I must have chronic DCS

[Remy B.]

DCS type	Bubble location	Signs & symptoms (clinical manifestations)
Musculoskeletal	Mostly large joints (elbows, shoulders, hip, wrists, knees, ankles)	Localized deep pain, ranging from mild to excruciating. Sometimes a dull ache, but rarely a sharp pain. Active and passive motion of the joint aggravates the pain. The pain may be reduced by bending the joint to find a more comfortable position. If caused by altitude, pain can occur immediately or up to many hours later.
Cutaneous	Skin	Itching, usually around the ears, face, neck, arms, and upper torso Sensation of tiny insects crawling over the skin (formication) Mottled or marbled skin usually around the shoulders, upper chest and abdomen, with itching Swelling of the skin, accompanied by tiny scar-like skin depressions (pitting edema)
Neurologic	Brain	Altered sensation, tingling or numbness paresthesia, increased sensitivity hyperesthesia Confusion or memory loss (amnesia) Visual abnormalities Unexplained mood or behaviour changes Seizures, unconsciousness
Neurologic	Spinal cord	Ascending weakness or paralysis in the legs Urinary incontinence and fecal incontinence Girdling (also referred to as girdle, banding, or tightening feeling) around the abdominal region and/or chest
Constitutional	Whole body	Headache Unexplained fatigue Generalised malaise, poorly localised aches
Audiovestibular	Inner ear [10][a]	Loss of balance Dizziness, vertigo, nausea, vomiting Hearing loss
Pulmonary	Lungs	Dry persistent cough Burning chest pain under the sternum, aggravated by breathing Shortness of breath

Just by looking at all the possible DCS symptoms, how the hell you know what is what, as you can encounter in daily basis some of the DCS simptoms without even diving, and after you dive same symptoms can show up and are likely that had nothing to do with diving .
Just surfing the web I find this, then one hear about divers staying inside the NDL and ascending enside the speed limits and get DCS Signs and symptoms of decompression sickness

---------- Post added January 29th, 2015 at 07:05 AM ----------

Just surfin the web, I found this, at least some of these symptoms you can have in daily or weekly basis, so what is what, even if you dive you can have some of these symptoms after the dive and likely have nothing to do with the dive

 

[rongoodman]

I haven't been in the water for months, but from the way my shoulders feel this AM, I must have gotten DCS in the gym yesterday during my squat improvement session!

 

[tbone1004]

that is why DCS is so difficult to diagnose

Joint pain, many of us have this on a regular basis

skin itching can be caused by dry skin, not uncommon after a long soak in the ocean, though the marbling and rash are usually good indicators

If you have neurological symptoms you're borderline fubar, so good luck

headache/fatigue could be dehydration or seasickness etc, same with inner ear

and coughing could be caused by the fact that you just spend an hour breathing cold dry air and then went straight to warm damp air, especially if it was a working dive. Remy, you're from the Caribbean so you may not know this, but during the winter if you are in cold climates it isn't uncommon to be breathing similar air as what is on scuba and if you are working hard outside, it is not uncommon to have burning lungs and dry coughing for a while after you get inside, your lungs work with warm moist air, not so much with cold dry air.

Long story short is a lot of those symptoms suck, they are symptoms of DCS, but they can also be symptoms of a plethora of other things. The big ones are the neurological symptoms, skin rashes especially localized on the chest or on someone who doesn't often get rashes *obviously ruling out nematocyst rashes*, and any deep joint pain, usually shows up in the knees, hips, and shoulders. If you have sharp localized knife like pain it is probably a bubble, the general aching may or may not be DCS, but is usually just your body being sore....

 

[Bear Yates]

See, this is the problem I have with these kinds of things. I'm an EMT, I haven't gotten M.D. posted behind my name, so I'm far from being a doctor. I know that these are things to look for that are taught during training. But if you DON'T have M.D. behind your name, and even if you do but aren't specialized in dive medicine, Don't try to be the guy who thinks you are automatically an expert in something just because you read it in a book. Mainly I'm just tired of the "I know everything about everything" and this is my rant because I just can. Don't like it, I don't care.

 

[SubAquatix]

"I'm not a Doctor, but I play one on Scubaboard." LOL

 

[tbone1004]

never said I was an expert, but I have spent quite a bit of time with them discussing symptoms and which ones need to be looked at more than others, and much of decompression training involves diagnosing DCS.

If I get out of a cold water dive with a lot of exertion and my joints are sore and I'm coughing, I don't go to DCS because I was working in an environment not conducive to staying comfortable. If I come out with a skin rash or acute joint pain, odds are DCS. Go through the training and work with DAN enough and you learn to distinguish what are relevant symptoms and in which sequence and groups they show up in. There is a progression of DCS symptoms that usually happens and combinations of symptoms that lead to a more reliable diagnosis.

If I come up from a dive and it's ocean diving and I'm exhausted and dizzy, it's more than likely dehydration and seasickness than DCS, not to say it isn't, but O2 and water will help drastically with both, it's worth calling DAN but not rushing to a chamber or executing IWR. When in doubt call the guys that do this for a living, most aren't MD's either, there are very few of those, but the nurses are usually pretty damned good since they deal with this all day every day. I took this post as somewhat tongue in cheek because the symptoms listed for DCS are very generic and unless they show up in combinations or a sequence, I was just pointing out that certain individual symptoms are usually meaningless, which they in fact are.

 

[Bob DBF]

As I've been getting older, I make a list of symptoms I have before I get in the water. It helps sort things out when I get out of the water.



Bob
----------------------------------------
I may be old, but I’m not dead yet.

 

[TSandM]

As a physician, I find DCS to be loathsome, because the symptoms, as per the table, are protean, can be generated by many other causes, and have no definitive test to rule in or out the diagnosis. The treatment isn't easy or, in some places, readily available. Patients MAY respond to the treatment even if their symptoms AREN'T DCS. Furthermore, diving (especially shore diving) is likely to induce various aches and pains, especially in the novice diver, who is probably the one most worried about DCS. Severe symptoms, especially if associated with profiles likely to cause them, are easy. It's the "undeserved" Type I hit in the recreational diver that's hard to sort out.

 

[boulderjohn]

I can tell you flat out two common medical conditions that can feel a whole lot like the classic DCS symptoms: spinal stenosis and carpal tunnel syndrome. Both of them can be aggravated by the physical activities of a dive day, especially carrying heavy tanks. I saw a document from DAN indicating that many people with spinal stenosis are mistakenly treated with chamber rides for DCS. The problem is that if you have both stenosis problems or carpal tunnel problems that flare up with diving, they will start feeling better along a timeline that coincides with a chamber treatment, so it can appear as if the chamber treatment worked.

THere was a recent study of people who had had (supposedly) DCS in the past, and it was shown they had a high incidence of DCS. The conclusion of the study was that spinal stenosis makes one more susceptible to DCS, but I question it. The subjects chosen as DCS victims were chosen on the basis of the fact that they had been diagnosed with DCS in the past and been given a chamber treatment. The test may in fact have confirmed instead that many people with spinal stenosis are mistakenly treated for DCS.

As someone who has both conditions, I know what I am talking about. I had a bad night after a day of diving two days ago, and if I had not known better, I would have been off to a chamber.

 

[Remy B.]

that is why DCS is so difficult to diagnose

Joint pain, many of us have this on a regular basis

skin itching can be caused by dry skin, not uncommon after a long soak in the ocean, though the marbling and rash are usually good indicators

If you have neurological symptoms you're borderline fubar, so good luck

headache/fatigue could be dehydration or seasickness etc, same with inner ear

and coughing could be caused by the fact that you just spend an hour breathing cold dry air and then went straight to warm damp air, especially if it was a working dive. Remy, you're from the Caribbean so you may not know this, but during the winter if you are in cold climates it isn't uncommon to be breathing similar air as what is on scuba and if you are working hard outside, it is not uncommon to have burning lungs and dry coughing for a while after you get inside, your lungs work with warm moist air, not so much with cold dry air.

Long story short is a lot of those symptoms suck, they are symptoms of DCS, but they can also be symptoms of a plethora of other things. The big ones are the neurological symptoms, skin rashes especially localized on the chest or on someone who doesn't often get rashes *obviously ruling out nematocyst rashes*, and any deep joint pain, usually shows up in the knees, hips, and shoulders. If you have sharp localized knife like pain it is probably a bubble, the general aching may or may not be DCS, but is usually just your body being sore....

That is my point of the post, it seems that a lot of people can have those symptoms after diving and are not even related, for example, sloulder just taking your BCD wrongly may cause you that pain, like you said of breathing dry air, etc, etc.

---------- Post added January 29th, 2015 at 07:46 PM ----------

Just for the fun, imagine you go to a bar and go heavy on drinking, you will combine a lot of those symptoms the next day, DCS or plain drunk ???, imagine you don't remember what happen that nigth of drinking because you were so drunk, falling over everthing, getting in to fights, then you even have more symptoms like deep pain, DCS or plain drunk ???, do I call DAN or mom to make a soup and give me pain killers.