Stage 2 hit, no diving for 6 months

[farsidefan1]

Recently in Coz (August) I took a stage 2 deco hit. After 5 hours 48 minutes in chamber that night then another 3 hours the next day the doctor advised me not to dive for 6 months. When I explained I had scheduled the manta dive in Hawaii for November he relented and ok'ed me for the one dive as it is very shallow.
My question is this, is it a fairly normal consequence of taking a hit to not be allowed to dive for an extended period of time? I am taking the doctors advise of course. He was VERY knowldgeable. I am just sort of wondering about my suceptability to future hits. Am I forever more vulnerable etc. My next trip is cocoview in June and I normally put in 4 dives most days and 5 when I go for a night dive. He also suggested that might be a bit excessive. This was my first experience with a hit so any input would be appreciated. Thanks

 

[Cave Diver]

Recently in Coz (August) I took a stage 2 deco hit. After 5 hours 48 minutes in chamber that night then another 3 hours the next day the doctor advised me not to dive for 6 months. When I explained I had scheduled the manta dive in Hawaii for November he relented and ok'ed me for the one dive as it is very shallow.
My question is this, is it a fairly normal consequence of taking a hit to not be allowed to dive for an extended period of time? I am taking the doctors advise of course. He was VERY knowldgeable. I am just sort of wondering about my suceptability to future hits. Am I forever more vulnerable etc. My next trip is cocoview in June and I normally put in 4 dives most days and 5 when I go for a night dive. He also suggested that might be a bit excessive. This was my first experience with a hit so any input would be appreciated. Thanks

I'm not a Doctor and I haven't stayed in a Holiday Inn recently, but I'll throw a couple things out there. I'm assuming by "stage 2" you're referring to type II DCS.

Type II DCS is more neurological related as opposed to Type I, which is musculoskelatal. Type II has been linked to medical conditions such as a PFO, so my first question would be whether or not you've been checked for that.

Information about your dive profiles leading to this event could also be relevant. Depth, time, previous dives, ascent rate, nitrox, etc.

I've read that people are more predisposed to DCS after a hit.

Another good source would be to check with DAN if you havent done so already.

 

[farsidefan1]

Thanks cave, I had a thorough checkup each day after my 2 visits to the chamber. The doc had me stay in the hospital till after the second 3 hour chamber visit. I recounted the dive details back in August. I never violated my computer (smartcom, uatek) so we came to the conclusion that dehydration was the culprit. (post was titled hydration hydration hydration) Now I have been out of the water for 8 weeks I'm getting a bit stir crazy so my primary concerns were 1) does 6 months sound about right and 2) is there anything definitive about whether or not I'm forever more vulnerable?
I did have neurological involvement. I read another post about how long to wait but the answer involved some technical terminology about stages of treatment which went directly over my head (but I'm sure it was very clear to most). As I said, my treatment was 5 hours 48 minutes (starting at midnight - within and hour of symtoms) followed later the next day by about 3 hours. Then daily checkups the next 4 days to get clearance to fly home. Other than signifigant weakness (I'm still not all the way back on my mountain bike) I'm fine and symptom free now.

 

[japan-diver]

How long you stay out after a DCS hit will vary from doctor to doctor. 6 months seems to be about the average I have seen. I would definitely put it off until I was at 100% recovery although others will also argue with this. There is no evidence that getting a hit will make you more susceptible to another one although it has been theorized by various docs but mostly discounted. A type II hit does not mean PFO. Was this a spinal hit? Many docs will suggest not diving again after a spinal hit.

 

[Thalassamania]

The standard within the scientific diving community is that if you are ever bent, for whatever reason, your diving career has just come to an abrupt end.

 

[Cave Diver]

Thanks cave, I had a thorough checkup each day after my 2 visits to the chamber. The doc had me stay in the hospital till after the second 3 hour chamber visit. I recounted the dive details back in August. I never violated my computer (smartcom, uatek) so we came to the conclusion that dehydration was the culprit. (post was titled hydration hydration hydration)

Here is the original recount of information: http://www.scubaboard.com/forums/4647787-post1.html

 

[TSandM]

The standard within the scientific diving community is that if you are ever bent, for whatever reason, your diving career has just come to an abrupt end.

On what objective evidence is this policy based?

 

[Kevrumbo]

Sounds like an AAUS Policy Issue:

Conditions Which May Disqualify Candidates From Diving (Adapted from Bove, 1998)
a) Abnormalities of the tympanic membrane, such as perforation, presence of a monomeric
membrane, or inability to auto inflate the middle ears.
b) Vertigo including Meniere’s Disease.
c) Stapedectomy or middle ear reconstructive surgery.
d) Recent ocular surgery.
e) Psychiatric disorders including claustrophobia, suicidal ideation, psychosis, anxiety
states, untreated depression.
f) Substance abuse, including alcohol.
g) Episodic loss of consciousness.
h) History of seizure.
i) History of stroke or a fixed neurological deficit.
j) Recurring neurologic disorders, including transient ischemic attacks.
k) History of intracranial aneurysm, other vascular malformation or intracranial
hemorrhage.
l) History of neurological decompression illness with residual deficit.
m) Head injury with sequelae.
n) Hematologic disorders including coagulopathies.
o) Evidence of coronary artery disease or high risk for coronary artery disease.
p) Atrial septal defects.
q) Significant valvular heart disease - isolated mitral valve prolapse is not disqualifying.
r) Significant cardiac rhythm or conduction abnormalities.
s) Implanted cardiac pacemakers and cardiac defibrillators (ICD).
t) Inadequate exercise tolerance.
u) Severe hypertension.
v) History of spontaneous or traumatic pneumothorax.
w) Asthma.
x) Chronic pulmonary disease, including radiographic evidence of pulmonary blebs, bullae
or cysts.
y) Diabetes mellitus.
z) Pregnancy.

http://data.memberclicks.com/site/aaus/AAUS_Nov_2006.pdf

 

[Thalassamania]

On what objective evidence is this policy based?

It is history, tradition and anecdote. It does back to the beginning, I think that the thought process went like this, if someone is bent while inside the table they have a propensity for bends, if someone is bent outside the tables they are reckless, or careless, or whatever, in either case the institution does not want to take the risk of having this person continue to dive under auspices. We know more about bends now then we did when the rule was made, however the only case I know of in which a previously bent diver went the route of collecting second, third, fourth, ad infinitum medical opinions to regain diver status rather quickly turned up bent a second time.

I don't know that the rule is fair, or reasonable, or scientific ... but we do have a DCS rate that is an order of magnitude better than recreational divers and that is two orders of magnitude better than commercial divers.

Good to have you guys back, you've been missed.

 

[tc]

The important question is- Did they determine WHY you got hit.

If you exceeded the tables for whatever reason then the basis for the problem is known- probably not as significant an issue to return to diving (but within the limits).

If the reason for the hit ISN'T clear then some additional medical follow up may be in order to determine if there may be medical issue that caused or contributed to it.