This post was posted by me on a UK Diving Forum, and I have edited to meet the posting criteria for this forum. For this reason all names of centres, companies and instructors have been removed.
Bend on the Zen - October 2010
As some of you will have known, I went on a family holiday to Paphos, Cyprus on the 10th of Oct for a fortnight in which I was going to do some diving. Ended up doing 10 dives in total over the week though I'll post a trip report of the rest of the dives later.
The last dives of the holiday was day trip to the Zenobia run by [A large Dive Centre in Paphos] on the 22nd of Oct. This comprised of a 6.45am pickup, a 1hr 30min bus trip to Larnaca before getting onboard the boat out to Zenobia, an ex-London fireboat if I remember correctly.
Briefed by guides (A [centre] Instructor and DM) on the dive. As with all the dives [centre] conducts, it was a no-deco dive which is inline with all the diving I have done so far. Nitrox had been ordered, but due to a fault with the compressor they couldn't mix it, so I ended up using air for both dives, like the rest of the party.
The two dives to plan, nothing extra-ordinary or unusual to report. I was using a Suunto Vyper computer with my buddy a Gekko. A three minute safety stop was completed on both dives, and to that point was happy as I had thoroughly enjoyed both dives, when I surfaced.
Dive 1:
Max Depth - 35.4m
Avg Depth - 20.2m
Dive Time - 36min
Surface Interval - 1hr 42min
Dive 2:
Max Depth - 29.3m
Avg Depth - 18.1m
Dive Time - 36min
My buddy and I swam to the ladder at the back of the boat, took off fins, passed them up climbed the ladder and went to the bench where we'd put our bags etc. Took kit off and wetsuit, had a drink of water and sat down waiting to be called for lunch once all the divers were back on board.
I then became aware of a pain in my upper left arm, around the bicep area (by this time 4-5 minutes had passed since surfacing). My initial thought was I must of hit it off something. I then took my rash vest off, and in the process noticed my arm was tremoring with an increasing pain.
At this point I think I really cottoned on to what it could be, so went towards the lead instructor who was standing at the front of the boat and informed him of the pain.
He said that he saw me come up, and the ascent was fine. He said he didn't think it was anything of concern, but to go and grab some food, he'd keep an eye on me and if I felt anything else to tell him immediately.
I then returned to the bench and sat down. I picked up a bottle of water in my left hand and it was shaking like heck.
I then feel a wave of nauseousness come over me and drink water to try and counter this.
Almost immediately after that my vision starts to go blurry. I thought I'd maybe looked directly the sun, so started blinking to try and clear it.
At this point the instructor, who had followed me back to where I was sitting asked what was wrong. I informed him of my blurred vision and was put on o2 immediately.
I was told to lay on my back on the bench and breathe the o2 and drink lots of water.
Had water bottle passed to me, and it was continuously topped off so I have no idea how much water I drank, but it was lots. A tingling developed in my right fingers.
From what I can understand during that time:
[Large Centre in Larnaca] was called to sort out the chamber and I think they sorted the ambulance as well
[Instructor] called the boss of [Paphos Dive Centre] to alert him of what was going on
Boat captain was informed.
I was then switched from [Paphos Dive Centre]'s o2 kit, to the boats which was a continuous flow mask connected to a J-bottle.
I was getting slightly cold so put dry t-shirt on.
I told the DM where my computer was, and got him to stick it on my wrist.
At this point the boat was back in harbour (as per normal) and most people from other dive schools had sorted their stuff ready to go and left. (I was waiting for ambulance.)
The other customers from [Paphos Dive Centre] were told to wait upstairs whilst DM and instructor dealt with me.
When the ambulance arrived it came right along the pier. I got on board with the DM carrying my rucksack. English speaking nurse on board, and was put on the ambulances o2. Taken to [Local Larnaca Hospital] emergency room.
Asked name
dob
depth of dives
Insurance? Do you have insurance?
Err, yes
Where are details of insurance?
Back in pathos
Who can we call for them?
Call [Owner of Paphos Dive Centre] he will speak to my parents (who I was on the holiday with)
Nurse put saline drip in and got blood sample
Assessed by [Hyperbaric and Cardiologist Consultant] (who I found out later was brought in specifically for me)
Where was pain?
Tested reflexes
Brush parts of body on either side to compare strengths etc.
I was then taken in wheelchair to x-ray room to get an x-ray of chest (lungs). I am presuming this was to check I didn't have any lung damage after the dive. The x-ray was quickly inspected by [doctor], before I got wheeled back out to the ambulance for the short trip to the hyperbaric centre.
Taken by ambulance to the [privately owned Hyperbaric Centre in Larnaca]
[Doctor] had driven there himself to the centre and met me there along with chamber operator and tender.
I was then taken into an examination room for blood pressures etc. Given hyperbaric clothes to wear (non-static clothes) which I got changed into. Then [Chamber Operator], originally from the Britain, came in to get details of insurance. I didn't have these with me, but gave them my parents number. Luckily they were back at the appt we were staying at, and could provide me with the travel insurance policy number and also contact number for the insurance company. My eu medical card number was also to hand, but wasn't wanted. I then handed phone over to [chamber operator] to continue speaking with them. My dad then asked to speak to the Dr. Didn't hear convo, but apparently it was along the lines of him saying, I authorise any treatment, now hurry up and put him in the chamber.
As Dr. put it, treatment couldn't start until the paperwork was done. And by this I can safely assume meant that the insurance company would authorise the treatment. Once insurance company said they would cover it I was taken into chamber for treatment.
4Hr 50 on USN table 6.
5mins down to depth
20mins airbreak
20mins
so on
Symptoms improved slowly over the time and by the end had improved greatly
My parents arrived at the medical centre quite near end of treatment, having hired a car to get from Paphos to Larnaca (about 1hr 30min drive.)
At around 9 or 10pm my treatment was finished. My drip was temporarily disconnected something was injected into it to stop it clotting.
I was then taken by [doctor] in his car (nice sporty BMW) back to [Larnaca private hospital] where I was staying the night for observation.
Nice ward only two beds in it, of which I was the only one. They were the fancy beds with all the electrics in them as well (which I didn't spend hours playing with). The room was ensuite and had a tv also which is great if you understand Greek.
Put on multi-vitamin saline drip and was brought soup later on, which I appreciated since I hadn't eaten since breakfast. Well actually I lie, I was given 3 go-ahead biscuits in the chamber, but apart from that - nothing.
Woken next morning at 6.50. Given breakfast
Drifted back to sleep
Vitals taken by nurse
[Doctor] visited near 10am taken back to hyperbaric unit
The drip was removed.
Went into chamber for USN table 5 (2 1/2hours in chamber)
Same tender, Same operator
It seemed to go quicker, as there were only 3 air breaks
Assessment once done, paperwork was prepared for discharge. Among the conditions of discharge, was no pressure for 72 hours. This meant I couldn't fly back on the scheduled flight on the Sunday. And as the insurance company only covered 1 person to stay with me, and last minute are expensive, my dad flew back on the Sunday with my mum and I staying on til at least Tuesday.
After several phone calls insurance company sorted the extension of the accommodation for us, flights and taxi. Won't go into too much detail but on the way home went:
Paphos>Taxi (1hr 30mins) > Larnaca Airport>London Heathrow>Glasgow Airport>Taxi(3hours)>Aberdeen
Luggage got lost in Heathrow because, well it's Heathrow and we were transfer passengers. What do you expect?
Got back to Aberdeen at 3am on the Wednesday.
At noon had an appointment with the Hyperbaric chamber in Aberdeen where I got checked out.
Luckily didn't have to go back in the pot, and they were happy with the treatment was given in Cyprus. I have been referred to a cardiologist I think it is, for a bubble (PFO) test and am awaiting an appointment for that though I have no idea of timescale.
Conclusion
Make sure you have insurance. You can't afford not to! My treatment, flights, accommodation has cost the insurance company damn near 20'000EUR. It doesn't bear thinking about what would happen if I didn't have it!
Why did the bend happened? I don't know.
Both dive profiles were fine and checked at the chamber in Larnaca. I can't dive for at least 6 weeks, maybe longer, maybe never, depending on the results of the PFO test. That is, if I wanted to, which I'm not decided upon yet. We'll see what the future holds.
Matty
And after proof reading that, I noticed it it maybe a little too detailed but hopefully someone can make use of it!
UPDATE
13th December 2010
My echocardiogram took place earlier today at [local hospital in Aberdeen], conducted by [echocardiologist]
He looked at my heart from several different angles and from inital inspection thought it to be healthy.
He then proceeded to inject a bubbled saline solution into a vein in my arm whilst I did a variety of things, coughing, snorting, equalising ears etc, to raise the pressure differential between the chambers of the heart whilst he observe the path of the bubbles.
Thankfully on no occasion did any of the bubbles cross the chambers of the heart (ie. no PFO was found) so my heart has been given a clean bill of health.
Now all I need to do is get my diving medical form approved by a medical referee, then I can return to the water which will hopefully happen in the near future.
UPDATE
Medical Referee Signs off Diving Medical Form
To date (27/1/11) I have conducted 3 sucessful dives post-bend and hopefully it won't have any further impact on my diving.
Bend on the Zen - October 2010
As some of you will have known, I went on a family holiday to Paphos, Cyprus on the 10th of Oct for a fortnight in which I was going to do some diving. Ended up doing 10 dives in total over the week though I'll post a trip report of the rest of the dives later.
The last dives of the holiday was day trip to the Zenobia run by [A large Dive Centre in Paphos] on the 22nd of Oct. This comprised of a 6.45am pickup, a 1hr 30min bus trip to Larnaca before getting onboard the boat out to Zenobia, an ex-London fireboat if I remember correctly.
Briefed by guides (A [centre] Instructor and DM) on the dive. As with all the dives [centre] conducts, it was a no-deco dive which is inline with all the diving I have done so far. Nitrox had been ordered, but due to a fault with the compressor they couldn't mix it, so I ended up using air for both dives, like the rest of the party.
The two dives to plan, nothing extra-ordinary or unusual to report. I was using a Suunto Vyper computer with my buddy a Gekko. A three minute safety stop was completed on both dives, and to that point was happy as I had thoroughly enjoyed both dives, when I surfaced.
Dive 1:
Max Depth - 35.4m
Avg Depth - 20.2m
Dive Time - 36min
Surface Interval - 1hr 42min
Dive 2:
Max Depth - 29.3m
Avg Depth - 18.1m
Dive Time - 36min
My buddy and I swam to the ladder at the back of the boat, took off fins, passed them up climbed the ladder and went to the bench where we'd put our bags etc. Took kit off and wetsuit, had a drink of water and sat down waiting to be called for lunch once all the divers were back on board.
I then became aware of a pain in my upper left arm, around the bicep area (by this time 4-5 minutes had passed since surfacing). My initial thought was I must of hit it off something. I then took my rash vest off, and in the process noticed my arm was tremoring with an increasing pain.
At this point I think I really cottoned on to what it could be, so went towards the lead instructor who was standing at the front of the boat and informed him of the pain.
He said that he saw me come up, and the ascent was fine. He said he didn't think it was anything of concern, but to go and grab some food, he'd keep an eye on me and if I felt anything else to tell him immediately.
I then returned to the bench and sat down. I picked up a bottle of water in my left hand and it was shaking like heck.
I then feel a wave of nauseousness come over me and drink water to try and counter this.
Almost immediately after that my vision starts to go blurry. I thought I'd maybe looked directly the sun, so started blinking to try and clear it.
At this point the instructor, who had followed me back to where I was sitting asked what was wrong. I informed him of my blurred vision and was put on o2 immediately.
I was told to lay on my back on the bench and breathe the o2 and drink lots of water.
Had water bottle passed to me, and it was continuously topped off so I have no idea how much water I drank, but it was lots. A tingling developed in my right fingers.
From what I can understand during that time:
[Large Centre in Larnaca] was called to sort out the chamber and I think they sorted the ambulance as well
[Instructor] called the boss of [Paphos Dive Centre] to alert him of what was going on
Boat captain was informed.
I was then switched from [Paphos Dive Centre]'s o2 kit, to the boats which was a continuous flow mask connected to a J-bottle.
I was getting slightly cold so put dry t-shirt on.
I told the DM where my computer was, and got him to stick it on my wrist.
At this point the boat was back in harbour (as per normal) and most people from other dive schools had sorted their stuff ready to go and left. (I was waiting for ambulance.)
The other customers from [Paphos Dive Centre] were told to wait upstairs whilst DM and instructor dealt with me.
When the ambulance arrived it came right along the pier. I got on board with the DM carrying my rucksack. English speaking nurse on board, and was put on the ambulances o2. Taken to [Local Larnaca Hospital] emergency room.
Asked name
dob
depth of dives
Insurance? Do you have insurance?
Err, yes
Where are details of insurance?
Back in pathos
Who can we call for them?
Call [Owner of Paphos Dive Centre] he will speak to my parents (who I was on the holiday with)
Nurse put saline drip in and got blood sample
Assessed by [Hyperbaric and Cardiologist Consultant] (who I found out later was brought in specifically for me)
Where was pain?
Tested reflexes
Brush parts of body on either side to compare strengths etc.
I was then taken in wheelchair to x-ray room to get an x-ray of chest (lungs). I am presuming this was to check I didn't have any lung damage after the dive. The x-ray was quickly inspected by [doctor], before I got wheeled back out to the ambulance for the short trip to the hyperbaric centre.
Taken by ambulance to the [privately owned Hyperbaric Centre in Larnaca]
[Doctor] had driven there himself to the centre and met me there along with chamber operator and tender.
I was then taken into an examination room for blood pressures etc. Given hyperbaric clothes to wear (non-static clothes) which I got changed into. Then [Chamber Operator], originally from the Britain, came in to get details of insurance. I didn't have these with me, but gave them my parents number. Luckily they were back at the appt we were staying at, and could provide me with the travel insurance policy number and also contact number for the insurance company. My eu medical card number was also to hand, but wasn't wanted. I then handed phone over to [chamber operator] to continue speaking with them. My dad then asked to speak to the Dr. Didn't hear convo, but apparently it was along the lines of him saying, I authorise any treatment, now hurry up and put him in the chamber.
As Dr. put it, treatment couldn't start until the paperwork was done. And by this I can safely assume meant that the insurance company would authorise the treatment. Once insurance company said they would cover it I was taken into chamber for treatment.
4Hr 50 on USN table 6.
5mins down to depth
20mins airbreak
20mins
so on
Symptoms improved slowly over the time and by the end had improved greatly
My parents arrived at the medical centre quite near end of treatment, having hired a car to get from Paphos to Larnaca (about 1hr 30min drive.)
At around 9 or 10pm my treatment was finished. My drip was temporarily disconnected something was injected into it to stop it clotting.
I was then taken by [doctor] in his car (nice sporty BMW) back to [Larnaca private hospital] where I was staying the night for observation.
Nice ward only two beds in it, of which I was the only one. They were the fancy beds with all the electrics in them as well (which I didn't spend hours playing with). The room was ensuite and had a tv also which is great if you understand Greek.
Put on multi-vitamin saline drip and was brought soup later on, which I appreciated since I hadn't eaten since breakfast. Well actually I lie, I was given 3 go-ahead biscuits in the chamber, but apart from that - nothing.
Woken next morning at 6.50. Given breakfast
Drifted back to sleep
Vitals taken by nurse
[Doctor] visited near 10am taken back to hyperbaric unit
The drip was removed.
Went into chamber for USN table 5 (2 1/2hours in chamber)
Same tender, Same operator
It seemed to go quicker, as there were only 3 air breaks
Assessment once done, paperwork was prepared for discharge. Among the conditions of discharge, was no pressure for 72 hours. This meant I couldn't fly back on the scheduled flight on the Sunday. And as the insurance company only covered 1 person to stay with me, and last minute are expensive, my dad flew back on the Sunday with my mum and I staying on til at least Tuesday.
After several phone calls insurance company sorted the extension of the accommodation for us, flights and taxi. Won't go into too much detail but on the way home went:
Paphos>Taxi (1hr 30mins) > Larnaca Airport>London Heathrow>Glasgow Airport>Taxi(3hours)>Aberdeen
Luggage got lost in Heathrow because, well it's Heathrow and we were transfer passengers. What do you expect?
Got back to Aberdeen at 3am on the Wednesday.
At noon had an appointment with the Hyperbaric chamber in Aberdeen where I got checked out.
Luckily didn't have to go back in the pot, and they were happy with the treatment was given in Cyprus. I have been referred to a cardiologist I think it is, for a bubble (PFO) test and am awaiting an appointment for that though I have no idea of timescale.
Conclusion
Make sure you have insurance. You can't afford not to! My treatment, flights, accommodation has cost the insurance company damn near 20'000EUR. It doesn't bear thinking about what would happen if I didn't have it!
Why did the bend happened? I don't know.
Both dive profiles were fine and checked at the chamber in Larnaca. I can't dive for at least 6 weeks, maybe longer, maybe never, depending on the results of the PFO test. That is, if I wanted to, which I'm not decided upon yet. We'll see what the future holds.
Matty
And after proof reading that, I noticed it it maybe a little too detailed but hopefully someone can make use of it!
UPDATE
13th December 2010
My echocardiogram took place earlier today at [local hospital in Aberdeen], conducted by [echocardiologist]
He looked at my heart from several different angles and from inital inspection thought it to be healthy.
He then proceeded to inject a bubbled saline solution into a vein in my arm whilst I did a variety of things, coughing, snorting, equalising ears etc, to raise the pressure differential between the chambers of the heart whilst he observe the path of the bubbles.
Thankfully on no occasion did any of the bubbles cross the chambers of the heart (ie. no PFO was found) so my heart has been given a clean bill of health.
Now all I need to do is get my diving medical form approved by a medical referee, then I can return to the water which will hopefully happen in the near future.
UPDATE
Medical Referee Signs off Diving Medical Form
To date (27/1/11) I have conducted 3 sucessful dives post-bend and hopefully it won't have any further impact on my diving.
