The difficulty in determining DCS – Anatomy of a Dive Accident

[mi000ke]

I had a very similar experience several years ago, and it appears you were correct in diagnosing it as a non DCS event. I also have a narrowing of the cervical spinal canal. I discovered this one day while working at my computer with the screen at a height that caused me to bend up at the neck. My left arm went numb, and I thought I might be having a stroke. I visited the hospital emergency room and was cleared. Subsequently I began to experience frequent occurrences of temporary paralysis in both arms simultaneously over the course of months. Both arms would literally be dead meat hanging by my side, and this would last for about 30-60 seconds (about the time it takes for 10-15 breaths). I saw a neurologist and a spine specialist, and after MRIs and other tests they were able to diagnose the cervical spine issue.

I have since done neck strengthening and stretching exercises every morning as well as placing my neck in traction for about 10 minutes every morning (you can buy home-use neck traction devices), and wearing a soft neck brace at night. The bouts of paralysis continued for about a year after diagnosis - initially about 1/week, eventually once every couple of months. Then for the next few years it might occur once or twice a year if I bent my neck the wrong way. About 2 - 3 years ago they stopped almost entirely. When I dive I am in the perfect position to bring on an event (head bent up looking ahead) but I try to look down often to relieve the stress and fortunately have never had an event while diving - so the exercises, neck brace and traction seem to be working.

 

[DanBMW]

Thanks for the excellent write up and glad that it turned out OK. The so called "correct horizontal" position is also used in skydiving. It's becoming a neck issue for many because of the way that smart phones are used. It reduces the natural curve in the neck and causes it to straighten out.

My guess is that we are going to see more and more of it in the future and I can see how it could be easily misdiagnosed. I had my neck X-rayed about a year ago and the pinched vertebrae is very easy to see.

 

[johndiver999]

I too have thought that an over emphasis on perfect horizontal trim was unnecessary and caused me neck strain. I found that strict and constant horizontal trim yielded two undesirable choices: being uncomfortable (and actually seeing what was around by looking up) or keeping your "face in the dirt" to avoid neck strain.

The constant "butt clenching" which also seems to be part of the recommendation was equally (or more) uncomfortable on my low back.

I found it beneficial to disregard the advice for a horizontal position and instead maintain a "comfortable level of trim" and thus relax my body as much as possible. This results in a position/posture that is probably similar to what was shown in the photo posted earlier.

If you are drift diving and/or swimming very slowly, a modest divergence from horizontal doesn't seem to materially effect swimming anyway. The ability to effectively see while being relaxed and comfortable outweigh a minuscule or theoretical improvement in propulsion efficiency.

 

[Angelo Farina]

Thanks for sharing this story, very useful for all.
I also think that that GUE approach is really fatiguing and inefficient. I love my freediving fins and often use dolphin kick, as when using the monofin. Leave that stupid and inefficient (and inelegant) frog kick to the very rare case I enter a cavern with muddy bottom (but why the hell do I have to do this? It is much nicer OUTSIDE the cavern)...
My preferred dives are along vertical walls, and for making photos or videos, why the hell should I stay horizontal?
For me the GUE approach is too much similar to religious beliefs, you have to thrust what they say, with no usage of your brains.
Why forcing yourself to be perfectly horizontal "for reducing drag", and then keep your arms extended in that unnatural and poorly hydrodynamic "superman" position, and use inefficiently your fins in that crap frog kick? I swim much more efficiently with my long freediving fins, keeping my hands and all the equipment attached to my body, and using dolphin kick at each body rotation I come looking forward without the need of extending my neck, while during the opposite movement my head looks fully down, slightly behind me, so I see my wife following me without need to turn around...
And the neck over-extension is not the only bad thing associated to that extreme trim recommended by GUE, there are other several issues, but they would be OT to be discussed here.
Regarding "undeserved" DCS, I had knowledge of a couple of cases where the diving profile was similar to yours, but in both cases the subsequent medical examination did show the presence of pervious oval foramen, which explains the DCS. So it was not really "undeserved", albeit fully compliant with recommended NDL.
Indeed this was not your case.

 

[Johnoly]

..” And…..”Did you try wiggling your toes or your feet?”..

Another great test to add to the notes..........Great writeup. You should send it to ScubaDiving Magazine.

 

[chillyinCanada]

Sandra and Dan, glad for how this has turned out so far. Very frightening experience, no doubt!

My initial reaction was that Sandra was having a heart attack.

May I assume that her heart has also been checked subsequent? Perhaps at the hospital after her ambulance ride?

 

[Pebbles Photo]

Sandra and Dan, glad for how this has turned out so far. Very frightening experience, no doubt!

My initial reaction was that Sandra was having a heart attack.

May I assume that her heart has also been checked subsequent? Perhaps at the hospital after her ambulance ride?

HI Chilly, no my heart was checked, and is in good shape....I still do competitive cycling, so it better be

 

[chillyinCanada]

HI Chilly, no my heart was checked, and is in good shape....I still do competitive cycling, so it better be

Yes, I was aware but even finely tuned athletes can have unexpected heart events.

But you're checked out so it's all good. I couldn't help but ask considering how you first felt the pain.

 

[Pebbles Photo]

Yes, I was aware but even finely tuned athletes can have unexpected heart events.

But you're checked out so it's all good. I couldn't help but ask considering how you first felt the pain.

As it happens, when you start looking into Cervical Stenosis.....pain between the shoulder blades which then spreads, is a primary way this presents.

 

[Ayisha]

...So now with this new knowledge, he is looking into all possible exercises and stretches that can increase neck mobility so that there would be less hyper extension inflammation...and in chiropractic and other treatments that might mitigate the less beneficial aspects of the GUE trim he still insists on

So Dan is still hyperextending.