Is it safe for me to fly? I really need to get home.

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I thought GF's in the teens at 8k would be safe enough, now I am questioning that.

At the same time, after a week of diving I have been at 7% after 30+hrs surface interval, which is well beyond the 24 hour conventional recommendation (and I didn't get bent).
FWIW, my personal TTF indication is a GF8k of < 13.5% (from a similar analysis of the Navy ascent table, using the minimum GF8k across various depths). The Navy guidance might indeed be considered a bit conservative when compared to some of the Duke results, and there's even a table illustrating that in the full proceedings. And perhaps it is overly conservative to apply the same rule to a week's worth of diving. Everyone has to choose their own threshold in that gray area.
 
I'm sorry, you seem to be trying to conflate two different kinds of gas emboli problems....(1) those caused by "lung over expansion" as in holding one's breath, typically called AGE, and (2) those caused by a shunt to get the venous bubbles into the arterial circulation....which I understand is not common, just possible. Is it not confusing -- even misleading -- to simplistically say that everything DCS or AGE, has the same symptoms and outcomes?
I think the confusion is that as divers we associate AGE with a lung over expansion injury. However arterial gas embolism occurs when gas bubbles enter or form in the arterial vasculature and occlude blood flow. A lung over expansion injury is not the only way that can occur.

AGE can occur from ruptured alveoli after lung barotrauma ( lung over expansion injury ). AGE can also occur via migration from the venous circulation (venous gas embolism) via a right-to-left shunt (PFO, ASD).

As divers we are taught that the 4 lung over expansion injuries are:
  • Arterial gas embolism - AGE
  • Pneumothorax
  • Mediastinal Emphysema
  • Subcutaneous Emphysema
No where is it stated that the only way an AGE can occur is through a lung over-expansion injury.
 
I think the confusion is that as divers we associate AGE with a lung over expansion injury. However arterial gas embolism occurs when gas bubbles enter or form in the arterial vasculature and occlude blood flow. A lung over expansion injury is not the only way that can occur.

AGE can occur from ruptured alveoli after lung barotrauma ( lung over expansion injury ). AGE can also occur via migration from the venous circulation (venous gas embolism) via a right-to-left shunt (PFO, ASD).

As divers we are taught that the 4 lung over expansion injuries are:
  • Arterial gas embolism - AGE
  • Pneumothorax
  • Mediastinal Emphysema
  • Subcutaneous Emphysema
No where is it stated that the only way an AGE can occur is through a lung over-expansion injury.
Then why do we even distinguish between DCS and DCI?
 
Do we know if you can apply the same rules for 10 000 ft? I.e. is there enough evidence?

Because gas is compressible, the formulae that work underwater don't work for going up in the atmosphere. You have to program in a whole 'nother model based on bent astronauts and fighter pilots.
 
I'm sorry, you seem to be trying to conflate two different kinds of gas emboli problems....(1) those caused by "lung over expansion" as in holding one's breath, typically called AGE, and (2) those caused by a shunt to get the venous bubbles into the arterial circulation....which I understand is not common, just possible. Is it not confusing -- even misleading -- to simplistically say that everything DCS or AGE, has the same symptoms and outcomes?
I don't believe it's conflating to say that both mechanisms of injury have the potential to result in similar symptoms. I'm not saying that they always result in the same symptoms or outcomes - that, as you said, would be simplistic, and comparing apples to oranges.

Best regards,
DDM
 
Then why do we even distinguish between DCS and DCI?
From the standpoint of symptoms and response to treatment we may well not, and that very argument as been put forth. That is one of the reasons that the Navy now recommends the same chamber treatment protocol for AGE and severe DCS. Dive profiles do help confirm a diagnosis - if a diver has a history of a panic ascent and presents with sudden-onset stroke-like symptoms that began two minutes after reaching the surface, we can be reasonably confident in our diagnosis and decision to treat in the chamber vs. sending for imaging to rule out a stroke and starting TPA (although they'll likely still get imaging before reaching the chamber anyway). The same symptoms with sudden and dramatic onset soon after surfacing in a different diver who's made back-to-back deep decompression dives and has a prior history of severe neurological DCS would help shore up a diagnosis of decompression sickness possibly related to arterialized VGE. We'd treat both divers on a U.S. Navy Treatment Table 6. In many instances, the distinction between the two more influences diver education, decisions on future diving, and follow-up treatments than the treatment itself. We'd have one type of conversation with diver #1 and a completely different type with diver #2.

Best regards,
DDM
 

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