In-water recompression to decompress - what are your thoughts?

Would you consider 'in-water recompression' to decompress

  • Yes

    Votes: 58 76.3%
  • No

    Votes: 11 14.5%
  • Not sure

    Votes: 7 9.2%

  • Total voters
    76

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Would people not be sometimes so bent that they cannot safely complete IWR? What is the normal procedure used for IWR? Do all divers get back in the water to help the diver who is bent complete his recompression? If he’s not physically able to?
 
Yes, it was.

My understanding (from a distance in time) was that Mia was low on air, had a deco obligation and requested a second tank to continue her deco stop below the surface. Sounds like it was similar to the question the OP asked.
All the evidence I have seen on her death indicates that although she was attempting to deal with an omitted decompression issue, her death was due to a combination of being OOA and technical problems and had nothing to do with DCS. She had no air in her own tank and redescended holding (not wearing) another BCD and tank, with that other BCD being her only means of achieving buoyancy. She apparently lost her grip on that, and a technical problem prevented her from ditching her own weight.
 
That sounds like omitted deco, rather than IWR. Was the victim diagnosed with DCS prior to re-entry into the water?
All the evidence I have seen on her death indicates that although she was attempting to deal with an omitted decompression issue, her death was due to a combination of being OOA and technical problems and had nothing to do with DCS. She had no air in her own tank and redescended holding (not wearing) another BCD and tank, with that other BCD being her only means of achieving buoyancy. She apparently lost her grip on that, and a technical problem prevented her from ditching her own weight.

This COD is not to be rehashed here some seventeen years later as per the Accidents & Incidents Forum, and is obviously off-topic to this thread . . . Is that clear Andy & John?

Already implied enough in passing & context from Post#13, and no need to insensitively interrogate or "correct" @drbill 's recollection and remembrance (the decedent's husband was a dive buddy of mine, and it is still hard to reconcile with the tragedy for me as well).

(Mods, edit the above as necessary)
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Back on topic:

I had three separate type I DCS incidents experienced on Truk Lagoon Trips in Oct-Nov 2014 -all were upper Right arm/Shoulder classical acute "pulsing" symptoms with increasing pain within 90min time post-dive, and occurring within three to four days of starting Open Circuit Deep Air bottom mix dives with 50% & O2 deco (two tech deco dives per day with a 3 hour SIT). Possible contributing factors were dehydration, insufficient "acclimatization" to the tropical environment, and no prior "work-up" practice deco dives to sensitize the body's immune/inflammatory response system to high FN2 saturation & resultant residual bubbles in slow tissues & venous blood vessels (first early AM deep dive with deco of that trip was SF Maru at 51msw ave depth, 45min BT and over two-and-a-half hours runtime, after long trans-pacific flight from Los Angeles arriving late in the night before).

All DCS type I Pain Symptoms at that time in Oct-Nov 2014 were resolved with Oxygen In-Water-Recompression (O2 IWR) sessions which were performed off the end of Truk Stop Hotel Pier. Lying prone & relaxed at 9m depth breathing standard open-circuit non-face mask regs, on a sandy bottom in 28°C water temp, the modified Australian Method IWR as taught by UTD was used -with either 30, 60 or 90min of elective prescribed O2 breathing therapy at 9msw depth (10min O2:with 5min Air Break); and then slow 0.1m/min ascent to surface (same breathing 10minO2:with 5min Air Break). Went with 60 minutes O2 time at 9msw. . .

So choosing 60 minutes of O2 time at 9msw in my case example, you alternate breathing 10min on Oxygen, and then take a 5min break on Air for a total bottom time of 90 minutes (that's 60min O2 time plus 30min Air Breaks for 90min total bottom time at 9msw), and on the slow 0.1meter-per-min O2 breathing ascent you have to hold at every 1 meter of ascent for the 5min Air Break: a time-to-surface of 135 minutes from 9msw. So the total treatment time would be 90min bottom plus 135min ascent equals 225 minutes. Can be done with an AL80/11L cylinder of Oxygen and another of Air on Open Circuit. .
 
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I speak from recent personal experience. IWR is a very viable tool if thought out in advance and all members of the team understand and can support it.
I did an extremely deep dive and both legs began tingling with a cute numbness just before my right leg became paralyzed during one of my deco stops. I went back down to a depth that relieved my symptoms, went 10' deeper, stayed several minutes, and began ascending again.
I got out of the water with no symptoms but my legs got soft in about 30 minutes. A chamber was available on the island and I took 6 rides over 4 days.
I do not think I would be walking right now if I would not have done the IWR to slow the onset of my DCS. I am still not recovered all the way but improving a bit every day. It has been 6 weeks since I got bent.
Do not take getting bent lightly. It is really humbling when a grown adult has to learn to walk, pee and poop all over again just because a few nerves got pinched by a gas bubble.
I am not going into more details of my incident, so do not bother asking.

I think you should man up, and reveal the details. Keeping tantalizing secrets like this, says you have something to hide.

Where you forced into a rapid / skipped stops type ascent? Or some other environmental condition causing issues? What are your thoughts on the cause?

Other wise if you started to get DCS in the water, then you ascent profile or gas choices, is likely not right for the job. What was your deco method / model?

.
 
Would people not be sometimes so bent that they cannot safely complete IWR? What is the normal procedure used for IWR? Do all divers get back in the water to help the diver who is bent complete his recompression? If he’s not physically able to?

Yes. Typically this is a Type II hit (neurological), where the diver may not be able to effectively perform recompression.

There are a few IWR procedures out there. There are papers on the various methods. Take a look at the Technical Diving and medical forums if you want to read more. Also, the U.S. Navy Dive Manual has a procedure.

General procedures are that there is at least one other diver in the water, often two, supporting the bent diver and someone on the surface. This is to help address oxygen toxicity hits and other issues. IWR for the bends is not a trivial endeavor and training is recommended.
 
Possible contributing factors were dehydration, insufficient "acclimatization" to the tropical environment, and no prior "work-up" practice deco dives to sensitize the body's immune/inflammatory response system to high FN2 saturation & resultant residual bubbles in slow tissues & venous blood vessels (first early AM deep dive with deco of that trip was SF Maru at 51msw ave depth, 45min BT and over two-and-a-half hours runtime, after long trans-pacific flight from Los Angeles arriving late in the night before).

So are you ruling out profile and PFO as potential contributing factors? I know Simon worked this, but I'm not familiar with a clinical elimination of profile.
 
So are you ruling out profile and PFO as potential contributing factors? I know Simon worked this, but I'm not familiar with a clinical elimination of profile.
PFO Ruled Out. Per negative indication of right-to-left cardiac shunt by Trans Cranial Doppler general test screening as part of a UCLA control group study in 2009.

RD 1.0 with gross deepstops was the deco algorithm over consecutive deco dive days, and most likely was contributory to the DCS pathology.
 
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