DCS Questions

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Shuu

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I already posted this earlier. However, it may be more suited to a new thread. Mods please feel free to edit as appropriate.


Hello. New to the site.

While searching for information on DCS, I found this thread. I'm hoping I can ask a few questions. While diving last weekend I may have taken an "unexplained" DCS hit after what I thought were very shallow dives (although in hindsight I embarrassingly now recognize several possible contributing factors: cold, not enough sit time between dives, not waiting long enough after dive before taking a shower). First dive 14m (avg. depth 11m) for 44min. Out for 53min. Second dive 14.1m (avg. depth 11.1m). Square profiles and both dives ended with slow ascents and 5m/3min safety stops.

I am outside the U.S. and due to a combination of stupidity on my part (I couldn't believe I could take a hit on that profile) and lack of facilities, I did not get to a doctor for about 30 hours. My original symptoms were headache (had a mask squeeze on first dive and blamed that) on and off tingling in my fingers in both hands (after showering) about 30 minutes after the second dive. Later experienced a burning feeling on the back of my wrists, arms and around my chin, similar to a sun burn, that all come and go. I thought I might have burned myself in the shower without realizing it, but no marks to show for it.

When I finally got to the hospital late in the evening the dive medicine doctor was not around but the doctor on duty said those symptoms were enough to warrant treatment in the hyperbaric chamber to be safe. Having been through two table 6 treatments the tingling in both hands and the numb/burning feeling in the chin still come an go. However, after the second treatment, I finished with a bad headache and felt bad again today (tired and vertigo). I have my next chamber treatment scheduled for tomorrow and will meet with the dive medicine doctor in two days to determine if one more is necessary.

I have many questions. Thanks in advance if anyone can address any part of them.


Does this sound like a mild DCS hit? I thought the burning feeling might suggest skin bends but I'm concerned about the tingling fingers. Is there any way to be sure?

Is it normal to feel bad (tired/headache/vertigo) after chamber treatment? Fortunately, the chamber is not extremely expensive here, but if this really wasn't a hit am I putting myself at any unnecessary risk?

It may be too early to ask, but assuming this was an actual DCS hit, what is the general outlook for this sort of injury? Does the tired and tingling feelings usually go away?

If the tingling does not go away after treatment, is that the end to diving? Is there any way to tell if it was not actually from a DCS hit?

The whole experience has left me embarrassed and a bit depressed. Both for my stupid mistakes noted above and for waiting to do anything about it. But also embarrassed that I might be going through all this for nothing. Thanks again for your comments.
 
My medical training is just of a Combat Medic, so hopefully one of the smart pepople can answer your questions. But while you wait for them I HIGHLY ​suggest you call DAN's toll free phone number or one that is accessible to the region you are in. Get the answers you need now, not wait on a forum.
 
I HIGHLY ​suggest you call DAN's toll free phone number or one that is accessible to the region you are in. Get the answers you need now, not wait on a forum.

Yes I second that. Give DAN a call in your region ASAP.
 
I am not a doctor. However I have some questions.

Were the symptoms present in both hands?

Were there any other symptoms in your arms or shoulders?

Do you have any issues with poor circulation?
 
I am not a doctor. However I have some questions.

Were the symptoms present in both hands?

Were there any other symptoms in your arms or shoulders?

Do you have any issues with poor circulation?


Yes, both hands felt like they'd fallen asleep after I got out of the shower approximately 30~40 minutes after the second dive. The pins and needles feeling did not last but returned off and on later.

Later hot/cold sun burn feeling on back of hands and under my chin, continued dull headache, slight tingling, sometimes burning feeling on forearms. All except headache off and on. Never had any pain in arms or shoulders. Never noticed any issues with poor circulation before this.

Since i have started treatment, I am inclined to continue. However, I have not been able to find any information whether the table 6 treatment poses any risk if it wasn't really a hit after all. Since medical staff apparently sometimes sit in with the patient receiving treatment my guess is no (but then again, they're not breathing the oxygen). I've also found several "when in doubt get the treatment" suggestions, so maybe I've answered my own question. Still, the dizziness and headache after the last chamber ride bothered me.

I will try to call DAN before my next chamber visit.

---------- Post added May 28th, 2015 at 12:57 AM ----------

Update: Spoke to staff at DAN. I was not a member, but they were great!

The opinion was most likely not DCS given the profile. In the U.S. they would would probably not do more chamber treatment without follow up, but one more round in the chamber would likely not be a problem.

Also, likely not skin bends (don't see that on the hands). He said the symptoms could be something other than DCS, but I'd need to get it checked out by an expert. Of course still need to know what the issue is, but I'm very relieved.
 
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Regardless of the profile (which makes it seem extremely unlikely). It's unlikely that it's DCS because of it's manifestation in both hands, and no other parts of your arms. DCS doesn't start in the hands, and it's also unlikely to manifest itself bilaterally.
 
Regardless of the profile (which makes it seem extremely unlikely). It's unlikely that it's DCS because of it's manifestation in both hands, and no other parts of your arms. DCS doesn't start in the hands, and it's also unlikely to manifest itself bilaterally.


I followed up with the decompression doctor here. He also says DCS possible but not likely. I asked about the tingling starting in both hands. He agreed unlikely DCS unless some sort of hit on the spine or moving both hands in the same way. He didn't seem impressed by my cold water no gloves theory. Said it could be from some sort of pinched nerve in the back or neck (although I haven't noticed anything) but didn't think cold water alone would do it.

As with DAN, he said it is better to figure out what is causing the tingling (still off and on mostly in hands, sometime arms) but he did not rule out future diving even with the occasional tingling.

In case I cannot pin down an easy explanation, I'd be curious to hear how other divers have dealt with similar symptoms. I'm thinking of waiting an appropriate amount of time (doctor suggested 3 months) to see if I can discover a cause or for the condition to resolve on its own. But if likely not DCS, I don't want to wait forever.
 
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For what it's worth, I have a chronic pinched nerve in the neck and my daily symptoms sound just like yours. I get the tinlgling down my arms, and what is refered to as a "nerve rash" in different parts of my hands and arms (it comes and goes and moves around - but never get in on my face) that feels like mild sunburn.
 
For what it's worth, I have a chronic pinched nerve in the neck and my daily symptoms sound just like yours. I get the tinlgling down my arms, and what is refered to as a "nerve rash" in different parts of my hands and arms (it comes and goes and moves around - but never get in on my face) that feels like mild sunburn.


Thank you for your response.

Is it possible to have a pinched nerve and not know?

This is all a bit of a mystery. In my case it seemed to start right after diving, so I naturally think it's related. Both DAN and the local doctor say that if it was DCS I could expect to see some improvement after three table 6 treatments. The tingling/pins and needles still comes and goes, but, if anything, the sunburn feeling is more common now. I also noticed increased itchiness all over the body yesterday (legs, chest, head, etc.) which was not the case before the treatments. I suppose that is good news in a way as I assume new symptoms post chamber treatment lowers the likelihood of DCS (is that a correct assumption?).

As you note with your "nerve rash", my best guess at this point is some sort of nerve condition that was somehow triggered by the diving. Now it is a matter of eliminating other possibilities, pinched nerve, diabetes, B-12 deficiency, etc. But I still have a lingering worry about DCS. Maybe I'm in the bargaining stage because I find myself reasoning, "OK, I can live with the symptoms as long as I can rule out DCS and continue diving."

I googled "nerve rash" but that search turns up many examples of skin rashes. If your condition is like mine, there are no visible indications on the skin. Does it affect your diving?
 
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I'm not a doctor but am a paramedic with heavy dive experience.

it does sound like it could be a pinched nerve or other type or nerve/neurologic issue. I would agree that DCS would be unlikely.

potentially it could be (and i'll say only a very outside maybe) a mild stroke or transient ischemic attack (TIA) or something similar. However, symptoms generally impact only one side of the body.

bottom line is only a full medical workup and tests will answer the question.
 

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