Possible undeserved DCS hit?

[dmcutter]

Four weeks ago yesterday, I did a night dive at the quarry. We stayed shallow, above 30 ft, for the entire 51 minute dive, with the obligatory safety stop. Probably the last 20 minutes was only at 20 ft anyway. Shortly thereafter I began having numbness and tingling in the pinky and ring fingers of my right hand. I can't specifically recall when I started feeling it, though. I has not gotten appreciably better or worse since. I dove yesterday, most of the dive between 60 and 80 ft, and did not feel any improvement to the hand at depth. After the dive my hand was very weak and I even had trouble tying my shoes. Part of that may be associated with a lot of time in 48 degree water, as my hands did get cold even in 5 mm gloves.

I am 52, but very fit. I have had issues with cervical vertebrae 10 or 11 years ago, involving nerve damage beteween C5/C6 and a year later C4/C5. Both of these resulted in sudden significant strength loss to very specific muscles, most of which has been recovered by daily weight training. I saw a neurosurgeon about it back then and he said there wasn't anything he could do surgically, but it was a one time type deal, not an ongoing deterioration. I did not have numbness or tingling of extremities prior to those episodes.

My sister in law is a former neuro OR nurse and she says what I am experiencing is symptomatic of cervical vertebrae issues, although I have not experienced a loss in grip strength. Having a history of deteriorated vertebrae this makes plenty of sense to me, and I'm in the process of getting an appointment to see my neuro guy. I figured that if it was the result of barotrauma I would have noted improvement at depth, although it might have been pretty hard to tell a subtle change with my hands as cold as they were. I was just curious, though, as to whether anyone had experienced similar symptoms which were eventually diagnosed as DCS. I only live an hour from Durham NC so going to see someone at DAN is certainly viable. My wife pooh poohs the idea of DCS and says I'm just looking for a more interesting excuse than getting old, but if it's something that could be treated without slicing open my neck and fusing vertebrae, that would be a big plus.

Thanks

[fisheater]

When your wife makes a trip to the grocery store, CALL DAN.

[Duke Dive Medicine]

Four weeks ago yesterday, I did a night dive at the quarry. We stayed shallow, above 30 ft, for the entire 51 minute dive, with the obligatory safety stop. Probably the last 20 minutes was only at 20 ft anyway. Shortly thereafter I began having numbness and tingling in the pinky and ring fingers of my right hand. I can't specifically recall when I started feeling it, though. I has not gotten appreciably better or worse since. I dove yesterday, most of the dive between 60 and 80 ft, and did not feel any improvement to the hand at depth. After the dive my hand was very weak and I even had trouble tying my shoes. Part of that may be associated with a lot of time in 48 degree water, as my hands did get cold even in 5 mm gloves.

I am 52, but very fit. I have had issues with cervical vertebrae 10 or 11 years ago, involving nerve damage beteween C5/C6 and a year later C4/C5. Both of these resulted in sudden significant strength loss to very specific muscles, most of which has been recovered by daily weight training. I saw a neurosurgeon about it back then and he said there wasn't anything he could do surgically, but it was a one time type deal, not an ongoing deterioration. I did not have numbness or tingling of extremities prior to those episodes.

My sister in law is a former neuro OR nurse and she says what I am experiencing is symptomatic of cervical vertebrae issues, although I have not experienced a loss in grip strength. Having a history of deteriorated vertebrae this makes plenty of sense to me, and I'm in the process of getting an appointment to see my neuro guy. I figured that if it was the result of barotrauma I would have noted improvement at depth, although it might have been pretty hard to tell a subtle change with my hands as cold as they were. I was just curious, though, as to whether anyone had experienced similar symptoms which were eventually diagnosed as DCS. I only live an hour from Durham NC so going to see someone at DAN is certainly viable. My wife pooh poohs the idea of DCS and says I'm just looking for a more interesting excuse than getting old, but if it's something that could be treated without slicing open my neck and fusing vertebrae, that would be a big plus.

Thanks

Hi dm,
It's next to impossible that this was DCS. You just didn't have enough nitrogen on board. Even if your dive had been square-profile, the Navy Diving Manual lists 371 minutes as the no-d limit for 30 feet.
It's far more likely that this is indeed related to cervical issues. The spinal nerve that exits below your 7th cervical vertebra innervates the pinky and ring finger.
To clarify, you can't "see someone at DAN" per se; DAN itself does not perform medical evaluation of divers. The Duke Hyperbaric Center and DAN are two completely separate entities. We'd be happy to see you in the clinic here if you think you need further evaluation.
Best regards,
DDM

[PatW]

Hi dm,
It's next to impossible that this was DCS. You just didn't have enough nitrogen on board. Even if your dive had been square-profile, the Navy Diving Manual lists 371 minutes as the no-d limit for 30 feet.
It's far more likely that this is indeed related to cervical issues. The spinal nerve that exits below your 7th cervical vertebra innervates the pinky and ring finger.
To clarify, you can't "see someone at DAN" per se; DAN itself does not perform medical evaluation of divers. The Duke Hyperbaric Center and DAN are two completely separate entities. We'd be happy to see you in the clinic here if you think you need further evaluation.
Best regards,
DDM

I agree. People can and do take "undeserved" hits. But the nitrogen load would seem to be so low as to not make DCS very unlikely. I would think that the cold and your CNS issues might have worked together to produce the problem.

As for undeserved hits, I have heard that people who take blood pressure meds and other heart and circulatory medicines tend to be good candidates for the undeserved hit. But again with that dive profile, I just do not see how you would get enough nitrogen load to cause an issue.

[dmcutter]

Alas, I have come to realize that it is just old age and I'm having issues at C7 similar to what I have previously experienced with other vertebrae. I have an appt to see my neuro guy next Tuesday.

[vladimir]

CALL DAN.

It's a reflex, right? You can't control it?

"I spent twelve minutes at three feet today in my pool playing with my SpareAir. I think I got sunburned, but it might be skin bends."

"CALL DAN."

[Mr.X]

Alas, I have come to realize that it is just old age and I'm having issues at C7 similar to what I have previously experienced with other vertebrae. I have an appt to see my neuro guy next Tuesday.

52 is not that old. Stuff happens all the time. I spent a few nights sleeping funny on a bed and it has affected a whole bunch of things - including my neck, hands etc. I figure I will get over it once I use a better pillow. Keep us apprised on the neuro. appt. and I hope the prescription is nothing more than just a aspirin once a day. Best.

X

[dmcutter]

Well, saw my neurosurgeon today. The pinky and ring finger appear to be ulnar neuropathy. The general weakness in my hand/thumb appear to be due to goings on at C8. Goody for me, potentially 2 separate operations . MRI Thursday morning and nerve conduction testing next Wednesday to determine how much of what is going on and what the fixes will be. I hate that EMG testing...getting shocked and watching your muscles twitch involuntarily-big fun, like the old frog in biology lab. I have a feeling I won't be taking a Christmas dive vacation this year...