Wife got bent; we can't understand why. Would love some advice.

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kfahmi

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Location
San Francisco, CA
# of dives
100 - 199
Hello all,

My wife and I are relatively novice divers (106 dives logged over the past 10 years...about 10 night dives, about 30 dives to 30m.) We absolutely love diving, but last week in Thailand we had an incident that scared the c**p out of both of us. I'd love to hear any insight from you folks.

It was the very first dive of a four-day liveaboard. The dive was planned for 30m and an in-water time of 50 minutes, but one of the other divers had some air problems, so the divemaster ended the dive early. We maxed out at 24m with an average of 15m, and were in the water just 33 minutes. Our descent and ascent were normal, with the usual safety stop at 5m for 3 minutes. It was one of the shortest and shallowest dives I've done in a long time.

Anyhow, a few minutes after exiting the water, my wife started to feel odd. She lost motor control of her limbs, and collapsed. She was lucid and talking coherently, but couldn't move at all -- she was totally paralysed. She then reported that her vision had gone. We immediately put her on O2, and had her drink a rehydration solution. She then reported light tingling in her fingers and toes. After about 10--15 minutes, her vision slowly returned, and after half an hour she was able to walk again under her own power. The tingling also vanished.

We got her off the boat and evac'd her to Phuket Intl'l Hospital, keeping her on O2 the entire time. By the time we got there (5 hours after the symptoms appeared), she reported feeling normal. The deco chamber staff gave her some neurologic tests and decided she didn't need to go into the chamber, but she stayed in the hospital overnight (on O2 the entire time) and was released the next day. Since then she's been fine.

What I simply cannot understand is what could have caused this. She was well-hydrated and rested. She's in good physical shape. Her dive was well within normal recreational dive profiles, and it was the first dive she'd done in months.

The doctor suggested that a cardiologist examine her for a patent foramen something-or-other (a flap in the heart, I believe, which could allow nitrogen bubbles to pass from venous blood to arterial blood, creating an air embolism that could have affected her brain and spine, which would explain her paralysis and blindness.) We will have those tests done. But aside from that, what else could have caused this? I love diving, but seeing her get bent after having had none of the risk factors whatsoever, and after a very short and relatively shallow dive, was terrifying.

Any info would be much appreciated. Thanks folks.
 
A venomous fish sting of some sort?
 
A severe case of DCS that self resolves in 5 hours?
 
PFO would explain the 'undeserved' hit. Basically (and the Doc's will explain far better, I am sure), blood flow can bypass the lungs, reducing the efficiency of off-gassing.

Were there other factors? Sickness, dehydation, injury etc? Ill-fitting gear (too tight)? Hot shower/jacuzi immediately after dive?
 
Sounds like they suspected a TIA which could have been provoked by a PFO and maybe explain the decision not to use a chamber. Did anyone contact DAN?

My best advise is to contact DAN. They will be able to put you in contact with a doctor who is knowledgeable in this subject area. www.dan.org
 
A severe case of DCS that self resolves in 5 hours?

Well, it didn't exactly self-resolve. She was on 100% O2 for about 30 hours after the incident...

---------- Post added March 1st, 2013 at 07:30 PM ----------

PFO would explain the 'undeserved' hit. Basically (and the Doc's will explain far better, I am sure), blood flow can bypass the lungs, reducing the efficiency of off-gassing.

Were there other factors? Sickness, dehydation, injury etc? Ill-fitting gear (too tight)? Hot shower/jacuzi immediately after dive?

As for other factors, there were none. She is healthy, relatively young (36), in good athletic shape. She wasn't dehydrated (she's quite good about drinking lots of water before and after every dive.) The gear was her usual size and felt comfortable. And she didn't hit the shower after the dive (she collapsed maybe 3 minutes after exiting the water.)

I was her buddy, and I know for a fact that her ascent was normal.

That is why I am so confused. NONE of the factors that would normally cause DCS were present.

The doc did mention that she should have her PFO tested...so far that is the only explanation I can think of. Sigh. I hate to think that she may never dive again...

---------- Post added March 1st, 2013 at 07:31 PM ----------

A venomous fish sting of some sort?

Nope...she reported nothing of the sort and you'd think you'd notice getting hit by a lionfish...

---------- Post added March 1st, 2013 at 07:32 PM ----------

Sounds like they suspected a TIA which could have been provoked by a PFO and maybe explain the decision not to use a chamber. Did anyone contact DAN?

My best advise is to contact DAN. They will be able to put you in contact with a doctor who is knowledgeable in this subject area. www.dan.org

That's great advice; thank you.
 
The confirmation of a PFO does not necessarily disqualify you from diving. Thats why you should consult a diving physician. The people at DAN can point you in the right direction.

I know a diving MD who dives with a confirmed PFO, but he does so cautiously. He dives on nitrox using conservative profiles and setting his computer to air.

Call DAN. Member or not, call DAN.
 

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