My friend just got her OW and she's been diagnosed with DCS

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If it would help you to have the actual performance requirements for the dives you did (that is, what you were supposed to have done on each of the dives) let us know and we can post that... it's not a secret. :) There should also be a list of skills (the performance requirements) in your Adventures in Diving book at the end of each section.

kari
 
Thank you. I would like that to see if it differs from the book, or there is more to it. As I saw in the book, the deep dive had one activity and the PPB had a few. Some of the dives though seemed to have little in the requirements.

The following were the dives:

Peak Performance Buoyancy
Photography
Wreck
Deep
Navigation

Thanks for your help.

If it would help you to have the actual performance requirements for the dives you did (that is, what you were supposed to have done on each of the dives) let us know and we can post that... it's not a secret. :) There should also be a list of skills (the performance requirements) in your Adventures in Diving book at the end of each section.

kari
 
Thank you. I would like that to see if it differs from the book, or there is more to it. As I saw in the book, the deep dive had one activity and the PPB had a few. Some of the dives though seemed to have little in the requirements.

The following were the dives:

Peak Performance Buoyancy
Photography
Wreck
Deep
Navigation

Thanks for your help.

Here you go.

Deep:
Considerations
1. If you do not have recent dive experience with the diver, in preparation for the dive, generally assess diver knowledge, and, before going to depth in open water,
evaluate the diver inwater for prerequisite skills needed to complete the Deep Dive.
2. Directly supervise all student divers. Position yourself so that you or a certified assistant can make immediate physical contact with and render assistance to divers. Continually observe divers with only the brief, periodic interruptions needed to lead the dive and to provide assistance to individual divers.
3. Maximum ratio is 8:1. Do not increase this ratio with the use of certified assistants. If conditions affect your ability to directly observe and respond to divers, reduce ratios.
4. Conduct dive between 18-30 metres/60-100 feet.
5. Follow depth limits and ratios for Junior Divers as described in the General Standards and Procedures Guide.
Performance Requirements
1. Descend using a line, wall or sloping bottom.
2. Compare changes in color at the surface and at depth.
3. Compare a depth gauge to another diver’s depth gauge.
4. Ascend at a rate not to exceed 18 metres/60 feet per minute using a dive computer (or depth gauge and timing device).
5. Make a safety stop at 5 metres/15 feet for at least three minutes.

PPB:
Performance Requirements
1. Rig a weight system with the following considerations in mind:
a. Estimate weights using PADI’s Basic Weighting Guidelines.
b. Position and distribute the weight for comfort and desired body position (trim) in the water.
2. Use visualization techniques before the dive to relax, establish a comfortable breathing pattern and move gracefully.
3. Adjust for proper weighting – float at eye level at the surface with an empty BCD, while holding a normal breath.
4. Make a controlled, slow descent to the bottom and adjust for neutral buoyancy.
5. Adjust for neutral buoyancy at a predetermined depth.
6. Hover using buoyancy control for at least one minute, without kicking or sculling.
7. Swim in a neutrally buoyant, horizontal position without touching the bottom or surface.
8. Make minor depth adjustments using breath control.
9. Swim efficiently using long, slow kick strokes and gliding.
10. Control buoyancy while swimming without touching anything and without breaking the surface.
11. Adjust weights (trim) and practice hovering in different positions – vertical, horizontal, feet elevated and head elevated.Adjust weights (trim) and practice hovering in different

Navigation:
Performance Requirements

1. Maintain neutral buoyancy.
2. Determine the average number of kick cycles and average amount of time required to swim underwater at a normal, relaxed pace approximately 30 metres/100 feet.
3. Navigate to a predetermined location and return to within 15 metres/50 feet of the starting point using natural references and estimated distance measurement
(kick cycles or time). Surface only if necessary to verify direction or location.
4. Position and handle a compass underwater to maintain an accurate heading while swimming.
5. Navigate without surfacing to a predetermined location and return to within 6 metres/20 feet of the starting point using a compass and estimated distance
measurement (kick cycles or time).
6. Swim a square pattern underwater, returning to within 8 metres/25 feet of the starting point using a compass and beginning from a fixed location. Recommended size of square – each side 30 metres/100 feet, or total combined length of approximately 120 metres/400 feet.

Underwater Photography:
Performance Requirements – choose either macro or medium/wide angle format, depending on camera configuration
Macro Photographs
1. Prepare and assemble an underwater camera system for macro photography.
2. Set the shutter speed, aperture and focus for macro photography.
3. Bracket the exposure of each type of photo taken underwater by varying either strobe-to-subject distance or on automatic cameras, changing the ISO number.
4. Compose each macro photo factoring in flash angle, camera angle, subject position, image completeness, foreground, background and complementary colors.
5. Frame and expose a complete roll of film, taking underwater macro photos.


Medium/Wide Angle Format Photographs
1. Prepare and assemble an underwater camera system for medium/wide angle photography.
2. Set the shutter speed and aperture (if appropriate) for an exposure based on manual meter readings, general film exposure information or automatic programming information.
3. Focus the camera by varying subject-to-camera distance or focus knob setting.
4. Bracket the exposure of each type of photo taken underwater by varying either shutter speeds or f/stops (if appropriate).
5. Compose each photo factoring in camera angle, subject position, image completeness, foreground, background and complementary colors.
6. Frame and expose a complete roll of film, taking underwater pictures.

Wreck:
Considerations
1. Directly supervise divers at a maximum ratio of 8:1 or have a certified assistant supervise divers at a maximum ratio of 4:1.
2. Do not allow wreck penetration.
Performance Requirements
1. Swim on the outside of a wreck. Identify and avoid potential hazards.
2. Navigate the wreck to locate the ascent point without surfacing. Use instructor/certified assistant as needed.
3. Maintain neutral buoyancy and body position to avoid touching the bottom and the wreck.

----------

So for each of the dives that you did as part of your AOW course, these "performance requirements" are what the instructor should have asked you to do.

kari
 
I know this is a very old thread. I kept the name of this place anonymous back in 2011. At the time, some people recommended stating who it was so that others were informed. A recent Facebook post showing how this shop made the TripAdvisor 2015 Hall of Fame and another post by someone made me think of this all again and I decided it was probably best to say who it was. I think for guided dives, people love this shop so my comment won't affect that. However, for instruction, I cannot recommend them due to my AOW experience and what I saw with my friend's OW certification dives (and the DCS she suffered). Maybe things have gotten better since 2011, I don't know. The shop is Scorpio Divers in Cancun.

Last year, my daughter got certified with Biff (Elizabeth) Wright at Ocean Divers in Key Largo, Florida. She was amazing. Comparing what I saw there with what I saw with Scorpio divers with my friend who got DCS during her OW cert is like night-and-day. If it had been my daughter who got DCS because of a dive shop's carelessness I would have been livid and bad reviews would have been the least of their worries.

I definitely hope that Scorpio has made improvements since 2011 so that this does not happen again (the owner has told me directly that they have). As I understand it (from personal accounts and reviews), they are an outstanding shop for dive tours in Cancun, however I have not went diving with them since then so I have no other experience with them.
 
The only other new diver I've been with who got bent on a short series of non-deep, non-long, benign dives (in Bonaire), was diagnosed after she got home as having a PFO. Being on Bonaire, and having DAN insurance, she did her chamber ride there. It was DAN who talked her HMO into testing for a PFO when she got home. It has all resolved without any residual effects.
 
ok so i did not read the bunches of replies on this thread but my question is would a chamber schedule hurt even at this late date?
 
I took my friend with me to Cancun to get her OW. We did six dives over the coarse of three days. Two were shallow at 30 feet, and the rest were between 50 and 80.

We waited 24 hours after our last dive before we flew. She was in a lot of pain the day we flew but all I knew of was the headache she had so I thought it was nothing.

Then, when she got back, she got skin blotches, nausea, was tired, her joints hurt, and she had the general feeling that she was out of it. The skin blotches went away but the general feeling of being out of it, and the pain got worse.

Well, yesterday, seven days after we last dove, she went to the hospital and they told her she has DCS. However, they said it is too late to go into a hyperbaric chamber and that too much time had passed. I thought that the only way to cure DCS is to put someone under pressure?

So the question is, should she be in a hyperbaric chamber or is it possible for too much time to pass for that to be of any help?

I was also curious if waiting 24 hours after diving okay to fly, or should it really had been 48 hours?

The trouble with dive training on the spot prior to actual barometric exposure is that it is extremely dangerous. Even when the times and tables are followed. Head ache is a serious neurological type two DCS symptom. When neglected can cause permanent damage. In this case is sounds like that was unresolved as well as unrecognized. Complications arose even after waiting 24 hours preflight wait times. First thing I think of is PFO. I don't think waiting 24 or 48 hours is the question but having bought either medical insurance (hyperbaric and medical evacuation insurance that covers a one atmosphere jet as well. A treatment table 6 was indicated and likely maximum extensions, a minimum one week no fly time (if a one atmosphere jet is not available).

The pathophysiolgy of DCS is initially cause by bubbles that eventually are absorbed with resulting sequlea inflamation caused by the cascade of histamines and products trying to ward of the insulting injury caused by the actual bubbles and offending injury. Recompression does not help crush the bubbles once they are gone but the decompression with maximum oxygen with help minimize the inflammation causing the persistent symptoms by improving the circulation.
 
Tholden1,
Thanks for the update on this old thread. How did your friend do long term with the DCS? Was there any permanent damage? Does that person dive anymore or did that experience make it so she never wanted to do it again?
 
The trouble with dive training on the spot prior to actual barometric exposure is that it is extremely dangerous. Even when the times and tables are followed. Head ache is a serious neurological type two DCS symptom, so I disagree with some of the previous posts. When neglected can cause permanent damage. In this case is sounds like that was unresolved as well as unrecognized. Complications arose even after waiting 24 hours preflight wait times. First thing I think of is PFO if tables and schedules where followed. I don't think waiting 24 or 48 hours is the question but having bought either medical insurance (hyperbaric and medical evacuation insurance that covers a one atmosphere jet as well. A treatment table 6 was indicated and likely maximum extensions, a minimum one week no fly time (if a one atmosphere jet is not available). Diving is simple and that is why it can be so dangerous.

The pathophysiolgy of DCS is initially cause by bubbles that eventually are absorbed with resulting sequlea inflammation caused by the cascade of histamines and products trying to ward of the insulting injury caused by the actual bubbles and offending injury. Recompression does not help crush the bubbles once they are gone but the decompression with maximum oxygen with help minimize the inflammation causing the persistent symptoms by improving the circulation. The goal of increased circulation is to restore the tissue to the normal state prior to insult. In this case a head ache. Theoretically coalescing bubbles in the brain caused the head ache (neurological - hence type II). These bubbles cause the tissue distortion but eventually get absorbed but the resulting insult causes inflammation and continued symtomology. If left unrecognized and untreated then further complicating things by flying commercially she is actually fortunate something worse did not happen.

On trips like this the weather, alcohol, and dehumidified compressed diving air is a recipe for dehydration and classic clinical diving injuries in exotic places....

I first got certified by NAUI then US Navy scuba. During my scuba training I wondered why they did not teach more diving medicine by NAUI. After hard hat training I asked the same question about Navy Scuba training...Why don’t they teach this level of dive medicine in Scuba Training. After finishing mixed gas hard hat I asked this question again... Finally I went to advanced dive med tech differential diagnosis training and strongly believe dive medicine is under taught at most every level of diving training especially the ability to perform a decent diver’s neurological exam..
 
I know this is a very old thread. I kept the name of this place anonymous back in 2011. At the time, some people recommended stating who it was so that others were informed. A recent Facebook post showing how this shop made the TripAdvisor 2015 Hall of Fame and another post by someone made me think of this all again and I decided it was probably best to say who it was. I think for guided dives, people love this shop so my comment won't affect that. However, for instruction, I cannot recommend them due to my AOW experience and what I saw with my friend's OW certification dives (and the DCS she suffered). Maybe things have gotten better since 2011, I don't know. The shop is Scorpio Divers in Cancun.

Last year, my daughter got certified with Biff (Elizabeth) Wright at Ocean Divers in Key Largo, Florida. She was amazing. Comparing what I saw there with what I saw with Scorpio divers with my friend who got DCS during her OW cert is like night-and-day. If it had been my daughter who got DCS because of a dive shop's carelessness I would have been livid and bad reviews would have been the least of their worries.

I definitely hope that Scorpio has made improvements since 2011 so that this does not happen again (the owner has told me directly that they have). As I understand it (from personal accounts and reviews), they are an outstanding shop for dive tours in Cancun, however I have not went diving with them since then so I have no other experience with them.

Just curious, what did they do that you feel contributed to your friends DCS?
 
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