I am a 46 year old male who suffered a type 2 dcs 4 years ago .it affected me from the waist down, blatter disfuncton unstable gait, hot and cold sensitive. zero paralisis everything has returned to normal. my mri I had 4 years ago came back normal. I made alot of mistakes that day, could easily understand why I took the hit. Dove for 13 years before that day and never had a problem I feel good and like to try it again. Mabe I am a nitrox candidate.what do you think, how would go about it.I believe I have recovered.
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TJ, while our Doc's sometimes read the Doc Deco Forum, generally our Diving MD's read and reply on the Diving Medicine Forum. You will probably get a better, more timely response if you will re-post there! It is one level up on the Home Page.
You've asked "how would (we) go about it"?
I am not medically trained, and my opinion is only that. My response is not intended to be harsh.
IMO, Decompression is an inconsistent and inexactly understood phenomenon. A large part of how I might go about it would initially include some searching questions regarding quality of life and my willingness to tolerate heightened risk. Many factors enter into the equation; do you have children? How does your wife/significant other feel?, etc. You, perhaps more than many, likely realize that you may have a higher probability (than a diver who has never been bent before) of ending up in a wheelchair following a second hit.
(Yes, many divers could plausibly wind up in a wheelchair following DCS. But, do the chances alter when your physiological baseline is post-Type II DCS? I am not familiar with any empirical studies regarding past DCS predisposing a diver to a second episode. They would be "Small-N" studies. Logically this might seem unlikely, but DCS is a complex behavior. Why bubble formation occurs in some subjects and not in others when all other parameters are equal is not well-understood.) You would need to accept that there is a possibility that your DCS risk is greater than that of the general diving population. And, that the consequences of a second hit could be devastating.
I would begin with a literature review regarding what is known about decompression and its after-effects.
I would then consult a number of medical personnel, including my personal physician, DAN medical personnel, and - if one were available - someone like a US Navy Diving Medical Officer. What sort of physical condition are you in - particularly with respect to characteristics that may predispose a diver to either fatigue or bends?
Then if I felt that the trade-off of enhanced quality of life was worth the increased risk, once I had reasonably quantified what that level of risk was; I might begin diving again. But I would dive incredibly conservatively, well within no-decompression limits, and only under optimum conditions.
I wish you the best. FWIW, YMMV.
Doc
I am not medically trained, and my opinion is only that. My response is not intended to be harsh.
IMO, Decompression is an inconsistent and inexactly understood phenomenon. A large part of how I might go about it would initially include some searching questions regarding quality of life and my willingness to tolerate heightened risk. Many factors enter into the equation; do you have children? How does your wife/significant other feel?, etc. You, perhaps more than many, likely realize that you may have a higher probability (than a diver who has never been bent before) of ending up in a wheelchair following a second hit.
(Yes, many divers could plausibly wind up in a wheelchair following DCS. But, do the chances alter when your physiological baseline is post-Type II DCS? I am not familiar with any empirical studies regarding past DCS predisposing a diver to a second episode. They would be "Small-N" studies. Logically this might seem unlikely, but DCS is a complex behavior. Why bubble formation occurs in some subjects and not in others when all other parameters are equal is not well-understood.) You would need to accept that there is a possibility that your DCS risk is greater than that of the general diving population. And, that the consequences of a second hit could be devastating.
I would begin with a literature review regarding what is known about decompression and its after-effects.
I would then consult a number of medical personnel, including my personal physician, DAN medical personnel, and - if one were available - someone like a US Navy Diving Medical Officer. What sort of physical condition are you in - particularly with respect to characteristics that may predispose a diver to either fatigue or bends?
Then if I felt that the trade-off of enhanced quality of life was worth the increased risk, once I had reasonably quantified what that level of risk was; I might begin diving again. But I would dive incredibly conservatively, well within no-decompression limits, and only under optimum conditions.
I wish you the best. FWIW, YMMV.
Doc
blackwater
Guest
I don't know of any causallity that would make one DCS hit change the chances for a second,
how ever, any pre-desposition that lead to the first would probably still exist for the second, and
the risk is that since nerves don't really regenerate, if the first one was recovered by the body learning to re-route nerve impules along other nerves, then a second DCS hit would not have that back-up option, and so the concequenses would be much more sever....
GT
how ever, any pre-desposition that lead to the first would probably still exist for the second, and
the risk is that since nerves don't really regenerate, if the first one was recovered by the body learning to re-route nerve impules along other nerves, then a second DCS hit would not have that back-up option, and so the concequenses would be much more sever....
GT
fins wake
Guest
TJ, as a layman I can only concur with blackwater. Yours appears to have been a severe case of neurological DCS and I honestly don't think anybody, including experienced hyperbaric doctors, can give you any firm advice. If pressed, I'd venture that they'd ground you ...
You must understand that you might have another hit and you might die or get paralyzed for life from it. Or you may have no further incidence of DCI for the rest of your diving career and no further problems. Only you can make this decision, and only you are responsible for your well-being.
That said, there are some thoughts that spring to mind ...
You must understand that you might have another hit and you might die or get paralyzed for life from it. Or you may have no further incidence of DCI for the rest of your diving career and no further problems. Only you can make this decision, and only you are responsible for your well-being.
That said, there are some thoughts that spring to mind ...
Absolutely! Anything you can do to decrease inert gas loading is good. Then again, it's no catch-all against contracting DCI again.
If it were me experiencing neurological DCS, not being able to urinate properly and perhaps experiencing sexual dysfunction, I would take a long and hard think about diving again. If I - personally - decided it was worth the risk for me to continue diving, I'd do a proper accident analysis. How did your dive go wrong? What did you do wrong? What could have been done differently, by you or by your support? I'd get any which training which would decrease the risk (e.g. O2 provider, update my MFA/EFR/other primary care), read up on decompression illness and on decompression theory and go for ultra-safe diving with overlong safety stops and nice multi-level profiles. But that's just me.
Dr Deco
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Dear tj:
Research and Neurological DCS
This is really the most difficult to study because there is not a reliable animal model for it. Many have been attempted, but all models have been found wanting.
It sounds from your description that you acquired spinal cord DCS. I personally suspect that spinal DCS is the result of bubble growth from nuclei generated by the flexible spinal cord. This is not proven experimentally and is only my hypothesis. Were this true, possibly on the day you experienced the hit, your activity was greater, possibly lifting something with your back.
Variability of DCS
It is pretty well accepted that DCS risk varies from individual to individual. It is not so with the understanding that this variability is a constant from day to day. I believe that it is all things being equal. In reality, all things are not equal and we vary in hydration, in what we eat, and especially in our physical activity level.
Remodeling of Nervous System
There exist repair mechanisms that the body can utilize, but these are only reusable to a point. You never known when your luck has run out, that is, you do not have any more neurological reserve (in medical parlance).
There is no way of telling if diving might not provoke another very serious problem from which you would not recover. :boom:
Dr Deco :doctor:
Readers, please note the next class in Decompression Physiology :grad:
http://wrigley.usc.edu/hyperbaric/advdeco.htm
Research and Neurological DCS
This is really the most difficult to study because there is not a reliable animal model for it. Many have been attempted, but all models have been found wanting.
It sounds from your description that you acquired spinal cord DCS. I personally suspect that spinal DCS is the result of bubble growth from nuclei generated by the flexible spinal cord. This is not proven experimentally and is only my hypothesis. Were this true, possibly on the day you experienced the hit, your activity was greater, possibly lifting something with your back.
Variability of DCS
It is pretty well accepted that DCS risk varies from individual to individual. It is not so with the understanding that this variability is a constant from day to day. I believe that it is all things being equal. In reality, all things are not equal and we vary in hydration, in what we eat, and especially in our physical activity level.
Remodeling of Nervous System
There exist repair mechanisms that the body can utilize, but these are only reusable to a point. You never known when your luck has run out, that is, you do not have any more neurological reserve (in medical parlance).
There is no way of telling if diving might not provoke another very serious problem from which you would not recover. :boom:
Dr Deco :doctor:
Readers, please note the next class in Decompression Physiology :grad:
http://wrigley.usc.edu/hyperbaric/advdeco.htm
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