone OTHER than them, someone in the medical profession, on their behalf, to ensure that they were seen by someone with some basic information about DCS. This didn't happen. All DAN did was talk to them personally, and give them names and phone numbers. Is that what we're paying for? I hope not, because if that's all they offer - advice on the phone to ME only - that's not worth my money, IMO.

Thank you for understanding. Actually they would not give me the contact phone numbers for the doctors (I asked). I found them after much internet searching and calling in some favors of people with a physicians directory for the hospital.

I do not know if i was naive to imagine that having/contacting DAN would make a difference in the care I received or facilitate receiving care. I drove a good bit of distance (an extra hr) to go to the hospital per DANs request. I never expected DAN to treat me over the phone. I am not an idiot. I did expect them to be an advocate for me. That must make me an idiot. If I just wanted insurance to cover DCS or dive related injuries their are many choices. I choose DAN from the stories I have read about how they assist divers in need. It is much like OnStar. I asked for DANs help. I asked them to contact the hospital or one of their recommended doctors on my behalf as i was unable to do so. They did/could not. That is my problem clear and simple. Is this to much to ask? Am I wrong to expect that?

Bash me all you want. We are dumbass divers because she got bent. How stupid can we be. Of course only people who deserve it because they are incompetent and lesser humans get bent. It is a well known fact. I remember that in my initial training. It does not happen to REAL divers.

I know now that you need to have someone on your side with high enough credentials to get through the system. Unfortunately I guess i will now have that as I will have a doc trained in DCS's phone number after we do a follow up visit.

FYI - part of what triaging patients is based on if time to intervention changes outcomes. Time to a chamber make a big difference. What I thought DAN would do is lead me to qualified personnel to make an assessment and judgment on ANY treatment (even if that is no treatment). I would have been much better off going to the local small hospital because they would have realized they did not have the knowledge and ability to asses and treat and would have contacted people to find out what they needed to do.

Lesson learned. I hope that others may learn from my mistakes. The mistakes that surprise/confuse me are not the ones that got her bent, but what happened afterward.

 

[jimmy71]

I would also ask if the OP specifically asked the ER staff to contact DAN and if they did so. If not, why not? DAN will try to assist in making arrangements when necessary. The OP had GF on 02, transported her to ER, and contacted ER personnel. Er personnel hopefully evaluated her and at this point should have at the patient's insistence contacted DAN for consult. Instead they walked out after deciding for themselves that she was ok. Where did DAN drop the ball? There is also a clear demonstration of poor planning and dive practices on the part of the OP and GF. This more than anything would appear to be the root cause of this entire incident.

I have to ask what your expectations are from DAN. I THOUGHT I was getting more than insurance from them. I thought I was also getting a patient advocate that is able to navigate logistics and systems that I can not on my own (this could be a language issue in a foreign country or our own health care system in the US). If this is not the case, than this is very important to know.
In the middle of the USA, I would love you to find me a MD that deals with DCS or "undersea medicine" as their primary income. The vast majority of MDs that have access or knowledge of a camber is because they make their living as a wound clinic. When she called to make an appointment with a MD who states they handle undersea medicine and dive injuries and stated she needed an appointment for such, they made sure to ask her where her wound was and if she was diabetic (and were confused when she said she had neither). This is not how these doctors make their living. If you do have such doctors than you live by the ocean. I do not.

 

[jimmy71]

Your GF was stable with no symptoms in the ER.

This means that as long as the O2 doesn't run out, they're going to treat the guy with the gunshot wound, the old guy with the heart-attack, the person who might be having a stroke and the guy with the infection that might eat all the flesh off his body in a few hours.

When everybody else is all set, then they'll take care of the people who have colds and should have stayed home and the people who had DCS symptoms that resolved on O2.

If you would have cooled your heels for a while, they would have eventually taken care of your GF.

flots.

Good point. As long as you hold pressure on the GSW I am sure the bleeding would stop (Guess they go to the back of the line, they are fine as long as you do not remove pressure). The guy with the heart attack has ALREADY had his heart attack. He should have shown up right BEFORE it happened (then we could have done something about it. He can go to the back of the line). The same thing goes for the stroke patient. As for the flesh eating infection you speak of. I assume you are talking about necrotising fasciitis. The funny thing about that is i have taking care of a few of those patients. What is really funny is that they get treated with a chamber ride as well. So i realllllly do not want him seen first as a line for the chamber will form.

I hope you can understand why it is very hard for people who do not understand an illness to properly triage someone.

 

[jimmy71]

Just thought while we are sharing quotes from damn literature and interperating meaning I would add one.
"Since DCI is a random event, almost any dive profile can result in DCI, no matter how safe it seems. The reason is that the risk factors, both known and unknown, can influence the probability of DCI in myriad ways. Because of this, evaluation of a diver for possible decompression illness must be made on a case-by-case basis by evaluating the diver's signs and symptoms and not just based on the dive profile."
source: DAN Divers Alert Network : Decompression Illness: What Is It and What Is The Treatment?

 

[Hetland]

Bash me all you want. We are dumbass divers because she got bent. How stupid can we be. Of course only people who deserve it because they are incompetent and lesser humans get bent. It is a well known fact. I remember that in my initial training. It does not happen to REAL divers.

I think you're missing the point. You and your partner take serious risks every time you get in the water because she can't manage her own gear, and because she is apparently dependent upon you making safety decisions. That's dangerous.... even in a pool. Add altitude, drysuits, cold water, dehydration, one computer and gear issues.... it's almost inviting an injury or worse.

Lesson learned. I hope that others may learn from my mistakes. The mistakes that surprise/confuse me are not the ones that got her bent, but what happened afterward.

When you consider that her symptoms responded to O2 treatment, and that you left the hospital without seeing a doctor, what happened at the hospital is almost irrelevant. The lesson that you are apparently not learning is that your buddy is diving outside her training and experience. That's how divers get killed.

No one is calling you a dumbass. No one on this board is perfect, and everyone here has made mistakes. We're not trying to pick on you, or say that you guys deserved anything bad. Speaking for myself, I want you guys to keep diving, and keep being a part of the dive community. But you need to take a hard and critical look at the risks you were taking (not just the computer).

 

[jimmy71]

I think you're missing the point. You and your partner take serious risks every time you get in the water because she can't manage her own gear, and because she is apparently dependent upon you making safety decisions. That's dangerous.... even in a pool. Add altitude, drysuits, cold water, dehydration, one computer and gear issues.... it's almost inviting an injury or worse.



When you consider that her symptoms responded to O2 treatment, and that you left the hospital without seeing a doctor, what happened at the hospital is almost irrelevant. The lesson that you are apparently not learning is that your buddy is diving outside her training and experience. That's how divers get killed.

No one is calling you a dumbass. No one on this board is perfect, and everyone here has made mistakes. We're not trying to pick on you, or say that you guys deserved anything bad. Speaking for myself, I want you guys to keep diving, and keep being a part of the dive community. But you need to take a hard and critical look at the risks you were taking (not just the computer).

I have learned from my mistakes. Coming to a scuba forum for dive training is one i am not going to make. As a previous poster pointed out, I am not asking for help on how not to get bent or what we did wrong in the water. Please feel free to start another fresh post to discuss such things. I did not start that post because it was not what i was looking for. If I did not make that clear I am sorry. What i can not get from my local divers and instructors is if i have unrealistic expectations of DAN and there role/ ability to assist me. The fact that they are not able or willing to contact someone other than me even after i asked them to concerns the hell out of me and tells me that i need to look to spend my money elsewhere. Part of my planning is knowing that i have "DAN on my side" to help me through a system that I have little means to navigate myself.

If you had a problem with the law in another country, do you think you would be better off speaking to the law directly or having your embassy contact them on your behalf? Which method would you want? I thought DAN was my embassy. I seem to be wrong.

 

[Jeff Toorish]

I have to say, I'm a little stunned by this thread.

Personally, I'm not sure DAN (or any other insurance company) can help you navigate the system. DAN has an excellent product that does exactly what it is advertised to do; it is a secondary insurer, meaning it picks up what your primary insurance does not pay for. DAN also has a medical evacuation program which is second to none --I know non-divers who have DAN insurance just for that.

Needless to say, there are limits to what DAN can do, just like there are limits on everything in life.

What DAN (nor anyone else) can not do is magically produce a doctor or ensure that the ER you are going to will be adequate. That is unrealistic. DAN will help, confer with doctors, etc., but if the hospital itself is not really up to the job or they don't have available staff there is not much DAN can do the navigate that.

I do have to say, based on the original post, it sounds as if the divers involved made some unfortunate choices and then are expecting DAN to fix everything.

DAN is a resource, and the folks at DAN are excellent at what they do. But DAN will not take the place of basic diver common sense.

I am delighted to hear the bent diver has apparently recovered.

Jeff

 

[flots am]

I hope you can understand why it is very hard for people who do not understand an illness to properly triage someone.

I'm pretty sure they understood all they needed to.

Your GF was there sucking on O2, had no symptoms and was in no immediate danger.

All you had to do was sit there until they got to you, but you just got up and left.

flots.

 

[jimmy71]

I have to say, I'm a little stunned by this thread.

Personally, I'm not sure DAN (or any other insurance company) can help you navigate the system. DAN has an excellent product that does exactly what it is advertised to do; it is a secondary insurer, meaning it picks up what your primary insurance does not pay for. DAN also has a medical evacuation program which is second to none --I know non-divers who have DAN insurance just for that.

Needless to say, there are limits to what DAN can do, just like there are limits on everything in life.

What DAN (nor anyone else) can not do is magically produce a doctor or ensure that the ER you are going to will be adequate. That is unrealistic. DAN will help, confer with doctors, etc., but if the hospital itself is not really up to the job or they don't have available staff there is not much DAN can do the navigate that.

I do have to say, based on the original post, it sounds as if the divers involved made some unfortunate choices and then are expecting DAN to fix everything.

DAN is a resource, and the folks at DAN are excellent at what they do. But DAN will not take the place of basic diver common sense.

I am delighted to hear the bent diver has apparently recovered.

Jeff

You would not expect DAN to contact one of their recommended MDs who is on call on your behalf? Especially after you are UNABLE to contact them (I tried)?

I read a lot about DAN and I will post some more of their literature that lead me to such conclusions. Please read it.

"For injured divers, it can mean much-needed help at a critical time. This assistance often comes in the form of helping divers reach definitive hyperbaric care. DAN maintains an active database of operational chambers that serve divers. In additional, DAN has the communications infrastructure to verify a chamber's availability, no matter where in the world a diver is injured, as well as the ability to get the injured diver to that chamber via the fastest and most appropriate route. When you suspect a pressure-related injury in diving, call DAN. DAN's relationships with hyperbaric physicians and centers can open doors to an array of facilities. "

"Divers often represent a complex set of problems for hyperbaric centers, and these problems are not always easy to evaluate. Injured divers usually show up in busy emergency departments at odd hours, often with vague symptoms that can represent a wide variety of possible medical conditions. Since injured divers rarely make scheduled appearances, they frequently undergo evaluation by physicians and staff who are relatively unfamiliar with assessing dive-related illnesses.

As an unfortunate consequence, these patients may become delayed in hospital waiting rooms, or worse, faced with a battery of tests of questionable benefit in the diagnosis of decompression illness (DCI).

There is a bright side to this. About 10 to 12 percent of the calls to DAN's 24-Hour Diving Emergency Hotline each year come from physicians and hospital emergency room staff seeking consultation and guidance for the assessment of dive-related injuries. Situations like these allow DAN to provide the evaluating physician with the ability to recognize DCI and establish an action plan that is likely to include identifying and contacting the nearest appropriate hyperbaric center. " -- maybe the fine print here is "situations like these" meaning that I have to get a doctor to call DAN. It is hard to see a doc. I just did not read it this way.