Mike Boswell
Contributor
FYI - Mike and his wife Linda will visit here to read your thoughts and answer any questions you may have. Your kindness will be appreciated.
Mike is 63, six foot one, slim and physically fit, a PADI dive master with four decades of diving experience. On March 3, 2013 he suffered Type II (spinal cord) DCS. Today, nine months later, he is learning how to walk again. We are telling Mike’s story in the hopes that it will help other divers.
On March 2, 2013 my wife Katy and I (Mike Boswell) and Mike (Mike's friend Mike) and his wife Linda departed San Diego at 6:00 a.m. We changed planes in Houston and landed in Cancun at 2:30 p.m., went through immigration and retrieved our bags. Then we boarded a van for the 5-hour trip south to Xcalak. At 5 p.m. we stopped at a restaurant for dinner and each had two beers. Back in the van, the driver handed us bottled water. At 10 p.m., after 15 hours of travel, we arrived at the dive resort, checked into our palapas, and went to bed.
At 8:00 a.m. the next morning we met at the restaurant for breakfast, and then met with our dive master, produced our cert cards, signed releases, and arranged for our first dive.
At 10:00 a.m. Mike, Katy, and I (Linda is not a scuba diver) met at the dock with our gear, piled into the panga and set off. Our DM began the briefing: The dive spot was ten minutes away, was one of his favorites, would start at 50 feet, would go as deep as 95 feet, and would end when we reached our NDLs or ran low on air: He estimated a 45-50 minute dive, saying the boat would pick us up after we completed our safety stop. I recall thinking that 95 feet was deep for a first dive, and that DMs like to take their groups on a shallower first dive to get them “checked out”, but I wasn’t worried about it.
Our dive was just as described: The temperature was 79 degrees, the vis was about 100 feet, with lots of beautiful coral and small fish. We started at 50 feet, swam out along a long coral finger, and then turned left and swam over a number of parallel coral fingers, averaging about 70 feet with a maximum of a bit over 90 feet in one or two spots. Mike, a conservative diver, wore both a Suunto and a Tusa computer. We completed the dive, ascended slowly, completed our safety stops, and were back in the boat with a total dive time of 41 minutes. No one had exceeded their NDLs or generated any computer alarms.
On the windy and choppy 10-minute ride back to the dock, Mike sat uncomfortably on the floor, his tall frame twisted to fit between a bench and the side of the boat. Stepping out onto the dock, he said he felt kind of “funny”, with the skin on the right side of his back and shoulder feeling numb.
At 11:00 Linda joined us at an outdoor table at the restaurant and we ordered lunch. Mike noted that the numbness seemed to be moving down his right leg. We talked about it at some length: Obviously DCS was possible. Mike said the numbness might be the result of sitting on the floor of the boat and bouncing against the side. Another explanation might be a stroke, but I noted that Mike’s facial expressions and speech seemed normal. Katy suggested that Mike ought to go on oxygen just to be safe. Mike said he would rest, keep an eye on his symptoms, and skip the second dive.
After lunch, at about noon, Mike and Linda walked to the dive center and told the dive master that he didn’t feel well enough to go on the next dive. They had Mike pull up his shirt and looked him over for signs of a rash or other symptoms, but found nothing. Mike and Linda went to their palapa to rest. At 1:00 p.m. Katy and I went on our second dive, similar to but shallower than the first one.
When we returned at 2:00 p.m. we met Mike and Linda coming out of their palapa and Mike was favoring his right leg. He said Linda had been massaging his leg but there was no improvement. Mike then returned to the dive center to request oxygen and notify the resort owners that his symptoms of numbness and lack of muscle control were worsening. A domestic-use type oxygen bottle with a nostril inhaler was provided. It was covered with dust and corrosion. The gauge showed less than 20% remaining. After about 20 minutes, it was empty.
Mike returned to his palapa to wait for the resort owners. While waiting, he lost bladder control. The owners arrived and assessed Mike’s situation. They noted that the nearest chamber in Belize was one-and-a-half hours to the south, but doubted if it would be staffed on a Sunday, and because Xcalak’s electric system was down there was no phone service and no way to call Belize or to contact DAN. They arranged for a driver and vehicle to take him four hours north to Playa del Carmen, where the nearest reliable recompression chamber was located. They provided Mike with a second domestic-type oxygen bottle, which lasted for about three more hours.
The ride north in a small pickup truck was later described by Linda as ”horrific”, with Mike rapidly losing all function below the waist. They had to stop for military checkpoints and twice more for gas. Mike described the ride as being “Hell on Earth.” He had never experienced so much pain for such a long period of time.
At about 7 p.m. they arrived at PdC. Unsure of the chamber’s location, the driver went to the public hospital instead. Mike tried to get out of the truck and into a wheelchair but fell to the ground as his legs had become totally paralyzed. He was taken into the hospital and placed on a fluid IV. The doctor on call summoned an ambulance to take him to the SSS Recompression Chamber Clinic. He was at the hospital for about one hour.
Upon arrival at the SSS Clinic, Mike’s blood pressure was 220 over 180. This was caused by a combination of the intense pain and a nitrogen bubble at cervical vertebrae 7. Nerves to the heart and lungs pass through that vertebrae, and the doctor was afraid that Mike was at risk of cardiac arrest from the spinal cord damage. Additionally, he had spinal cord damage at thoracic vertebrae 10. All functions from the rib cage down were paralyzed. The doctor warned Linda that Mike’s condition was extremely grave, and that he might not survive his recompression treatment: If his heart stopped in the chamber, it would be impossible to revive him.
At 9 p.m., ten hours after his dive, Mike was rolled into the chamber on a stretcher for his first treatment, which lasted 9 hours. Linda was not allowed to watch the video monitor of Mike’s chamber treatment. She sat and waited by the chamber door.
Mike had six more recompression treatments at the PdC clinic over the next four days: A second 9-hour treatment, two 7-hours, two 5-hours, and one 3-hours. The doctors then determined that the bubbles were gone, and that Mike needed additional treatments. He was moved to the SSS Clinic in Cozumel where he received another thirty 2-hour hyperbaric enhanced oxygen treatments over the next three weeks, with Linda living in his room, sleeping on a cot. He gradually gained partial recovery of the nerve damage and partial recovery from the paralysis. After four weeks, the nerve recovery reached a plateau, showing no further improvement, and the doctors in Cozumel released Mike to fly home. A paramedic accompanied him on his flight back to San Diego.
Mike’s recovery has been long and arduous for him and his family. Since returning home he has had 20 additional chamber treatments and continuous physical therapy. As we write this nine months later, he has recovered much of his nerve function and he can get around with a cane, but is still without feeling and function in many areas from the waist down. His doctors are optimistic that he will continue to improve. Mike has decided to give up diving and has sold his scuba gear because he can’t risk getting DCS again.
Conclusions:
1 Examine the dive op’s emergency facilities before you dive, and dive accordingly. Ask to see the dive op’s compressor, safety equipment, DAN-approved oxygen tanks and masks. Do they have electricity? Phone service? Cell phone service? An ambulance? A chamber nearby? Is the chamber open and staffed? How would you get there? Can you reach DAN if you need to?
2 Time is critical. If you feel “funny” or have symptoms after a dive, assume DCS until proven otherwise. This will get you thinking about communicating, transportation logistics and treatment options, and finding out what really works and what doesn’t. We don’t know why Mike got DCS, but we think that faster responses on our part could have reduced the severity of the effects Mike suffered.
3 Your dive computer is no guarantee against DCS. Mike had done this dive on previous trips with no problems, and he wore two computers. DCS can strike anyone, and the results can be immediate and devastating. The doctors at the chamber in Cozumel cited a DAN study that said about 30% of DCS cases are “unexplained.”
4 Good insurance is vital. Through an oversight, Mike’s DAN policy had elapsed, but fortunately he does have good medical insurance. For this incident, his insurance has been billed $212,000 and his “out-of-pocket” expenses are $20,000 to date. He will have continued “out-of-pocket” expenses for uncovered medical supplies, incontinence supplies, and physical training/therapy.
---------- Post added December 19th, 2013 at 08:08 AM ----------
Addendum: Mike sold his computers and does not have his profile, but I will try to get the profile of my wife's computer and post it - They would be nearly identical.
Mike is 63, six foot one, slim and physically fit, a PADI dive master with four decades of diving experience. On March 3, 2013 he suffered Type II (spinal cord) DCS. Today, nine months later, he is learning how to walk again. We are telling Mike’s story in the hopes that it will help other divers.
On March 2, 2013 my wife Katy and I (Mike Boswell) and Mike (Mike's friend Mike) and his wife Linda departed San Diego at 6:00 a.m. We changed planes in Houston and landed in Cancun at 2:30 p.m., went through immigration and retrieved our bags. Then we boarded a van for the 5-hour trip south to Xcalak. At 5 p.m. we stopped at a restaurant for dinner and each had two beers. Back in the van, the driver handed us bottled water. At 10 p.m., after 15 hours of travel, we arrived at the dive resort, checked into our palapas, and went to bed.
At 8:00 a.m. the next morning we met at the restaurant for breakfast, and then met with our dive master, produced our cert cards, signed releases, and arranged for our first dive.
At 10:00 a.m. Mike, Katy, and I (Linda is not a scuba diver) met at the dock with our gear, piled into the panga and set off. Our DM began the briefing: The dive spot was ten minutes away, was one of his favorites, would start at 50 feet, would go as deep as 95 feet, and would end when we reached our NDLs or ran low on air: He estimated a 45-50 minute dive, saying the boat would pick us up after we completed our safety stop. I recall thinking that 95 feet was deep for a first dive, and that DMs like to take their groups on a shallower first dive to get them “checked out”, but I wasn’t worried about it.
Our dive was just as described: The temperature was 79 degrees, the vis was about 100 feet, with lots of beautiful coral and small fish. We started at 50 feet, swam out along a long coral finger, and then turned left and swam over a number of parallel coral fingers, averaging about 70 feet with a maximum of a bit over 90 feet in one or two spots. Mike, a conservative diver, wore both a Suunto and a Tusa computer. We completed the dive, ascended slowly, completed our safety stops, and were back in the boat with a total dive time of 41 minutes. No one had exceeded their NDLs or generated any computer alarms.
On the windy and choppy 10-minute ride back to the dock, Mike sat uncomfortably on the floor, his tall frame twisted to fit between a bench and the side of the boat. Stepping out onto the dock, he said he felt kind of “funny”, with the skin on the right side of his back and shoulder feeling numb.
At 11:00 Linda joined us at an outdoor table at the restaurant and we ordered lunch. Mike noted that the numbness seemed to be moving down his right leg. We talked about it at some length: Obviously DCS was possible. Mike said the numbness might be the result of sitting on the floor of the boat and bouncing against the side. Another explanation might be a stroke, but I noted that Mike’s facial expressions and speech seemed normal. Katy suggested that Mike ought to go on oxygen just to be safe. Mike said he would rest, keep an eye on his symptoms, and skip the second dive.
After lunch, at about noon, Mike and Linda walked to the dive center and told the dive master that he didn’t feel well enough to go on the next dive. They had Mike pull up his shirt and looked him over for signs of a rash or other symptoms, but found nothing. Mike and Linda went to their palapa to rest. At 1:00 p.m. Katy and I went on our second dive, similar to but shallower than the first one.
When we returned at 2:00 p.m. we met Mike and Linda coming out of their palapa and Mike was favoring his right leg. He said Linda had been massaging his leg but there was no improvement. Mike then returned to the dive center to request oxygen and notify the resort owners that his symptoms of numbness and lack of muscle control were worsening. A domestic-use type oxygen bottle with a nostril inhaler was provided. It was covered with dust and corrosion. The gauge showed less than 20% remaining. After about 20 minutes, it was empty.
Mike returned to his palapa to wait for the resort owners. While waiting, he lost bladder control. The owners arrived and assessed Mike’s situation. They noted that the nearest chamber in Belize was one-and-a-half hours to the south, but doubted if it would be staffed on a Sunday, and because Xcalak’s electric system was down there was no phone service and no way to call Belize or to contact DAN. They arranged for a driver and vehicle to take him four hours north to Playa del Carmen, where the nearest reliable recompression chamber was located. They provided Mike with a second domestic-type oxygen bottle, which lasted for about three more hours.
The ride north in a small pickup truck was later described by Linda as ”horrific”, with Mike rapidly losing all function below the waist. They had to stop for military checkpoints and twice more for gas. Mike described the ride as being “Hell on Earth.” He had never experienced so much pain for such a long period of time.
At about 7 p.m. they arrived at PdC. Unsure of the chamber’s location, the driver went to the public hospital instead. Mike tried to get out of the truck and into a wheelchair but fell to the ground as his legs had become totally paralyzed. He was taken into the hospital and placed on a fluid IV. The doctor on call summoned an ambulance to take him to the SSS Recompression Chamber Clinic. He was at the hospital for about one hour.
Upon arrival at the SSS Clinic, Mike’s blood pressure was 220 over 180. This was caused by a combination of the intense pain and a nitrogen bubble at cervical vertebrae 7. Nerves to the heart and lungs pass through that vertebrae, and the doctor was afraid that Mike was at risk of cardiac arrest from the spinal cord damage. Additionally, he had spinal cord damage at thoracic vertebrae 10. All functions from the rib cage down were paralyzed. The doctor warned Linda that Mike’s condition was extremely grave, and that he might not survive his recompression treatment: If his heart stopped in the chamber, it would be impossible to revive him.
At 9 p.m., ten hours after his dive, Mike was rolled into the chamber on a stretcher for his first treatment, which lasted 9 hours. Linda was not allowed to watch the video monitor of Mike’s chamber treatment. She sat and waited by the chamber door.
Mike had six more recompression treatments at the PdC clinic over the next four days: A second 9-hour treatment, two 7-hours, two 5-hours, and one 3-hours. The doctors then determined that the bubbles were gone, and that Mike needed additional treatments. He was moved to the SSS Clinic in Cozumel where he received another thirty 2-hour hyperbaric enhanced oxygen treatments over the next three weeks, with Linda living in his room, sleeping on a cot. He gradually gained partial recovery of the nerve damage and partial recovery from the paralysis. After four weeks, the nerve recovery reached a plateau, showing no further improvement, and the doctors in Cozumel released Mike to fly home. A paramedic accompanied him on his flight back to San Diego.
Mike’s recovery has been long and arduous for him and his family. Since returning home he has had 20 additional chamber treatments and continuous physical therapy. As we write this nine months later, he has recovered much of his nerve function and he can get around with a cane, but is still without feeling and function in many areas from the waist down. His doctors are optimistic that he will continue to improve. Mike has decided to give up diving and has sold his scuba gear because he can’t risk getting DCS again.
Conclusions:
1 Examine the dive op’s emergency facilities before you dive, and dive accordingly. Ask to see the dive op’s compressor, safety equipment, DAN-approved oxygen tanks and masks. Do they have electricity? Phone service? Cell phone service? An ambulance? A chamber nearby? Is the chamber open and staffed? How would you get there? Can you reach DAN if you need to?
2 Time is critical. If you feel “funny” or have symptoms after a dive, assume DCS until proven otherwise. This will get you thinking about communicating, transportation logistics and treatment options, and finding out what really works and what doesn’t. We don’t know why Mike got DCS, but we think that faster responses on our part could have reduced the severity of the effects Mike suffered.
3 Your dive computer is no guarantee against DCS. Mike had done this dive on previous trips with no problems, and he wore two computers. DCS can strike anyone, and the results can be immediate and devastating. The doctors at the chamber in Cozumel cited a DAN study that said about 30% of DCS cases are “unexplained.”
4 Good insurance is vital. Through an oversight, Mike’s DAN policy had elapsed, but fortunately he does have good medical insurance. For this incident, his insurance has been billed $212,000 and his “out-of-pocket” expenses are $20,000 to date. He will have continued “out-of-pocket” expenses for uncovered medical supplies, incontinence supplies, and physical training/therapy.
---------- Post added December 19th, 2013 at 08:08 AM ----------
Addendum: Mike sold his computers and does not have his profile, but I will try to get the profile of my wife's computer and post it - They would be nearly identical.
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