skin bends precautions

[wedivebc]

I have posted on here before about a reoccurring skin bend issue I have and often get PMs from those who get them regularly as well but don't want to discuss them publicly. I was suppose to do a couple of dives today but decided to take it easy because I got a case of skin bends yesterday.
I was diving a reasonably conservative VPM profile with about 70 minutes of deco and when my dive partner's VR3 decided we had to do another 18 minutes after my Shearwater cleared I did that too. The issue was how cold I got on the dive and I am sure the extra 18 minutes didn't help with off-gassing as I was shivering for most of it.

Anyway my questions is, and feel free to PM me if you wish. How long would you wait to dive after a mild DCS encounter? No I did not go to the chamber and have a pretty good idea what reply I would get from DAN if I did contact them.

 

[Cave Diver]

I'd probably lean towards a minimum of 48 hours after symptoms resolved before I'd dive again.

Any hypothesis regarding why you have reoccurring issues?

 

[Superlyte27]

Have you been checked for PFO? Are you grossly overweight? Feel free to PM me. We had a guy in Comm Dive school get skin bends. He went to Penn State for treatment and was diving the next day. Granted, you're not going into the chamber, so I'm not sure if this helps.

Can you send me your dive profile or tell me your max depth, average depth, dive time, etc? Are these the normal dives you are doing. What gradient factor is your shearwater set to?

I'm just curious as to why you're getting skin bends more than once.

 

[Duke Dive Medicine]

I think I remember you posting about this before... what kind of skin bends are you getting? Do you have any photos?

 

[wedivebc]

My dive was 300ft for 15 minutes using v-planner +2 which gave us a run time of 88 minutes using 1.2 PO2. It was agreed though that we would allow the computers to clear at each level, mainly so my partner's VR3 would not be locked out for today's dive. As it turns out the deep stops required by the VR3 caused my Shearwater to keep me in the water for 92 minutes. Then at the last stop my partner's VR3 wanted to do an extra 18 minutes after SW cleared. By the time we ascended at 112 minutes we had exceeded the required deco time of the SW and v-planner tables by 24 minutes.

I had a bit of a neck seal leak at the start of the dive and although I am not obese I do have a bit of a protrusion around the mid-section. This is where my usual affliction occurs. Right where the water puddles in my drysuit I get red itchy sore rash often with the tell-tale purple mottled skin around the mid-section.

I recently attended a lecture by Dr Neal Pollock about thermal stress and DCS. I wish I could find a transcript of the lecture at RF3 because he discussed a US Navy study that puts people who start a dive warm but get cold during the dive at a higher risk of DCS due to the fact the off-gassing is less effective when cold yet tables always presume on-gassing and off-gassing occur at the same rate.

This is not the case where a diver gets cold during the dive. That seems to be the common thread in all my DCS encounters and although I have done plenty of deeper warm water dives this problem seems to happen in cold water dives.

---------- Post Merged at 01:26 PM ---------- Previous Post was at 01:24 PM ----------

I think I remember you posting about this before... what kind of skin bends are you getting? Do you have any photos?

Not much to see this time, just red blotches. I did post some pics of my orange peel shoulder on here a few months ago.

I just realized when I had posted in this thread in April http://www.scubaboard.com/forums/di...unusual-dci-inquiry-i-received-last-week.html I had not attended Dr Pollock's lecture but I was still suspecting cold water was involved in the problem.

 

[Duke Dive Medicine]

Dave,

It might well be related to the cold. Red blotches is sort of hard to pin down... did it look like cutis? Also, what gas are you using to inflate your drysuit?

The UHMS abstract linked below was done at the NEDU... this may be the one that Dr. Pollock was referring to.
[abstract] DIVER THERMAL STATUS AS A RISK FACTOR FOR DECOMPRESSION SICKNESS (DCS).

Best,
DDM

 

[wedivebc]

Yes that is the study he was quoting, thanks.

The skin rash was irregular patches of reddish skin, No mottling effect (if that was what you meant by cutis) the discoloured areas are sore like a sunburn and itchy. I was using my leanest non-helium bailout gas (32%) for suit inflation.

I do 6-10 dives like this a year and it seems I have issues in about 1 in 6 cold water deep dives. I'm 55yo and have been doing this type of diving for about 10 years but have only been having problems the last 5 years or so.

Dave,

It might well be related to the cold. Red blotches is sort of hard to pin down... did it look like cutis? Also, what gas are you using to inflate your drysuit?

The UHMS abstract linked below was done at the NEDU... this may be the one that Dr. Pollock was referring to.
[abstract] DIVER THERMAL STATUS AS A RISK FACTOR FOR DECOMPRESSION SICKNESS (DCS).

Best,
DDM

 

[Duke Dive Medicine]

We had a chamber operator who used to get skin bends pretty frequently after chamber dives. Some people are just more prone to it.
It can be hard to differentiate cutis from Type I skin bends. Type I bends look more like hives - very non specific type rash. Cutis is more streaky and can be red, blueish or purple. Have you ever been examined by a diver medic or physician right after you get these bends? Do you ever have any other symptoms?

 

[Cave Diver]

Is it possible that you're experiencing a rash or allergic reaction to something? What makes you certain that it's skin bends?

 

[ScubaAl]

I have had similar itching and burning feeling after some dives. Started last year if memory serves, this was after two deep dives 200ft plus for both runtimes around 70 minutes, with about 2hrs surface interval. Diving a rebreather, sp 1.3, 10/50 dil.
I'm older then the OP will be 63 next month. Also could loose a few lbs like most people. I actively ride bike 100-160 miles per week. At least during the warmer months (Minnesota).
We have modified our dives now making the second dive shallower. This has help, but in June had the same symptoms after a dive on the Pringle in Lake Michigan. Depth 280ft dil 10/60 runtime 112min. Next day made the same dive with no issues, did keep the runtime shorter?
On this trip in was mentioned that using a heated vest might contribute to this type of skin bends. Not sure, but thought I'd put it out there.

Al