First Cold Water Dive & Sore muscles: cramps or the bends?

[DiverAB]

I am a newly certified diver (completed Open Water in late January), and therefore am quite new to the diving world. After a hiatus of a few months, I attempted my first two cold water dives, yesterday actually! I went with the local divemaster/instructor as a guide, who also helped me rent all my gear. Having done only warm water dives I was not used to all the extra gear and weight required; I had trouble with buoyancy and breathing throughout and burnt through my air quickly (c. 17 minutes each dive). On my first dive, I ascended a bit rapidly as a result of difficulty with buoyancy. The maximum depth was 57 feet, and I may have gone up at least part of that too rapidly. I have some issues that I fear may be decompression, but also just general muscle fatigue:

I felt fine the entire day after the dive (finished around 12:00 pm). Around 8 pm, I felt some pains in my left shoulder, but they subsided after a few hours and only a little today. This was after I returned to my hotel and felt fine the entire day otherwise. Today I also have some lower back pain and a little knee soreness, but this is nearly identical to the soreness I feel after a too-intense workout, where I lift too much weight. For neither region is the pain extreme or continual, more soreness (ie. feels better at rest). I would also like to note that prior to this I spent a week-long vacation where I did a great deal of walking, and yesterday spent about 4 hours walking wearing a heavy back pack. The shoulder soreness seems to focus close to where the pack-straps are.

So my question is, as a new diver I am quite anxious that because of my lack of preparation I got DCS, but at the same time the feelings are very close to simply wearing too much weight on the back and shoulders (had over 20 pounds in addition to the wetsuit, gloves, hood etc), and I'm a bit overweight. Is the DCS pain intense and non-stop, and is it similar to back soreness akin to heavy lifting of weights or furniture? I feel fine otherwise but I'm worried... thanks for any help!

---------- Post added June 7th, 2013 at 08:52 PM ----------

Just wanted to post a quick update here. I'm feeling generally better since I posted. I visited my local hot tub / jacuzzi, and that seems to have alleviated some of the discomfort. Overall, I feel just a little discomfort in my shoulders, and the lower back pain has dulled somewhat. This might be due to the hot water - but if it is DCS, would hot water dull the pain? It has not spread anywhere else and overall, it still feels like that over-worked back. What is generally encouraging to me is that the shoulder pain that was more intense yesterday is mostly gone, and the other pain also. Considering all this, is this still a possible case of DCS or just fatigued muscles? Does DCS pain remiss and return, or once it appears, it keeps intensifying? I don't know how it should 'feel'.

There is a hospital in my city with a decompression unit, that I could visit in an emergency, but not sure if this is one. If someone could please give me their thoughts, I would be very grateful and this would give me peace of mind, as well. Thank you.

 

[TSandM]

It is never a good idea to seek diagnosis over the internet, but I think it's likely you have correctly diagnosed your symptoms as muscle strains and stress from unaccustomed weight and activity. The 8 hour time period before the onset of symptoms is not typical for DCS, and although you can certainly load nitrogen at 57 feet, if your total dive time was 17 minutes, you didn't load much of it. The resolution without treatment argues against DCS, as well.

I think we all went through times, when we were new divers, when we fretted about various aches and pains and whether they were related to decompression. You aren't alone -- but I think it's probably safe to decide this isn't DCS.

 

[Wolfie]

First, welcome to the board!
and as far as medical advice on the Internet. TSandM is about as good as it gets. And yes cold water diving is a PITA (there's a whole thread on that specifically that goes on and on.)
As far as being sore. All that gear, extra lead, more exertion in buoyancy and moving about, heck, just donning and doffing a 2 piece 7 mil suit should make you sore.
Then you took a 4 hour hike? If you're a desk jockey like I am, you should be sore and fatigued.

 

[DiverAB]

Thanks for your replies, TS and Wolfie. And thank you for the welcome! This is an excellent board and it looks like a great place to meet others and improve my knowledge. Indeed, it was a false alarm. Feel much better today after a good night's rest. But as you say, it's easy to panic and jump to conclusions when you're not entirely confident in your diving skills and how it went, particularly when you are new to the sport and have heard so much about DCS in training and elsewhere. The combination of the thick wetsuit, weights, hood, gloves, cylinder etc plus all of the other walking caused it. And I would have had it even without diving. I just read that the symptoms for DCS can include shoulder pains so panicked a bit.

Now that I'm feeling OK I'm more disappointed with how short my dive was, and how I only got a peek at the wonderful sea life to be found there. The cold water gear was certainly quite heavy; although the water was chilly, around 10 C, it was over 20 and sunny outside, so I think part of it was also overheating on the surface in all the gear, therefore breathing faster in general. The visibility was very limited, so I probably got a little disoriented and worried and burnt through the air so quickly. And although I am displeased in that my dives were under 20 minutes, in a way perhaps it helped protect me from any injuries because of the short duration. I think it's time for a refresher to improve breathing and buoyancy, and I will join my Uni's Scuba club in the Fall. I felt great after my Open Water dives because it seemed I finally got great buoyancy, and I was almost ideal in breathing rates, but fell to half of this in cold water. But now I know just how different cold water diving is and how much more complicated things are than in the tropics. I made an analogy to driving in the winter through ice and snow, and how special skills are required, as opposed to beautiful weather year-round. And also, I'm not in my ideal physical shape, so I'm working on that too.

I guess my main question is, how does one differentiate DCS pains from general muscle aches and pains? Is there a specific type of feeling (sharp, dull, hot, etc)? I assume once it starts, it does not recede so easily and one would be quite aware of the feeling. Just would be good to know this so as not to get overly worried in the future. Thanks.

 

[Hawkwood]

Welcome to diving in Alberta!

It is not unusual to be sore and tired after a dive. Lots of very heavy gear, extreme temperature changes between surface and depth, often lots of walking or climbing in gear. Shorter dives than the tropics are often the norm.

I was working with two open water students today. 5C at depth, 22C at surface. They went from 6lbs in the pool to 24lbs in a two piece 7 mil. You bet they are tired right now. It is hard work. Their dives were in the 20 minute range too.

Bill

 

[TSandM]

It can be very difficult to sort out DCS from other pains, because there is nothing particularly different about DCS. Type I does tend to occur in the joints, and usually is a dull pain that doesn't change with palpation or movement. Most cases occur within an hour of surfacing, although delayed presentations are known. The vast majority occur within 24 hours.

DCS is a clinical diagnosis made by combining the history -- location of pain, time of onset, aggravating and ameliorating factors -- with the dive profiles, which give an idea of nitrogen loading. Most hyperbaric docs work on the principle, "When in doubt, recompress," because you are unlikely to hurt anyone by recompressing them, but you WILL hurt a diver with DCS by failing to do so. Response to treatment is considered a confirmation of the diagnosis, which is interesting, because little else in medicine works that way.