Type II DCS Caused by..SWINE FLU??

[DandyDon]

A good side discussion for Dr. Deco's forum here...?

 

[Bubbletrubble]

From Post #30 in this thread...

If I were this diver, I'd get a PFO test, especially with neuro symptoms on a dive where no one else had any problems.

@TSandM: Lynne, I was under the impression that studies have only shown an association between the existence of PFO and severe neurological DCS. Is ModulationMan's clinical picture consistent with the severe neurological form? I would think that his pain and sensory abnormalities would place his occurrence on the "less severe" end of the spectrum.

Even if the existence of PFO were determined, would it be advisable for him to undergo PFO occlusion procedure? From what I read, the procedure is not without risk. I thought that the current recommendation for recreational divers found to have PFO is simply to alter decompression procedures to decrease venous bubble load. Perhaps that is what he should be doing anyway.

My thoughts on this matter are largely based on the DAN webpage article and its source publication, an editorial in UHS co-authored by Moon and Bove.

Any thoughts on this?

No response to this post yet.
To clarify, I didn't mean to direct this question only to TSandM. If anyone else out there has any input, I'm all ears.

Also, I realize this may require a Mod, but as suggested by DandyDon, it might be appropriate to move some of this discussion to Dr. Deco's forum.

 

[DandyDon]

Also, I realize this may require a Mod, but as suggested by DandyDon, it might be appropriate to move some of this discussion to Dr. Deco's forum.

No, anyone could start a new thread in Dr. Deco's forum asking about it, perhaps quoting the first person story. It'd probly be best if ModulationMan did it.

Or Dr.Deco could be PMed and asked to look in here.

 

[dumpsterDiver]

This post is interesting. I have one more piece of anecdotal info. The ONLY time I have ever been bent (that I'm sure about) was while diving when i was also recovering from a flu.
I was not dehydrated, but didn't feel 100%. Did two air dives in the 80-90 ft range, swam hard, ran my skinny dipper CLOSE to deco and then did a slow ascent and also a safety stop. Same thing I did many times before.

Ended up with total skin numbness on only one leg almost immediately on surfacing. No pain, just total numb skin..felt like I was touching someone else's leg. Breathed 100% oxygen for 15 -20minutes on boat, felt better, never talked to a doctor and didn't dive for a week.

This was before I knew about deep stops.

 

[TSandM]

The association between DCS and PFO is not at all clear, and the association is definitely strongest with severe neuro (or skin) bends -- but a transcranial Doppler is noninvasive and relatively inexpensive, and if I had neuro symptoms following a dive within planned limits and without any ascent violations or other technique issues, I personally would get one. And consider having the PFO closed, if it were sizable and I wanted to continue diving.

 

[Bubbletrubble]

Hmmm. And I guess by getting the PFO closed, you would have the added benefit of protecting against paradoxical embolism unrelated to diving.

Getting back to how swine flu might predispose a diver to DCS...
Something that occurred to me, but hasn't been mentioned since it's probably so obvious, is that the variation in intrathoracic pressures caused by coughing (particularly persistent coughing) is known to increase right-to-left shunting in the setting of PFO. Any maneuvers approximating a Valsalva (e.g., straining during exercise) could also induce right-to-left shunting through a PFO. This shouldn't be that surprising, since these are techniques widely used by cardiologists to diagnose PFO in the first place.

 

[TSandM]

Interesting thought, Bubbletrubble!

As a side note, when I was getting my TCD done in LA, the tech told me that they were primarily studying the association of PFO with strokes in post-menopausal women . . . but the study had so quickly reached statistical significance, that they were widening their scope of questions.