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A personal case of DCS...


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#1 DoctorB

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Posted 05 August 2012 - 06:18 PM

DoctorB.....So sorry to hear this happened! Can you tell us what your symptoms were?


I was sore after diving (Bonne Terre Mine). If you haven't been there, it's cold (58 degrees), and the dive deck is about 110 feet below ground. So between dives it's a long walk up to the surface, especially after the last dive carrying your gear. So I was sore from the climbing. The next day, that soreness started getting better, but I had a new deep ache in my shoulders, and paresthesias (tingling and numbness) in my hands and to a lesser extent in my feet. Interestingly shoulder ache and peripheral paresthesias are the most common DCS symptoms. It would be VERY easy to blow it off as overexertion. I went to bed and the next morning it wasn't any better, so I quickly got over my denial and called the DAN emergency number and soon thereafter, dive 100 was under way (attached). The symptoms disappeared at 60 feet on pure O2, but returned after treatment. So far:

Dive 100 - USN Table 6 (4 hrs)
Dive 101 - USN Table 5 with extensions
Dive 102 - USN Table 5
Dive 103 - USN Table 6 (I had new neuro symptoms, paresthesias throughout both legs, after dive 102)
Dive 104 - USN Table 5

I'm glad I got it treated right away. The doc and DAN folks were telling me that the longer you let it go, the less successful treatment is, and it more likely you will never be able to dive again. Also, the chamber is nothing to fear. It's just VERY boring.

In the mean time, I can't fly for a month, and can't dive for two months.

Have fun in T&C. Wish I could be there blowing bubbles, celebrating my B-day and Dive 100 in SD style! O/W I'll see you all in Bonaire in the spring.

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#2 ScubaSis

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Posted 05 August 2012 - 10:21 PM

Thank you for this information! I am glad that you will be alright to keep diving in the future. Maybe we can all learn something through you.

I'm sorry you have to bail on T&C, but happy you can continue this sport we all dearly love!!

Until next time!!
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Just pee on it and walk away.

#3 WreckWench

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Posted 05 August 2012 - 11:06 PM

Exertion during a dive is commonly known to bring on a hit but exertion AFTER a dive is not considered as much. This gives credence to DAN's recommendations to NOT exercise after diving as it can release nitrogen back into the bloodstream.

It also begs the question as to how fit we are in general... it seems we can continue to dive despite a decreasing level of fitness but perhaps we are only fooling ourselves and should be more conscience of getting into shape to dive???

One of the main differences between exertion and DCS is WHERE the pain is located. If its deep in the bone or joint...then its more likely DCS or at the very least DCS should be ruled out by a DOCTOR. If its in the muscle then its more likely to be exertion. BUT if you have ANY TINGLING GET IT CHECKED OUT IMMEDIATELY! Exertion never causes tingling...

HOWEVER ITS BEST TO CHECK OUT ANY ODD SYMPTOMS REGARDLESS...

If you go too long without treatment you will suffer permanent damage and may not be able to dive. So check it out... forget the part about not having done anything wrong so it can't be DCS... more and more cases of DCS are unexpected or unjustified hits meaning you did nothing wrong and did not violate the tables nor dove unsafely....however you still took a hit.

So just check it out... this is TRULY a case of "better safe than sorry".


:thankyou: DoctorB for sharing with us... hopefully others will learn from your experience. :respect: Kamala

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#4 shadragon

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Posted 06 August 2012 - 05:59 AM

Sharing personal stories of DCS experiences is the only way to educate people that it CAN happen to anyone.

The inside of a chamber might not be the best place to be for 6 hours, but it sure beats the alternatives.
Remember, email is an inefficient communications forum. You may not read things the way it was intended. Give people the benefit of the doubt before firing back... Especially if it is ME...! ;)

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#5 libra89

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Posted 06 August 2012 - 10:20 AM

DoctorB.....So sorry to hear this happened! Can you tell us what your symptoms were?


I was sore after diving (Bonne Terre Mine). If you haven't been there, it's cold (58 degrees), and the dive deck is about 110 feet below ground. So between dives it's a long walk up to the surface, especially after the last dive carrying your gear. So I was sore from the climbing. The next day, that soreness started getting better, but I had a new deep ache in my shoulders, and paresthesias (tingling and numbness) in my hands and to a lesser extent in my feet. Interestingly shoulder ache and peripheral paresthesias are the most common DCS symptoms. It would be VERY easy to blow it off as overexertion. I went to bed and the next morning it wasn't any better, so I quickly got over my denial and called the DAN emergency number and soon thereafter, dive 100 was under way (attached). The symptoms disappeared at 60 feet on pure O2, but returned after treatment. So far:

Dive 100 - USN Table 6 (4 hrs)
Dive 101 - USN Table 5 with extensions
Dive 102 - USN Table 5
Dive 103 - USN Table 6 (I had new neuro symptoms, paresthesias throughout both legs, after dive 102)
Dive 104 - USN Table 5

I'm glad I got it treated right away. The doc and DAN folks were telling me that the longer you let it go, the less successful treatment is, and it more likely you will never be able to dive again. Also, the chamber is nothing to fear. It's just VERY boring.

In the mean time, I can't fly for a month, and can't dive for two months.

Have fun in T&C. Wish I could be there blowing bubbles, celebrating my B-day and Dive 100 in SD style! O/W I'll see you all in Bonaire in the spring.


I always read these kinds of things with interest, because I'd want to be able to learn something from someone else's experiences too. I have a question....sounds like you were diving, had some symptoms that could be explained elsewise, so you kept diving. Is that right? And then, after that came the call to DAN the following morning? I'm inferring from how you described it, that DAN suggested it was NOT DCS, and that more diving would be acceptable? And then you started the string of dives listed above, which culminated in even more symptoms so you got to a doctor at that point?

The thing that is scary to me, and probably a lot of other people, regarding the bends is how easy it would be to overlook many of the symptoms if they are fairly mild. The soreness part especially. And who wants to be alarmist and cry "Bends!" when you're just a little muscle sore? But then, you don't want to mess around if it IS the bends either. What a catch-22. It sounds like you did what the situation called for, but I'm just wondering about the sequence of events and if DAN suggested you were fine and could keep diving?

I am glad this all results in you being fine with just a little hiatus. And in the end you were in need of a chamber, so you made the right call! Scary stuff indeed.

Tina

#6 WreckWench

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Posted 06 August 2012 - 10:30 AM

My read was he did 2 am dives at the mines and exerted himself with the long walk with heavy gear on back to the car. When the *soreness* issues did not respond normally he called DAN.

The dives he lists in his post are the *recompression* dives that DAN has you do to reabsorb the nitrogen back into the body. People refer to chamber rides as *dives* so it can be confusing.

Is that what you were referring too or the discomfort he felt after the first am Bonne Terre Mine dive?
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#7 libra89

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Posted 06 August 2012 - 11:26 AM

My read was he did 2 am dives at the mines and exerted himself with the long walk with heavy gear on back to the car. When the *soreness* issues did not respond normally he called DAN.

The dives he lists in his post are the *recompression* dives that DAN has you do to reabsorb the nitrogen back into the body. People refer to chamber rides as *dives* so it can be confusing.

Is that what you were referring too or the discomfort he felt after the first am Bonne Terre Mine dive?


Hmm....OK, I'd never heard trips to the chamber refered to as "dives". If that's what he meant, clears up what I was asking about. I couldn't understand why, if DAN suspected DCS, they would tell him to make more dives. Didn't make sense to me like that :) But if in fact "dives 100-104" are his chamber rides, I get it now. And that does make sense, and puts "to celebrate dive 100" into better context as well!

As for the initial soreness, I am certain I would have done the same thing he did. Work hard = feel it a little bit more than usual later on. Being one that does a lot of physical activity, some part of my body is sore a lot. It's a part of life for me. I wouldn't have been concerned at all at first. I may have noted it, and then carried on, same as he did. What a fine line to walk, really. Makes you think and really remind yourself to pay attention to your body.

Thanks for the explanation!
Tina

Edited by libra89, 06 August 2012 - 11:30 AM.

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#8 Sir Pete

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Posted 06 August 2012 - 11:46 AM

Sorry to hear of your problem also. Interesting reading but would it be possible to list the dives up to you being bent, please. My son and I did five dives there in the mine last year but we were in Dry Suits. Fascinating place. Where you down at 110ft on the Old Locomotive and for how long etc.



#9 Capn Jack

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Posted 06 August 2012 - 02:03 PM

My read was he did 2 am dives at the mines and exerted himself with the long walk with heavy gear on back to the car. When the *soreness* issues did not respond normally he called DAN.

The dives he lists in his post are the *recompression* dives that DAN has you do to reabsorb the nitrogen back into the body. People refer to chamber rides as *dives* so it can be confusing.

Is that what you were referring too or the discomfort he felt after the first am Bonne Terre Mine dive?


Hmm....OK, I'd never heard trips to the chamber refered to as "dives". If that's what he meant, clears up what I was asking about. I couldn't understand why, if DAN suspected DCS, they would tell him to make more dives. Didn't make sense to me like that :) But if in fact "dives 100-104" are his chamber rides, I get it now. And that does make sense, and puts "to celebrate dive 100" into better context as well!

As for the initial soreness, I am certain I would have done the same thing he did. Work hard = feel it a little bit more than usual later on. Being one that does a lot of physical activity, some part of my body is sore a lot. It's a part of life for me. I wouldn't have been concerned at all at first. I may have noted it, and then carried on, same as he did. What a fine line to walk, really. Makes you think and really remind yourself to pay attention to your body.

Thanks for the explanation!
Tina


A little read, but valuable book, is the US Navy Dive Manual. I recommend it highly for all divers who want to know more about diving.

Chapter 20 - Diagnosis and Treatment of Decompression Sickness and Arterial Gas Embolism includes details on each of the tables for treatment. Given the Navy requires a dive supervisor, two outside tenders and an inside tender, and the fact your body is experiencing the same pressures as a dive, it's not surprising they call them dives.

For all professionals, I think the manual is an essential.
Link to free USN Dive Manual
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#10 DoctorB

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Posted 06 August 2012 - 07:20 PM

Sorry to hear of your problem also. Interesting reading but would it be possible to list the dives up to you being bent, please. My son and I did five dives there in the mine last year but we were in Dry Suits. Fascinating place. Where you down at 110ft on the Old Locomotive and for how long etc.



My post was originally in the Turks and Caicos Trip thread. I referred to the chamber "dives" as dives tongue and cheek, since I was SUPPOSED to do dive 100 with Kamela as my buddy on that trip.


Here are the dives info for Sunday (My secretary told me it's what I get for skipping church Posted Image)

All dives with Nitrox 32 (except as noted), in drysuit with Argon (I was VERY comfortable, and not cold at all)

Saturday:
Dive 94: Max depth 68 feet, average depth 45 feet, duration 37 minutes, 4 min safety stop at 15-19 feet
Dive 95: Max depth 45 feet (briefly, 20 min into dive), average depth 17 feet, duration 53 minutes 2:50 surface interval, 8 minute safety stop done and last 30 mins of dive was less than 30 feet
Dive 96: (Nitrox 25%, they must have run out of O2!) Max depth 58 feet, average depth 36, 1:50 surface interval, 8 minute safety stop.

Sunday:
Dive 97: Max depth 53 feet, duration 53 minutes, 18:00 surface interval, last 25 minutes of dive at 20 feet average depth.
Dive 98: Max depth 85 feet (to locomotive, above which I hovered), average depth 57 feet, duration 33 min, 5 min safety stop at 15 feet. 1:50 surface interval
Dive 99: Max depth 56 feet, Average depth 25 feet, duration 50 mins, 4 min safety stop at 15 feet, surface interval 0:34. Of note, the deepest part of the dive was 34 minutes into the dive when we went thru a single file restriction into a room. I stayed near the rock ceiling to stay as shallow as I could, but was still about 50 feet deep for 7 minutes.

We stayed in the mine between 98 and 99.

I stayed within no deco limits on my computer (Oceanic VT4, DSAT algorithm).

Notes from my monday morning quarterbacking:

PLAN THE DIVE AND DIVE THE PLAN! We had a small group, 2 divers and one guide. Neither of us wanted to climb out of the mine between dives. I was also thinking that it was a good idea not to climb the stairs after the deep dive 98. 99 was supposed to be shallow, so we figured it'd be what amounts to a long safety stop, and went in with a short surface interval. Unfortunately the lights were burned out in the area we were supposed to dive in, so the DM changed the plan under water, and you don't want to leave the guide, lest you get lost in the mine. Then, after that dive I had to lug all my equipment out of the mine.
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#11 DoctorB

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Posted 06 August 2012 - 07:32 PM

My read was he did 2 am dives at the mines and exerted himself with the long walk with heavy gear on back to the car. When the *soreness* issues did not respond normally he called DAN.

The dives he lists in his post are the *recompression* dives that DAN has you do to reabsorb the nitrogen back into the body. People refer to chamber rides as *dives* so it can be confusing.

Is that what you were referring too or the discomfort he felt after the first am Bonne Terre Mine dive?


Hmm....OK, I'd never heard trips to the chamber refered to as "dives". If that's what he meant, clears up what I was asking about. I couldn't understand why, if DAN suspected DCS, they would tell him to make more dives. Didn't make sense to me like that :) But if in fact "dives 100-104" are his chamber rides, I get it now. And that does make sense, and puts "to celebrate dive 100" into better context as well!

As for the initial soreness, I am certain I would have done the same thing he did. Work hard = feel it a little bit more than usual later on. Being one that does a lot of physical activity, some part of my body is sore a lot. It's a part of life for me. I wouldn't have been concerned at all at first. I may have noted it, and then carried on, same as he did. What a fine line to walk, really. Makes you think and really remind yourself to pay attention to your body.

Thanks for the explanation!
Tina


For the rest of sunday and monday morning, all I had was garden variety muscle soreness. On monday, later in the day, the tingling started and I had a new deep dull ache (although not very bad) in the shoulders. The concerning thing was as the the muscle aches were getting better, and the new symptoms were not. I got up tuesday and it was no better, so I got over my denial and called DAN, and they sent me to a local chamber.

One of the problems with DCS is that the symptoms can be vague, non-specific and subtle. Sometimes the only way to know is to go into the chamber and see if they get better, which they did quickly in my case.

I did learn that the chamber is nothing to fear, and it's better to be sure, since delayed treatment can make the difference between being able to dive again or not. The doc who treated me told me about another patient who delayed treatment, and not only couldn't dive, but got bent when flying. Long story short, he can't even even FLY any more.
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#12 Greg@ihpil

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Posted 06 August 2012 - 08:29 PM

Hi, Doc, B T is a challenge with the steep climb down & back up. I agree.Was there in Jan 2012.Did you get to the chamber in Bonn Terre?Or did you make it home & go to Lutheran Gen'l up here?
This hit's home since I just finished my Rescue class a couple of weeks ago.I agree with Tina's comment .It might be hard to distinguish a ache to the dcs hit.
Take care.
Greg
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#13 WreckWench

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Posted 07 August 2012 - 05:15 AM

I want to extend a very special :thankyou: to Charles who is actually a Doctor to have taken so much time and effort to respond in such a detailed fashion to our inquiries. I moved this to our "Diving & Health" forum from the T&C trip thread so that EVERYONE would be able to benefit and not just those on the T&C trip. I am also hoping as Doctor B's interest and knowledge in diving/diving medicine continues that he will regularly contribute to this forum with tidbits of knowledge and insight he has discovered. :respect:

And I have also discovered those funny looking + and - signs at the bottom of each post mean "like" and "dislike" so I have hit "like" or + on all DoctorB's posts in this thread. :cool1:
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#14 DoctorB

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Posted 07 August 2012 - 07:09 PM

Hi, Doc, B T is a challenge with the steep climb down & back up. I agree.Was there in Jan 2012.Did you get to the chamber in Bonn Terre?Or did you make it home & go to Lutheran Gen'l up here?
This hit's home since I just finished my Rescue class a couple of weeks ago.I agree with Tina's comment .It might be hard to distinguish a ache to the dcs hit.
Take care.
Greg


Congrats on finishing your Rescue Class.

I drove home from Bonne Terre immediately after the last dive. Got home later in the evening, and threw all my equipment in the bathtub for later cleanup. The symptoms started the next day, so I was treated near home.

It can be hard to distinguish a hit from symptoms that may just be from a day of diving and weekend warrior exertion. It points to a need to stay in shape in general, so you don't get sore in the first place.

Having experienced both soreness after a dive and DCS, I CAN say that there was something different enough about the DCS symptoms for me to say to myself that something just isn't right. I've been sore after overexerting myself enough times to know what it feels like, and this one was different. I just didn't feel good.
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#15 Sir Pete

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Posted 07 August 2012 - 10:20 PM

All dives with Nitrox 32 (except as noted), in drysuit with Argon (I was VERY comfortable, and not cold at all)


I'm impressed that you had the foresight to be using Argon!

Do we also understand that you drove home to the Windy City? How far was that and do you think the drive tired you out a bit more like the climb to the surface ? Pete

Edited by Sir Pete, 07 August 2012 - 10:20 PM.





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