I'm hit and I hurt...LONG

[dctexan]

Hi all, new diver here. Took my open water class this past spring (PADI). Went down to Ft. Lauderdale on 6/20 to complete my check out dives (with a PADI affiliated dive shop). Did dive 1 & 2 on 6/21 and dives 3 & 4 on 6/22. All dives were to 30 ft for about 20 minutes each...probably a 3 minute surface interval between dives 1 & 2 and dives 3 & 4. Loved diving, was very excited about getting certified, however about 10 minutes after I exited the water from dive 4, my skin started to feel prickly and my body felt a tiny bit achy.

About 2 hours later I felt a bit worse, and started kidding around with my friends that I thought I had lyme disease (aching joints and all). Took a shower, went to dinner. During dinner I started hurting really badly and just couldn't sit still. Finally decided (about 6 hours after symptoms first appeared) that I was probably bent and that I needed to go to the ER.

Doc at ER took forever trying to decide whether I had DCS or not (kept checking the dive tables and saying "but you were within the limits”. Finally he agreed that I had DCS and arranged to transport me to Miami (Mercy Hospital) for treatment.
While waiting for the ambulance, I received IV fluids, but no O2.

Finally arrived at Mercy around 1:00AM (about 9 hours after symptoms first appeared). At this point I am crying in pain and just basically miserable. I think my favorite thing to tell people was "why do they say skin tingling? It feels like glass shards are being rubbed into my skin". Got assessed by the doc at Mercy where I am asked to rate my pain on a scale of 1-10 (I said 8...but looking back I realized I should have said 10. Not that it was the worst pain that I had ever felt, but it certainly was the most prolonged intense pain I have ever felt). Then I took a 6 (maybe 5? I am not sure) hour chamber ride with O2. Absolutely no relief from the chamber. I become basically hysterical and am screaming at the doctor that the stupid chamber didn't work and that I wasn't going back in, that I was exhausted, and that I REALLY needed my pain to go away. I then tell the doctor that he can either kill me or give me something to stop the pain. I get admitted to the hospital and am given some sort of pain reliever.

An hour later I am still in pain so we try pain reliever number 2. No luck with that so on to pain reliever number 3. At this point it is time for chamber ride #2. Due to my previous hysteria, the doctor has decided that I need to something to help me with my "anxiety" so I also receive some sort of anti-anxiety med. Enter the chamber and go down to 60 ft. Finally the pain lets up and I decide I might actually live through all of this. Whether the pain relief was due to the meds or the pressure I don't know...maybe both? When I get out of the chamber this time I rate my pain at a 6.

4 more chamber rides (2 at 15 feet with the diabetics for 2 hours and another 2 for 6 hours) and 2 days later I am finally discharged from the hospital. My diagnosis was DCS II. My pain level at discharge was a 5....mostly consisting of aching joint pain with some tingling (real tingling this time, the glass feeling is all gone). I am given instructions not to fly for 72 hours.

Okay, so I spend the next 72 hours in Miami, taking it easy. The day I am to fly out my pain is at a 1...present but not unmanageable by any means. There were 3 legs to my flight from Ft Lauderdale to Louisville. First leg, no problems. Second leg, I start to get that stupid ache back...especially in my hips, legs, and back. By the third leg, my pain is back to being a 5. Argh!

My flight home was on Sunday (6/29), it is currently Tuesday (7/1) and my pain is at a 4 with some very minor and very occasional skin creepy-crawlies. My questions are
1). will this go away?
2). can anything else medically be done for me or is it just a wait & see thing? Please keep in mind that I am a graduate student & the health insurance I have basically covers emergencies & then visits to the student health center where we DO NOT have a dive doctor.
3). am I completely stupid to ever dive again? I mean who gets hit during their freaking cert dives?!

Please let me know your thoughts. Thanks.

 

[raviepoo]

I'm not saying this is what caused you're symptoms, but the dive shop that did your check out dives was CHEATING. You didn't do 4 dives. You did 2, with an ascent to the surface in the middle of each dive. I don't suppose you want to email me and tell me what shop did your check out dives so I can avoid them in the future?

You SHOULDN'T be getting bent on a 30 ft dive but.....

How quickly did you ascend?

Were you dehydrated after a long flight the day before your diving?

Were you dehydrated from alcohol?

Did you let yourself get dehydrated after the diving was over?

Did you do a lot of heavy physcial work after your dives?

About the prospect of diving again - what did the doctor say when you were discharged? Did he say it's OK for you to dive again? After some types of hits a doctor will clear you to dive again. After others you will be told that it is too risky to consider. We anonymous folks on the Internet can't answer that question for you. Ask the doctor you did your treatment.

I'm sorry this happened to you. I hope you turn out to be OK and you can go back in the water.

I have a few suggestions for you if you are able to dive again.

Don't dive if you are feeling under the weather or dehydrated. Drink lots before and after your dives. You want to drink the night before so the water has a chance to get into your tissues. Also, you continue to offgas for many hours after you come out of the water. Be sure to stay hydrated while your body is discharging Nitrogen.

Get DAN insurance. You don't mention whether your grad school insurance is going to pay for your chamber rides. It might not.

Talk to your original OW instructor about the incident. Perhaps they can help you figure out why this happened so you can avoid it in the future.

If you don't get satisfactory answers from your instructor, call DAN.

 

[agstreet]

And some people wonder if PADI attracts the bottom 0.1% of the bell curve.....

 

[Braunbehrens]

Wow, what an awful experience. I would try to get some more chamber rides if you don't have to pay for them. It might help, and it is very unlikely to hurt.

I don't know why you got bent. Some people are more bend proof than others, and some bend very easily. You may be an extreme case.

If I were you I'd try windsurfing.

For the joint pain you can try a variety of things. A large part of your problem is probably inflammation. For this I usually take Ibuprofen, but in the long term you can also try some supplements like fish oil, and glucosamine.

For immediate relief of joint pain DMSO works extremely well. However, I have NEVER heard of anyone using it for dive related injuries, so I don't know how well it would work, or if there would be any side effects.

If you do any of this, I would be curious how it works, if you care to share.

Please be aware that I'm not a doctor or a scuba instructor, and research anything I suggest on your own before making any decisions. I'm only mentioning things I would try myself.

I hope you feel better soon.

 

[DiveTub]

3 Minute Surface interval between dives 1-2 and 3-4

I would be doing some serious thought to
Your instructor and reporting the incident to PADI

 

[BigJetDriver]

dctexan once bubbled...
My questions are:
1). will this go away?
2). can anything else medically be done for me or is it just a wait & see thing? Please keep in mind that I am a graduate student & the health insurance I have basically covers emergencies & then visits to the student health center where we DO NOT have a dive doctor.
3). am I completely stupid to ever dive again? I mean who gets hit during their freaking cert dives?!

Please let me know your thoughts. Thanks.

My first thought is, please, if you read this, call DAN right away! Even if you are not a DAN member, call them right away. Explain to them that you are in distress from a diving incident and ask them to put you in touch with someone who can advise you further. I am quite certain they will not turn you down! Call
800-446-2671 toll free. You will get the best possible medical advice in relation to diving medicine.

As for feeling unusual about getting hit, please do not! Statistically, and in reallity, ANY diver can be bent on ANY dive. Further, there are medical conditions that may be present without overt symptoms which can predispose one to DCS.

I SAY AGAIN, PLEASE CALL DAN AT 800-446-2671!

 

[BigJetDriver]

Dear Agstreet,

We have a diver who is in significant distress from a diving incident and is desperately seeking good advice, as well as further relief.

Comments such as yours are truly not helpful, and may, in fact, create more distress on the part of the diver seeking aid. Please try to be kinder to your fellow diver, in what is obviously a serious situation.

 

[Wendy]

Sorry that you first diving experience was so bad.

Did you contact the shop that you did your check out dives with and let them know what was going on. Did you ask the EMT's to give you O2 ( I saw you mentioned that they didn't, so this leads me to believe that you thought you should have been).

When I did my ow dives, I was covered under DAN insurence as part of my class, you may want to check into that when you call them.

 

[Dr Deco]

Dear dctexan:

You certainly have a case of something, but I doubt that it is decompression sickness. I believe that the dives confused the diagnosis. I will put my money on something else such as an organism (or other toxin) in the water to which you show a particularly sensitivity.

Why not DCS ?

• Only diving to 30 feet for sixty minutes (combined dives) is very shallow and represents a minor “dose” of nitrogen.
• You mention that all joints were aching. That is too many, in fact. Joint-pain DCS does not manifest itself with all of your joints sore.
• There is the possibility of skin "bends". However, this is a very distinctive red marbling of the skin (not mentioned here), and is not associated with pain to my knowledge.
• If this were an embolism problem from e.g. a pulmonary barotrauma, it most likely would have appeared sooner than ten minutes. While “something” appeared after leaving the water, you state that the real problem was a couple of hours later. A long time for an arterial gas problem with that little gas load (i.e. "delayed arterialization" from venous bubbles).
• You indicate that there was no relief from pressure, however the interval between the dives and treatment was hours. That is rather long. I would not expect much from pressure per se but would have expected some effect of pressurized oxygen if this were DCS related.
• Pain relievers should have been of help with DCS, and they did not appear to be.
• Flight would have provoked problems if this was a gas-filled, space-filling lesion, but it did not until the third leg of the trip. I would thus be suspicious of a gas-filled lesion.
• I am guessing some toxin with which you had contact in the water and/or ingested.

DAN

As the other responders have indicted, the physicians at DAN should be able to give advice. I know that everyone would be curious to hear the final disposition of this.

Best of fortune!

Dr Deco :doctor:

 

[ppo2_diver]

Were you eating a lot of fish during your trip? I knew one girl who did her checkout dives in St. Thomas and thought she was bent. It turned out to be a toxin found in some species of fish. She ate fish everyday she was there. Her first doctor diagnosed her with DCS. She took a chamber ride that didn't help. A second doctor diagnosed her with this toxin and gave her an antidote and she was fine. Something to consider as well.