Mike's DCS And Some Lessons Learned

[Agility]

Thank you for beginning this thread for us all to learn.

As you can see, we left the bottom and began our slow ascent at about the 28-minute mark, riding the current over the reef. The stop at 32 minutes/50 ft. was in mid-water and was intentional, as a "deep stop" to off-gas a bit.

Just trying to put together a hypothesis how this hit could have been acquired.
IIRC a 3m/min ascent creates much more bubbles than a 10m/min ascent. And your ascent was very slow up to your deep stop. It is clear to me that the topography of the site often dictates the dive profile.
What then followed seems to be a textbook ascent to the safety stop. But then according to the log you only needed 10 seconds for the last 5m (I do not know at what depth this computer "ends" the dive, so you might have taken longer) which seems to me to be rather fast.
Sitting in a crunched up position might have interfered with breathing and so impeded offgassing on the boat. As Steve_C noted keeping ones balance in an uncomfortable position requires quite a lot of muscle work and shearing at the joints which may introduce additional bubbles into the circulation.

 

[DandyDon]

We were told that Ambergris Caye could be reached by boat or by road via Chetumal. That's all I know.

Had we been able to call DAN, I think they might have helped diagnose DCS faster, and they could have advised us on whether the Belize chamber was open.

Yes, Xcalak has good diving. The coral formations are really nice, and we saw a lot of fish life there. The offshore area is a preserve, but I was told they do allow "locals" to fish, and there were numerous signs of that.

The boat to Ambergris might have worked jf you knew the chamber was staffed. Based on Google maps(?), the road to Chetumal would be over 3 hours, and continuing to Belize city and ferry to Ambergris over 7 not counting Immigration & Customs. Last I heard, Ambergris had the only chamber in Belize. The road trip to PDC was horrible, but the safer call - as well as better for Medi-vac if it had been needed.

I carry a PLB now, including diving, but for remote adventures like Xcalak - maybe renting a satellite phone would be a good idea?

 

[Mike Boswell]

In re-reading this thread it occurred to me that it sounds like I wrote the OP. Actually, Mike and Linda wrote most of it, and I just tidied it up a bit. So any thanks you all have should go to Mike and Linda.

Changing the subject a little, I'd like to hear from those who have information about the recovery process from nerve damage.

How does it work? What therapies help? Why does it take so long? Is there any information out there that would be helpful to Mike?

 

[ianr33]

Changing the subject a little, I'd like to hear from those who have information about the recovery process from nerve damage.

How does it work? What therapies help? Why does it take so long? Is there any information out there that would be helpful to Mike?

This might be of some help: About Peripheral Nerves | Columbia Neurosurgery

 

[Jax]

In re-reading this thread it occurred to me that it sounds like I wrote the OP. Actually, Mike and Linda wrote most of it, and I just tidied it up a bit. So any thanks you all have should go to Mike and Linda.

Changing the subject a little, I'd like to hear from those who have information about the recovery process from nerve damage.

How does it work? What therapies help? Why does it take so long? Is there any information out there that would be helpful to Mike?

This might be of some help: About Peripheral Nerves | Columbia Neurosurgery

Not damaged from DCS, but it took over two years to get over sciatica when my first disk herniated. Stretching, exercise, consistently will result in steady improvement. It simply takes a really long time for nerves to heal.

 

[TSandM]

The prognosis really depends on where the damage was done, and what the damage actually was. Neurons don't regenerate (that's now in a bit of question, but as a rule of thumb, they don't) so if nerve cells in the spinal cord or at the nerve roots actually died, the only way to regain function is to reroute pathways. How successful that is depends on how many pathways there are that remain undamaged.

If the neurons were damaged but not killed, they can heal . . . they can make new connections, or the glial cells can generate new myelin.

Bernie Chowdury sustained a fairly horrible Type II hit during the time period of Shadow Divers (I believe his book is called the Last Dive, and recounts the story). His eventual recovery has been, to my knowledge, almost complete, and he is most definitely back to diving. I think it took a couple of years. In fact, your friend Mike might get some moral support from contacting him -- he is on FB, and his email is bernie@alphadivetraining.com.

 

[Steve A]

As a new diver I like to read these posts to try and help avoid problems, but reading this post over again has kind of made me nervous now.
What are the statistics on the likelihood of sustaining an undeserved hit?

 

[miked]

Changing the subject a little, I'd like to hear from those who have information about the recovery process from nerve damage.

I had a DCS2 hit in August, 2004, but not as severe as your friends. I needed"only" 6 USN table 6 treatments before I was released to return home.
Once home, I was fatigued, had the paresthesia (sp?) (tingling in feet and legs,worsening with over-exertion) I was given no specific regimen, just told to "go easy, let yourself heal". The symptoms lessened after about 4 months, and were not noticeable after 7. (The Drs. mentioned that if my symptoms were more severe, physical therapy would be required.)

[I realize that the time frame mentioned above has already been passed by Mike W. Please extend to him my best hopes for a full recovery]

 

[scubadada]

...But then according to the log you only needed 10 seconds for the last 5m (I do not know at what depth this computer "ends" the dive, so you might have taken longer) which seems to me to be rather fast.

Thanks for posting on this most frightening incldent, I only found this thread today

The nitrogen exposure on this dive was within NDL but not inconsequential. The Suunto RGBM algorithm lists 50 minutes at 60 ft and 33 minutes at 70 feet as the NDL for air for the 1st dive in a series. As mentioned, this algorithm tends to be at the conservative end of the spectrum. As pointed out by Agility, what does seem potentially striking is the terminal ascent from the safety stop at 14 feet, to the surface, in less than or equal to 10 seconds. Given the large pressure change from about 1.5 atm to 1.0 atm, I try to make the final ascent in at least 30 seconds, if not longer. Whether this played any role in the DCS hit is complete conjecture and I realize this was not Mike's computer but a buddy's.

This thread has made me much more aware of the critical variables at any dive location such as availabilty and amount of oxygen, communication (I have generally assumed landline or cell would be available), location and staffing of nearest hyperbaric unit, and transportation. I'm much more likely to ask these questions in the future.

I hope Mike continues to improve from this devastating event and wish him and his wife the best.

 

[DandyDon]

As a new diver I like to read these posts to try and help avoid problems, but reading this post over again has kind of made me nervous now.
What are the statistics on the likelihood of sustaining an undeserved hit?

Oh, extremely rare. Hits of any kind are quite rare; if they were common, it wouldn't be such a popular sport. DAN's Annual Accident report has stats and can be rewarding to read.