Seeking advice for recovering from DCS

[Oli125]

Hi everyone, new diver here in need of seasoned advice. If posting in the wrong place please move it.
Two weeks ago I completed my OW course in Bali. Amazing! I’ve been wanting to do it for years. Loved every minute of it until I got sick.
I did the pool session on June 11th, 3 dives on the 12th, and 2 dives on the 13th. All were safe and controlled. We can’t figure out why I got DCS.
Driving back from the dives on the 13th I had fatigue set in, and generally felt off - kind of “high”.I also felt pretty banged up. But it was a shore dive and I fell getting out when I got knocked by a wave.
Long story short we put my symptoms down to being tired, new etc and delayed seeing a doctor until the next day when it got worse. Chest pain, hard to breath, pain in my pinkie finger and then dizziness and confusion set it. I was having trouble thinking clearly.
It was 42 hours between the last dive and the first hyperbaric treatment - US Navy table 6 for 5 hours. Then two more treatments of 2 hours each.
I just arrived back home to Toronto and have been trying to contact a couple of doctors that DAN has recommended I see for follow up.
In the meantime does anyone have any advice for the actual recovery now? The doctor in Bali said I could have symptoms for weeks, even months. I’m still tired and get dizzy if I walk too much. And I’m drinking about 4 liters of water a day - docs orders but also because I get dizzy if I don’t. Is there anything else I can do to help my body recover? Or are there any resources o can turn to on what to expect for the recovery? I wasn’t given any information and all I can find online seems to be only about the actual hyperbaric treatment - not what comes after. Thank you in advance.

 

[lexvil]

Better to ask here; Marine Science and Physiology

 

[scubadada]

Hi @Oli125

I would imagine your dives were relatively short and relatively shallow. What did DAN have to say about your presumptive episode of DCS?

What symptoms were present at the time you sought medical care? Were you put on oxygen prior to HBO and was there a response? What symptoms were present just before HBO, was there a response to therapy? I assume the two follow up treatments were for residual symptoms, what symptoms were present, was there a response?

I'd be interested in hearing about your follow up visit now that you are home

 

[jadairiii]

It would help if you posted the actual dive profiles you did, depth/time/SI, just to get an idea of how you got "here". Then did most of the symptoms disappear after the chamber treatments?

Also, your basic fitness level, normal exercise routine.

This is the internet, we are all "experts", but your symptoms could be a lot of things unrelated to diving.

 

[BoltSnap]

Better to ask here; Marine Science and Physiology

Did you mean here: Ask Dr. Decompression

 

[lexvil]

Did you mean here: Ask Dr. Decompression

Not specifically since there is a diving medicine section too.

 

[caydiver]

We recently had a diver who did a table 6 and then a number of table 5s. He was not cleared to fly until he was not showing symptoms. Had to change his flight home. Were you still showing symptoms before you flew? How long between the final ride and the flight?

 

[Duke Dive Medicine]

Hi everyone, new diver here in need of seasoned advice. If posting in the wrong place please move it.
Two weeks ago I completed my OW course in Bali. Amazing! I’ve been wanting to do it for years. Loved every minute of it until I got sick.
I did the pool session on June 11th, 3 dives on the 12th, and 2 dives on the 13th. All were safe and controlled. We can’t figure out why I got DCS.
Driving back from the dives on the 13th I had fatigue set in, and generally felt off - kind of “high”.I also felt pretty banged up. But it was a shore dive and I fell getting out when I got knocked by a wave.
Long story short we put my symptoms down to being tired, new etc and delayed seeing a doctor until the next day when it got worse. Chest pain, hard to breath, pain in my pinkie finger and then dizziness and confusion set it. I was having trouble thinking clearly.
It was 42 hours between the last dive and the first hyperbaric treatment - US Navy table 6 for 5 hours. Then two more treatments of 2 hours each.
I just arrived back home to Toronto and have been trying to contact a couple of doctors that DAN has recommended I see for follow up.
In the meantime does anyone have any advice for the actual recovery now? The doctor in Bali said I could have symptoms for weeks, even months. I’m still tired and get dizzy if I walk too much. And I’m drinking about 4 liters of water a day - docs orders but also because I get dizzy if I don’t. Is there anything else I can do to help my body recover? Or are there any resources o can turn to on what to expect for the recovery? I wasn’t given any information and all I can find online seems to be only about the actual hyperbaric treatment - not what comes after. Thank you in advance.

Hi @Oli125 ,

Your symptoms could be attributed to a pulmonary barotrauma that led to mediastinal emphysema and possibly pneumothorax, but you're also describing the symptoms of a heart attack. What kind of workup did you have at the hospital in Bali? Did they do an EKG and draw cardiac enzymes? Chest xray or CT? Rule out other causes? What were your dive profiles, and what was the rationale for calling this DCS? Did your symptoms get better with the hyperbaric treatment?

Best regards,
DDM

 

[Oli125]

Hi everyone, thanks for your responses. Sorry it’s taken me so long to respond. I was admitted to the hospital here after another bad dizzy spell and put on oxygen overnight. They’ve decided not to put me back in a chamber for now.

Hi @Oli125

I would imagine your dives were relatively short and relatively shallow. What did DAN have to say about your presumptive episode of DCS?

What symptoms were present at the time you sought medical care? Were you put on oxygen prior to HBO and was there a response? What symptoms were present just before HBO, was there a response to therapy? I assume the two follow up treatments were for residual symptoms, what symptoms were present, was there a response?

I'd be interested in hearing about your follow up visit now that you are home

Hi @scubadada,
DCS was confirmed by DAN and 3 doctors based on my symptoms and examination at the hospital in Bali. I don’t have my dive profiles handy but all 5 dives over the two days were short - it was my open water cert. The last dive was 47 mins, bottom depth was 18m but that was only for a few minutes. We did our safety stops, and stayed well within our limits.
Initial symptoms were fatigue, lightheaded, feeling “high”, dizzy. Then came chest pain, body aches, shortness of breath, pain in my little finger and then brain fog. I was getting confused and had a hard time finishing my sentences- that was scary.
The hyperbaric treatment helped a lot, but it wasn’t a good experience. I felt like I was being squeezed back together. The chest pain went away and i was able to breath normally again. It’s the dizziness and fatigue that have lingered which is why they gave me the two follow up treatments.
The hospital here consulted with a hyperbaric doctor specializing in dive medicine to ask if I should go back in a chamber and they have decided to wait and watch saying I am having residual symptoms and they could last for another month or so. I trying to get an appointment to see this doctor in person next week for a follow up. They did say I have water behind my left eardrum and that could be contributing to the dizziness.

@BurhanMuntasser and @lexvil tjanks for the suggestions on forums. I didn’t see those when I first looked.

@caydiver the doctor in Bali told me I was clear to fly as of 3 days after my last hyperbaric treatment. I waited 5 days to be safe. I would have waited longer but I was over my visa in Bali and it’s approx $100 a day fine - they didn’t care I had a letter from the hospital and charged me for the 8 days.

Hi @Oli125 ,

Your symptoms could be attributed to a pulmonary barotrauma that led to mediastinal emphysema and possibly pneumothorax, but you're also describing the symptoms of a heart attack. What kind of workup did you have at the hospital in Bali? Did they do an EKG and draw cardiac enzymes? Chest xray or CT? Rule out other causes? What were your dive profiles, and what was the rationale for calling this DCS? Did your symptoms get better with the hyperbaric treatment?

Best regards,
DDM

Hi @Duke Dive Medicine
They did a very basic examination at the hospital. No xrays or blood work ups were done because they were certain it was DCS even though my dives shouldn’t have warranted it. The doctor said basically if my symptoms don’t improve with the hyperbaric treatment then it’s something else. Since I had a lot of improvement it was confirmed. I’ll find my dive profiles and put them up for everyone to look at - just buried in my unpacked suitcase for now.

I am being sent to a cardiologist to check for PFO - about 25% of ppl have a little hole in their heart and never know it. However apparently divers with it almost always get DCS. Something to do with trapping nitrogen.

I’m still very tired and get bouts of dizziness so what I’m looking for is just info on what to expect from here for the recovery. The specialist I spoke with when I was at the hospital last night said I could have symptoms for another month. I’ve been told no exercise or strenuous activity, no hot showers or baths, no massages, no alcohol, and to drink minimum 3-4 litres of water a day. I get dizzy going up one flight of stairs and I’m frustrated on how slow I’m recovering. I’m 37, in decent health, eat well, escerise refuary - I was in Bali for a CrossFit/yoga vacation. So to be so bed bound right now is killing me.

Thanks again for your input. I really appreciate it.

 

[The Chairman]

Check for a PFO (Patent Foramen Ovale).