Lizard Leg
Contributor
To start here is the email my wife sent to family and friends explaining our extended stay:
"Explanation of why I had to take a chamber ride in the Florida Keys during a wonderful week of diving: I was experiencing a fantastic Thursday morning dive on the USS Spiegel Grove with Steve and 18 other divers on the boat. Light current, 60-80’ vis, diving an AL100 with a 32% mix. Total dive time 40 minutes, max depth 96’. The USS Spiegel Grove is awe inspiring and we can’t wait to do it again.
After the dive at depth was over, we made a nice slow ascent and a leisurely safety stop goofing off with each other. The drop line was crowded with divers from 65’ all the way to 15’, so the ascent was very slow. No problems at all from splash in to this point.
As soon as I broke the surface I felt like I could not draw a breath through my regulator, even though I still had 1000 psi left. I inflated my BC, left my mask on, took my reg out to swap over to my secondary – and still couldn't draw a full breath at all, even with no second stage in my mouth. I immediately cut line and got on the boat, with Steve right behind me. I still couldn't draw a full breath, but after about 5 minutes I was fine. I assured Steve, the Captain and the DM that I was fine, breathing was back to normal and I was 100% sure I was okay to do the second drop on the Benwood, even though Steve tried to get me to sit it out.
After a 33 minute SI we splashed in again. Vis was 20-30’, max depth 31’, moderate current. About 40 minutes into the dive I started having difficulty breathing again – I was breathing, it just felt like I wasn't getting enough air. Steve noticed me in mild distress (we were at 21’ at this point and heading back to the boat) and immediately thumbed the dive and got me to the surface. We surfaced about 75-100 yards from the boat and again I inflated my BC fully, left my mask on, took my reg out, but still felt like I couldn't catch my breath. At this point, of course, I started to get a little panicked. Told Steve to just get me back to the boat.
Steve immediately went into “rescue mode”. Rescue swam me back to the tagline, talking to me, trying to calm me down, and swimming his @$$ off. He had signaled the boat diver in distress, but that we were okay and coming in under our own power. To me the boat felt miles away, but Steve had me to the tag line in under a minute and I was back on board. I've never seen him climb a ladder so fast before.
Once back on board, I started to catch my breath, but even after the ride back to the dock I still couldn't draw a full, deep breath - maybe 85-90%. Steve made us stay around the dive shop for about 30 minutes. He explained this as the shop had 02 if I needed it so he wanted to stay there for a while. I started to feel much better, and was starving, but still felt winded and tired. Mild headache, but barely noticeable. We left and had lunch at Mrs. Mac’s, and headed back down to Marathon. From the time I got out of the water on the second drop, until we got back to Marathon was about 3.5 hours. We stopped at the dive shop in Marathon to talk to our friends there, and from walking around and talking breathing became difficult again within just a few minutes. Immediately back to the hotel room behind the dive shop and called DAN. 10 minutes later we were on our way to Mariners hospital in Tavernier, about 40 miles away – there was a closer hospital, but no chamber there.
I’ll skip over all of the emergency room procedures, but the staff at Mariners Hospital is at the top of their game when it comes to distressed divers. Within 15 minutes I had been seen by 3 doctors, the hyperbaric supervisor and been x-rayed, poked and prodded and tested beyond comprehension. The scary part was when everyone started running – literally. When you see the staff working on you running flat out, you get nervous.
Steve appeared calm, but says he was really freaking out at this point. He gave all the doctors the profiles, a synopsis of our dives this week, and any other info they asked for, and then some. Diagnosis was suspected DCI, although the general consensus “off the record” was excessive CO2 buildup, but “When in doubt, treat”, so I did a standard Table 6 ride.
The day after the ride, I was exhausted. Hydrating, napping, and taking it easy. Went to dinner with friends last night and I feel 100% this morning, although still slightly tired. Of course we had to extend our vacation some due to the no flying within 72 hours of a ride, and no diving for 6 weeks. Bummer, but even though it appears I didn't get bent, better safe than sorry."
Her profile:
The rest of the story:
All gear was our own except tanks and weights and had been serviced within the last 6 months. No O2 was offered on the boat after either dive. She is in above average health, normal weight (I'm NOT going there), 42 years old, 5'4".
We flew back March 24th. Since then she has had a complete cardiac workup, a pulmonology workup, venous scan, CT scan with contrast, blood tests for everything, etc. etc. All came back normal. The first PFT the pulmonologist noted a "subclinical airflow obstruction", but at her last visit he said it was "very minor" and she is in perfect health. She has been cleared by both the cardiologist and the pulmonologist to return to diving.
The initial thought from the pulmonologist was Irritant Induced Asthma. After all tests were completed, he says that her symptoms fit more into "Sigh Syndrome". Basically he said she breathes really shallow, and every so often sighs or yawns to clear out excess CO2. Even though she is getting enough oxygen, her body is telling her she is out of breath. On a deep dive, she didn't breath deep enough to clear all of the "dead space" and it appears she took a CO2 hit. At this point, this is the diagnosis and Sigh Syndrome is supposed to go away by itself shortly. Looking at the videos, and listening to the sound on the raw footage, she was breathing very short and shallow with a cycle of about 1.5 seconds in/1.5 seconds out. Every 10-15 seconds she would "overbreathe" the reg and just suck down a second or so of max airflow. Her reg "sounded" very stiff as well, and when informally tested, was found to be "breathing stiff". Before I could stop him, they adjusted it. Upon the return home I had it formally tested, and it now breaks at 1.1 open/1.6 closed.
Since we returned home, she has had two episodes. The first, she woke up and said she just felt out of breath - "air hungry". The second was after an hour long workout at the gym. After her initial cardio routine and weights, she got back on the treadmill at a 7.2 mph pace. When she started feeling out of breath (more than she normally would) she focused on long deep breaths, and the feeling passed.
We have some pool sessions scheduled (17' max depth) just to get her back in the water before we head back out to OW. She is not nervous or scared about getting back in the water, but we want to make sure it's done right. We learned a lot from this incident and have changed a few things around on the way we dive. Mainly, if either of us have an issue on a dive, we lose decision making authority and the other makes all decisions for the other. ASK for O2 if it is not offered. We've also discussed what to do if this ever happens again, a month or 10 years from now, especially at depth. I'm also finally getting around to finishing my rescue course next month.
I wanted to post this here to see if any of the doctors/experts had anything else to add...
"Explanation of why I had to take a chamber ride in the Florida Keys during a wonderful week of diving: I was experiencing a fantastic Thursday morning dive on the USS Spiegel Grove with Steve and 18 other divers on the boat. Light current, 60-80’ vis, diving an AL100 with a 32% mix. Total dive time 40 minutes, max depth 96’. The USS Spiegel Grove is awe inspiring and we can’t wait to do it again.
After the dive at depth was over, we made a nice slow ascent and a leisurely safety stop goofing off with each other. The drop line was crowded with divers from 65’ all the way to 15’, so the ascent was very slow. No problems at all from splash in to this point.
As soon as I broke the surface I felt like I could not draw a breath through my regulator, even though I still had 1000 psi left. I inflated my BC, left my mask on, took my reg out to swap over to my secondary – and still couldn't draw a full breath at all, even with no second stage in my mouth. I immediately cut line and got on the boat, with Steve right behind me. I still couldn't draw a full breath, but after about 5 minutes I was fine. I assured Steve, the Captain and the DM that I was fine, breathing was back to normal and I was 100% sure I was okay to do the second drop on the Benwood, even though Steve tried to get me to sit it out.
After a 33 minute SI we splashed in again. Vis was 20-30’, max depth 31’, moderate current. About 40 minutes into the dive I started having difficulty breathing again – I was breathing, it just felt like I wasn't getting enough air. Steve noticed me in mild distress (we were at 21’ at this point and heading back to the boat) and immediately thumbed the dive and got me to the surface. We surfaced about 75-100 yards from the boat and again I inflated my BC fully, left my mask on, took my reg out, but still felt like I couldn't catch my breath. At this point, of course, I started to get a little panicked. Told Steve to just get me back to the boat.
Steve immediately went into “rescue mode”. Rescue swam me back to the tagline, talking to me, trying to calm me down, and swimming his @$$ off. He had signaled the boat diver in distress, but that we were okay and coming in under our own power. To me the boat felt miles away, but Steve had me to the tag line in under a minute and I was back on board. I've never seen him climb a ladder so fast before.
Once back on board, I started to catch my breath, but even after the ride back to the dock I still couldn't draw a full, deep breath - maybe 85-90%. Steve made us stay around the dive shop for about 30 minutes. He explained this as the shop had 02 if I needed it so he wanted to stay there for a while. I started to feel much better, and was starving, but still felt winded and tired. Mild headache, but barely noticeable. We left and had lunch at Mrs. Mac’s, and headed back down to Marathon. From the time I got out of the water on the second drop, until we got back to Marathon was about 3.5 hours. We stopped at the dive shop in Marathon to talk to our friends there, and from walking around and talking breathing became difficult again within just a few minutes. Immediately back to the hotel room behind the dive shop and called DAN. 10 minutes later we were on our way to Mariners hospital in Tavernier, about 40 miles away – there was a closer hospital, but no chamber there.
I’ll skip over all of the emergency room procedures, but the staff at Mariners Hospital is at the top of their game when it comes to distressed divers. Within 15 minutes I had been seen by 3 doctors, the hyperbaric supervisor and been x-rayed, poked and prodded and tested beyond comprehension. The scary part was when everyone started running – literally. When you see the staff working on you running flat out, you get nervous.
Steve appeared calm, but says he was really freaking out at this point. He gave all the doctors the profiles, a synopsis of our dives this week, and any other info they asked for, and then some. Diagnosis was suspected DCI, although the general consensus “off the record” was excessive CO2 buildup, but “When in doubt, treat”, so I did a standard Table 6 ride.
The day after the ride, I was exhausted. Hydrating, napping, and taking it easy. Went to dinner with friends last night and I feel 100% this morning, although still slightly tired. Of course we had to extend our vacation some due to the no flying within 72 hours of a ride, and no diving for 6 weeks. Bummer, but even though it appears I didn't get bent, better safe than sorry."
Her profile:
The rest of the story:
All gear was our own except tanks and weights and had been serviced within the last 6 months. No O2 was offered on the boat after either dive. She is in above average health, normal weight (I'm NOT going there), 42 years old, 5'4".
We flew back March 24th. Since then she has had a complete cardiac workup, a pulmonology workup, venous scan, CT scan with contrast, blood tests for everything, etc. etc. All came back normal. The first PFT the pulmonologist noted a "subclinical airflow obstruction", but at her last visit he said it was "very minor" and she is in perfect health. She has been cleared by both the cardiologist and the pulmonologist to return to diving.
The initial thought from the pulmonologist was Irritant Induced Asthma. After all tests were completed, he says that her symptoms fit more into "Sigh Syndrome". Basically he said she breathes really shallow, and every so often sighs or yawns to clear out excess CO2. Even though she is getting enough oxygen, her body is telling her she is out of breath. On a deep dive, she didn't breath deep enough to clear all of the "dead space" and it appears she took a CO2 hit. At this point, this is the diagnosis and Sigh Syndrome is supposed to go away by itself shortly. Looking at the videos, and listening to the sound on the raw footage, she was breathing very short and shallow with a cycle of about 1.5 seconds in/1.5 seconds out. Every 10-15 seconds she would "overbreathe" the reg and just suck down a second or so of max airflow. Her reg "sounded" very stiff as well, and when informally tested, was found to be "breathing stiff". Before I could stop him, they adjusted it. Upon the return home I had it formally tested, and it now breaks at 1.1 open/1.6 closed.
Since we returned home, she has had two episodes. The first, she woke up and said she just felt out of breath - "air hungry". The second was after an hour long workout at the gym. After her initial cardio routine and weights, she got back on the treadmill at a 7.2 mph pace. When she started feeling out of breath (more than she normally would) she focused on long deep breaths, and the feeling passed.
We have some pool sessions scheduled (17' max depth) just to get her back in the water before we head back out to OW. She is not nervous or scared about getting back in the water, but we want to make sure it's done right. We learned a lot from this incident and have changed a few things around on the way we dive. Mainly, if either of us have an issue on a dive, we lose decision making authority and the other makes all decisions for the other. ASK for O2 if it is not offered. We've also discussed what to do if this ever happens again, a month or 10 years from now, especially at depth. I'm also finally getting around to finishing my rescue course next month.
I wanted to post this here to see if any of the doctors/experts had anything else to add...
