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How do I tell the difference between DCS and plain old nerve issues?

Discussion in 'Ask Dr. Decompression' started by khacken, Jul 28, 2009.

  1. khacken

    khacken Solo Diver

    # of Dives: 200 - 499
    Location: Dallas, Tx
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    This weekend I was doing a lot of valve drills and after my shoulder was achy and my hand was a little tingly. This started when I removed my gear. This would have been alarming to me but it was just a 90 minute dive to 27 feet, also when I took my anti-inflammatory prescribed to me by my doc for past shoulder nerve issues, the pain went away and I am symptom free. So I feel a hit is extremely unlikely.

    My worry is that on deeper dives, how will I know if I took a hit or not if the same symptoms occur? Should I take the anti-inflammatory and see if the issue goes away?
     
  2. Kaliber35

    Kaliber35 Barracuda

    # of Dives: 25 - 49
    Location: South Florida
    229
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    Good question. I would call DAN. Always call DAN. lol Good luck and post back the response you get from them!
     
  3. DocVikingo

    DocVikingo Senior Member Staff Member

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    Hi khacken,

    While it cannot conclusively be stated that the event described wasn't DCS, a number of factors suggest it's unlikely. These include:

    - the dive profile described, if representing total diving for a several day period, appears unlikely to have generated sufficient nitrogen loading to precipitate DCS.

    - a large number of valve drills involving the affected side of the body could explain shoulder discomfort and hand tingling on a mechanical rather than a gas phase basis.

    - bona fide DCS-related complaints of pain are very little befitted by oral anti-inflammatory medications, and certainly are not permanently resolved by them.

    Helpful?

    Regards,

    DocVikingo

    This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice to you or any other individual and should not be construed as such.
     
  4. TSandM

    TSandM Missed and loved by many.

    # of Dives:
    Location: Woodinville, WA
    36,350
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    This is not a stupid question, particularly for those of us who have various arthritic or other complaints, and are constantly evaluating some kind of post-dive discomfort.

    You can use some information to help you decide on the level of suspicion. Very shallow dives are unlikely to cause musculoskeletal DCS. Long, moderate or deep dives are more suspect, as are symptoms following multiple dives or multiple days. Symptoms which are familiar are less suspicious, as DCS does not tend to recur in the same joints (at least according to Dr. Deco, although some of my tech diving friends would differ). When in doubt, consultation with DAN is a good idea -- they can evaluate the reported symptoms and the profiles and make an educated decision as to the likelihood of a decompression illness.
     
  5. DocVikingo

    DocVikingo Senior Member Staff Member

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    I would join your tech friends in differing.

    Regards,

    Doc
     
  6. khacken

    khacken Solo Diver

    # of Dives: 200 - 499
    Location: Dallas, Tx
    423
    0
    0
    I just got off the phone with DAN. What I was told was that DCS would feel like a constant throbbing and pain in the area effected no matter how I moved. The symptoms I described above would go away or lessen if I held my arm by my side.

    DAN also made sure to emphasize to call them if I was unsure or if the symptoms worsened beyond my normal aches (which would be a 2 or 3 with 10 being the worst pain ever).

    Thanks for your help.
     
  7. Dr Deco

    Dr Deco Loggerhead Turtle

    # of Dives: I just don't log dives
    Location: Issaquah [20 miles east of Seattle], Washington.
    2,384
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    Hi Readers:

    My original thought was that DCS is more random. For example, if DCS always appears in the arms and shoulders, it is probably from carrying gear [especially with trivial gas loads]. However, there certainly can be reasons for reoccurrence in a given anatomical spot.

    Thanks for pointing out this error. [And in days past, it is most embarrissing for me when I have put an error in a published paper. Ugh. :shocked2:]
     
  8. khacken

    khacken Solo Diver

    # of Dives: 200 - 499
    Location: Dallas, Tx
    423
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    Would you all agree with this statement? In the past, when I had joint pain after handling my luggage and gear, the pain would only occur when the affected joint was moved. So this would seem to be a good test, but I would like to hear more opinions.

    PS> The above quote may or may not be the official stance of DAN. This was me talking to one person on the phone.
     
    Last edited: Aug 18, 2009
  9. Dr Deco

    Dr Deco Loggerhead Turtle

    # of Dives: I just don't log dives
    Location: Issaquah [20 miles east of Seattle], Washington.
    2,384
    86
    48
    Hello kracken:

    It is generally said that DCS pain is present even without movement. The pain does not necessarily increase when the joint is moved, either actively or passively.
     
  10. Kevrumbo

    Kevrumbo Solo Diver

    # of Dives: 1,000 - 2,499
    Location: South Santa Monica Bay/Los Angeles California, USA
    4,414
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    I've had both on the same deep dive: Left Shoulder muscular/joint strain with pain immediately noticeable while reaching back manipulating stage deco bottles from my left hip d-ring during the initial descent to depth. And afterward, throbbing left shoulder joint and upper arm pain around ten minutes post-dive, the initial signs & symptoms of type I DCS (see http://www.scubaboard.com/forums/near-misses-lessons-learned/264517-type-i-bends-hit-chuuk.html).

    I also had a pinched nerve (Cervical Radiculopathy) earlier last year before the DCS hit in Chuuk; the big difference I learned the hard way was the pain from DCS grows more acute over a shorter length of time, especially if you unwisely decide to delay Hyperbaric Oxygen Therapy (HBOT) . . .and obviously the pain resolved within one day post-HBOT thus confirming DCS type I with secondary (co-morbid?) musculoskeletal joint strain. (In comparison, it took nearly four months before the nagging ache from the pinched nerve finally went away). . .
     
    Last edited: Aug 18, 2009

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