help!

[dannymd]

I AM NOT SURE WHERE I OUGHT TO BE POSTING THIS BUT COULD SOMEONE OUT THERE HELP?

I went diving yesterday and did two dives: one to about 120 ft. stayed there for about 25 minutes then surfaced (stopped at all the deco stops - stayed 3 minutes at 20 ft, 12 minutes at 10 plus an extra 3 minutes for "mandatory" stop prescribed by my dive computer). After a 2 1/2 HOUR surface interval I did my second dive. This was down to 90 feet for about 30 minutes. My dive computer did not ask for a stop at 20 feet so I went to 10 and did my deco for about 15 minutes then surfaced.

Soon after I surfaced (about 10 minutes) I got a severe headache over the left temple, my vision blurred (I think I was also seeing double but my eyelid drooped so I am not so sure iF I actually had double vision). The left side of my face started swelling.

I started breathing oxygen by mask (at probably - 4 liters/minute) and was rushed back to shore and to the hospital. BY the time I got ashore my headache was much better but my eyelid was still drooping and my face swollen. I went to the hospital and inhaled more oxygen for another 45 minutes. The pain did not recur but swelling persisted till the following day (today).

In restrospect, I did have a left sided headache (left temple) prior to the second dive. I attributed it to the heat and took two paracetamols (total of 1 gram) for it. By the time I dove the second time the headache was gone.

My last dive prior to yesterday was two weeks ago.

I think this is DCS but I think I did all my required stops does anyone have any advise on how I may avoid this from happening again?

 

[DwayneJ]

Please contact DAN as soon as possible...

DAN:

Australia and New Zealand, with regional IDAN responsibility for Papua New Guinea, Fiji, Indonesia, Malaysia, Vietnam, Singapore, Cambodia, Myanmar, Philippines, Vanuatu, India, Solomon Islands, Brunei, Thailand, Hong Kong, Korea, China and Taiwan.

P.O. Box 384
Ashburton, VIC 3147
AUSTRALIA

+61-3-9886-9166
+61-3-9886-9155 Fax

Diving Emergencies

DES Australia
1-800-088-200 (within Australia)
+61-8-8212-9242 (outside Australia)

DAN / DES New Zealand
0800-4DES111

DAN Asia-Pacific - Korea
(010) 4500-9113

DAN Asia-Pacific - China
+852-3611-7326

 

[DevonDiver]

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A ScubaBoard Staff Message...

Moving this to dive medicine.

To the OP: contact DAN immediately.

Please seek medical attention or call the Divers Alert Network (DAN) at 1-800-446-2671. For the international DAN telephone numbers, click here.

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[LeeChamberlain]

Questions come to mind:
Did you know you had a headache before diving?Not trying to be cute, but diving with sinus problems is a definite risk to possible dive related illnesses.

The second is:
If you suspected a dive related illness, did you contact the Divers Alert Network?

Now with the above said. In water decompression stops, are not normally associated with recreational diving. What tables were you using? Navy, NOAA or a Specialty set of tables.

Diving and decompression stops go hand in hand, in recreational diving the norm is a stop at 15 feet for three minutes and added time when you cross over the line of the dive table rules.

In reality no diver is going to advise you as to whether its DCS or DCI, that is a decision for competent MEDICAL authority. I am a certified rescue diver, not knowing your level of dive status, I am assuming Advanced Open Water based on depth you report. You shold contact two primary sources, one as I said before contacting COMPETENT MEDICAL AUTHORITY and possible DECOMPRESSION CHAMBER. The other is Divers Alert Network Medical.

As to advice:
1- NEVER DIVE WITH A SINUS ILLNESS or a headache for that matter.
2- You should have SCRATCHED the Second Dive

If what was going on as you said then you should have immediately terminated diving, period until you have had a complete medical for diving by a competent doctor whose knowledge of dive illnesses and DCS. Failing to do so is a risk to you and as well to other divers who may be in water with you.

Dive computer or no, a depth gauge is a pre-requisite if your computer was foiliable as to stops its also foiliable to depth. You need a through check of your gear especially the computer. You should plan your dive based on dive tables. Looking at the Recreational tables your maximum time should have been 13 minutes, so if you stayed 25 you were 12 minutes overdue, which if you had stayed within 13 you would have been in a pressure group of k. However you stayed 12 minutes over and should have stayed at 15 feet (5 meters) for 8 minutes. Upon exiting the water after the first dive you should have stayed out of the water for a minimum of 6 hours and with the related problem you described you shold have sought medical attention and stayed in hospital for examination or emergency decompression procedures (ie DECO Chamber).
It should come to you that this was a risk you took, one that thankfully had no fatal result. The dive rules of NDL diving are based upon general physiology and you should consider yourself lucky to not be experiencing any serious side effects or not being able to dive anymore.Since I do not know which tables you were using, Navy Tables,NOAA or NDL Recreational, I would seriously hope you consult your dive manual and former instructor and discuss safe dive limits. Otherwise the next time may not be with only a headache, You could have created an embolism. 120 foot depth 13 minutes with a 3 full minute stop at 15 feet or 5 meters.

 

[Kern]

What tables/computer were you using for decompression info?

According to V-planner set to nominal conservation.
1st dive:
1st stop would have been at 60' for 1 minute, 2nd at 50' for 2 minutes, 3rd at 40' for 3 minutes, 4th at 30' for 5 minutes, 5th stop 20' for 7 minutes & final stop at 10' for 13 minutes.

2nd dive after 2.5 hour SI.
1st stop at 30' for 1 minute, 2nd stop at 20' for 4 minutes, final stop at 10' for 8 minutes.

These numbers increase quite a bit as the conservation factor is increased.

As deco requirements are not much more than voodoo, the only way to guarantee you won't get bent, is to not dive.

Personally, I'd suggest you stop using the bend & mend methodology you're currently applying, & use a higher level of conservancy.

PS. I think this should have been moved to "Ask Dr. Deco", rather than "dive medicine".

 

[Quero]

Danny, you are a neurologist, so you yourself are in a good position to describe your presentation of symptoms along with onset times, progression of treatment, etc. by phone to the specialist on call at DAN. They will be able to give you a preliminary assessment of what to do, and if indicated, refer you to a local hyperbaric facility should you need recompression treatment.

This is a list of emergency contact telephone numbers for the Philippines. I'm not on the ground there, so some of the medical staff may have changed, but you could double check any of that locally:

DAN (Divers Alert Network) DAN Asia-Pacific (Australia)
Tel: 618-8212-9242

DAN South East Asia Pacific – Philippines
Tel. : (632)-632-1077, (63917)-834-8363
Contact: Dr. Benjamin Luna
Director DAN SEAP Philippines, Cardiologist
Room 123, Makati Medical Center
Room 210, Asian Hospital and Medical Center

Hyperbaric chambers (or recompression chamber) in the Philippines:

Manila (Quezon City): AFP Medical Center (V. Luna hospital), V. Luna Road, Quezon City.
Phone: (632)-920-7183, (632)-426-2701 to 14 local 8991/6445/6245
Contact: Dr. Jojo R. Bernardo (63919)-347-1773

Batangas City: St Patricks Hospital, Batangas City St. Patricks Hospital Wound Care & Diving Medicine Centre
Phone: (6343) 723-8388 / Fax. (6343) 723-8388
Beeper: 150-611-169
Chamber Phone: (6343) 723-7089
Contact: Dr. Michael Francis M. Perez, Director
General Surgery, Diving and Hyperbaric Medicine
Tel: (63917)-536-2757
Email : mperezmd@batangas.net.ph

Cavite: Sangley Recompression Chamber, NSWG, Philippine Fleet, Naval Base Cavite Sangley Point, Cavite City
Phone: (6346) 524-2061 local 4191 / 4193
Contact: Capt. Pablo Acacio

Cebu City: Recompression Chamber
Viscom Station
Hospital
Military Camp Lapu-Lapu
Lahug,Cebu City
Phone: (6332)-310-709
Chamber
Phone: (6332) 232-2464 to 68 local 3625 / 233-9942
Contact: Dr. Mamerto Ortega, (63919)-517-5900
Kitoy Mercado, (63920)-782-6515
Dr. Jet Santos, (63917)-620-2168, Hyperbaric Physician – Cebu City

Coron (Busuanga, Palawan): Sea Dive Resort Hyperbaric Chamber
Phone: (63920)-458-1360
Contact: Maribel Fortes

Subic Bay: Recompression Chamber Subic Bay Freeport Zone SBMA, Olongapo City
Phone: (6347) 252 7566, (6347) 252 7052 , (6347)-252-5211 (evening)
Contact: Dr. Lito Roque
Randy de lara (63919)-419-6274

Armed Forces of the Philippines Air and Seaborne Search and Rescue Facilities and Equipment
Phone: +(63-2) 833 7546 / 911 79 96 / 911 63 85

 

[DocVikingo]

Hi dannymd,

Bummer, Daniel. Please let us know what DAN has to say.

In the meantime:

1. Do you have any history of migraine or other headache?

2. Did you have any difficulties equalizing either on descent or ascent?

3. Any chance you could have been envenomated by a pernicious marine creature?

4. Are you using any medication?


Regards,

DocVikingo

 

[Garrobo]

I double-dip the Speigle Grove, Eagle, Duane and Bibb off of Largo and Islamorada regularly, all of them around 100 feet or more. My ascent on all these ships is a two minute stop at fifty feet, a two minute stop at thirty feet and at least a five minute stop (depending on what my computers say) at between twenty and fifteen feet, and depending on the wave action. We take an hour SI between dives. I have never had any problems of any kind following this program. You could have a sinus problem along with some sort of eye problem which shows up under pressure. At my age, 71, I'd be looking at a stroke but every time I get something temporarily wrong we old folk immediately figure the worst case scenario.