Undeserved hit to inner ear

[vjongene]

I learned this past Sunday that a buddy of mine had a "freak" accident the previous week. Here is what happened (second hand I am afraid):

This is a reasonably experienced diver, and one I know to be very serious about planning the dive and diving the plan. He was diving with three other guys from the club, two of them instructors, and buddied up with one of the instructors. The dive was one of our favorites: a swim along a wall, whose top is sloping down from about 6 m near the entry point to well over 30 m. Reach the top of the wall at 30 m, where a local dive club has erected a small memorial. Then follow the top of the wall back to the entry point, which makes for a nice gradual ascent with places to do deco stops if necessary. The profile of the buddy team included a descent to about 45 m on the wall, with a gradual ascent to catch the memorial. We have done this dive dozens of times without any problems.

The divers has some deco obligations at the end, which they followed rigorously. In fact, because one of them was diving with a Suunto computer, the deco stops were reasonably long (I do not know the actual times, but the Suunto showed about 5 min more than the Aladdins worn by the others). They returned to their cars, which involves climbing about 80 steps from the entry site to a fly bridge over the railway line (read relatively strenuous exercise). They put away their gear and repaired to a local cafe for a drink. While sitting in the cafe, my friend suddenly fell from his chair. He was very badly dizzied, and unable to maintain a sitting or standing position. He also started vomiting. One of the guys dragged him into his car and drove him to the hospital, which is only about 20 min away. He had two rides in the chamber, and was released on Tuesday. He apparently is still feeling a little dizzy, but has regained control over his posture. He was told not to dive for at least a month.

The most likely diagnosis for what happened is that a bubble formed in or near the inner ear. CAT scans at the hospital were unable to pinpoint the bubble. Doctors will be checking my friend for a PFO that may have allowed a bubble to travel into the arterial circulation and block the blood supply to the inner ear. There were no other symptoms of DCI. Scary...

 

[ScubaTwo]

I learned this past Sunday that a buddy of mine had a "freak" accident the previous week. Here is what happened (second hand I am afraid):

This is a reasonably experienced diver, and one I know to be very serious about planning the dive and diving the plan. He was diving with three other guys from the club, two of them instructors, and buddied up with one of the instructors. The dive was one of our favorites: a swim along a wall, whose top is sloping down from about 6 m near the entry point to well over 30 m. Reach the top of the wall at 30 m, where a local dive club has erected a small memorial. Then follow the top of the wall back to the entry point, which makes for a nice gradual ascent with places to do deco stops if necessary. The profile of the buddy team included a descent to about 45 m on the wall, with a gradual ascent to catch the memorial. We have done this dive dozens of times without any problems.

The divers has some deco obligations at the end, which they followed rigorously. In fact, because one of them was diving with a Suunto computer, the deco stops were reasonably long (I do not know the actual times, but the Suunto showed about 5 min more than the Aladdins worn by the others). They returned to their cars, which involves climbing about 80 steps from the entry site to a fly bridge over the railway line (read relatively strenuous exercise). They put away their gear and repaired to a local cafe for a drink. While sitting in the cafe, my friend suddenly fell from his chair. He was very badly dizzied, and unable to maintain a sitting or standing position. He also started vomiting. One of the guys dragged him into his car and drove him to the hospital, which is only about 20 min away. He had two rides in the chamber, and was released on Tuesday. He apparently is still feeling a little dizzy, but has regained control over his posture. He was told not to dive for at least a month.

The most likely diagnosis for what happened is that a bubble formed in or near the inner ear. CAT scans at the hospital were unable to pinpoint the bubble. Doctors will be checking my friend for a PFO that may have allowed a bubble to travel into the arterial circulation and block the blood supply to the inner ear. There were no other symptoms of DCI. Scary...

Strenuous activity and booze after a dive? Being a newbie Im not sure but I thought both of those could contribute to DCI? And he dove a decompression dive?

 

[vjongene]

Strenuous activity and booze after a dive? Being a newbie Im not sure but I thought both of those could contribute to DCI? And he dove a decompression dive?

No one talked about booze. I am not even sure whether they were having a glass of wine or a cup of tea, and this was after the dive anyway. Yes, it was a deco dive. The victim was trained to do them, and followed proper protocol. Regarding the exercice, yes it could be a contributing factor. The fact is that at this site one has to lug one's equipment back up from the lake shore - no way to avoid it.

 

[Randy43068]

They had to walk back up the steps to the car.. what else should they do? That, my friend, is sometime quite strenuous.

No mention of alcohol in his post.

The guy posted for our benefit, so we could learn from it, and not to be scrutinized by you or others!

Please don't be so rude and harsh with your comments.

Strenuous activity and booze after a dive? Being a newbie Im not sure but I thought both of those could contribute to DCI? And he dove a decompression dive?

 

[mrobinson]

Scubatwo, I think you asked a question with no ill intent. I would recommend reading more about the nitrogen bubbles theory so you understand a little better about off-gasing. With strenuous activity, you increase your chances of getting bent because of how the body exchanges the nitrogen out of your blood system. Also do a PFO search on this board so you can see how that relates to this incident.

This is an invalueble thread because it's educational... the bends just happen. We get to learn first hand about why hydration, proper food, and exercise prior to a dive is as important as the dive itself. I'm going for a PFO test as well and would encourage anyone who dives A LOT to do so, even if you're not doing deco. (IMHO all deco divers especially should get tested...)

Thanks for posting!!!

 

[jagfish]

...Please don't be so rude and harsh with your comments.

Hi Randy
I didn't think Scuba Two's comments were so rude. Actually, I think he rightly points out that the activities after the dive may have contributed to the hit, especially if someone exited the water with a high level of N2...

I think this is at least as important to learn from as the original poster's point that DCI can happen without apparent reason.

 

[DiveGolfSki]

Deco Dives are, by themselves, not difficult but one must have experience in them. In this case, it seems your friend has done them before. My dive instructure (NAUI Tech and DIR) always follow proper protocols with these dives. One of them is NOT engage in any strenous activity within 30 min. after the dive. The stairmaster exercise IS a factor. Perhaps, this should have been part of the dive plan consideration.

However, micro bubbles can form even after following all protocols. Another thread in this forum describes how an exprienced diver on a non-deco dive and long safety stop still got DCI.

Vjongene, I'm sorry about your friend but at least he was near proper medical facilities. I'm curious about the deco stop he made. You stated "the deco stops were reasonably long (I do not know the actual times, but the Suunto showed about 5 min more than the Aladdins worn by the others). " Did your friend use the Suunto or, at least, follow the deco requirements? What model Suunto? My understanding is that most Suunto use the RGBM algo (some would argue that it's not a true RGBM) and are usually more conservative (deep stops combined with shallow stops, etc.). Perhaps, this would be a good post on decostop forum as well.

 

[vjongene]

Deco Dives are, by themselves, not difficult but one must have experience in them. In this case, it seems your friend has done them before. My dive instructure (NAUI Tech and DIR) always follow proper protocols with these dives. One of them is NOT engage in any strenous activity within 30 min. after the dive. The stairmaster exercise IS a factor. Perhaps, this should have been part of the dive plan consideration.

In summer, we often schedule a 30-60 min rest period at the point of entry while discussing the dive and having a cup of tea. In winter (it was snowing hard on the day of the dive) we just get the hell out of there. But this may change as a result of this incident...

Vjongene, I'm sorry about your friend but at least he was near proper medical facilities. I'm curious about the deco stop he made. You stated "the deco stops were reasonably long (I do not know the actual times, but the Suunto showed about 5 min more than the Aladdins worn by the others). " Did your friend use the Suunto or, at least, follow the deco requirements? What model Suunto? My understanding is that most Suunto use the RGBM algo (some would argue that it's not a true RGBM) and are usually more conservative (deep stops combined with shallow stops, etc.).

I do not have the precise data in hand, and I don't feel it is my place right now to call my friend and ask him for details. I do know, however, that proper protocol was followed in that the most conservative computer (in this case, my friend's Suunto) was used to determine the buddy team's deco stop.

 

[jagfish]

It might be interesting to see how the deco schedule for your computers match up to a program like V-planner or similar.

I don't know any avid deco divers who do thier deco by wrist computer, except maybe one VR3 fellow.

Not saying it can't be done safely, just an observation. Depending on the computer, I have seen some that have only relatively minimal deco compared to dedicated deco software, and usually grouped at 3 meters, with some obligation occasionally at 6, but rarely...much less of the deep and intermediate stops than V-planner.

 

[Web Monkey]

Regarding the exercice, yes it could be a contributing factor. The fact is that at this site one has to lug one's equipment back up from the lake shore - no way to avoid it.

That makes it a bad dive site.

Dr. Deco has mentioned several times that strenous activity significantly increases the chances of DCS.

Terry