Beachman
Guest
This scenario was posted on another board recently by a guy I've met and converse with sometimes. Just wondering if you have any thoughts or comments.
Thanks Dr. Deco
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Heading to Coz on Tuesday for a week and I might not dive.
The reason that I might not be able to dive is that I've developed some sensory nerve problems in my right foot and a teeny tiny bit in my right lower leg. It's not numbness, just a different feeling, especially on the ball of my foot. It's more of a hypersensitivity than anything. It doesn't bother me much, and it has not affected me in the least -- I've been skiing, hiking, and still work out (wieghts and cardio) regularly with no problems. I'm just worried that if there is some sort of nerve damage, that it could be worsened by diving, i.e. microbubbles, which are always present.
What sort of worries me is that it started on a live-aboard back in mid-December. I noticed a slight tingling in the tips of 2 or 3 toes around mid-day on the 5th day. I can't remember, but I think there may have also been occasional faint tingling on my upper shin. I immediately thought about DCS, but I did not have any other symptoms. There was no mottled skin, no joint pain, no numbness at all, no paralysis, no uncoordination, no ill feeling, no blurred vision etc. I did another dive and the tingling did not change. I did a night dive and the tingling did not change. I was a little concerned, and even found some books and checked on the symptoms again to make sure that I was not making a mistake. I attributed it to having something to do with having to kick like hell against a strong current for much of the dives and perhaps pinching a nerve (or something).
The next morning, I woke up and had no tingling at all. I did two more dives and later in the day once again noticed the tingling. The diving was over at this point, and we were heading back to port. Again, the symptoms did not worsen and disappeared overnight. I don't remember noticing any further tingling the next day nor on the plane ride home. The "strange" feeling and hypersensitivity has since come on gradually. I now rarely have any tingling at all, but the "wierd" and hypersensitive feeling on the bottom of my foot and big toe is usually present. It is worse some days and I hardly notice it others.
If it was an undiagnosed case of a spinal DCS hit, I'll be a bit surprised. I was diving EAN32 for most dives, but started topping off with air on many days to lower the O2% as my computer is rather conservative on O2 loading. My deepest depth for the week was 91' and I usually did not go deeper than 80. I did not come within 1 "click" of the yellow zone on my computer on any dives, and surfaced 4 or more "clicks" in the green, away from the yellow. My safety stops included a few minutes at 40, a few at 30, a few at 25 and 20, and then a full 10 minutes or more between 20 and 15 and a very slow ascent from 15. I noticed that I did go into the yellow several times on my ascent indicator, but I think it was when I was much deeper, as I watched it carefully above 30. I was very well hydrated all week, I'm thin and in-shape.
I have called DAN twice, and neither physician that I spoke to thinks that it was DCS, since the symptoms never progressed any and did not worsen on the plane ride. It could be caused by several things. There could be some type of nerve impingement or I could have a back problem that I'm unaware of. One said that I should be fine if I continue to dive. I, on the other hand, want to be cautious. I was unable to get an appointment with a neurologist until the day before I leave, so I doubt he'll be able to perform any of the necessary tests (EMG, MRI etc.) to try to diagnose it. I've done a bit of research on the web, and it looks like I could be suffering from Peripheral Neuropathy, which is often hard to determine the cause of and treat. My general practitioner did the standard blood tests to rule out the obvious causes, including checking my vitamin B-12 levels, glucose levels (diabetes) and CBC. All were fine.
I'm going to make a third call to DAN today and get another opinion. It will bum me out if I can't dive, but I'd rather be safe than sorry. I've already been looking into things to keep me occupied while my buds are diving, such as fishing charters, jungle hikes, jeep tours, Chichen Itza tours etc. I'm sure I'll have a good time even if I can't dive. However, if I get opinions from 2 DAN doctors and my neurologist that I can dive, then I may dive. I haven't decided.
In retrospect, I perhaps should have opted to get on O2 and sit out the rest of the dives despite the lack of other symptoms. I guess the element of denial, lack of "traditional" DCS symptoms, and the fact that I was diving pretty conservatively convinced me that it could not be a spinal hit.
Any thoughts?
Thanks Dr. Deco
^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^
Heading to Coz on Tuesday for a week and I might not dive.
The reason that I might not be able to dive is that I've developed some sensory nerve problems in my right foot and a teeny tiny bit in my right lower leg. It's not numbness, just a different feeling, especially on the ball of my foot. It's more of a hypersensitivity than anything. It doesn't bother me much, and it has not affected me in the least -- I've been skiing, hiking, and still work out (wieghts and cardio) regularly with no problems. I'm just worried that if there is some sort of nerve damage, that it could be worsened by diving, i.e. microbubbles, which are always present.
What sort of worries me is that it started on a live-aboard back in mid-December. I noticed a slight tingling in the tips of 2 or 3 toes around mid-day on the 5th day. I can't remember, but I think there may have also been occasional faint tingling on my upper shin. I immediately thought about DCS, but I did not have any other symptoms. There was no mottled skin, no joint pain, no numbness at all, no paralysis, no uncoordination, no ill feeling, no blurred vision etc. I did another dive and the tingling did not change. I did a night dive and the tingling did not change. I was a little concerned, and even found some books and checked on the symptoms again to make sure that I was not making a mistake. I attributed it to having something to do with having to kick like hell against a strong current for much of the dives and perhaps pinching a nerve (or something).
The next morning, I woke up and had no tingling at all. I did two more dives and later in the day once again noticed the tingling. The diving was over at this point, and we were heading back to port. Again, the symptoms did not worsen and disappeared overnight. I don't remember noticing any further tingling the next day nor on the plane ride home. The "strange" feeling and hypersensitivity has since come on gradually. I now rarely have any tingling at all, but the "wierd" and hypersensitive feeling on the bottom of my foot and big toe is usually present. It is worse some days and I hardly notice it others.
If it was an undiagnosed case of a spinal DCS hit, I'll be a bit surprised. I was diving EAN32 for most dives, but started topping off with air on many days to lower the O2% as my computer is rather conservative on O2 loading. My deepest depth for the week was 91' and I usually did not go deeper than 80. I did not come within 1 "click" of the yellow zone on my computer on any dives, and surfaced 4 or more "clicks" in the green, away from the yellow. My safety stops included a few minutes at 40, a few at 30, a few at 25 and 20, and then a full 10 minutes or more between 20 and 15 and a very slow ascent from 15. I noticed that I did go into the yellow several times on my ascent indicator, but I think it was when I was much deeper, as I watched it carefully above 30. I was very well hydrated all week, I'm thin and in-shape.
I have called DAN twice, and neither physician that I spoke to thinks that it was DCS, since the symptoms never progressed any and did not worsen on the plane ride. It could be caused by several things. There could be some type of nerve impingement or I could have a back problem that I'm unaware of. One said that I should be fine if I continue to dive. I, on the other hand, want to be cautious. I was unable to get an appointment with a neurologist until the day before I leave, so I doubt he'll be able to perform any of the necessary tests (EMG, MRI etc.) to try to diagnose it. I've done a bit of research on the web, and it looks like I could be suffering from Peripheral Neuropathy, which is often hard to determine the cause of and treat. My general practitioner did the standard blood tests to rule out the obvious causes, including checking my vitamin B-12 levels, glucose levels (diabetes) and CBC. All were fine.
I'm going to make a third call to DAN today and get another opinion. It will bum me out if I can't dive, but I'd rather be safe than sorry. I've already been looking into things to keep me occupied while my buds are diving, such as fishing charters, jungle hikes, jeep tours, Chichen Itza tours etc. I'm sure I'll have a good time even if I can't dive. However, if I get opinions from 2 DAN doctors and my neurologist that I can dive, then I may dive. I haven't decided.
In retrospect, I perhaps should have opted to get on O2 and sit out the rest of the dives despite the lack of other symptoms. I guess the element of denial, lack of "traditional" DCS symptoms, and the fact that I was diving pretty conservatively convinced me that it could not be a spinal hit.
Any thoughts?
