Numbness in pool. Ill fitting gear? Cold? Anxiety? DCS? Appendicitis?

[Ber Rabbit]

Last week part of our pool session consisted of no-mask work and about 30 minutes in the deep end (14 feet) of the pool. We surfaced after an OOA exercise and one of my students reported numbness in her hands that had started underwater while waiting for the rest of the class to descend and had moved to her elbows. She said it felt like her hands were asleep all the way to her elbows. She was wearing the same gear she's worn for the last few weeks but I had her remove the gear in case it was pinching. She said there was no improvement after about 5 minutes so we put her on O2 and I called DAN. DCS didn't make any sense but I wasn't taking any chances. Symptoms started to resolve on O2 and by the time the DAN medic returned my call the numbness was nearly gone. The medic said DCS didn't make sense given the depth and the exposure time and the fact that both arms were affected made the probability even smaller. He told me anxiety can cause numbness, that made sense to me because she had been stressed during the no-mask exercise (the medic did not know about that when he offered anxiety as an explanation). We had slowly worked through the exercise and she successfully completed it and had been comfortably hanging out in the deep end. I asked the medic why the O2 seemed to resolve the symptoms and he told me the perception of people doing "something" to help could alleviate anxiety and therefore the symptoms. He told me if the symptoms returned to have her go to the local hospital. I called her the next day and she said they had come back in the night but she admitted to being too stubborn to go to the hospital. She told me she was no longer numb but her wrists were stiff and a little sore.

Fast forward one week. I get a phone call from her before the pool session, she won't be attending class because she's having her appendix out in a few minutes. She plans to attend class next week since it will be a laparoscopic procedure. I advise her to check with her doctor about that and let her know we can finish the classroom stuff this quarter and finish the pool stuff after the doctor clears her.

I'm curious about a couple of things:
Whether the problems in the pool last week could have been an early sign of the appendicitis and what the relationship between anxiety and numbness is.

What's the recovery time for appendix removal via laparoscopy and when might it be reasonable for her to return to the water?
Ber :lilbunny:

 

[TSandM]

I would be willing to state definitively (something I'll rarely do on line) that the numbness in her hands had nothing to do with her incipient appendicitis.

Some possibilities for numbness in both hands that come to me: Pressure of the straps on the nerves in the upper arm; exaggerated arching of the neck in someone with some cervical arthritis or disc disease (how old is the student?); carpal tunnel symptoms from holding the wrists flexed for some reason; hyperventilation (true hyperventilation, where you blow your CO2 down). Tingling in the hands is a common symptom of hyperventilation, and hyperventilation is associated with anxiety. The fact that it came back during the night kind of argues against hyperventilation, though, and makes me wonder more about neck position.

Recovery time from laparoscopic appendectomy depends on several things: How far the disease has progressed before the surgery is done, how generally fit and well the person is otherwise, their pain tolerance, and the lack of complications. In general, someone who is otherwise fit and has the operation before rupture will go home the next day. I have known people to have laparoscopic surgery on Friday and go back to work on Monday. Diving would be restricted for probably three weeks due to the lifting requirements of moving gear (again, this is assuming uncomplicated recovery).

 

[Ber Rabbit]

The student is college age, I know she's at least 21 but don't remember off the top of my head exactly how old she is. She wasn't hyperventilating but was anxious then frustrated at her anxiety nearly to the point of tears. I know I hold tension in my shoulders and while I don't get numb I do come back from stressful dives with a stiff neck. Could tension in the shoulders put pressure on the nerves? She said the gear didn't feel any different than it had the previous sessions and she didn't feel any pinching sensations. Could being cold mask the sensation of being pinched?

This was the strangest thing I had ever seen and quite frankly is scared the bejeebers out of me. Naturally it was the one night all of my experienced staff was out of town. My DM's son is taking the class and as soon as he heard me tell her I wanted to put her on O2 he shucked out of his gear and went to figure out how to put the O2 bottle together. About then another staff member stopped by to say "Hi" and I heard air escaping from the O2 bottle so I sent him to help with the assembly. I was really proud of the OW student considering he had never even seen an O2 set-up; the staff member found the missing seal in the DAN box to finish the assembly but basically the OW student had it together and ready by the time we were out of the water.
Ber :lilbunny: