Diving and climbing to 3,500 feet

[elhajoui]

Hi all,

I did the following TODAY in Cape Town, South Africa and was wondering whether I was facing a risk of DCS:

10:05-10:31 AM - First dive - Depth 24m, Bottom Time 25min
12:16-12:38 PM - Second dive - Depth 18m, Bottom time 22min
Pressure group by end of dive: between O and P. Sea-level diving

3:58PM-4:08PM (2.5 hours later) - Ascent from 1,000 to 3,500 feet to top of Table mountain via cable car
5PM-5:10PM (45-50 minutes later) - Descent from 3,500 feet to 1,000 feet via cable car

No symptoms so far; called the diving center and they said I should be fine. Anything else I should do? I assume I would have felt symptoms of DCS by now? Should I go through the pain of calling a doctor?

Thanks all!

M.

UPDATE:
Ok I think I figured it out but can someone double-check / give me extra advice?
Using this table: ndc.noaa.gov/pdfs/NoDecoAirTable.pdf , my repetitive dive group is "H"

Then reading this table: ndc.noaa.gov/pdfs/AscentToAltitudeTable.pdf it appears as if I should leave between 1:31hr (3,000 feet) and 3:26hr (4,000 feet) before climbing to 3,500 feet. I waited about 3.5 hours, so it appears I am right on the edge.

Since the water was cold (10 degrees), I guess I am still a bit concerned...Your thoughts are appreciated, experimented divers!

 

[elhajoui]

Any opinions? A mild but persistent pain began in my right shoulder 18 hours after my descent from 3,500 feet (24 hours after the dive). Should I consult a doctor?

 

[Rick Inman]

Any opinions? A mild but persistent pain began in my right shoulder 18 hours after my descent from 3,500 feet (24 hours after the dive). Should I consult a doctor?

I always say, if in doubt call Dan.

I always say it, but I don't always do it.

Personally, I don't think your ascent to 3500', based on your profiles, is an issue. And although it's possible, 18 hours is a bit of time for first symptoms to appear. But I'm no doctor, and a call to DAN is free and can take the unknown away and give you some peace.

Give DAN a call (number above your post in red).

Oh, and you mention the descent twice, but any DCS injures and symptoms would be ascent related only.

Keep us posted!

 

[elhajoui]

I did indeed call DAN, and they said it is "very unlikely" it is DCS given timing, etc. They said I should take Ibuprofen and rest, and call them back if I still feel pain (which I do, but it could be caused by a million other things).

I am only worried because I am embarking upon a 16 hour flight in two days, and DCS could be fatal then.

If I make it back from Cape Town to Philadelphia, I'll drop y'all a line

 

[lamont]

I did indeed call DAN, and they said it is "very unlikely" it is DCS given timing, etc. They said I should take Ibuprofen and rest, and call them back if I still feel pain (which I do, but it could be caused by a million other things).

i think you're probably stressing yourself out and the anxiety can actually give you psychosomatic symptoms (or you just wrenched you shoulder on the dive, or on the hike).

I am only worried because I am embarking upon a 16 hour flight in two days, and DCS could be fatal then.

its very unlikely that even if you have DCS in your shoulder that it would be fatal on the flight. its more likely that you'd just get additional shoulder pain on the flight and then need to take some chamber rides. that's about the worst case.

If I make it back from Cape Town to Philadelphia, I'll drop y'all a line

i'm pretty sure you'll be okay.

 

[tc]

Onset of pain 24 hours after the dive would be at the very outside edge of the envelope for DCS, while possible VERY few cases start that late.

An onset when you ASCENDED to altitude would be of concern, again pain that started that long after you descended would be of lesser concern.

Don't be concerned about the flight, three days after a series of two no deco dives is not even close to putting you at risk.

 

[elhajoui]

Update: I went to a doctor today in Cape Town. She performed a series of tests with needles, ice, and other similar stuff. At the end, she said everything looked fine, and the pain in my shoulder and throughout my arm was most likely muscular. She said I'd be fine flying.

Here's a question though: in the unlikely case I have DCS, how will I know once I get back? What "trigger" should alarm me, and within which time frame? I am not being paranoid, just trying to be safe.

Thanks all, fellow divers!

M.

 

[tc]

Pain on ascent to altitude would be a concern, but again, if it's more than 24 hours after you made the dives DCS is not likely to be the culprit.

Glad to hear the doc said it looks OK.

 

[Dr Deco]

Hello elhajoui:

DCS Appearance
It is unlikely that DCS makes an appearance after twenty-four hours. This is simply because the gas phase [bubbles] will not grow. The dissolved nitrogen is washed out of the tissues, and none remains to diffuse into bubbles. It is possible for a problem to appear after a few hours post-dive and to linger for hours; this is a different matter. DCS "residuals" are a problem with neurological DCS where they might linger for months or even longer.

Late Appearance
In your hypothetical case, the DCS problem would not appear when you reached home. Rather it would present itself on the airplane, as the cabin pressure is reduced [about 8,000 feet equivalent] during flight. Were this to occur, the pain would remit upon descent as the cabin pressure increases. [This is commonly felt as a familiar pressure change in the passenger's ear.]


Dr Deco :doctor:

 

[elhajoui]

Hey doc, thanks for the advice! I am a bit confused though.

As described above, the alledged symptom (pain in the upper right arm) appeared about 18-20 hours post-dive. To this day (3 days later) the pain remains, although it only shares some characteristics with typical DCS-induced pain.

However, what you are saying is that unless I feel increased, sharper arm pain on the airplane I can assume that my pain is muscular in nature and not DCS-induced? I can always consult a Hyperbaric medicine doctor in the U.S., but if you are telling me it's not necessary, I'd rather not shell out the $50 co-pay

Thanks much!

P-S: Chamber rides are 100% covered though, so I figured i'd get a 2-hr ride anyhow - thoughts?