Skin Bends? Looking for Dr. in NYC

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Illumita

Registered
Messages
36
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Location
Brooklyn, NY
# of dives
50 - 99
Hey all,

I read up on some previous threads on skin bends and I am looking for a doctor who I can go see in New York City.

I was certified about a year ago in Roatan, and on my last day of diving, I did two dives (I no longer have the specific data on the dives but they were well within limits) during the day followed by a night of last night partying in West End. Yes, I know, terrible idea to be drinking on a dive trip, but I did... When I got home after said partying, I discovered that my stomach and upper thighs were red and blotchy. It wasn't particularly itchy but was a little tingly and puffy. The rash was almost gone by morning when I was able to talk to a DM, who said it might be a minor case of DCI and I did not have to worry unless I had joint ache or dizzyness. By the time I got on the plane that afternoon, the rash was gone. I did not think much of it until last month, when I was in Bonaire.

I averaged about 2 dives per day, with 1 dry day in the 2 weeks. On my 11th day, I did two dives. The first one was 79' max; 63 min; 37' avg, followed by 1:17 of surface interval. The second dive was 56' max; 58 min; 35' avg. The second dive ended at around 1pm and I did not dive for the rest of the day. At around 9pm, I discovered that I had the exact same rash on my stomach and thighs with the same tingly sensation. I only had a couple of 8 oz beers that night. However, the night before, the hotel had had a party, and I probably consumed 3-4 alcoholic drinks in the span of several hours. I was SLIGHTLY hung over when I did the dives but nothing major.

The obvious lesson here is that I should not drink excessively on dive trips but I want to see a specialist to make certain that I am not prone to more serious types of DCI. I have Cigna HMO which makes it kind of difficult to find a specialist but I was wondering if anybody on here would possibly know a doctor in NYC who I can go see.

Tanks a lot!
 
Hello Illumita:

The question of the rash known as "skin bends" is a reoccurring one. It appears that it is not associated with any DCS problems if it appears by itself. It often appeared in NASA and Air Force altitude tests and made analysis difficult as many people were classified as DCS and the number of successful runs was decreased.

There is some thought that this rash has an embolic origin and is associated with a PFO. Your thought about having a physician look into this is sound and might save some pain and woe in the future. DAN will supply names and phone numbers.

The fact that you could take an airplane home shortly thereafter would argue that more severe joint pain problems or DCS issues were not present.


Dr Deco :doctor:
 
Thanks for your replies! I spoke to a doctor from DAN yesterday who supposes it was skin bends. He gave me some tips on diving more safely and some precautions I should take if I should get it again. He didn't seem to be too concerned about my needing to get checked for PFO at this point. I plan to do a little more research before I make that decision.
 
As a veteran of several bouts with the bends, I have been where you are with questions about the PFO.
I saw Dr. Bove at Temple Hospital in Philly; after a transesophogial echocardiagram, I found that I do indeed have a PFO. Dr. Bove's opinion was that the surgery to repair the PFO carries far more risk that diving with the small PFO, which is not definitely linked to susceptibility to bends.
His suggestions -- stay shallow, stay hydrated, don't overdo it
 
Hello Nubiesan :

PFO and DCS

Researchers have examined data for a couple of decades and found that individuals with a PFO do not really appear to be at a greater risk for DCS than individuals without one. [1] This is true even when the PFO does not require a Valsalva maneuver to open it. This is counter intuitive at first.:confused:

Why might this be so?


1. Normally, the right atrium is at a lower pressure than the left atrium. Thus, the gradient is not in a favorable direct for arterialization. [This is most likely the primary reason.]

2. Generally, tables are conservative and do not produce a large number of venous bubbles.

3. Because of the high arterial pressure, bubbles will tend to pass through the capillaries of the brain. This becomes less probable as the number of bubbles increases. [2-4]

What is bad?

Valsalva-like maneuvers such as coughing, breath holding when climbing boat ladders or when lifting or pushing heavy objects are bad.[5]


Dr Deco :doctor:


References :read:

[1] Germonpré P, P Dendale, P Unger, and C Balestra (1998). Patent foramen ovale and decompression sickness in sports divers. J. Appl. Physiol., 84 (5), 1622 - 1626.

[2] Gorman, D. F. and D. M. Browning (1986). Cerebral vasoreactivity and arterial gas embolism. Undersea Biomed. Res., 13, (3), 317.

[3] Powell M. R. and M. P. Spencer (1980). The Pathophysiology of Decompression Sickness and the Effects of Doppler Detectable Bubbles. final Technical Report: O.N.R. Contract #N00014 73 C 0094. I. A. P. M., Seattle, Wash., 98122.

[4] Powell, M. R.; M. P. Spencer and O. van Ramm (1982). Ultrasonic Surveillance of Decompression. In: The Physiology and Medicine of Diving, Eds.: P. Bennett and D. H. Elliott. Bailliere Tindall, London.

[5] Balestra C; Germonpre P; Marroni A (1998). Intrathoracic pressure changes after Valsalva strain and other maneuvers: implications for divers with patent foramen ovale. Undersea Hyperb Med; 25(3):171-4
 
Dan will refer you to several.

Try Dr. Marc Spero 212.355.8315

Dive Doctor, lung specialist, great practice. Great guy.
 

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