SB Member Littlejohn in critical condition
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truck1
Contributor
With out changing the topic, the reason you are having a hard time getting info from the hospital, is that unless you are a blodd relative of Littlejohn, they wont talk to you. I am surprised they have given you that much info due to the pt confidentiality laws that have been in effect. Even as a FF/EMT I have a hard time getting info out of a hospital on pts I have treated.
Yes it does... and even more strange that his first chamber ride didn't improve symptoms at all, but he apparently got worse. I mean, he didn't violate his computer, and he dove the same profile as everyone else, all typical of a two-tank Jupiter dive. So even if he did take a DCS hit, it should just be a relatively mild type I and a chamber ride should improve things. Something else is probably going on here and I hope they get to the bottom of it quickly!
>*< Fritz
OK, I have since downloaded my computer so I can relay some more dive details. Note these are my results from my computer (a Sherwood Wisdom 2) and not John's computer (I forget which model, but a wristmount and I don't think it was air-integrated). We all got in the water on both dives at the same time, but John ended up with another group the first dive, so I can't be 100% sure of his profile. The second dive, however, he was nearby me the entire time and we ascended together.
First, some background: I had posted a notice here on ScubaBoard that I was going diving in Jupiter on Saturday morning, Oct. 25, 2008. I was already planning to pick up a friend in Melbourne on the way, and John also responded to me via PM that he was interested in carpooling. Since he lives in east Orlando and I am in Titusville near the intersection of SR50 and I-95, he agreed to come this far and we would travel together.
To get to Jupiter Dive Center at 8:00 (to give us plenty of time to board for the 9:00a departure), I had to leave the Titusville area at 5:30a, when meant John had to leave Orlando just after 5:00a. He made it right on time and we left about 5:30a, picked up the other diver on the way, and got to the dive center just after 8:00a, signed our release forms & checked in, and loaded our gear onto the Republic IV. Since I had not met John before, I asked him about his diving experience during the drive and learned he had received his OW cert last year and had been diving pretty regularly since, and was aiming for 100 dives by the end of the year (which stuck in my head because that's also my goal).
There was no wind to speak of. The trip out the inlet was a bit rock-and-roll, but once we cleared those waves, the sea itself was relatively calm, 2-3' swells. Skies mostly overcast, but no precipitation and occasionally sunny.
John and I had adjacent spots on the boat, farthest away from the dive deck on the starboard side, under cover (as opposed to the exposed parts of the bench towards the dive deck).
First dive (from Fritz's computer)
Location: Jupiter FL, Area 51 (Reef)
Time in: 09:54a
Time out: 10:36a
Dive time: 0:42
Max. Depth: 87fsw
Average depth: 67fsw
FO2: 35% (I'm pretty sure John's was 32%)
Min water temp: 80F
Viz: Started out 50'+, but slowly deteriorated to about 25'
Again, I did not ascend with John on the first dive, but he was fine and reported no problems and was ready to go on the next dive. I think he spent awhile on the surface, as his group was the last to be picked up by the boat.
During the approximately 50 minute surface interval, nothing of note happened.
Second dive (from Fritz's computer)
Location: Jupiter FL, Bluffs (Reef)
Time in: 11:24a (0:48 surface interval)
Time out: 12:17p
Dive time: 0:53
Max. Depth: 78fsw
Average depth: 64fsw
FO2: 34% (again, John's was 32%)
Min. water temp: 80F
Viz: Started out 50'+, but slowly deteriorated to about 25'
The second dive, we ascended with the divemaster after we reached the divemaster's bottom time limit of 45 minutes. It was a slow steady ascent, basically at the same rate as the DM who was reeling in the flag line. A three-minute safety stop at about 17fsw was made by all three. For both ascents, I also made a 2-3 minute half stop at approximately 40fsw, but I don't think anyone else did.
My computer showed one bar segment away from deco, as did John's, but neither computer went into deco mode and mine dropped back a segment already towards the end of the shallow safety stop.
After the second dive, we boarded the boat and rested in our seats adjacent to one another on the bench for a few minutes. We chatted a bit and he seemed fine. He mentioned that he was "pushing deco" but that he didn't violate his computer (which was confirmed later, upon getting his computer data for the hospital). He said he was glad he joined in for the trip that day (we were all wondering earlier if conditions would be good enough).
After a few minutes of rest, I got up and started disassembling my gear while the boat was picking up a few other divers. John continued to rest, but others were too. I was busy with my gear. During this time, the divemaster had to go downstairs (to the head maybe?) and when she came back up, I guess she noticed something and asked John if he were OK. John said he was fine, just a little short of breath. The DM probed further, but at first John was dismissive. However, she kept asking and offered him oxygen, and at that point John agreed so she retrieved the DAN bottle and kit.
On O2 now, at first John said he would probably be fine and not to call the paramedics. But then he started to complain about tingling in his fingers and the paramedics were called. Shortly after, he wanted to lay down so we cleared the deck and he remained there until we pulled into dock where the EMT's were waiting.
The EMT's came onboard and talked to John, who was responsive. They obviously knew about DCS and diving injuries because they were asking detailed questions about his dives (e.g. depths and times, was he using nitrox or air, what percent, etc.), which all of us present helped to answer.
They put him in an evac chair and took him off the boat into their truck. When they first sat him up in the chair, he felt nauseous but only had a few dry heaves. His condition was obviously worsening. I inquired as to their destination and they said probably Jupiter Hospital first, but then to St. Mary's in West Palm for the chamber.
When they left, we collected John's gear and left it as-is with the dive center. We discussed what happened with the folks at JDC who gave us directions to Jupiter Hospital, which was not far. My buddy from Melbourne and I drove to Jupiter but were informed that John was taken directly to St. Mary's.
So, we drove to St. Mary's just in time to see John's transport vehicle leaving the ER. We informed the ER we were his dive buddies and had his folder with his dive cert cards in it, which they asked for as ID.
As directed by staff, we waited in the ER waiting room for about 10-15 minutes when they called us back to see John, who had an oxygen mask on at the time but was conscious and aware. We asked him where his other ID and such was, and he informed us it was with his dive gear (immediately afterwards we called JDC and informed them, so they moved his gear to a more secure location). We stepped outside as they wheeled in a portable c-arm to do a chest x-ray, whereupon they asked us for details about his dive. We had his computer with us, so were were able to give them everything we could read from his computer log.
We then said farewell to John, encouraged him towards a speedy recovery, and I assured him his vehicle would be safe at my house. We left there presuming he had received a type I DCS hit and would take a chamber ride and everything would be fine.
After that, well... if you've been reading the threads you know about as much as I do.
John and I were diving similar tanks (HP120's) and had similar levels of dive experience, in total number of dives as well as frequency of dives over the past several months. The biggest differences between him and myself that I can think of include:
1) Hydration. We all started our day with some coffee, but I drank approximately 2 liters of water in preparation for the dive, and almost as much during the surface interval, whereas I did not see John drink much water, although he did have a few drinks from the paper cups supplied by the boat.
2) Nitrox mix. I was diving 34%-35% mix while I'm pretty sure both John's tanks were right at 32%.
3) Half-depth stops. I regularly do a half-maximum-depth safety stop for 2-3 minutes nowadays, in addition to a 3-minute shallow stop, but I don't think anyone else was doing half-depth stops.
So, those are the facts as I saw them. What I can say for sure is, John did not violate his computer and was diving within its limits. While that's no 100% gurantee you won't take a DCS hit, I would think that at least means if you do get bent, it should be a relatively mild type I.
>*< Fritz
First, some background: I had posted a notice here on ScubaBoard that I was going diving in Jupiter on Saturday morning, Oct. 25, 2008. I was already planning to pick up a friend in Melbourne on the way, and John also responded to me via PM that he was interested in carpooling. Since he lives in east Orlando and I am in Titusville near the intersection of SR50 and I-95, he agreed to come this far and we would travel together.
To get to Jupiter Dive Center at 8:00 (to give us plenty of time to board for the 9:00a departure), I had to leave the Titusville area at 5:30a, when meant John had to leave Orlando just after 5:00a. He made it right on time and we left about 5:30a, picked up the other diver on the way, and got to the dive center just after 8:00a, signed our release forms & checked in, and loaded our gear onto the Republic IV. Since I had not met John before, I asked him about his diving experience during the drive and learned he had received his OW cert last year and had been diving pretty regularly since, and was aiming for 100 dives by the end of the year (which stuck in my head because that's also my goal).
There was no wind to speak of. The trip out the inlet was a bit rock-and-roll, but once we cleared those waves, the sea itself was relatively calm, 2-3' swells. Skies mostly overcast, but no precipitation and occasionally sunny.
John and I had adjacent spots on the boat, farthest away from the dive deck on the starboard side, under cover (as opposed to the exposed parts of the bench towards the dive deck).
First dive (from Fritz's computer)
Location: Jupiter FL, Area 51 (Reef)
Time in: 09:54a
Time out: 10:36a
Dive time: 0:42
Max. Depth: 87fsw
Average depth: 67fsw
FO2: 35% (I'm pretty sure John's was 32%)
Min water temp: 80F
Viz: Started out 50'+, but slowly deteriorated to about 25'
Again, I did not ascend with John on the first dive, but he was fine and reported no problems and was ready to go on the next dive. I think he spent awhile on the surface, as his group was the last to be picked up by the boat.
During the approximately 50 minute surface interval, nothing of note happened.
Second dive (from Fritz's computer)
Location: Jupiter FL, Bluffs (Reef)
Time in: 11:24a (0:48 surface interval)
Time out: 12:17p
Dive time: 0:53
Max. Depth: 78fsw
Average depth: 64fsw
FO2: 34% (again, John's was 32%)
Min. water temp: 80F
Viz: Started out 50'+, but slowly deteriorated to about 25'
The second dive, we ascended with the divemaster after we reached the divemaster's bottom time limit of 45 minutes. It was a slow steady ascent, basically at the same rate as the DM who was reeling in the flag line. A three-minute safety stop at about 17fsw was made by all three. For both ascents, I also made a 2-3 minute half stop at approximately 40fsw, but I don't think anyone else did.
My computer showed one bar segment away from deco, as did John's, but neither computer went into deco mode and mine dropped back a segment already towards the end of the shallow safety stop.
After the second dive, we boarded the boat and rested in our seats adjacent to one another on the bench for a few minutes. We chatted a bit and he seemed fine. He mentioned that he was "pushing deco" but that he didn't violate his computer (which was confirmed later, upon getting his computer data for the hospital). He said he was glad he joined in for the trip that day (we were all wondering earlier if conditions would be good enough).
After a few minutes of rest, I got up and started disassembling my gear while the boat was picking up a few other divers. John continued to rest, but others were too. I was busy with my gear. During this time, the divemaster had to go downstairs (to the head maybe?) and when she came back up, I guess she noticed something and asked John if he were OK. John said he was fine, just a little short of breath. The DM probed further, but at first John was dismissive. However, she kept asking and offered him oxygen, and at that point John agreed so she retrieved the DAN bottle and kit.
On O2 now, at first John said he would probably be fine and not to call the paramedics. But then he started to complain about tingling in his fingers and the paramedics were called. Shortly after, he wanted to lay down so we cleared the deck and he remained there until we pulled into dock where the EMT's were waiting.
The EMT's came onboard and talked to John, who was responsive. They obviously knew about DCS and diving injuries because they were asking detailed questions about his dives (e.g. depths and times, was he using nitrox or air, what percent, etc.), which all of us present helped to answer.
They put him in an evac chair and took him off the boat into their truck. When they first sat him up in the chair, he felt nauseous but only had a few dry heaves. His condition was obviously worsening. I inquired as to their destination and they said probably Jupiter Hospital first, but then to St. Mary's in West Palm for the chamber.
When they left, we collected John's gear and left it as-is with the dive center. We discussed what happened with the folks at JDC who gave us directions to Jupiter Hospital, which was not far. My buddy from Melbourne and I drove to Jupiter but were informed that John was taken directly to St. Mary's.
So, we drove to St. Mary's just in time to see John's transport vehicle leaving the ER. We informed the ER we were his dive buddies and had his folder with his dive cert cards in it, which they asked for as ID.
As directed by staff, we waited in the ER waiting room for about 10-15 minutes when they called us back to see John, who had an oxygen mask on at the time but was conscious and aware. We asked him where his other ID and such was, and he informed us it was with his dive gear (immediately afterwards we called JDC and informed them, so they moved his gear to a more secure location). We stepped outside as they wheeled in a portable c-arm to do a chest x-ray, whereupon they asked us for details about his dive. We had his computer with us, so were were able to give them everything we could read from his computer log.
We then said farewell to John, encouraged him towards a speedy recovery, and I assured him his vehicle would be safe at my house. We left there presuming he had received a type I DCS hit and would take a chamber ride and everything would be fine.
After that, well... if you've been reading the threads you know about as much as I do.
John and I were diving similar tanks (HP120's) and had similar levels of dive experience, in total number of dives as well as frequency of dives over the past several months. The biggest differences between him and myself that I can think of include:
1) Hydration. We all started our day with some coffee, but I drank approximately 2 liters of water in preparation for the dive, and almost as much during the surface interval, whereas I did not see John drink much water, although he did have a few drinks from the paper cups supplied by the boat.
2) Nitrox mix. I was diving 34%-35% mix while I'm pretty sure both John's tanks were right at 32%.
3) Half-depth stops. I regularly do a half-maximum-depth safety stop for 2-3 minutes nowadays, in addition to a 3-minute shallow stop, but I don't think anyone else was doing half-depth stops.
So, those are the facts as I saw them. What I can say for sure is, John did not violate his computer and was diving within its limits. While that's no 100% gurantee you won't take a DCS hit, I would think that at least means if you do get bent, it should be a relatively mild type I.
>*< Fritz
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I posted more in John's well-wishing thread regarding his status, but I wanted to note here that according to John's brother, the doctors are now thinking that the dive itself (i.e. DCS) is not the primary cause of his troubles, maybe just a trigger.
>*< Fritz
>*< Fritz
Could a PFO be the cause of this?
... thanks for the info, and all your help, Fritz
... thanks for the info, and all your help, Fritz
DennisW
Contributor
I have, as many of you have, dived almost the same profiles. Which, if this is indeed a DCS incident, shows that anyone can get DCS at anytime for no reason what so ever that we can understand.
There is just too much here that isn't consistent with DCS, even with a PFO. Usually, with a PFO, the hit is neurologic, because the bubble that goes through into the arterial circulation follows the flow, which is into the large vessels going to the brain. It doesn't sound as though he had much of any neurologic symptoms -- primarily shortness of breath. You can be short of breath with a DCS hit, if you are bubbling massively and overwhelming the pulmonary circulation, but massive bubbling after those profiles would be VERY strange. And almost anything DCS-related (except a big AGE with neurologic devastation) should have improved with chamber treatment, and he deteriorated. This is a very strange case.
snepdiver
Contributor
Wishing him a speedy and full recovery. Thanks for the detailed report Fritz.
I would also like to add that I learned the hard way about ID. Now most of us have our cell phones with us all the time, Even on a dive boat. In my phonebook internal to the phone, By my wifes name is (WIFE) and by my moms name (MOM) etc. You get the idea.
We had a very bad car wreck in front of my place of business, When myself and two others arrived in the middle of the street after a 2 vehicle head on collision with both vehicles traveling around 50 mph it was not pretty. We had to just scroll through the victims recent call lists and start calling people. Both drivers needed someone to meet them at the hospital as they were both unconsious and critical per the EMS guys.
I would also like to add that I learned the hard way about ID. Now most of us have our cell phones with us all the time, Even on a dive boat. In my phonebook internal to the phone, By my wifes name is (WIFE) and by my moms name (MOM) etc. You get the idea.
We had a very bad car wreck in front of my place of business, When myself and two others arrived in the middle of the street after a 2 vehicle head on collision with both vehicles traveling around 50 mph it was not pretty. We had to just scroll through the victims recent call lists and start calling people. Both drivers needed someone to meet them at the hospital as they were both unconsious and critical per the EMS guys.
Unfortunately, John's cellphone was dead when the hospital tried to access it, and they had no compatible charger available (although I gotta wonder how hard they really looked, since it was a Treo).
John's brother told me this morning that the way they finally got in touch with him was because, when I searched John's vehicle, I found the business card for his dive instructor and passed that number to the trauma center, knowing that students usually have to provide contact information on the forms they fill out before taking a class. Sure enough, they were able to get his brother's contact info from John's student forms.
But still, while I'm glad that finally worked, you're talking a 12-hour-plus delay with such an indirect method for finding family to contact. It's hard to beat something like the DAN tag where you have printed information right there on the diver with contact information that doesn't require batteries or any other technology to access.
>*< Fritz
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