Flying home after DCS treatment

[kell490]

I got bent you can read it in the other post but wanted to see if anyone else that has gotten DCS flew home after the 72 hour wait time they recommend after my last treatment had issues. I got some conflicting answers from the folks at the hospital but standard they said was 72 hours. Please post if you have been though DCS I had type 2 still have little skin tingles but doc's think it's just tissue swelling or nerve shock need time to heal. I had 3 rids in the chamber 1 5 hour 2 90min dives.

[fisheater]

Best to ask DAN.


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[kell490]

I did there answer is they have seen some get symptoms again after flying, but most don't. They recommend if there is a way to drive it is better to do that it's just not practical for me it would take too long. Just wondering if anyone here that has experienced DCS how they recovered. Would be nice if we had a forum for only divers who have experienced DCS .

[Jax]

Kell, it sounds like you've been released - good to hear! :hugs:

If you are concerned, perhaps wait another 24 hours?

[miked]

I had a DCS2 hit in 2004, in Grand Cayman. 6 table 6 "rides", etc.
I had to wait the 72 hours after the last treatment before I was cleared to fly.
I still had symptoms-fatigue, paresthesia (?sp)-the tingling,"pins and needles" feelings in lower legs and feet)-before the flight, and they persisted for approx 6+ months after returning home. The flight itself, however caused NO increase in the symptoms.
Good luck with your recovery.

[Cave Diver]

Thread moved to Diving Medicine for better exposure to our medical staff.

[Duke Dive Medicine]

The recommended wait time to fly is 72 hours after treatment with complete symptom resolution. It gets a little fuzzy if you still have symptoms. Although the bubbles are gone, hypoxia induced by increased altitude (the nominal cabin altitude of a commercial airliner is 8000') can cause a return of symptoms in tissue that still has some circulatory compromise, i.e. "tissue swelling or nerve shock". If you have concerns, you may want to consider asking the treating physician to have you fly home using supplemental oxygen.
Best regards,
DDM

[kell490]

The only symptoms I might have is what you call circulatory if I sit in one spot my lower legs get a little tingling when I stand up it goes away it will be over 72 hrs since I had the last treatment last 90 min chamber ride on Tuesday 2am and Ill be flying out tomorrow Saturday at 7:10am. It's our last day here not sure if Ill have time to get o2 bottle setup for the flight home.

[miked]

Re the O2: if you can get the Dr. to put in writing that you need the O2, it might expedite things with the airlines.
Good Luck, and best wishes for a complete recovery.

[mselenaous]

Think about Amtrak. Amtrak (http://www.amtrak.com)
Ok so that takes several days (Sun-Thu), scenic tour to DC then onto Phoenix via Chicago:shakehead:?...

Greyhound, probably not as comfortable, but shorter (Fri Nite to Mon am):depressed:.

Good luck man. We don't have many options :dontknow:in the US when traveling cross country.

[kell490]

I called the doc they said I don't need O2 they send people home all the time after 72 hours and no issues. He said my hit was on the lighter side. I passed all the motor skills test what I call the drunk driving tests. I'm just going to make sure I hydrate well for the trip home I have never had any issues at high alt we snow board in the winter in Southern CO at Wolf Creek and that is 10-11k so I'm hoping my lungs will keep up enough. Ill post let you guys know how it turns out. I looked into AmTrak still have to drive 1000 miles to get where they pick up a line to the west either southern or northern if I took north it goes over 8k to flagstaff I would have to drive home from there so southern would be the only low alt route it starts in New Orleans about 1000 miles from southern FL.

[Splitlip]

Kell: Glad to hear you have been cleared and seem to be on the way to recovery. Do let us know. Best wishes.

[kell490]

Thanks for he words It was a scary situation I hope none of you ever have to experience just don't think about DCS until it happens. I have found it's not tables or computers that can get you it's proper rest and hydration. I spent a lot of time think about tables and computers ascent rates not that those are not important but I totally forgot about hydration, and proper rest which can bend anyone.

[Splitlip]

Thanks for he words It was a scary situation I hope none of you ever have to experience just don't think about DCS until it happens. I have found it's not tables or computers that can get you it's proper rest and hydration. I spent a lot of time think about tables and computers ascent rates not that those are not important but I totally forgot about hydration, and proper rest which can bend anyone.

Yup. A wake call for me. I really never flew while I dived. Never gave it a thought. A few years ago, my daughter was doing travel volley ball and her open water at the same time. Were due to fly out after her first two dives. then she says "Dad..what about flying after diving?" Crap! I started clicking and hammering and decided it was ok. Having read your posts...we might have stayed home.

[kell490]

Made it home felt weak and my left hand fingers started to tingle as the plane ascended to cruse it wasn't fun I started to panic little but tried to stay calm and breath deep after awhile. After about 30 minutes started to get better helped that I turned the air on above me got some fresh air maybe less CO plane was full. A few times I felt my fingers tingle and my head was feeling kind of strange but I made it. I don't think it was anxiety from before but could have been some. Just wanted to get it over took 4 1/2 hours hope this doesn't happen I would like to go snow boarding this winter which is 10k feet high.

[mselenaous]

Glad you are finally home and sleeping in your own bed. I'm sure that alone will greatly speed up your recovery.

[miked]

Glad that you got home without any major problems.
As one who has "been there, done that", some advice: please rest, take things easy, and listen to your Drs.
You might want to discuss their feelings on snowboarding in a few months, especially at 10k ft.
(No frame of reference for that, but I was much less than 100% for at least 4 months.)
Again, best of luck and wishes for a complete recovery.

[ianr33]

I have found it's not tables or computers that can get you it's proper rest and hydration. I spent a lot of time think about tables and computers ascent rates not that those are not important but I totally forgot about hydration, and proper rest which can bend anyone.

That's very true,and some other things as well.

Only time I was ever on a dive where someone got bent it was from being cold (flooded drysuit) and exertion immediately after the dive (carrying large steel tank uphill). The computer was happy. The diver was not.

[popje]

Our protocol used to be treat until symptoms are gone or until there is no more improvement. No-fly time is at least 72 hours after discharge. That said my boyfriend is flying 16 hours after diving. (ie Tomorrow morning.) The 2 dives weren't particularly strenuous or challenging. However, the 5-10 minute (depending on load you're carrying and thus speed) climb/trek to and from dive site to car was. I figure if he's not bent by now he'll be ok tomorrow. Nevertheless, I've reminded him that they have a fantastic chamber facility where he's headed to (Stockholm)! :D

[kell490]

16 hours huh well all I can say is I thought the same as your BF look what it got me. You know after the dives I drove back to the hotel as fast as I could because checkout I had extended until 1pm I had to rinse all my gear, pack 6 large bags the room was a mess my wife hadn't really done much except get her stuff ready. We drove all the way back 130 miles from key west to Fort Lauderdale. We stopped on the way a bunch of times to buy stuff like shirts. We took a scenic helicopter ride around Marathon. We didn't get to the airport hotel until 11:30 pm that night. It takes a long time to drive 130 miles on A1A lot of areas you can't go over 40-45. Had to clean up the mini van we rented it was trashed by then had to return it at 5am the next morning. Went to bed at midnight got up at 3:45am still felt great except tired but no DCS issues. So I can tell you flying before 24hours is just pushing your luck I never felt any DCS until we hit 5k feet in the cabin. The flight crew debated to land or not I'm assuming they had no idea how much trouble I was in I'm sure they see folks freak out on planes they give them a some O2 and keep going. I noticed on Flighttrackker they really didn't make a change until a doctor told them they need to land. I had told the flight attendant several times they need to descend I'm experiencing Decompression sickness.

[AFdivedoc]

The post-treatment return of symptoms during flight even after a 72 hour delay is common enough to warrant mention in Dr. Bove's DIVING MEDICINE book. ..."Occasionally, altitude exposure precipitates a return of symptoms (usually mild and reversible) after more than a week following recompression treatment."

I've seen this in both diving and high altitude hits (no previous diving), and treated them successfully even after return of CNS symptoms a week after the initial treatment. The recommendation for supplemental oxygen for flight is fairly new, and is starting to gain ground, especially after the more severe hits.

Glad you made it home OK!

[kell490]

Thanks AFdivedoc took about 3 weeks for all the symptoms to go away although I noticed I still feel some tingling when I ascended to about 3800 feet not sure if this is going to be ongoing I normally snowboard in the winter at 8-11k feet high mountains and I'm hoping in January I won't have issues. The only thing I have left from the event was my left ear is ringing (tinnitus). The left ear was plugged and low frequency were muffled but higher frequency's like the beeping noise a truck makes when backing up was really loud I had to cover my ear. The plugged feeling has gone away as of a week ago but this tinnitus is still there I'm hoping that goes away.

[AFdivedoc]

I went back and read the "other thread" to get the details of your dives and your injury. You were doing some pretty aggressive dives for a relative newcomer, for sure. Being so close to the no-stop limits the day before a long flight out is not a good idea. It makes the possibility of a flying after diving hit even more unpredictable than usual. From your discussion, you've owned up to it and plan to take steps and training to mitigate this in the future--good on you.

I'm glad to hear everything but the hearing issues have cleared. At this point, only time will tell whether your tinnitus will clear up, but prepare yourself for the possibility it may be permanent. You may want to discuss the tinnitus or any perceived hearing loss with your private or company physician.

[Gene_Hobbs]

There is very little literature available on this available. I did add a section on this to the bottom of our suggested reading list (http://rubicon-foundation.org/flying-after-diving/) on flying after diving.

The best stats for flights with active symptoms come from: Freiberger, JJ; DeNoble, PJ; Uguccioni, DM; Vann, RD. (2002) An association between flying with symptoms of DCS and residuals after recompression treatment. Undersea and Hyperbaric Medical Society Annual Scientific Meeting. RRR ID: 1141 (http://archive.rubicon-foundation.org/1141)


Flying with symptoms is associated with and adverse outcome. This effect is worse if the presenting symptoms are neurological in character and/or associated with pain.

The results from the 2004 DAN survey were also interesting:

Vann, RD; Freiberger, JJ; DeNoble, PJ; Dovenbarger, JA; Nord, D; Winkler, P; Marroni, A. (2004) Flying after recompression therapy. Undersea and Hyperbaric Medical Society Annual Scientific Meeting. RRR ID: 1474 (http://archive.rubicon-foundation.org/1474)


The available data did not indicate that flying after treatment predisposed to DCI relapse or that a delay of many weeks before flying was frequently needed. Relapse due to flying after treatment alone did not appear common. These tentative conclusions require confirmation.

[Duke Dive Medicine]

Gene,
To clarify, Jake's study looked at divers who flew with symptoms but hadn't been treated beforehand, correct? That's the way I read it, anyway.

[Gene_Hobbs]

Gene,
To clarify, Jake's study looked at divers who flew with symptoms but hadn't been treated beforehand, correct? That's the way I read it, anyway.

If I remember correctly, this was the lead up work for the recommendations for evacuation so the patients were being flown to a chamber for their treatment. I would be willing to make the jump with his data to flying with residual symptoms though. If it is not resolved, it's still DCS in my book. <g>

More on this would likely be in the Remote Locations (http://archive.rubicon-foundation.org/5523) Workshop.


--BTW - Had issues with our embargo test last night... might be middle of next week before I can get the profiles back to you

[farsidefan1]

I had dcs type 2 followed by a couple chamber ides (about 6 hours and later another 3 hours). I was afraid I was going to miss my flight as the doc in Coz had me check in every morning to see if he would clear me for my flight home. Fortunately it was 48 hours so he cleared me with a day to spare. I later was checked and found to have a condition similar to a pfo which I had corrected. My hit was also an "unexplained" episode.