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

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One final thought from me (I have few thoughts so I hope this is a good one). Those last 15 feet are crucial. The fact is that during those 15 feet you exp[erience more significant pressure changes than 15 feet at greater depths. One other modification I made to my diving is to take forever to rise from the safety stop. and slowest the last 5 feet. Just a thought. Happy diving

Agree 100%. I crawl up the last 15, spouse is Joan Jet. I've told her over and over to slow down. You can get an AGE by breathing on the bottom of a swimming pool in five feet of water and rapidly standing up. I'm convinced the victim here went up fast from the safety stop.
 
I think that aviation is indeed a more exact science, but caca happens. I've talked to professional airline pilots who tell me that have tried to fly thru a simulated microburst like the one that crashed a Delta plane at DFW around 1988 - and none I talked with said they could.

This is true -- Delta 191 is a landmark accident that looked to be pretty much unavoidable at the time. But that accident definitely changed the way we think about potential thunderstorm effects near the ground (such as microbursts) -- it dramatically raised pilot awareness of what can happen near a big cell. I hold an ATP (airline transport pilot) certificate and I think that accident must have come up during all of the many oral exams in my many checkrides leading up to the ATP. In other words, the aviation industry learned a lot from it -- just as Air France 441 totally changed the way stall recovery is taught in transport-category aircraft.

Back to the main topic -- I suppose it is possible that she got the AGE from a slightly-too-quick ascent from the safety stop, but if that kind of hit can happen from a just-slightly-too-fast ascent, then this whole diving thing makes flying look safer than lying in bed...

---------- Post added March 4th, 2013 at 10:16 PM ----------

Agree 100%. I crawl up the last 15, spouse is Joan Jet. I've told her over and over to slow down. You can get an AGE by breathing on the bottom of a swimming pool in five feet of water and rapidly standing up. I'm convinced the victim here went up fast from the safety stop.

I'm not arguing -- I'm such a novice at this whole diving thing -- but her ascent was normal. I was 5 feet away from her. She did ascend faster than I did, but that's only because we had been in the water such a short time (the DM cut the dive short) that I was highly annoyed we had to surface so early, so I recall literally inching up the last 15 feet, just hoping to see something interesting swimming around near us. I probably took 3 minutes to rise that last 5 m. She just did a normal ascent.

I used to go up pretty fast from the safety stops until a DM told me to cut it out -- I'm much better about it now. Again, not remotely an expert, but her ascent looked quite sedate to me...
 
Well, nothing is certain I guess...
...if that kind of hit can happen from a just-slightly-too-fast ascent, then this whole diving thing makes flying look safer than lying in bed...
Sinkhole Swallows Florida Man Sleeping In Bed

I can understand your strong desire to know exactly how your wife got hurt and how to prevent it, but a certain answer may not be possible - especially this late. Talking around the AGE possibility, I've survived some really fast ascents in surges and similar, but I have huge lungs. I don't know how big of a lady she is, but I do bet hers are smaller - and who knows what else as we all are different. I think it would be prudent to consciously slowly exhale on ascent from the SS, but then that may not have been it? There are indeed other possibilities.

good luck to you both...
 
Thanks for coming back and posting the DAN response, helpful in what they thought of it even though it's too hard to nail it down to one thing.
 
So we do have more progress to report. My wife saw her primary care physician (she has an HMO), and with plenty of help from Eric Hexdall (who spoke to her doc on her behalf -- THANK YOU Eric!), she's got a number of tests scheduled. First a test for a PFO, then they will also do an EKG and an MRI.

Eric was kind enough to ask my wife for a lot of detail about her case, which he wrote up and presented as a formal case to one of his colleagues who specializes in that specific area. Their conclusion was that a PFO was most likely the cause. Hopefully the tests may shed more light on this.

So we'll see what happens and I'll report back to the group. But again I wanted to thank all of you who have provided thoughtful insight, and a huge shout out to Eric, who has just gone above and beyond.
 
I'm not sure if you are still reading this thread, but I thought I should share - I had a very similar experience nearly a year ago.

I also had just over 100 dives, though those 100 dives were from a year and a half of diving so I was diving fairly regularly. I had done the exact dive probably five times before. I was on 36% nitrox, max depth of 46 feet in a small cavern (yes I was trained for that environment) for about 45 minutes. It was an uneventful dive, with a slow ascent. Shortly after surfacing while floating in the surface pool I became paralyzed from the neck down, and had some visual problems (like a migraine aura). I was given O2 while still in the water for probably 15 minutes or so and was able to walk myself out of the site, which involved some steep stairs. I went to the hospital and called DAN, who (not surprisingly) said given the profile and the quick resolution of symptoms without recompression that it was most likely not DCS. After a migraine pill, O2, and IV fluids I went home.

The next day I had some residual symptoms - numbness in my upper extremeties - and went back to a hospital, called DAN, and ended up doing one chamber ride, probably more as a precaution. The chamber doc was not entirely convinced it was DCS either, but advised I not dive for some time. I went on a mission to see what happened. I was tested for a PFO and did not have one. After visiting several doctors, it seemed most likely that it may have been a complicated migraine with peripheral neurological involvement.

I had a trip planned and payed for Truk lagoon shortly after I was allowed to return to the water, and was worried that the middle of the pacific doing some intense diving was not a good "first dive back" environment. Worried about the trip, I'll admit I returned to the water a little earlier than recommended (18 weeks rather than 24), doing shallow dives on high mixes.

When I finally did moderately deep wreck dive (the USS Mohawk - max 85 ft, average around 65, 45 min total dive time), I dove 34% and stayed well within decompression limits. I did a longer-than-normal half stop (5 min) and a longer-than-normal safety stop (7 min), and was careful to ascend slowly. Nothing about that dive said DCS, the only thing I had going against me was the prior history of what might have been but didn't really seem like a hit.

Ascending from my safety stop I lost feeling below my waist. Again, I had visual problems, and developed a migraine. This time, it did not resolve with O2. I was airlifted to the nearest chamber (Orlando). After my first ride, about 7 hours (a padded table 6) I was not better. The next morning, I was worse. I lost the ability to walk and to control bodily functions. I was given a catheter and a wheelchair.

I spent the next week in the hospital in the chamber every day. When I wasn't in the chamber I was either getting some test or in physical or occupational therapy. I did a total of 9 rides and spent almost 48 hours in the chamber.

That was over 6 months ago and I still don't have normal sensation in my legs or feet. I can walk now and no longer need a catheter. On bad days I might wear an adult diaper and use my cane. I am 28 years old. Some days, I feel 80.

My point is, PFO or not, if your wife wants to dive again PLEASE be very, very careful. My experience was very similar to your wife's at first. If I had stopped after the first time it happened, I would be in a lot better shape today. Diving was a big part of my life and I didn't want to let it go - but in the end it wasn't my choice.
 
majickyl, what test did they do for PFO? The miss rate on transthoracic echocardiogram is significant.
 
Transthoracic echo with bubble. I hadn't heard there was a high miss rate, but I have often wondered if I might actually have a PFO we just didn't see during the test.

As a scientist I'm always thinking if you see something you know it's there, if you don't it's either not there or you just didn't see it. Perhaps I have one that opens under deeper pressure than me doing a valsava while on a table could muster.
 
The gold standard for diagnosing a PFO is transesophageal echo; another test, which can't diagnose PFO but can diagnose a shunt, is transcranial doppler. Given your story, I would be VERY curious as to what a TCD would show.

BTW, I am very sorry to hear what happened to you. I can't imagine ending my diving career that way.
 
I'm also very sorry to hear what happened to you, not just to have your diving cut short but to be so young and suffering/dealing with the results. May I express my best wishes to you that ultimately everything will resolve itself fully and that your youth will help to speed that resolution. Thank you for sharing your story, especially as a warning.
 

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