Got bent, preferred IWR to my local chamber

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AbyssDiver1983

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Here goes..
Last Monday I went on a 45m dive with around 28min of bottom time. I racked up around 30min total deco after switching gas (main tank 28% stage 50%). Other than a current we had to swim against and some jerking around with my right arm trying to adjust my buddy’s pony on his back tank the dive was uneventful. Once back on the boat I felt a dull pain in my right shoulder. I didn’t think much of it but by the time we got back to the marina the pain had increased and now my elbow joined the party. I mentioned it to a fellow diver and he suggested I breathe some O2 (should’ve listened), a few other divers joined in the conversation and after we all analysed the dive on my Teric we agreed it was unlikely to be DCS as I hadn’t done anything wrong. So I headed home. Pain kept getting gradually worse until it became unbearable, it also spread to my hand and fingers. It was now 10PM, 6hrs since I surfaced, and I was convinced that I was bent. I called my dive buddy who still didn’t think it could be DCS but who drove over and dropped off an O2 tank. The general consensus of most divers I know was to avoid HBOT if you can. This is not due to ignorance, but to the fact that in our country only one old chamber is available and it was considered.. well.. less than reliable. After breathing the O2 for the next 3-4hrs I felt considerably better. The pain had subsided enough for me to get some sleep. The next day the pain was where I left it, a dull ache that was annoying at the most. Not the excruciating pain I had experienced the night before. But I couldn’t get it out of my mind that I had to recompress, and I needed to do it soon. So I thought to hell with it and called the hospital that managed the chamber. I told them I was bent and needed to talk to the hyperbaric specialist. The secretary told me he was available for consultation the next day at 8AM, and that he was the only Dr who was qualified to operate the chamber. Yep, just him. After asking her if she understood what an emergency was, and if she actually knew what these chambers are usually for, I explained the urgency of the issue to the secretary and she gave me the Dr’s number. After explaining the situation to him he asks me if I’m experiencing any muscle weakness. I told him it was type I not type II DCS, he didn’t seem to follow. He says if there’s no muscle weakness he won’t admit me. I considered persuading him to just run a table 6 protocol on me but he didn’t exactly fill me with confidence in his abilities. Pain wasn’t that bad at this point, but I was still convinced I needed to recompress ASAP. My only remaining option was pure O2 IWR. But I had to convince someone to be my tender. After much ado two of the best divers in my club agreed to do it. And honestly if I didn’t trust in their abilities and CPR training I wouldn’t have considered it. So we do 10min at 9m, 30min at 6m and 30min at 3m with two 5min air breaks. When my CNS O2 levels passed 200% one grabbed my BC and the other was staring at my face practically waiting for the convulsions to start. Thankfully I maxed out at 320% with no issues. This was 24hrs after the previous dive. Now after 72hrs from the initial hit I’m feeling some slight residual aches but the pain is almost unnoticeable. I’ll get an MRI in a week or so to check the damage, hopefully no bone involved, but otherwise I’m not planning any further treatment. I called DAN and they told me the bubbles are gone by now and HBOT at this point would be used for it’s anti-inflammatory and healing benefits, so I don’t think it’s worth the recommended plane ride to the nearest country with a decent facility, especially with the pain level so low. Then again I might be wrong, and I’d appreciate any thoughts on the whole episode. In closing I think my risk factors other than the exertion at depth may have been dehydration as I tend to forget to hydrate and it was a particularly warm day. I’ve gone deeper for longer with no issues so the why of it still eludes me. Apologies for the length of this post, this is my first thread and I got carried away

N.B. (I’ve had many sports injuries over the years, everything from snowmobiling and skiing to squash and weightlifting, this was not that. Sports injuries hurt less when you immobilise the affected limb. This didn’t, the deep throbbing pain was unlike anything I’ve ever experienced)
 

BoltSnap

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Salam @AbyssDiver1983

I am glad that you are feeling better. I am very sorry to read that there is only one operating chamber in Lebanon. I thought we are the only unlucky poor people without a chamber in Libya.

Do you have DAN diver insurance there? If you do, why didn't DAN fly you out to the nearest real chamber in a close by country?

May Allah protect and heal you Inshallah.

ربي يشفيك ويعافيك ان شاء الله.
 

johndiver999

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You asked for comments... you need new dive buddies. You ascend from a deco dive with obvious decompression symptoms and they elect to review the profile on your computer, verify there was no violations and conclude that this is definitive proof that the obvious symptoms are not what they appear.. It almost sounds like a joke.

If you are going to engage in planned decompression dives and have access to 100% oxygen in a scuba tank and you KNOW the local chamber is questionable, why the heck have you not worked through a rough emergency scenario of using the oxygen for IWRC?
 

Jack Hammer

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@AbyssDiver1983
First off, Thank You for being brave enough to share your experience, that takes a lot of courage, especially online.

As a tech diver you should never be embarrassed or give pause to safely going on O2 after potential issues arise from a deco dive. Nor should you think twice about calling DAN right away. IWR while useful in some cases has risks and it is important, not just for you but for everyone involved, to understand those risks and how IWR actually works to avoid trading one problem for another or potentially making things worse.

I'm glad to hear you are feeling better and seem to be having a positive outcome.
 

tursiops

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@AbyssDiver1983
First off, Thank You for being brave enough to share your experience, that takes a lot of courage, especially online.

As a tech diver you should never be embarrassed or give pause to safely going on O2 after potential issues arise from a deco dive. Nor should you think twice about calling DAN right away. IWR while useful in some cases has risks and it is important, not just for you but for everyone involved, to understand those risks and how IWR actually works to avoid trading one problem for another or potentially making things worse.

I'm glad to hear you are feeling better and seem to be having a positive outcome.
^^^THIS^^^, especially the first part.

I expect the lesson-learned is that O2 as soon as possible for as long as possible is the default answer; that can be done while conferring about dive profiles and other options.
O2 and DAN are most helpful immediately....delay is not to your advantage.
 

Julius SCHMIDT

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In water recompression knowledge should be another tool in everyones brain, but don't make the boat late for their afternoon trip.

Were you wearing a gauge too tightly on your right wrist, think about it, or was it loose and you pulled it up your forearm.
 

Imla

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I had the same emotions around breathing O2 as you did for a long time in my dive past. However, I remember as it was yesterday hoe my Fundies-instructor worded it.

Would you be embarrassed to put ice on a sprained ankle? Or call an ambulance for a broken leg?
DCS is divings "leg-injury". Nothing to be embarrassed about, but super critical to treat without delay to get a good result. O2 is not dangerous to breathe on the surface, and in most places are relatively cheap.
So after my fundies-awakening, I have told all new divers I meet, that o2 to diveinjury is like ice to a leginjury.

Hope you have a speedy recovery.
 

AbyssDiver1983

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You asked for comments... you need new dive buddies. You ascend from a deco dive with obvious decompression symptoms and they elect to review the profile on your computer, verify there was no violations and conclude that this is definitive proof that the obvious symptoms are not what they appear.. It almost sounds like a joke.

If you are going to engage in planned decompression dives and have access to 100% oxygen in a scuba tank and you KNOW the local chamber is questionable, why the heck have you not worked through a rough emergency scenario of using the oxygen for IWRC?

I should’ve taken some surface O2 right after the dive just to be safe. But to be fair, the pain at that point was quite minor, and like I said I’ve had injuries before. My rotator cuff’s been through hell, so the differential diagnosis was not as straightforward as you reckon, that’s why the dive profile was a deciding factor. The truly excruciating pain began 6hrs later. I’m a proponent of IWR for sure, but IWR carries its own risks, so I don’t agree that jumping back in the water on pure O2 is the best thing to do every time you surface with minor discomfort. Thanks for the advice, but I’m keeping my dive buddies, the decision to go back in the water was based on my trust in their abilities.
 

AbyssDiver1983

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@AbyssDiver1983
First off, Thank You for being brave enough to share your experience, that takes a lot of courage, especially online.

As a tech diver you should never be embarrassed or give pause to safely going on O2 after potential issues arise from a deco dive. Nor should you think twice about calling DAN right away. IWR while useful in some cases has risks and it is important, not just for you but for everyone involved, to understand those risks and how IWR actually works to avoid trading one problem for another or potentially making things worse.

I'm glad to hear you are feeling better and seem to be having a positive outcome.

I agree. Lessons learned I guess. We are all aware of the risks of IWR hence the initial reluctance to perform it. My CNS O2 hit 320%, from what we know about PO2 limits I shouldn’t be writing this.

Thank you for your feedback, I appreciate your concern
 

AbyssDiver1983

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Salam @AbyssDiver1983

I am glad that you are feeling better. I am very sorry to read that there is only one operating chamber in Lebanon. I thought we are the only unlucky poor people without a chamber in Libya.

Do you have DAN diver insurance there? If you do, why didn't DAN fly you out to the nearest real chamber in a close by country?

May Allah protect and heal you Inshallah.

ربي يشفيك ويعافيك ان شاء الله.

Thanks, God bless

To tell you the truth the idea of flying with DCS freaks me out. With what I know now, I’d opt for IWR risk instead
 
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