How do I determine if my DCS treatment was successful short of diving again?

[Tim Ingersoll]

I took a hit in Cozumel in April of this year. I did the chamber rides and feel totally recovered. Is there some way I can determine if I have residual effects? I am anxious to dive again but of course am worried about taking another hit because I still have residual nitrogen in my tissue.

 

[Jean eve]

I took a hit in Cozumel in April of this year. I did the chamber rides and feel totally recovered. Is there some way I can determine if I have residual effects? I am anxious to dive again but of course am worried about taking another hit because I still have residual nitrogen in my tissue.

Just want to know how did you get the hit???And what is the sign.Thanks :06:

 

[rmediver2002]

Well, you do not have any residual nitrogen in your system.

You could go for an evaluation with a diving medical specialist to see what if any residual symptoms or damage may be present.

 

[MonkSeal]

Just want to know how did you get the hit???And what is the sign.Thanks :06:

There are two threads about this that Tim posted at the time of the accident. You can find the threads in this and Cozumel forums.

 

[Tim Ingersoll]

Well, you do not have any residual nitrogen in your system.

You could go for an evaluation with a diving medical specialist to see what if any residual symptoms or damage may be present.

Educate me. . .what are the residual symptoms of a Type I hit? Am I more susceptible to another hit? I assumed that the residual symptoms would be associated with nitrogen in the tissue that was not reabsorbed into my blood during the recompressions at the chamber. Not the case?

 

[Tim Ingersoll]

Just want to know how did you get the hit???And what is the sign.Thanks :06:

There are two threads on the subject:

http://scubaboard.com/t52617.html

http://scubaboard.com/t53196.html

 

[rmediver2002]

Educate me. . .what are the residual symptoms of a Type I hit? Am I more susceptible to another hit? I assumed that the residual symptoms would be associated with nitrogen in the tissue that was not reabsorbed into my blood during the recompressions at the chamber. Not the case?

If you only had type I symptoms then more than likely there is no residual symptoms. Symptoms could include pain or stiffness at the injury site.

You are not neccesarily more susceptable to DCS from the original injury (unless there was signifigant tissue damage) but, may be more suceptable than others to DCS when following the same set of tables. For this you would need to look at the specifics of the dive profile, your physical condition (hydration, sleep, physical conditioning) prior to the dive.
Every one has different charecteristics that will influence the chance having difficulties from absorbed gas upon surfacing, an example often sited is the Navy divers used in the original Haldanian models.

A simple laymans preventative measure the Navy uses is to select the next deeper or longer table for a diver who was working especially hard or who was very chilled, this is something you would want to discuss in depth with a diving medical specialist if your intent is to pursue decompression diving.



Residual symptoms of any type of DCS are the result of tissue damage either direct (damaged through the expansion of the bubble) or indirect (tissue damaged from lack of O2) not the result of remaining nitrogen.

If treatment is initiated soon after the injury then the chances of residual damage is pretty slight, the longer the delay in treatment though the more chance of tissue damage due to hypoxia, the tissues go longer without O2

Often follow on treatment protocols are followed for days or weeks following the treatment, not to remove any remaining nitrogen but to supersaturate the tissues with O2 to aid healing of damaged tissue.

Glad your feeling better and ready to get back in the water!!

Jeff

 

[Dr Deco]

Hello Tim:

DCS Treatment

You can rest assured that the DCS problem you experienced in Cozumel a few months ago has abated with respect to nitrogen gas loads. The body does not store nitrogen in the form of large gas bubbles. This is different from tissue micronuclei that are always present to some degree. This is the theory anyway. Were it not for micronuclei, you would definitely not be able to get bubble formation with the small supersaturation present from diving.

All things considered, you will have eliminated what you gained a few months ago. In fact, with the exception of gaseous nitrogen sequestered in microbubbles, you will lose all excess dissolved nitrogen in about one day. As a fact, you are actually slightly undersaturated with respect to nitrogen in the atmosphere. The nitrogen in your lungs is diluted to a small degree by water vapor and carbon dioxide. The total pressure of all gases is 1.0 atmosphere. Nitrogen must be reduced by some degree because of the presence of water vapor and carbon dioxide.

DCS Residuals

From the original posting, the problem seemed to be one of pain in the arm or shoulder. Pain does not persist from DCS. Neurological damage is a different story, and, if nerves were injured, there could be a persistence of a problem. This does not appear to be your case, however. If your arm is fine, it will remain fine, at least as far as the original dive injury was concerned. That is what a century of commercial experience with diving has shown, anyway.

Future DCS Risk

All things being equal, some individuals are simply more susceptible to DCS than others. Why this is true is not known, but it was used to select high altitude bomber crews during WW II. The fact that you had one incident of DCS might indicate that you are an individual who forms micronuclei more readily that the average diver. It might also only indicate that, on that particular day, you engaged in a very stressful session of musculoskeletal work and formed many nuclei. In that case, “all things would not be equal” since you were exercising heavily.

It still might be advised to go easy o gas loading and exercise in the future.

Dr Deco :doctor:

Readers, please note the next class in Decompression Physiology :1book:
http://wrigley.usc.edu/hyperbaric/advdeco.htm

 

[vlada]

I took a hit in Cozumel in April of this year. I did the chamber rides and feel totally recovered. Is there some way I can determine if I have residual effects? I am anxious to dive again but of course am worried about taking another hit because I still have residual nitrogen in my tissue.

Tim, if you have no pain left and all the motions and strength in the affected shoulder are the same as before the hit, then the docs are not going to tell you much, other than what's been said already - you are probably ready to try again

From my own experiences, when you re-start diving, take it extra slow and shallow. Make sure you eliminate all contributing factors (i.e. no alcohol, well hydrated, not tired, etc.)

Most importantly, before every dive, run a mental check and note all the unusual pains and sensations in the affected area and others - then monitor yourself for few hrs after the dive - if any new pain and sensaiton presents itself, and you can't find logical explanations for it, then you know what to do

Good luck,

 

[Tim Ingersoll]

You guys are the best. Thanks for all the words of wisdom. For the record I intend to dive nitrox on air tables and work diligently to remove all contributing factors for DCS (I certainly know those by heart). I can't wait to get back in the water in January. I will return to Cozumel and get back on the horse that threw me!