Options when the Doc says no more?

[redacted]

We met a wonderful couple last week in Cozumel. We dove together for the first week of their 2 week vacation. It turned out to be a bit longer for them. This is a part of the e-mail I received:

" Then, after 8 days of diving, Gene had a dive accident, and was stricken with decompression sickness. Gene's "bubble" was in the area of the spine.

The doctor and personnel at the hyperbaric chamber reviewed the profiles of all 16 dives that we had done and determined that they were all done safely and well within safe table limits. The doctor said that 46% of dive accidents presented no reason for that accident; the other 54% happened because of unsafe diving or poor decisions. This was something that "just happened". Within 15 minutes of arrival at the chamber facility, Gene was in the chamber with an attendant for a 6-hour treatment. He was kept overnight for observation (and because he couldn't walk well enough to be released). The next day he received a 5-hour treatment, and was still considered an in-patient, but was allowed to return to the resort because it would be more healthy for him in the fresh air and sunshine rather than within 4 white walls. During the next 7 days, he received a 2-hour treatment each day. Then it was to be at least 72 hours after the last treatment when he would be allowed to fly.

The staff at the chamber, the people we were diving with, the employees at the resort, the cab drivers - everyone we came in contact with were most helpful. The chamber people are extremely professional - they know their job and do it very well. The folks at the resort are Extended Family. We are thankful for each and every one of them.

After we returned home, Gene was evaluated by a doctor of hyperbaric medicine at St. Luke's Hospital in Miwaukee. That doctor stated that his treatment in Cozumel was aggressive and complete. He was given permission to return to normal living from that point on. He is expected to fully recover - although it may take some time.

But - no more SCUBA diving. I guess we'll be snorklers from this time on. "


While I'm sure this is the minimal risk option, is that really the only reasonable answer? How about 10 ft on EAN40 or 25 ft on EAN70? Is it just that it is a venture into the unknown or is the danger of continued scuba clear and imminent?

I'm sure they will accept this prognosis of snorkling & continue enjoying life. I'm afraid, if it were me, I would not be so content.

 

[kkrepps]

You might get in touch with DAN and ask for a referral for a second opinion. Unfortunatly when there is a severe undeserved hit like this there is no way to determine how to prevent a second one. Its very unfortunate and sad but its better than risking permant injury or death.

 

[DocVikingo]

Our own Scubadoc has indicated:

"Many physicians believe a person should not return to diving if he or she has experienced severe neurological spinal or cerebral decompression illness (Type II) with residual neurological symptoms. One of the reasons for this is the known increased risk of recurrent decompression illness in the area of scarring from the previous sites of the bubbles.

The recommendations for diving after a bout with the bends:

Type I DCS—If uncomplicated and produced by exceeding dive profiles or ascent rates, a diver may return to diving in four weeks.

Type I DCS, unexpected—Should return to diving only after ruling out diseases and factors that might increase susceptibility. Change of diving to a more conservative pattern.

Complicated Type I; neurological and other Type II DCS—Return to diving in a limited manner (no decompression dives, bottom times halved, maximum depth 50 feet and surface intervals of six hours) one month after identifying all causes and undergoing full neuropsychological assessment."

My reading of this is that return to scuba would require that a diver be free of any residual signs/symptoms of DCS, neuropsychologically normal & the cause of the DCS identified. In this diver's case, the last criteria appears likely to be very problematic.

Even after those criteria are fulfilled, the recommended diving schedules, profiles and surface intervals are far more conservative than for the diver with no history of Type II DCS.

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.

Best regards.

DocVikingo