Bizarre effects after diving - reasons?

[idocsteve]

Are you taking any other prescription, OTC, or homeopathic meds?

"homeopathic medication" is an oxymoron.

 

[gcs118]

It might be useful for you and your dive buddies to learn how to do a quick-and-dirty neurological exam. At the very least, it would be helpful for y'all to appreciate "normal" so that if this happens again you can be on top of it.

Any links or further information for this basic/field assessment?

 

[Bubbletrubble]

Any links or further information for this basic/field assessment?

There are a couple of webpages that list what should be covered in a 5 minute neuro exam on a scuba diver:

• GUE article
• DIR Explorers article

Obviously, certain parts of the exam might not be appropriate on a rocking boat at sea. Take that into consideration when conducting the exam. If the patient could not complete certain tasks, make note of it. Also, do not allow the neuro assessment to interfere with first aid efforts. Do them in parallel if possible (with first aid taking precedence).

As someone who lacks medical training, you aren't going to understand the meaning behind the various elements of exam, but that doesn't diminish the importance of your job. Your mission is to collect information and present it to the paramedic/fire/EMT team in a coherent manner during the patient hand-off. Eventually, this valuable information should make it to the medical treatment team at the hyperbaric facility or ER. To this end, it probably makes a lot of sense to create a laminated checklist and leave it in your dive bag. Write down the results of each exam on a piece of paper with time, date, and patient name noted. You may also want to write down a brief description of the dive profile and history. (This can be verified by PC download from a dive computer at a later time.) It's certainly appropriate to administer the neuro exam multiple times at regular intervals (every 30 or 60 minutes). Pay particular attention to how the exam results change over time. Add whatever additional information to the notes that you think might be helpful.

DAN sponsors a course on conducting a neuro exam for scuba divers. I haven't taken it, but others have said that it is quite helpful.

 

[gcs118]

Great links. A DAN course or two in the future might be a good idea as well. Thanks for the tips.

 

[Cruisin Home]

anyone interested in PFO related issues might want to look at a post I put up on the last page of the Denisegg incident on the accident forum. Good research linking PFO and susceptibility to High Altitude Pulmonary Edema (PE).

knowing how to conduct a basic Neuro exam is a great thing to know in life even outside of diving.

 

[SeaHorse81]

Why did I choose to dive on Sunday? Looking back now, I don't know. I assumed it was dehydration/sun/exhaustion and never once thought it could be something more serious until a few days later. My buddy who I mentioned my symptoms to didn't think it was serious either. I felt much better in the morning (minor headache only if I shook my head back and forth), so I dove.

I read an excellent article on DCS in Dive Training a few years ago, in which they highlighted the mistakes most often made by people experiencing it. Two of the biggest are shown in the quote above: denial that one could have something serious like DCS happening, and consulting fellow divers rather than trained medical personnel. I think these mistakes stuck with me because I could so easily see myself making them, and your story is a good demonstration of them in action. What the article left me with, and what your story reinforces for me is that when in doubt, call DAN immediately. I think they'd really rather you call with a false alarm than call a bit behind the curve in an emergency.

Thanks for your post; it will help me stay safer, and I'm really glad it worked out okay for you.

 

[gcs118]

An update after diving today...

Two beautiful dives off the North Carolina coast in an ocean like glass. No return of symptoms. I did notice some things though. Sometimes I hold the reg too firmly in my mouth which results in jaw fatigue and over two dives possibly a minor headache. Paired with this, my vision is 20/30-ish so when fatigued (especially with the calm seas and sunlight constantly reflecting in my eyes) I think this results in more of a headache/difficulty with vision. Not to mention the fact that I get up at 4:30 or 5am for these dives when used to getting up at 8am.

What was different today? I thought I was entering the very first stages of what I had experienced last time, but when I went to return my tanks and wash my gear in an air-conditioned shop my head cleared right up. Absolutely no problem when cooled off and no direct sun. Additionally, on the ride home I found some cheap sunglasses and this corrected my deteriorating vision - again, I believe due to too much direct sunlight. These simple fixes today that had amazing results are hopefully indicators that my first, much more pronounced experience was merely a result of sun/fatigue/dehydration as initially suspected. Regardless, I'll be playing it safe (15-20 ft./min. ascents and 10 min. safety stops today for starters).

 

[tracydr]

Could be that you are experiencing an unusual migraine variant, especially with this past episode. If I were you, I'd be seeing a near doctor to get a definite explanation.
For the jaw pain, try one of the custom mouthpieces that you boil. Also, for the sun glare, a big hat and dark sunglasses with UV protection.
Still, a neuro appointment is important as there are so many possible causes and some can be pretty serious. Not something to blow off.

 

[Cruisin Home]

I just CT scanned a friend of mine (helps that I own an imaging company) who has complained of headaches, blurry vision, and other symptoms for several years. Finally convinced him to come in and get a scan. Found a sizable tumor (thank god it's a benign Osteoma) invading his orbit (eye) and frontal sinus. Almost broke thru into brain cavity. His outcome will be great after surgery next month. He is quite greatful.

Some people always tell me they dont want to go for checkups, tests, scans because they dont want to know. Bullcrap, you really want to know before its too late. Go get checked.

GCS: Most people dont understand the effects of just taking boat rides into ocean (sun, waves, heat, etc). It really wears you down. It's why one can get really buzzed on fewer drinks at sea, as I so often see many nutcase boaters do! I firmly believe there is a linkage between fatigue and effects of nitrogen on body, it's just common sense.

 

[idocsteve]

Found a sizable tumor (thank god it's a benign Osteoma) invading his orbit (eye) and frontal sinus. Almost broke thru into brain cavity. His outcome will be great after surgery next month. He is quite greatful.

Some people always tell me they dont want to go for checkups, tests, scans because they dont want to know. Bullcrap, you really want to know before its too late. Go get checked.

Quite often tumors in that location will show up during an eye exam if a visual field screening is done. That's a standard part of my eye exam procedure on all patients 18 and over. Most tell me they "never had that test before".