In-Water Recompression, Revisited

[cerich]

Anyway, with all due respect, what you just said seems that you are very very out of touch with 'remote' expedtionary diving, very out of touch!

having read your replies in this thread, I am somewhat grateful that I am "out of touch" with YOUR school and experience of expeditionary diving.

Because in my world, I would seriously question my approach if I had to do over 10 IWR's over the years. Just saying.

You will counter that with some type of posturing on experience I'm sure, (basically a d#8k measuring thing) and barring that a Ad hominem phase of this conversation.

Honestly, i could care less. I am fairly experienced, not much interested in yahoo pushes when I know the same can be done with much more acceptable risk profiles.

 

[cerich]

Some chose for a follow up chamber ride when back ashore, just to be safe, but most kept on diving, some the next day, some with a day off, and a couple who choose to not continue diving on that expedtion (but not because of any residual symptoms, they just thought it prudent to not do so).

well..that isn't so smart. i understand the why and how it happens (ego, money, reps and get it done itis), however a solid expedition leader with a solid grasp of modern approaches to dcs treatments wouldn't allow it.

Even with what may seem like being "cured" they likely aren't and you're just setting up for a bigger issue IMHO. Inflammatory and immune responses, healing time and I am sure a med pro can add a few more.

But hey... dive on

 

[Duke Dive Medicine]

Some chose for a follow up chamber ride when back ashore, just to be safe, but most kept on diving, some the next day, some with a day off, and a couple who choose to not continue diving on that expedtion (but not because of any residual symptoms, they just thought it prudent to not do so).

Kay Dee, I promise I'm not singling you out for picking on, but returning to diving a day or two after receiving IWR for decompression sickness is not advisable. For the sake of providing sources aside from opinion, the US Navy Diving Manual stipulates that Navy divers who have suffered DCS require clearance by a military physician trained in diving medicine before returning to diving. The old Navy recommendations were a minimum of one week after full resolution of Type I symptoms, and 30 days and diving medical officer clearance after full resolution of Type II or AGE symptoms. For civilians who we've treated and whose symptoms fully resolve, we rarely recommend less than 30 days. Returning to diving the the day after treatment for DCS could present a higher-than-acceptable risk of DCS given the inflammatory mechanisms which are likely still present, as @cerich has noted. I'm glad to hear that at least some of the people whose cases you're referring to chose to sit out the rest of the expedition.

Best regards,
DDM

 

[Kay Dee]

you aren't alone, that said I also know divers that didn't have as much luck as you.

When are you going to realize that 'luck' as you call it has nothing to do with it

 

[cerich]

When are you going to realize that 'luck' as you call it has nothing to do with it

would it be a fair summation to state that your position is that IWR is indicated in 100% of situations and will always work out well?

 

[Dr Simon Mitchell]

Jesu Christo! It seems almost no one, and I repeat almost no one here read or fully understood the so-called 'hypothetical' situation I described way back when. Talk about falling on deaf ears.

As boulderjohn quoted (my clarification for one and all here now in capitals "The only reason you would go to 60 feet, as I thought you meant in your original post (I DID MEAN THAT), is that Brett Gilliam (OR SOMEONE ON THE BOAT IN A POSITION SIMILAR SO TO SPEAK) was dictating the conditions of your treatment and you had no say in it whatsoever (EXACTLY!!!!!.)

Hello Kay Dee,

I certainly understood your hypothetical. I guess the problem for DDM and I is that we see it as an extraordinarily implausible scenario even though it sounds like it happened to you - or approximately so. There are problems with it at multiple levels. For a start, I would not, in a million years, suggest that anyone invoke IWR (irrespective of the depth it is conducted at) for a diver who is not in a position to have a say in the matter (that is, who cannot consent to the procedure). This is an intervention with significant risks (again, irrespective of the of the depth) and the benefits are controversial. To do it "to" someone without their explicit consent would be an extremely risky undertaking from a medico-legal perspective. To do it at a depth considered by all true experts to be too dangerous, AND to not get consent would be, well, insane.

I totally respect your right to be happy with what happened to you, but you must also respect the right of the medical moderators on a medical forum designed to educate divers to point out that aspects of what happened to you were actually wrong despite the good outcome.

Simon M

 

[cerich]

When are you going to realize that 'luck' as you call it has nothing to do with it

to sum up my thoughts, given that your reports of success with IWR that seem to be statistically better than in chamber treatment...luck. If not luck than we need to convert every chamber to a flower pot and just treat people with IWR

 

[Kay Dee]

Allow me to help you out with how people interpret things...

By saying you would do it you are inadvertently recommending it.

So you are a mind reader, besides a diver?

Anyway, that is your opinion, certainly not mine, and in every post I say it is what I would do in a very specifc situation, and besides if you dont like what I have to say, or are so offended by it, then simply just overlook my posts.

My understanding was that free speach (or opinions) was actually still allowed, although not really encouraged (by many).

 

[Duke Dive Medicine]

Simon, interestingly, Kay Dee said earlier that her personal treatment on IWR involved an abbreviated Australian protocol - I'm assuming she stuck with 30 feet. She had worsening spinal DCS and came out relatively asymptomatic. @Kay Dee, please feel free to clarify if I'm incorrect, but I think all the hullabaloo about her doing a 60-foot IWR treatment is hypothetical.

Best regards,
DDM

 

[cerich]

So you are a mind reader, besides a diver?

Anyway, that is your opinion, certainly not mine, and in every post I say it is what I would do in a very specifc situation, and besides if you dont like what I have to say, or are so offended by it, then simply just overlook my posts.

My understanding was that free speach (or opinions) was actually still allowed, although not really encouraged (by many).

I think you misread Jack