I have seen 1 diving accident this summer and unfortunately my buddy is in the hospital right now being assessed for Decompression illness. He went caving without me this weekend and went with a new diver. His experience involved a reverse squeeze on the way up. He couldn't equalize in one of his sinus cavities on the way up and waited 2 days before admiting to me he maight have a problem. Not sure what happened to him but he has excrusiating pain below his righ eye and into hi upper and lower jaw. I have been diving for 15 years and he for 10. We always practice safety but I fear he was lax with the new guy and I wasn't there to mother hen him about being safe. In your case and his it was in cold water under a moderate stress load. Do you think the cold played a major factor in both accidents?? I am interested in your opinion.
DCS? Reverse Squeeze?
- Thread starter Peat Bogg
- Start date
Please register or login
Welcome to ScubaBoard, the world's largest scuba diving community. Registration is not required to read the forums, but we encourage you to join. Joining has its benefits and enables you to participate in the discussions.
Benefits of registering include
- Ability to post and comment on topics and discussions.
- A Free photo gallery to share your dive photos with the world.
- You can make this box go away
thethumper
Guest
Well I had a really nice dive Sunday.... Right until I hit 15' for my saftey stop.
I'll start @ the beginning. I dove w/a fairly new, but well trained diver. I was not diving w/my Life long buddy Peat Bogg. We dove Orange Grove sink in Peacock State park in Florida. Good night's rest, breakfast... Got out fills & 34% in my dbl Al 80's. This was a dive for me to work out some trim issues w/new set up.
After a 3-5 min 25' dive playing w/trim we srufaced & discussed our dive. We descended to 50'+- to tie off @ the log & proceeded into the cavern. We were @ 90-95' for 35 minutes & turned on my buddies 3rds. We ascended slowly to 20' where I wanted to hang for about 25 minutes. While doing so I worked on some drills, boyancey & kicks. At the 25 minute mark I signaled to goto 10' & hold for 2 minutes. I hit 15' & started a reverse squeeze. Droped back a few feet, cleared & went to 10' for 2 minutes. Surfaced but could still feel the pressure from the squeeze. We exited the water & unrigged to head back to the shop. I felt like crap.... Head ache on right side & my jaw & teeth hurt. While @ the shot having my regs adjd. it got worse. I felt like my teeth on the right (mainly upper & lower molars) felt like they were going to explode out of my gums.
Four hours later the teeth pain subside, after Tylanol & a Valium. Monday Not too bad, but still sore jaw & headache. By noon today I called DAN & Baptist hospital were we have a HBC. They checked my out & did some films. Turns out it a "mass" in my Maxillay Sinus the size of an Aggie marble (1 1/2" dia.). Tey started me on Alergra D & some stuff like FloNaze w/a steroid in it. to help reduce the "mass".
Reradiograph in 2 weeks. If still present.... It's the suction tube for me as I understand it. I have had squeezes & reverse squeezes befor but I have NEVER before & hope to NEVER again experiance this again. I really can't explain the pain this caused. As close as I can... It felt like having all 4 upper & lower molars pulled @ once w/NO drugs. I'll try to scan the radiographs on Thursday or Friday, if anyone is interested. I'll try to keep ya posted. Sorry so long winded.
Thank the Lord it didn't require the chamber.
Thanks,
David
I'll start @ the beginning. I dove w/a fairly new, but well trained diver. I was not diving w/my Life long buddy Peat Bogg. We dove Orange Grove sink in Peacock State park in Florida. Good night's rest, breakfast... Got out fills & 34% in my dbl Al 80's. This was a dive for me to work out some trim issues w/new set up.
After a 3-5 min 25' dive playing w/trim we srufaced & discussed our dive. We descended to 50'+- to tie off @ the log & proceeded into the cavern. We were @ 90-95' for 35 minutes & turned on my buddies 3rds. We ascended slowly to 20' where I wanted to hang for about 25 minutes. While doing so I worked on some drills, boyancey & kicks. At the 25 minute mark I signaled to goto 10' & hold for 2 minutes. I hit 15' & started a reverse squeeze. Droped back a few feet, cleared & went to 10' for 2 minutes. Surfaced but could still feel the pressure from the squeeze. We exited the water & unrigged to head back to the shop. I felt like crap.... Head ache on right side & my jaw & teeth hurt. While @ the shot having my regs adjd. it got worse. I felt like my teeth on the right (mainly upper & lower molars) felt like they were going to explode out of my gums.
Four hours later the teeth pain subside, after Tylanol & a Valium. Monday Not too bad, but still sore jaw & headache. By noon today I called DAN & Baptist hospital were we have a HBC. They checked my out & did some films. Turns out it a "mass" in my Maxillay Sinus the size of an Aggie marble (1 1/2" dia.). Tey started me on Alergra D & some stuff like FloNaze w/a steroid in it. to help reduce the "mass".
Reradiograph in 2 weeks. If still present.... It's the suction tube for me as I understand it. I have had squeezes & reverse squeezes befor but I have NEVER before & hope to NEVER again experiance this again. I really can't explain the pain this caused. As close as I can... It felt like having all 4 upper & lower molars pulled @ once w/NO drugs. I'll try to scan the radiographs on Thursday or Friday, if anyone is interested. I'll try to keep ya posted. Sorry so long winded.
Thank the Lord it didn't require the chamber.
Thanks,
David
The Pirate
Contributor
- Messages
- 101
- Reaction score
- 0
Man, thats one really big booger you got there.
ut: I'd go for the suction and get it out of there asap. You'll feel a whole lot better after.The Pirate
The Iceni
Medical Moderator
Hi Peter,
Thanks for your good wishes.
Yes indeed, hypothermia is a killer.
Although divers use environmental suits we are not totally protected from heat loss and hypothermia is very dangerous because we become less able to cope. Indeed humans become quite euphoric before they succumb. In my opinion hypothermia is as bad as narcosis. In the dim and distant past I learned to dive with a home-made 4mm wetsuit and now realise I was frequently hypothermic at the end of a day's diving in the Atlantic Ocean but worryingly I seldom felt cold or shivered, particularly when submerged.
The second factor is that cold is a stressor and stress is a factor in CNS oxygen toxicity. (Perhaps hypothermia itself is also causative??) I have little doubt that it was stressful for me to practice that CBL and maybe that was just enough to tip the balance in my case.
It is certainly much less stressful to dive with a regular, experienced, buddy.
As for your own buddy, it sounds like he may have suffered from a blown sinus - a form of sinus barotrauma, but of course I do not have access to a proper history or scan results. I cannot think how the cold could have had a bearing on that.
I do hope he soon recovers.
Why temperature should have any effect on sinus and/or ear clearing I don't know. I do know that in my case there is an inverse relationship between water temp and the likelihood of clearing difficulty - the lower the water temp, the more likely the problem.
Rick
The Iceni
Medical Moderator
Hi Rick,
From the perspective of a physiologist I can now think of a possible reason. As you know, inhaled air is warmed by the blood-rich mucosal lining of the nasal turbinates.
Just as there exist reflexes adjusting the circulation to the skin according to temperature there may exist a reflex affecting circulation to the nasal (and orofacial?) mucus membranes. It would seem logical for this mucosa to become engorged with more blood when it is cold, the bettter for heat transfer from this blood to warm the inhaled air.
If such a reflex does exist (and I admit I do not know whether it does or not) it would explain my common experience of a frequently blocked nose in winter and your own clearing difficulties, all of which could be due to the engorged membranes obstructing the lower opening of the eustachian tubes and the foramina of the sinuses.
The fact that sudafed helps confirms that sympathetic nerves are involved in some way at least.
thethumper
Guest
The Pirate once bubbled...
Man, thats one really big booger you got there.
The Pirate
Man... That's just not right. If only it's that easy. I can only hope. I'm ready for 'em to get this thing out. It's still got the right side of my face swollen. Kind of an improvement.
But really... The pressure now is still nearly unbareable.What concerns me the most is... What the hell is it. They will most likely do a histopathology on it. Say a little prayer it's nothing more than a big booger.
thethumper
Guest
Hey Dr. Paul... Hope you are doing well. I am Peter's friend he refered to. Here is a breakdown of what happened on Sunday.
Well I had a really nice dive Sunday.... Right until I hit 15' for my saftey stop.
I'll start @ the beginning. I dove w/a fairly new, but well trained diver. I was not diving w/my Life long buddy Peat Bogg. We dove Orange Grove sink in Peacock State park in Florida. Good night's rest, breakfast... Got out fills & 34% in my dbl Al 80's. This was a dive for me to work out some trim issues w/new set up.
After a 3-5 min 25' dive playing w/trim we surfaced & discussed our dive. We descended to 50'+- to tie off @ the log & proceeded into the cavern. We were @ 90-95' for 35 minutes & turned the dive on my buddies 3rds. We ascended slowly to 20' where I wanted to hang for about 25 minutes. While doing so I worked on some drills, boyancey & kicks. At the 25 minute mark I signaled to goto 10' & hold for 2 minutes. I hit 15' & started feeling a reverse squeeze. Droped back a few feet, cleared & went to 10' for 2 minutes. Surfaced but could still feel the pressure from the squeeze. We exited the water & unrigged to head back to the shop. I felt like crap.... Head ache on right side & my jaw & teeth hurt. While @ the shop having my regs adjusted, it got worse. I felt like my teeth on the right (mainly upper & lower molars) felt like they were going to explode out of my gums.
Four hours later the teeth pain subsided a bit, after Tylanol & a Valium. Monday, not too bad, but still sore jaw & headache. By noon Tuesday I called DAN & Baptist hospital were we have a HBC. They checked my out & did some films. Turns out it a "mass" in my Maxillay Sinus the size of an Aggie marble (1 1/2" dia.). They started me on Alergra D & some BecoNaze w/a steroid in it. to help reduce the "mass".
Reradiograph in 2 weeks. If still present.... It's the suction tube for me as I understand it. I have had squeezes & reverse squeezes before, but I have NEVER before & hope to NEVER experiance this again. I really can't explain the pain this caused. As close as I can... It felt like having all 4 upper & lower molars pulled @ once w/NO drugs. I'll try to scan the radiographs on Friday, if anyone is interested. I'll try to keep ya posted. Sorry so long winded.
Thank the Lord it didn't require the chamber.
Thanks,
David
__________________
Well I had a really nice dive Sunday.... Right until I hit 15' for my saftey stop.
I'll start @ the beginning. I dove w/a fairly new, but well trained diver. I was not diving w/my Life long buddy Peat Bogg. We dove Orange Grove sink in Peacock State park in Florida. Good night's rest, breakfast... Got out fills & 34% in my dbl Al 80's. This was a dive for me to work out some trim issues w/new set up.
After a 3-5 min 25' dive playing w/trim we surfaced & discussed our dive. We descended to 50'+- to tie off @ the log & proceeded into the cavern. We were @ 90-95' for 35 minutes & turned the dive on my buddies 3rds. We ascended slowly to 20' where I wanted to hang for about 25 minutes. While doing so I worked on some drills, boyancey & kicks. At the 25 minute mark I signaled to goto 10' & hold for 2 minutes. I hit 15' & started feeling a reverse squeeze. Droped back a few feet, cleared & went to 10' for 2 minutes. Surfaced but could still feel the pressure from the squeeze. We exited the water & unrigged to head back to the shop. I felt like crap.... Head ache on right side & my jaw & teeth hurt. While @ the shop having my regs adjusted, it got worse. I felt like my teeth on the right (mainly upper & lower molars) felt like they were going to explode out of my gums.
Four hours later the teeth pain subsided a bit, after Tylanol & a Valium. Monday, not too bad, but still sore jaw & headache. By noon Tuesday I called DAN & Baptist hospital were we have a HBC. They checked my out & did some films. Turns out it a "mass" in my Maxillay Sinus the size of an Aggie marble (1 1/2" dia.). They started me on Alergra D & some BecoNaze w/a steroid in it. to help reduce the "mass".
Reradiograph in 2 weeks. If still present.... It's the suction tube for me as I understand it. I have had squeezes & reverse squeezes before, but I have NEVER before & hope to NEVER experiance this again. I really can't explain the pain this caused. As close as I can... It felt like having all 4 upper & lower molars pulled @ once w/NO drugs. I'll try to scan the radiographs on Friday, if anyone is interested. I'll try to keep ya posted. Sorry so long winded.
Thank the Lord it didn't require the chamber.
Thanks,
David
__________________
Keep us posted thethumper.
I am glad you didn't have to go for a ride and I hope that everything works out OK.
Chad
I am glad you didn't have to go for a ride and I hope that everything works out OK.
Chad
Saturation
Medical Moderator
You describe a reverse squeeze, and much of the pain is sinus related, as corroborated by the "films".
It gets worse as you get older if the cause that started it all, maybe this 'mass' was smaller then, continues to grow or worsen. It could be chronically inflammed sinus mucosa or even a sinus cyst.
The definitive way to find out is a biopsy. However, if decongestants and steroids reduce the size of the mass noticeably by X-ray, CT or MRI, a rapid change is size suggests its primary component is inflammatory, and one could take medications to control this without surgery.
Granted temperature can play a factor, its unlikely in Luraville unless the recent cold spell in North Fl did give you a bit of sinus trouble pre-dive.
If you dove with a minor sinusitus pre-dive then it explains a lot.
If you dove without any trace of sinusitus pre-dive then its trickier.
The tricky issues is if in decompression dives, these sinuses off gas slower than your other tissues, so that they tend to flare up during deco dives. You may need to adjust your deco schedule and prolong the 20' stop and even do a 10' stop, and see if that helps. Other possibilities include medicating yourself with steroid sprays and decongestants a week before the dive, then stop decongestants 1-2 days pre-dive to remove its potential risk for oxtox.
It gets worse as you get older if the cause that started it all, maybe this 'mass' was smaller then, continues to grow or worsen. It could be chronically inflammed sinus mucosa or even a sinus cyst.
The definitive way to find out is a biopsy. However, if decongestants and steroids reduce the size of the mass noticeably by X-ray, CT or MRI, a rapid change is size suggests its primary component is inflammatory, and one could take medications to control this without surgery.
Granted temperature can play a factor, its unlikely in Luraville unless the recent cold spell in North Fl did give you a bit of sinus trouble pre-dive.
If you dove with a minor sinusitus pre-dive then it explains a lot.
If you dove without any trace of sinusitus pre-dive then its trickier.
The tricky issues is if in decompression dives, these sinuses off gas slower than your other tissues, so that they tend to flare up during deco dives. You may need to adjust your deco schedule and prolong the 20' stop and even do a 10' stop, and see if that helps. Other possibilities include medicating yourself with steroid sprays and decongestants a week before the dive, then stop decongestants 1-2 days pre-dive to remove its potential risk for oxtox.
Similar threads
