Intense Pain 5 Hours After Diving

[DocVikingo]

There is absolutely no way for anyone here on SB to reliably offer any assistance other than to suggest you seek out a competent "dive doctor" and get evaluated.

Hey Guba,

I'm not sure I'd be quite so summary, unconditional and categorical about the inability of properly trained professionals on this board who chose their words carefully to offer some "reliable assistance" on this inquiry. Do you really find my response immediately above so totally lacking in information and merit? ; )

Regards,

DocVikingo

 

[DocVikingo]

A Just got done emailing DAN. Hopefully they can find me a good Dive Doc to take a look. I know that is what I need. Thank you all for any advice that you have given.

BTW, brandonze, for those not truly familiar with DAN's specialist referral base, the probability of them having an appropriate referral varies wildly by state and city. In many cities that are not large, well recognized metropolitan areas they have none. I’d certainly guess that Florida has a better base than (especially in cities such as Miami), say, Iowa (especially cities such as Algona) , but the point is there's no guarantee. If DAN comes up empty or you'll need to travel too far to see their recommendation, a quality non-diving orthopedist very likely can get the ball rolling.

In any event, please let us know how it turns out—it helps us to learn.

Regards,

DocVikingo

 

[Duke Dive Medicine]

Hello all,
This is my first post on the forum and I am looking for answers on a pain that has happened on my last four dives.

A little backgroud. I dislocated my shoulder in 2005, Forcing it forward out of the socket. This tore a piece of bone up to create a little bone spur that has since filled in and does not bother me at all on land.

I made a dive April 20th. First dive was to 90 ft and second of the day was 60 ft. Hour surface intervel, and both dives where well within the tables. Safety stop for both was 15ft for three min.

After returning home, and washing my gear, I sat down and began to notice an intense pain in my left shoulder. Took some Motrin and still persited. Went away after @ 12 hours.

Made two more dives this last saturday. one 60 ft and one 50 ft. Same thing happened but it seemed worse.

All pain is localized to that shoulder and only lasts for about 12 hours. I am 32 and in good health. I am wondering what the heck is cuasing this. Any ideas are welcomed!

Brandon,

Hopefully you've been in touch with DAN by now and have received a referral so this may be moot, but I don't know if I'd be so quick to rule out DCS. Last weekend we treated an Army SF diver who made two 80-85 foot recreational dives well within the tables and ended up with severe shoulder pain a few hours afterward. If you had DCS after your dives on the 20th, you weren't treated, and you dove again 10 days later (I'm assuming you're talking about Saturday April 30th), it's possible that there was some residual inflammation and/or circulatory impairment and you had a second hit despite the relatively shallow depths.

I'm also a bit troubled by the time course of your symptoms. If you had a mechanical injury, it probably wouldn't have taken five hours to show itself. You're well within the time of onset for DCS - CNS symptoms tend to present more quickly, but it's not at all uncommon for less severe symptoms like shoulder pain to appear, or at least get noticed, several hours after a dive. The U.S. Navy Diving Manual gives the often-cited statistics that in a series of military divers, 42% of symptoms occurred within 1 hour after diving, 60% within 3 hours, 83% within 8 hours, and 98% within 24 hours (taken from Vann et. al. Decompression Illness, Lancet 2010; 377: 153–64).

If you're still in need of a referral, please don't hesitate to contact us either via PM here or via phone. The number is on our webpage in the link below the signature. I hope you get an answer soon.

Best regards,
DDM

 

[ScubaNurse758]

Brandon, You mentioned that the shoulder injury was in 2005. Were these the first 4 dives you have made since the shoulder injury? Or have you dove before now and had no pain from the shoulder injury?? Just wondering.

Jordan.

 

[Guba]

Hey Guba,

I'm not sure I'd be quite so summary, unconditional and categorical about the inability of properly trained professionals on this board who chose their words carefully to offer some "reliable assistance" on this inquiry. Do you really find my response immediately above so totally lacking in information and merit? ; )

Regards,

DocVikingo

Hello, Doc
1) Look carefully at the time stamp on both my initial reply and the Mod's movement of the thread to this (medical) forum. The OP's thread was initially in the "general" forum (where I saw it), and WHILE I WAS COMPOSING MY REPLY, the thread was moved to this one. I was very surprised to find my post here. I think you will agree (after re-reading my post) that "general" was not the proper place for a question such as this one.
2) I do not think my reply is so far removed from even your own post. While you did much to alleviate the OP's anxiety (which is good), it does not negate the need for competent physicians to evaluate his condition, symptoms, history, and possible treatment in a TIMELY manner and first-hand. If the condition is unrelated to DCS, then there is no problem. However, if the symptoms HAD been a result of diving, then wasting time waiting for return comments on an on-line forum (rather than contacting a DAN professional by phone, for example) would be unwise.

I have the utmost respect for medical professionals, especially ones that are willing to share their time and expertise with others in forums such as this one. However, seeing the post addressed to a general population of divers, on an online venue, when the person was obviously stressed over the condition, yet potentially delaying a prudent reaction was just cause to write precisely what I did. No offense was intended.

Thanks for all you (and other diving, medical care providers here) do for all of us.
Bill

 

[brandonze]

ScubaNurse,

I have been diving since I had my dislocation. I got certified in 2009 so all dives have been after. These last four are the first times it bothered me. Also I looked in my logs last night and realized that I was wrong on the date of the first set of dives. they where on the 13th of April giving me 17 days in between dives.

Seeing how I was not as proactive as I should have been, I will just be going to my assigned Family Practice and see if he wants to issue me a referal (i'snt Military healthcare wonderful?)

Thank you all for the advice and I will know for future referance to post in the correct forum.

 

[ScubaNurse758]

Well if you have dove since the injury and didnt experience any symptoms but now you are having symptoms would leave me to two possible scenarios. Either you are, like DDM said, experiencing some DCS symptoms, or you are doing like some of us well-worn 29 year olds and experiencing some early onset arthritis. Either way, I would call DAN's 1-800 number listed at the top of the page and get an idea from them as to which way to go from here. Good Luck!

Jordan.