Skin Bends

[Allison Finch]

I have seen many cases of skin bends, santa claus bends, and weakness bends in extreme deep cave exploration. I recommend treatment for all types of DCI in a professional hyperbaric treatment facility.

This is what we do in the field.

Normally we do nothing (no treatment) about skin bends (red rash on the skin) normally caused in places where a dry suit restricts blood flow for underwater exposures of 3-7 hours. These rashes normally go away after 12-48 hours.

Santa Claus bends are more serious and cause water retention in the belly fat around the waist. I have never gotten Santa Claus bends, but a friend of mine has many times. He has never gotten treatment except more inwater decompression on oxygen and a few days of rest.
NOTE: Inwater recompression is not a recommended decompression treatment.

Weakness Bends, Many dives you can have small signs of possible DCS, such as tingling in the fingers, weakness in hands, and shoulders. These signs normally go away within 3 days. Again, we normally seek no treatment for weakness bends.


Disclaimer: These are not the recommended treatments for DCI, Please contact DAN if you feel you have any symptoms of DCI. Curt Bowen, Advanced Diver Magazine, nor its staff recommends any other recompression treatment other than in a qualified recompression facility.
Note: Deep cave exploration should only be conducted by properly trained divers with vast amounts of experience.

You're right in saying that this is NOT what DAN would suggest. Their evidence suggests that some skin bends occur concurrently with a more serious CNS hit. How do YOU know this is not the case if you decide not to treat at all?

 

[Curt Bowen]

You're right in saying that this is NOT what DAN would suggest. Their evidence suggests that some skin bends occur concurrently with a more serious CNS hit. How do YOU know this is not the case if you decide not to treat at all?

I don’t know, but I also don’t run to a chamber every time I am not feeling good or have some red rash. A rash can be caused by many more things then DSC, such as, just being in a dry suit for 3-7 hours, or your shoulder straps a little to tight, or your undergarment squeezing you the whole dive, or just really cold water, or or or


Many of the deep, long dives we conduct are very demanding on the body alone. Most stiffness and fatigue is caused from the exertion of the dive and not DCS. Kind of the same feeling after running a mile for the first time after being a couch slug for five years.

Also, much of the pain can be caused from the exertion of just getting to the site. Some of the places we explore are over 1 kilometer from the hard road through swamp and mud. Just getting the gear to the hole is very very difficult. It’s a hard days work.

I am not here to start a debate about DCS, its signs and symptoms or its treatment. I don’t have that much time or interest.

I made a statement about what I do while in the field. If it was a true serious DCS hit, such as dizziness, vomiting, paralysis, disabling pain etc. a chopper would be sent in and the diver lifted to a chamber. Of course if the diver starts feeling worse after time (1-24 hours) and HE decides to go to a chamber, then so be it. We are all adults here and we can make our own decisions.

Since we started doing deep stops (3-4 years ago) much of the problems have stopped.

Again, I recommend going to a hyperbaric facility for treatment if needed. The choice is up to the individual.

 

[beachdivequeenbelam]

You don't go to sleep after a dive becuase you body is still processing nitrogen out and by going to sleep you slow that process down. It is why you can't go to sleep during chamber treaments a lot of times if you have severe DCI. Also the other reason that was stated earlier. You won't be able to monitor yourself for syptoms. Also I have heard not to take hot showers immediately after diving either.

 

[beachdivequeenbelam]

Your dive continues after you leave the water until you have no excess nitrogen left in your body is what I was taught.

This correct right?
That is why you monitor for DCI signs for 12 hours after a dive, AM I correct? If I am not please tell the right thing.
Thanks

 

[wedivebc]

You don't go to sleep after a dive becuase you body is still processing nitrogen out and by going to sleep you slow that process down. It is why you can't go to sleep during chamber treaments a lot of times if you have severe DCI. Also the other reason that was stated earlier. You won't be able to monitor yourself for syptoms. Also I have heard not to take hot showers immediately after diving either.

Henry’s law




Hen·ry’s law [ hénnreez làw ]

noun

principle involving dissolved gas and pressure: the principle that the amount of gas dissolved under equilibrium in a volume of liquid is in direct proportion to the pressure of the gas that contacts the liquid surface


[Late 19th century. Named for the English chemist William Henry (1774-1836).]
It matters not whether you are awake for it or not it just happens.

 

[tangfish]

your circulation and breathing rate also slows down though when you are asleep.

 

[Xman]

I don’t know, but I also don’t run to a chamber every time I am not feeling good or have some red rash.................
Again, I recommend going to a hyperbaric facility for treatment if needed. The choice is up to the individual.

Hi Curt. With the utmost respect to your ability, experience, and training, I don't think posting in this thread was particularly wise. Whilst what you and your dive buddies decide to risk is entirely up to you, whether you like it or not your qualifications, personality, experience, and activities will almost certainly lead less experienced divers to be influenced by your comments. Despite your disclaimers, I don't see what your post did to contribute positively to this thread, or diver safety.
You may have your reasons, or you may have just felt like letting us know, but felt I needed to give you my perspective.

At the end of the day, my personal opinion is that chamber time and oxygen spent treating symptoms that may or may not have been DCS are far better than the alternative.

 

[rmediver2002]

Patients are allowed to sleep during treatment, usually not until the later part of the treatment and normally at shallower depth.

When they are not allowed to sleep it is for observation purposes to track the symptom not so they do not tox.




Skin bends is not easily confused with skin rash, one of the indicators is hypoxic tissue (blue or purple) within the center of a raised rash (like a hive from an allergic reaction)

Following treatment the patient is normally observed on the surface at the chamber for signs of reccuring or new symptoms. After one to two hours (depending on the type of treatment) the patient is sent home and observed for another 24 hours.

 

[Curt Bowen]

Hi Curt. With the utmost respect to your ability, experience, and training, I don't think posting in this thread was particularly wise. Whilst what you and your dive buddies decide to risk is entirely up to you, whether you like it or not your qualifications, personality, experience, and activities will almost certainly lead less experienced divers to be influenced by your comments. Despite your disclaimers, I don't see what your post did to contribute positively to this thread, or diver safety.
You may have your reasons, or you may have just felt like letting us know, but felt I needed to give you my perspective.

At the end of the day, my personal opinion is that chamber time and oxygen spent treating symptoms that may or may not have been DCS are far better than the alternative.

Thanks for your concern and your oppinion has been noted.

Remember, much of our diving is conducted in extremely remote locations where hyperbaric treatment is a days travel or more away. Other alternatives must be examined.

Due to the introduction of modified deep pyle stops and RGBM, 99% of problems have been solved in the past 4 years.

 

[lragsac]

Your dive continues after you leave the water until you have no excess nitrogen left in your body is what I was taught.

This correct right?
That is why you monitor for DCI signs for 12 hours after a dive, AM I correct? If I am not please tell the right thing.
Thanks

Yes, decompression is not "finished" once you hit the surface. Think about it. If this were true, there would be no proscriptions on flying or exercising after diving. There would be no such concept as residual nitrogen time. Sleeping slows down circulation such that the offgassing process is impeded. For a more authoritative explanation of this, post a question on the Ask Dr. Deco forum. I just attended Dr. Powell's Advanced Decompression Physiology seminar and he does address this in depth in his presentation.