Skin Bends

[Rich Keller]

2) Just because you use a computer doesn't mean you don't know how to use a bottom timer and tables or the pre-dive function of your computer

4)You're a genius. We all wear a helmet and ride the short bus. Better? This isn't rocket science.

5)No, I make my own personal risk assesment based on knowledge of my own skills and experience and input from others I know and trust. (While I'm not as experienced as you according to your profile, it has served me well to date) As an example, I'm taking what you're dishing with a grain of salt.

PS: 2) I go into each dive with a plan. I carry a bottom timer (watch) and depth gauge as well as my computer. I have a pretty good idea of the dive parameters and associated NDL before I splash.

(Last comment is a bit over the top and apologize in advance, 'cause I found your post a bit condescending)

2) Everyone is told how to use tables in class. This however is not stressed much in favor of using a computer instead.

4) Thanks, I have been telling people I am a genius for years but not many seem to believe that. Also for the record it is the commercial divers who wear the helmets.

5) Was not directed at you personally.

PS: 2) I think you are the exception to the rule. Once most people get used to the computer they get comfortable then complacent and forget what they knew about the tables.

As for the tone of my comments I feel that I was responding in the same manor as I was being addressed.

 

[tangfish]

Ridiculous debate over using computers vs tables (computers of course!) aside, I just wanted to say thank you to the OP for sharing his experience.

Too often divers are afraid to/ashamed of sharing their unfortunate experiences. We all benefit from learning from others' accidents, preventable or otherwise. So, muchas gracias!

 

[drrich2]

Rich Keller:

2) So you can not dive without your computer? When your battery dies then you are the one staying on the boat?

3) If the dive is a square profile it makes the computer as safe as the tables not the other way around.

4) I explained some of the reasons you do not understand well.

5) So you let the opinions of others dictate the amount of risk you take?

6) Every time you dive you are taking calculated risks. I chose to take far less risks then the average sport diver.

PS: 2) What happens if you battery dies during your dive? Do you cut it short and take your buddy to the surface with you? Maybe you keep going and just hope for the best so you do not look like you don't know what you are doing?

Follow up.

I can dive without a computer. I'd need to refresh/review if I were going to use tables. Not everybody trains with tables these days.

I dive with 2 computers, and both have good battery life.

I take it most bottom timers also have batteries? And can have battery or other mechanical failure?

We all let others opinions impact the amount of risk we take. Take those tables that some seem to love. How many divers plotting dive depth/time limits via tables know what % risk they face of DCS using this approach? I figure most simply assume the tables' allowances are safe enough as demonstrated through historically wide-spread use.

Same deal with dive computers.

How I'd react to a computer failure has a lot to do with the type of dive I'm doing. Say for sake of argument I dove with one computer and it quit working. And that I was using an analog SPG. Would I call the dive? Hmm...well, is this a solo or buddy dive? What're the rough max. & average depths of the dive? Is it a repetitive dive? What are the conditions? If I'm diving an AL80 in aquarium-like tropical conditions, 1st dive of the day, max. depth 50 feet & average around 25, I've got enough experience to know I'm not going to hit NDL on that dive. Might just finish the dive.

The irony is rich when you talk about whether I'd cut a dive short & take my buddy to the surface with me. Most people in mainstream U.S. & Caribbean (and some other) locations seem to dive computers. If you're diving tables, assuming someone will buddy with you, you're going to be cutting the dive short & taking him to the surface with you on lots of dives...because you're diving tables and don't get as much bottom time as the computer users!!!

If the original poster had the same result diving a profile computed with tables, would you conclude that tables are too liberal & people who trust them are reckless?

Also, the human brain is capable of plenty of glitches. You dive, your mind wanders & you realize you went deeper than you planned. And not everyone has the recall & fluency with the tables to know what having dipped an extra 10 feet for 2 minutes or so means to planning.

Richard.

 

[mike_bayer]

Hey Tom,

I'm so glad to hear you are OK.

We almost made it back to the BA this month.

Cheers, Mike

 

[Freewillow]

Ridiculous debate over using computers vs tables (computers of course!) aside, I just wanted to say thank you to the OP for sharing his experience.

Too often divers are afraid to/ashamed of sharing their unfortunate experiences. We all benefit from learning from others' accidents, preventable or otherwise. So, muchas gracias!

Thank you for deflating the "non issue".

The funny thing is that a diver without a dive computor would not be authorized to dive on liveboard in Egypt and the Maldives. One thing that the authorities want, is to be able to check divers profiles, especially in case of accidents. Egyptien rules: no dive lower than 40 m for non tech divers, deco permitted. Maldives: max 30m (!), no deco dives permitted.

So, the issue should be closed

 

[clownfishsydney]

Back in August last year, my wife (who has done 1,700+ dives) got skin bends on a dive trip in Bali, Indonesia. We had done multiple days of diving, three dives (mostly) a day, never went into deco, at least 5 minutes safety stop and often 10 minutes and long surface intervals (at least 90 minutes). After the third dive on one day, she had an itchy stomach and then thigh. About 60 minutes later a blotch came out in these areas. We realised it was a skin bend so we called DAN. She was put on oxygen. I marked with pen the extent of the blotches and after a few hours it decreased.

Anyway, to cut things short, the next morning the blotches were gone but she had tingling in extremities. Whether this was a bend or from hyperventilation (she was a bit stressed) is not really known. After a 3.5 hour trip (on oxygen) she arrived at the recompression chamber and was given one five hour treatment. She was okay after this.

Back in Australia she was tested and found to have a PFO. Most people (it seems) who have skin bends have a PFO. She had that closed last December and this weekend will do her first dive.

In our dive club, there are at least four members who got bent. Every one had PFO and have had it fixed. I know a couple of others who also had PFOs.

You should get yourself checked when you get home and consider getting it fixed. Some will say this is not needed, but as we are heading off sailing in the next 6 weeks to remote areas of the Great Barrier Reef, we considered it essential as if she got bent again, it would be very problematic.

Glad to hear you are feeling okay now.

 

[DocVikingo]

DDM, Doc Vikingo, are there set guidelines for future diving in people who've had skin bends?Richard.

Hi drrich2

There is no single, universally agreed upon guideline as to when a diver who sustained an incident of “skin bends” may safely return to scuba. DAN, the Diving Medical Advisory Committee (DMAC; UK), and various individual diving medicine experts have differing recommendations.

Those who sustain a single event of a benign Type I form termed pruritus-only (sometimes appropriately referred to as the "fleas"), in which there are only itchy or prickly sensations on the surface of the skin that typically resolve completely without formal treatment, can generally return to diving after 24 hours, or as otherwise recommended by a diving medicine specialist.

Those who sustain a single event of the more worrisome Type II cutaneous DCS (as described in post #8 above) should be formally evaluated and treated. After full resolution of the rash, the diver should refrain from scuba for 2-4 weeks, or as otherwise recommended by a diving medicine specialist.

Where there is a history of multiple incidents of cutaneous DCS, one should rule out all disorders that might increase susceptibility (e.g., PFO) and return to scuba only after cleared by his or her diving medicine specialist.

Regards,

DocVikingo

This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice to you or any other individual and should not be construed as such.

 

[Tunaman68]

Hey Doc,

My 'undeserved' hit included a lot of soreness but no real itching, and did not resolve without further treatment of surface O2 (after 50 hours of wait and see), but did NOT include any other neurological symptoms. I am wondering how you would classify this? Most people describe fleas, and maybe some soreness, but I looked like grouper skin and it was pretty uncomfortable, but never in my arms, or legs or joints. I understand that I took two hits really and if I'd have recognized the first one and taken steps, the second and more severe hit likely could have been avoided.

First hit ever and never had anything of the kind before even though I have done loads of dive trips with the plans and the procedures we used this time. Getting old? I don't want to jump to the PFO conclusion as many suggest and will likely try again next year with some significant modifications in profiles and dive times and always using nitrox.

I'm not going to enter the square profile bottom timer discussion as it really feels like a philosophical debate.

I was looking forward to diving into retirement and still have Chuuk on my radar, but this has got me spooked if I'm honest.

I understand you are not giving medical advice, but would love to hear your thoughts.

PM me if more appropriate.

Tom

---------- Post added March 16th, 2015 at 05:51 AM ----------

Hey Doc, re-reading post #8, my rash looked exactly like your 2nd link and was on my upper abdomen right below the sternum and some above my love handles on the sides.

 

[DocVikingo]

Hey Doc, re-reading post #8, my rash looked exactly like your 2nd link and was on my upper abdomen right below the sternum and some above my love handles on the sides.

Morning Tunaman68

If it looks like a fish, smells like a fish & swims like a fish....

The appearance & behavior of your rash is extremely suggestive of cutaneous DCS.

Cheers,

DocVikingo

 

[duke dive medicine]

DDM, Doc Vikingo, are there set guidelines for future diving in people who've had skin bends?

Richard.

DocV summed it up pretty well. It's done on a case by case basis. Conservatively for type II skin bends, 30 days, but that varies widely by practitioner and depends a lot on whether there are residual neurological symptoms (apparently not applicable in this case). I think the most important point of DocV's post is to be evaluated carefully if there's a recurrence.

Best regards,
DDM

---------- Post added March 16th, 2015 at 10:31 AM ----------

I am glad to hear you were lucky on the couple of hundred dives you did previously with your computer but it was nothing more then just luck. Computers will give you more bottom time then diving a square profile but that extra time comes from cutting out the built in safety margins of a square profile. These margins come from decades of testing by the US Navy and the algorithms used on the computer are derived from the Navy tables minus the built in safety factors. Another problem is that you may not fit the physical type the computer program was based on so to account for that you add in a safety stop at 15'. The time spent at the safety stop takes away from your actual time ON the bottom so you do not gain as much time as you think. What additional time you did gain caused your problem unless you are one of those people who is more susceptible to the bends but that is very rare. Loss the computer, get a good bottom timer, dive a square profile and you should never have this problem again.

It appears that you're saying that the probability of DCS when diving tables (used as directed) is zero. Did I read this correctly?

Best regards,
DDM