Purple skin after a dive?

[oceansblu]

I apologize for the confusion. Lets try this again.

1) 2 months ago I did a 2 tank dive and after having lunch lost control of my right side for about 2 hours. DAN was given my dive schedule and was stumped.

2) Last week I did another 2 tank dive and about an hour after the dives I started to get purple spots on my stomach. DAN was contacted, given my dive information - again stumped.

It is now believed that it may have something to do with nerve damage in my spinal cord. After yesterday, the doctors seem to think that gases are getting trapped - go figure. They want to observe me and do some tests over the next few months to see what happens. I will keep you posted.

 

[TSandM]

I guess one of the things I would certainly consider is getting tested for a patient foramen ovale (PFO). This is an opening in the heart that can permit bubbles to pass from the venous circulation, where they are mostly harmless, to the arterial side, where they can wreak havoc. Even a small amount of bubbling (and for the most part, we all bubble post-dive) can cause serious problems if someone has a large PFO, and PFOs are not rare in the general population.

Just my two cents' worth.

 

[erparamedic]

Lynn, you took the words right out of my... uh... fingertips (since it's an online forum ). I was also wondering if he may have a PFO.

oceansblu... it would be wise to ask your doctor about being tested for one.

Please keep us informed, and best wishes for finding an answer to your mystery.

 

[DandyDon]

Welcome to SB, Oceansblu. These were both single dives on doubles, if I understand you correctly. I've gotten myself into deco on one 130 cf Nitrox tank, so I'm really wondering about all the details you have no presented yet? I know you said that DAN was stumped, but - I'm still curious, if you wouldn't mind...?
Air diving?
Depth & Time on each?
Did you do a deep stop?
What brand of dive computer and how did it read?
Any fast ascents chasing students?
Did you climb the doubles out on the ladder or pass them up?
And I do hope this does not sound stupid, but I believe younger ladies are more prone to dehydration a few days of the month - any connection?

I hope you find SB a community you would like to visit more. You can PM any Mod (name in green) with...
*Full name
*Contact phone number
*E-Mail address
*Agency & Instructor number
To obtain your Inst badge and admission to the I to I forum. To PM, click their name on the post, from the pull down menu select "Send a Private Message to..."

 

[Dr Deco]

Hello Oceansblu:

I just came upon this as I was down in the LA region for my class.

Purple Skin

One very strong possibility for the occurrence of this problem is arterial gas embolism. Some researchers who have examined this believe that many small bubbles in the arterial circulation occlude the circulation in the skin leading to the blotching. Repairing the PFO has alleviated the problem.

The fact that you have had some involvement of the spinal nerves is suspicious as embolization, though not common in the spine, could also occur. (Did you possibly have a weakness in the right arm?)

Your biographical sketch indicates that you have been diving for many years, but I surmise that this is the first time these events have occurred to you.

Arterialization

For gas bubbles to appear in the arterial circulation, they must first be in the venous circulation (discounting pulmonary barotraumas). Since the people at DAN were somewhat flummoxed, I will presume that the gas loads were minimal. For some reason, you appeared to make numerous, small bubbles those two days (proceeding with my line of reasoning). I have seen this “small bubble” phenomenon in experimental subjects. The Doppler bubble detectors do not pick them up as individual bubbles. These small bubbles can arterialize though
[a] a PFO or
through intrapulmonary shunts (a connection between blood vessels in the lungs).

Arterialization through either route is facilitated by such “Valsalva-like maneuvers” as coughing, sneezing, and straining. Other activities are climbing aboard the boat with heavy dive gear. These activities cause “rebound flow” and elevate the blood pressure in the right atrium (increase preload).

One can have a test for a PFO, and it would indicate a PFO or pulmonary shunt. Why decompression can produce these “small bubbles” is a mystery to me. Fortunately, it is not common.

My recommendation is that, above all, in the future, avoid straining following the dive. I would be curious to know what a PFO test indicates should you have one done.

Dr Deco :doctor: