Mild DCS ongoing effects

[sophieg1995]

Hi guys,

I had DCS at the end of September this year and I went to the diving centre to do 2 hyperbaric sessions of 2.5hrs each.

My experience of DCS has been shortness of breath and a tight and painful chest. The doctor said I had scarred tissue in the lungs.

The doctor told me it was mild and that I could dive after 30 days. The recovery went well with pain for the initial few days after, some numbness and some sore stomach cramps from the meds.

Fast forward 30 days and I started swimming properly again. Up to this point I wasnt at much cardio exercise just some pilates/yoga/walking/light swims.

Over 2 days I swam a lot in the pool and started diving down and swimming laps along the bottom of the pool with my breath held. I started practicing holding my breath under water and swam some max effort laps mixed with breathing and not breathing. The pool was probably 10-12mrters long. It was max depth 5ft.

Since then, I have had on and off chest pain which is reminding me of the dreaded DCS days I experienced before the chamber and just after.

I contacted the doc and he said it was over training which comforted me initially but the fact its continued on and off for 5 days has me concerned. It feels like dejavu!! Can anyone shed light on the recovery process and if it is normal to feel intense symptoms again from overdoing it??

Thanks in advance to anyone who reads this

 

[Sascha314]

I am a bit confused tbh. You mention scares in the lung and now just breath holding.

Was it really a dcs or more generically a dci? So what was about the dive profile for the initial event. Did you maybe experience a lung overexpansion, because you aacendet too fast for your exhaling rate?

 

[Duke Dive Medicine]

Hi guys,

I had DCS at the end of September this year and I went to the diving centre to do 2 hyperbaric sessions of 2.5hrs each.

My experience of DCS has been shortness of breath and a tight and painful chest. The doctor said I had scarred tissue in the lungs.

The doctor told me it was mild and that I could dive after 30 days. The recovery went well with pain for the initial few days after, some numbness and some sore stomach cramps from the meds.

Fast forward 30 days and I started swimming properly again. Up to this point I wasnt at much cardio exercise just some pilates/yoga/walking/light swims.

Over 2 days I swam a lot in the pool and started diving down and swimming laps along the bottom of the pool with my breath held. I started practicing holding my breath under water and swam some max effort laps mixed with breathing and not breathing. The pool was probably 10-12mrters long. It was max depth 5ft.

Since then, I have had on and off chest pain which is reminding me of the dreaded DCS days I experienced before the chamber and just after.

I contacted the doc and he said it was over training which comforted me initially but the fact its continued on and off for 5 days has me concerned. It feels like dejavu!! Can anyone shed light on the recovery process and if it is normal to feel intense symptoms again from overdoing it??

Thanks in advance to anyone who reads this

Hi Sophie,

Shortness of breath and chest tightness in the setting of decompression illness could mean a couple of things. Can you say more about the events that led up to this event? How many dives did you make prior, and what were the depth/time profiles? What terminology did the consultant at the hyperbaric center use to describe what happened?

Best regards,
DDM

 

[sophieg1995]

Sorry I forgot the dive details!!

I did the open water course so:
Day 1 - two 10 meter dives.
Day 2 - two 18 meter dives, with safety stop and a gradual ascent.

I felt headaches the first night but I was underslept so took it as being that.

After the 3rd dive I felt tired but didn't think anything of it. It was after the last dive I felt shortness of breath and a tight chest.

In general I don't have great sinuses and they were hard to equalise with a bit of pain. When I surfaced I had a lot of mucus. Asides from that I didn't have issues during the dives.

I went to hospital about 4 days after, (thinking it was strained from carrying the tank around).

Thry xrayed my chest and lungs looked good and healthy. Regular checks of my heart rate and O2 levels proved normal.

Up until doing this swimming a few days ago I felt fully recovered, only having the odd little sensation in My chest.

To note, before this course I only did 2 fun doves of 8m maybe in 2017 and the other in 2022. Only 8 meters and I never felt anything bad after.

 

[sophieg1995]

Hi Sophie,

Shortness of breath and chest tightness in the setting of decompression illness could mean a couple of things. Can you say more about the events that led up to this event? How many dives did you make prior, and what were the depth/time profiles? What terminology did the consultant at the hyperbaric center use to describe what happened?

Best regards,
DDM

Sorry I forgot the dive details!!

I did the open water course so:
Day 1 - two 10 meter dives.
Day 2 - two 18 meter dives, with safety stop and a gradual ascent.

I felt headaches the first night but I was underslept so took it as being that.

After the 3rd dive I felt tired but didn't think anything of it. It was after the last dive I felt shortness of breath and a tight chest.

In general I don't have great sinuses and they were hard to equalise with a bit of pain. When I surfaced I had a lot of mucus. Asides from that I didn't have issues during the dives.

I went to hospital about 4 days after, (thinking it was strained from carrying the tank around).

Thry xrayed my chest and lungs looked good and healthy. Regular checks of my heart rate and O2 levels proved normal.

Up until doing this swimming a few days ago I felt fully recovered, only having the odd little sensation in My chest.

To note, before this course I only did 2 fun doves of 8m maybe in 2017 and the other in 2022. Only 8 meters and I never felt anything bad after.

*****
Also, the doc said it was mild DCS having ruled out the lungs over xray. He said it was mild dcs and when leaving hospital he told me I could expect pain at random times with varying intensity and duration as it was an inflammatory response. He said there was scar tissue in the lungs that needed to repair.

I continued to take pantopump, b12 and interco for 7 days after I left hospital.

 

[Duke Dive Medicine]

Sorry I forgot the dive details!!

I did the open water course so:
Day 1 - two 10 meter dives.
Day 2 - two 18 meter dives, with safety stop and a gradual ascent.

I felt headaches the first night but I was underslept so took it as being that.

After the 3rd dive I felt tired but didn't think anything of it. It was after the last dive I felt shortness of breath and a tight chest.

In general I don't have great sinuses and they were hard to equalise with a bit of pain. When I surfaced I had a lot of mucus. Asides from that I didn't have issues during the dives.

I went to hospital about 4 days after, (thinking it was strained from carrying the tank around).

Thry xrayed my chest and lungs looked good and healthy. Regular checks of my heart rate and O2 levels proved normal.

Up until doing this swimming a few days ago I felt fully recovered, only having the odd little sensation in My chest.

To note, before this course I only did 2 fun doves of 8m maybe in 2017 and the other in 2022. Only 8 meters and I never felt anything bad after.

*****
Also, the doc said it was mild DCS having ruled out the lungs over xray. He said it was mild dcs and when leaving hospital he told me I could expect pain at random times with varying intensity and duration as it was an inflammatory response. He said there was scar tissue in the lungs that needed to repair.

I continued to take pantopump, b12 and interco for 7 days after I left hospital.

Hi Sophie, thanks for these details. A few more questions: what part of the world were you in when you were diving? You said you went to hospital four days after your last dive with continuing chest pain and shortness of breath, is that the case? Did the hyperbaric oxygen treatment resolve your symptoms? Did you have the chest x-ray before treatment, or after?

Best regards,
DDM

 

[sophieg1995]

Hi Sophie, thanks for these details. A few more questions: what part of the world were you in when you were diving? You said you went to hospital four days after your last dive with continuing chest pain and shortness of breath, is that the case? Did the hyperbaric oxygen treatment resolve your symptoms? Did you have the chest x-ray before treatment, or after?

Best regards,
DDM

Thanks for the reply! I was in Bali diving and yes I went to the hospital with those symptoms. The treatment didn't give me immediate relief although after the second one my energy was improved. I would say within a week after my chest felt good and my breathing was better. I had an xray before the chamber.

Now, my concern is I'm flying again on Monday and feeling like I felt before treatment. The doctor I saw knows I'm flying and he suggested I visit a Pulmonologist. I've found one in Vietnam and will go as soon as I arrive!!

 

[Duke Dive Medicine]

Thanks for the reply! I was in Bali diving and yes I went to the hospital with those symptoms. The treatment didn't give me immediate relief although after the second one my energy was improved. I would say within a week after my chest felt good and my breathing was better. I had an xray before the chamber.

Now, my concern is I'm flying again on Monday and feeling like I felt before treatment. The doctor I saw knows I'm flying and he suggested I visit a Pulmonologist. I've found one in Vietnam and will go as soon as I arrive!!

Thanks for that Sophie. My thoughts, for whatever they're worth, given the information you've provided: Pulmonary DCS is a possibility, though it would be quite unusual with that type of dive profile and the presentation is typically much more dramatic. Chest pain, shortness of breath, evident scarring in the lungs on x-ray, and lack of symptom improvement with treatment paint more of a picture of air trapping in your lungs that led to a pulmonary overinflation injury resulting in air somewhere in your chest cavity. That should have been visible on x-ray too but it's sometimes hard to detect, especially if the radiologist isn't looking for it. Have you had any sort of injury or medical condition that could have caused lung scarring? Severe COVID, inhaling some kind of industrial irritant, or anything else?

This may also be unrelated to diving. There are a lot of things that can cause chest pain and difficulty breathing. It could be as simple as a bad intracostal muscle strain or as complex as some kind of spinal pathology. A pulmonologist sounds like a good start given the information you have, but if you don't get any clear answers, then I'd recommend you keep looking and advocating for yourself until you do. Meanwhile, I would strongly recommend that you avoid diving. If this was due to air trapping in your lungs, you're at continued risk if you keep breathing air under pressure.

Best regards,
DDM

 

[sophieg1995]

Thanks for that Sophie. My thoughts, for whatever they're worth, given the information you've provided: Pulmonary DCS is a possibility, though it would be quite unusual with that type of dive profile and the presentation is typically much more dramatic. Chest pain, shortness of breath, evident scarring in the lungs on x-ray, and lack of symptom improvement with treatment paint more of a picture of air trapping in your lungs that led to a pulmonary overinflation injury resulting in air somewhere in your chest cavity. That should have been visible on x-ray too but it's sometimes hard to detect, especially if the radiologist isn't looking for it. Have you had any sort of injury or medical condition that could have caused lung scarring? Severe COVID, inhaling some kind of industrial irritant, or anything else?

This may also be unrelated to diving. There are a lot of things that can cause chest pain and difficulty breathing. It could be as simple as a bad intracostal muscle strain or as complex as some kind of spinal pathology. A pulmonologist sounds like a good start given the information you have, but if you don't get any clear answers, then I'd recommend you keep looking and advocating for yourself until you do. Meanwhile, I would strongly recommend that you avoid diving. If this was due to air trapping in your lungs, you're at continued risk if you keep breathing air under pressure.

Best regards,
DDM

Thank you for all that info. I definitely won't be diving again, unfortunate but not worth the risk.

I've had no issues in the past I terms of bad covid or anything like that. I'm not a smoker and no inhalation of anything either.

If it is an overexpansion, is it OK to fly? Also do you think its strange that I seemed to make a full recovery and then some cardio exercise set me off or is that typical of something like over expansion?

Also, while I think overexpansion seems like a better explanation of what's going on, I'm confused as to why it seemed like I made a full recovery after the chamber and over the past few weeks. Can you shed any light on that?

Thanks again for your time replying to me about this

 

[boulderjohn]

I'm confused as to why it seemed like I made a full recovery after the chamber and over the past few weeks.

In the vast majority of injuries of all kinds, the injured person gets better over time.

Duke Dive Medicine knows what he is talking about. The chances that you had decompression sickness after the dives you describe are incredibly slim. A very mild lung overexpansion injury is a better bet, but still not likely. If I were to place a bet, it would be that your symptoms had nothing to do with the dives.