Doc Wong Getting Bent in Monterey!

[DocWong]

A question can also be raised about the decision not to use a chamber initially, but please this is NOT a criticism (I don't know anything about how an episode like this should be managed), just a question for those who deal with DCS directly. Specifically, how symptomatic does one have to be to go into the chamber versus just using oxygen? When I was in the Caymans last year, one of the people in our conference had arm numbness after one wall dive and landed in a chamber immediately. How is this decision made...do the profiles enter here, or is a good response to oxygen sufficient to watch and wait?

When Dr. Hattari released me, he said it was a variety of factors. As with most conditions it's someone's best educated guess. I'm sure there was a possibility of a relapse while I was at home, though I still put myself on oxygen anyway. I think it was the fact that the skin redness and 90% of the dizziness had resolved, that in his neurological exam, there was no positive findings. He's been at this for a very long time, so I trusted his judgement.

My arm numbness did go away after being on oxygen for 5 minutes. I'm sure if any neurological symptoms persisted, I'd have been sent to the chamber.

I don't doubt that another physician who's more conservative would have sent me to the chamber though.

 

[DocWong]

Incidentally, check the active threads about PFO in people having DCS with normal dive profiles...

Yep, the thought did enter my mind on this too, but I did have a PFO check last year after a buddy go bent. I tested negetive, but as with most tests, it's not 100% accurate. It was freaky though, to see bubbles purposefully injected into your body and seeing it on the heart scan. I was half expecting to get DCS symptoms from that test.

 

[riguerin]

Glad to hear that you're OK. What advice did the doctor give you regarding when you can dive again ? Would you change anything in the future as result of this experience ?

 

[DocWong]

Doc Wong,
Thanks for sharing your DCS experience.
It can serve as a cautionary tale for us all.
Glad that you are OK.
Mike

You're welcome!!

I'm glad to be able to continue diving. I'm now doing my safety stops on oxygen, just to be on the safe side. For any recreational dives, I do deep stops at 50% of the depth, ascending 10' per minute and then 3 at 20' and 3 at 10', then a slow race to the top and then hanging around on the surface assuming conditions will allow it.

Today I did 2 wonderful dives at Pt Lobos scootering and doing my safety stops with oxygen and with trimix 30/30 as my back gas. Max depth was 100' and still within Minimum deco. Pretty expensive though ($70 in gas).

 

[DocWong]

Doc Wong, thank you for sharing that interesting story. If memeory serves me correctly I once started a thread about pre and post dive heavy excercise not being a great idea and the possiblity that it COULD lead to DCS. Most people dismissed that.

It is very interesting that you stayed within the NDL and still got bent because of the heavy excercise/exertion you did post dive. I also found it interesting that the doctor did not give you a chamber ride to be on the safe side? Thank God you are alright, which is the most important thing.

It was common knowledge to me to not do a lot of exercise or heavy lifting post dive, but I got complacent.

As far as no chamber ride, buy the time Hattari got to me, most symptoms had gone...thank goodness!

 

[DocWong]

Glad to hear that you're OK. What advice did the doctor give you regarding when you can dive again ? Would you change anything in the future as result of this experience ?

He said take off a week.

Yes, I'm changing a lot. Primarily my attitude on preventing DCS. Not that I was unsafe before or taking any chances but I was adhearing to more conservative standards than most divers just for good measure. Like it's a good thing to do, and makes sense to me, and it's fun doing deep stops and making it a game of accurately keeping accurage buoyancy and trim while ascending...like a game.

Now I'm adhearing to more stingent safety standards because it's now very real for me to get bent unexpectedly. After doing my Fundamentals of Diving with GUE (www.gue.com), my diving changed significantly. My ascents were much slower and more conservative.

Even on my last warm water trip to Cozumel, I was always last to get back on the boat. While everyone was waiting in line to get out of the water, I was still ascending, way slower than everyone else. No one got bent and I could see that some of the divers popped up to the surface way fast in my opinion.

Still, doing over 170 dives each year is a lot of diving so being more conservative is a good thing. So after a dive, that'll be me floating on the surface taking my time and being lazy on the surface before climbing back on board with my doubles, deco, stage bottles and scooters.

Tomorrow I get to dive Pt Lobos again, this time on an X-scooter (today was on my Gavin).

 

[pilot fish]

"This last year I was able to get in over 170 dives and many of them were deco dives, deep, trimix with no inicdences. Just goes to show, you may not be able to tell how close you are to the edge. " ]] Doc Wong

Doc, helloooooooooooooo? and you were in COLD water 46* & 44*on the two dives that preceeded your hit? I'm no doctor, nor an authority on diving, but it seems your answer lies hidden right in front of you? What you describe is your dive history indicates you are not just a rec diver but very advanced and diving near the edge of deco?

Anyway, stories like yours, thank you, only reinforce how careful we all must be.

 

[paulwlee]

Doc, helloooooooooooooo? and you were in COLD water 46* & 44*on the two dives that preceeded your hit? I'm no doctor, nor an authority on diving, but it seems your answer lies hidden right in front of you? What you describe is your dive history indicates you are not just a rec diver but very advanced and diving near the edge of deco?

Yes, but the dives he did before his presumed DCS incident were a non-deco profile dives and very far from his more challenging dives. Yes, his risk of DCS is probably greater in general, but only when he engages in more advanced dives. These particular dives were not in that category, and due to the extremely controlled ascents one starts employing after getting proper tech training, I'd argue that his risk of DCS on such dives is lower than for an average rec diver, all other things being equal.
(Although it does seem that his second dive may have been a "deco" dive depending on his profile according to a PADI table. His ascent profile was still very conservative, he seems to have done MUCH more deco than say a software such as Decoplanner wants one to do for such a profile.)

Maybe coldness was a factor, too. Harry, were you cold at all?

 

[Adobo]

Yes, but the dives he did before his presumed DCS incident were a non-deco profile dives and very far from his more challenging dives. Yes, his risk of DCS is probably greater in general, but only when he engages in more advanced dives. These particular dives were not in that category, and due to the extremely controlled ascents one starts employing after getting proper tech training, I'd argue that his risk of DCS on such dives is lower than for an average rec diver, all other things being equal.
(Although it does seem that his second dive may have been a "deco" dive depending on his profile according to a PADI table. His ascent profile was still very conservative, he seems to have done MUCH more deco than say a software such as Decoplanner wants one to do for such a profile.)

Maybe coldness was a factor, too. Harry, were you cold at all?

The description of these profiles are still pretty much ambiguous. Based on the info shared, it is difficult to ascertain how close these dives were to commonly accepted "limits" for recreational diving. As an example, when Harry says he did 47 minutes at 75 ft, are we talking about a square profile or is he describing an average depth? I suspect it was an average depth. And as far as I have heard, there is a pretty big difference between 100ft for 24 mins, 50 ft for 23 mins vs. 80 ft for 24 mins, 70 ft for 23 mins. Regardless, the profile on the second dive seems on the long side. I think Harry would agree since the ascent seemed to include extra time. (Typical GUE style ascent from an 80 ft recreational dive only really requires about 6 minutes. Harry's ascent was twice as long.)

Anyway, I personally will follow this thread to see if we can learn something from it based on some of the upcoming dissection of data. I suspect it is one of those things were the conditions (water temp, dive profile, exercise post dive, less hydration than normal) all lined up just right for Harry to take a hit.

Harry, I'm glad you came out of this event relatively unscathed. And thanks for sharing the experience.

 

[Cheekymonkey]

Ty for the great post Doc, we appreciate all the details, to many posts like this are lacking the information to learn from them.