Untreated DCI after 4 days

[DrMike]

Some mild knee pain felt for a few mins during 6m stop (trimix dive - 45mins @ 50m) Extended 6m stop by additional 20mins on pure O2, pain didnt return. Very slow ascent to surface (10mins) on O2. Climbed boat ladder Ok then whilst de-kitting knee pain returned -only more painful (6 on scale 1-10)

Breathed O2. After 20mins on O2 pain fully disapeared. No other symptoms. Full recovery.

Nearest chamber was 4 days away.

Question: Seeing as this happened 4 days ago and there is no symptoms now is there anypoint in taking a chamber ride?

Wouldnt it be too late to prevent any damage that could lead to Aseptic Bone Necrosis and wouldnt any bubbles be long gone? Would hyperbaic treatment just help to speed up healing but not change final extent of healing?

 

[vlada]

Some mild knee pain felt for a few mins during 6m stop (trimix dive - 45mins @ 50m) Extended 6m stop by additional 20mins on pure O2, pain didnt return. Very slow ascent to surface (10mins) on O2. Climbed boat ladder Ok then whilst de-kitting knee pain returned -only more painful (6 on scale 1-10)

Breathed O2. After 20mins on O2 pain fully disapeared. No other symptoms. Full recovery.

Nearest chamber was 4 days away.

Question: Seeing as this happened 4 days ago and there is no symptoms now is there anypoint in taking a chamber ride?

Wouldnt it be too late to prevent any damage that could lead to Aseptic Bone Necrosis and wouldnt any bubbles be long gone? Would hyperbaic treatment just help to speed up healing but not change final extent of healing?

IMO, 4 days after accident is too late for chamber, especially if you don't have any sympthoms.

But, since i am not a doc, why don't you get in touch with your local chamber folks (via DAN or directly) and find out what they think? A ride would not hurt that's for sure.

Vlada

 

[DocVikingo]

Mild to moderate pain in a joint unaccompanied by other symptoms of DCS & which resolves completely after O2 without return or residua generally would not be a basis for concern. After 4 days, any bubbles that may have been present very likely have been gone for ~3 days & 22 hours, and perhaps longer.

Moreover, a joint that has been without discomfort, limitation of motion, swelling, discoloration or any indicator of damage since very shortly after a dive would not be expected to benefit from hyperbaric treatment (with or without 02) 4 days later.

As for aseptic bone necrosis, this really is not a concern for the sport diver, and certainly not based on a history of a single, isolated incident of modest, transient joint pain.

In the diver who has a history of such events, a medical work up for conditions that may predispose to DCI would appear prudent.

I am also asking Dr Deco to look at your inquiry.

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.

Best regards.

DocVikingo

 

[Dr Deco]

Hello DrMike:

Healed? Good

Doc Vikingo has given an answer above that pretty much covers it. It is not possible to say with absolute certainty that it was joint-pain DCS, but it certain looks suspicious. Since it remitted with time and oxygen breathing, there is little more that needs to be done. Once things are healed, they are healed.

Aseptic Bone Necrosis

It is my understanding that this is virtually unknown in recreational diving. My guess is that the gas loads are just too small in some tissue (e.g., bone marrow). It is more disease of commercial compressed gas workers (i.e., tunnel workers).

DCS When Diving Again :06:

While I do not cover the topic too often, if one has had DCS, it is a possible indicator that one is in the “more susceptible” group. One should exercise caution in future dives.

Dr Deco :doctor:

 

[DrMike]

Thanks guys for your advice.

 

[DocVikingo]

(nt)

 

[IndigoBlue]

DCS When Diving Again

While I do not cover the topic too often, if one has had DCS, it is a possible indicator that one is in the “more susceptible” group. One should exercise caution in future dives.

Doc, by "in the more susceptible group" would that include:

1) not properly hydrated before the dive; and/or

2) possible PFO and does not know about it?

Just curious.

 

[DrMike]

Doc, by "in the more susceptible group" would that include:

1) not properly hydrated before the dive; and/or

2) possible PFO and does not know about it?

Just curious.

Good questions......also is there a simple test for PFO?

 

[DocVikingo]

"Is there a simple test for PFO?"


Depends on what one considers simple. The test of choice, TEE, is not all that simple.

The following thread (which by the way is close to the top on the present Diving Medicine forum page) should answer your question & prove informative in other aspects of PFO as well---->

http://www.scubaboard.com/t40456.html

If you have specific questions following a read, I will endeavor to field them.

Best regards.

DocVikingo

 

[dani_p]

sorry to butt in like this but are you saying that DCS can go away on its own? how is that possible? or are you saying it was most likely that he hadnt experienced DCS at all?
thanks
dani