How late is relapse possible on a flight after DCI?

[Dr Simon Mitchell]

I know I'm a bit late to this post, but I specifically signed up to this board to say a big thank you to @Dr Simon Mitchell for the in-depth answer that I came across on Google.

I have a similar situation as OP where I got hit with DCS last February, and received a few seasons hbot, obviously also scared to death to get on a plane afterwards (and I absolutely agree on your statement about hyper awareness).

It's been a year now and I still have symptoms like OP describes (tingling in arms/legs, arms falling asleep or even going numb almost every single night, some muscle twitches - but also clear head/neck mris). So it really helped me hearing you say that it can't really be any more nitrogen. I want to go hiking at high altitude this spring and the possibility of remaining nitrogen was a big worry for me.

Can I hijack this question and ask your experience with these long term symptoms? Is there a chance they'll ever go away?

Thanks again, I'm sure your answer will put more than one mind at ease.

Hello cbfunky,

First, sorry to hear about your DCS, and that you are suffering residual symptoms. Unless they are part of a severe spinal or cerebral event (typically indicated by a significant disability and confirmatory radiologic changes - absent in your case) the natural history in most cases is toward gradual improvement over time.

From a rehabilitation and activity point of view, you should go ahead and do whatever it is safe to do given your current functional / physical capacity. This is most likely to help with your recovery. You will not suffer any problems related to nitrogen in hiking at high altitude, though as you are no doubt aware, high altitude hiking has its own set of risks and potential complications. I could not definitively exclude the possibility that the physiological challenges of high altitude exposure could appear to exacerbate your current symptoms (which at the end of the day must be manifestations of some sort of subtle bubble-induced medium term injury). But I would consider it extremely unlikely that your present condition would be permanently worsened or affected in any material ongoing way by high altitude hiking.

All of this is, of course, difficult to assess from a keyboard on the other side of the world, and seeing a diving physician locally about these issues would be a smart idea. It does sound as though you have had fairly extensive follow up.

Simon M