Question about DCS

[Diver1969]

After a "by the book " wreck dive about 95 feet with a total dive time of 25 minutes with nothing out of the norm. My dive buddy surfaced and then within 10 minutes of being on the boat was doubled over in pain. The pain was acute and affected his abdomen primarily before spreading to his extremities. His legs went numb a few minutes later. It was only our third dive in three days, and pretty conservative so I honestly did not think it could be related to decompression. It was after we got him to the hospital in the Bahamas that I started to think DCS. The attending physician did a battery of tests including two MRI's. Nothing showed up and after two hours of receiving oxygen he felt better.We rushed back to the states by boat. The next day he was feeling tingling in his legs, so he went and did 5hrs in a HB. Then two more 1Hr stints and now feels better. It was suggested that he may have been dehydrated and therefore more susceptible to DCS. My question is has anyone experienced anything like this? What would your opinion be on future dive practice?
He does not have any other medical factors, like scarring or obesity. We where well within our no compression stop profile for recreational diving.Any ideas?

 

[Superlyte27]

There's a lot of these conversations in my circles lately. I'm amazed that people don't understand that the Tables and Computers work for most people NOT ALL PEOPLE.

I'd like to see the profile. But this is a good reminder to dive a lot more conservatively. Just because you shouldn't get bent, doesn't mean you won't get bent. Also, I would have assumed DCS the moment he encountered the pain you described. It's textbook symptoms.

 

[ajduplessis]

As requested, please share you actual dive profile.

 

[AfterDark]

The history of diving is full of undeserved DCS hits. Sometimes there's no explaining it.

 

[Diver0001]

After a "by the book " wreck dive about 95 feet with a total dive time of 25 minutes with nothing out of the norm. My dive buddy surfaced and then within 10 minutes of being on the boat was doubled over in pain. The pain was acute and affected his abdomen primarily before spreading to his extremities. His legs went numb a few minutes later. It was only our third dive in three days, and pretty conservative so I honestly did not think it could be related to decompression. It was after we got him to the hospital in the Bahamas that I started to think DCS. The attending physician did a battery of tests including two MRI's. Nothing showed up and after two hours of receiving oxygen he felt better.We rushed back to the states by boat. The next day he was feeling tingling in his legs, so he went and did 5hrs in a HB. Then two more 1Hr stints and now feels better. It was suggested that he may have been dehydrated and therefore more susceptible to DCS. My question is has anyone experienced anything like this? What would your opinion be on future dive practice?
He does not have any other medical factors, like scarring or obesity. We where well within our no compression stop profile for recreational diving.Any ideas?

People describe this as an "undeserved" hit because it's not immediately obvious why it happened. There could be some contributing factors in your buddy's physiology that make him more susceptible to DCS, or did during that particular dive.

Dehydration could be one of those factors but I would recommend your buddy get checked for a PFO. It's a normally innocuous deviation in the wall of the heart between two chambers (a small hole) that is known to be the source of a number of such "undeserved" DCS incidents. It can also be fixed. Link here

I hope your buddy makes a full recovery.

R..

 

[mmadiver]

After a "by the book " wreck dive about 95 feet with a total dive time of 25 minutes with nothing out of the norm. My dive buddy surfaced and then within 10 minutes of being on the boat was doubled over in pain. The pain was acute and affected his abdomen primarily before spreading to his extremities. His legs went numb a few minutes later. It was only our third dive in three days, and pretty conservative so I honestly did not think it could be related to decompression. It was after we got him to the hospital in the Bahamas that I started to think DCS. The attending physician did a battery of tests including two MRI's. Nothing showed up and after two hours of receiving oxygen he felt better.We rushed back to the states by boat. The next day he was feeling tingling in his legs, so he went and did 5hrs in a HB. Then two more 1Hr stints and now feels better. It was suggested that he may have been dehydrated and therefore more susceptible to DCS. My question is has anyone experienced anything like this? What would your opinion be on future dive practice?
He does not have any other medical factors, like scarring or obesity. We where well within our no compression stop profile for recreational diving.Any ideas?

Given that the symptoms occurred within 10 minutes of surfacing with acute pain in the abdomen I would of assumed POIS immediately. The actions taken by the medical providers is typical of those not familiar with diving medicine. The symptoms indicate type II DCS or AGE, take your pick but the treatment is the same - treatment table 6. They put your friend on O2 but didn't immediately run a chamber treatment?! The application of O2 saturates the blood plasma and masks symptoms. They treated your friend with o2 for two hours, symptoms masked he felt better and went home. Next day the symptoms returned - imagine that.

 

[WB2GLP]

Dive 1 of day 1? Any prior dives?

What hospital did you visit?

Did you contact DAN while in the Bahamas?

Who made the decision to transport off island by boat?

Just curious.

 

[lv2dive]

A couple of things... first of all, i agree with the others who are requesting the profile. It's really quite hard to know much of anything about the dive without the profile itself.

For example.... Both NAUI and PADI tables have NDL for EAN21 at 90 feet at 25 minutes... and one is supposed to round up to the next highest 10 foot increment and take THAT time as the max time for NDL.. A couple of thoughts:
- At 100 feet, NDL would be 20 minutes... not 25. I also understand that you all may very well not have spent most of your time at max depth... but if you did that may have played into why your friend was having trouble.
- You did say total dive time was 25 minutes, which may mean that only 20 minutes was spent on the bottom and two minutes on the ascent and three minutes on the safety stop... which would be within NDLs. But regardless, I wouldn't go so far as to call that "pretty conservative" - would still feel like it was *pushing* NDLs to me. Not that there is a problem with that, my point is just to be aware that is what it was is.

You asked for thoughts and absent the profile, I thought it was important to point out how close to NDLs this dive actually was.

Hope your friend is doing ok.

 

[Diver1969]

Thank you all for your replies. I am new to the board and very impressed with the massive amount of engagement. I will get his profile up as soon as I can get it from him. I only use "conservative" to describe the dive, because NDL on a Mares recreation dive computer is pretty conservative compared to the Cochran I used to use. It has Navy tables and much more aggressive. I can tell you my profile summary was 100ft max depth average depth 70 feet and 25 minute total dive time. I descended around 10 feet more into the wreck than he did and I hit my NDL by 1 minute. I did a deco stop at 45ft and a safety stop at 15.He did the stops with me even though his computer was not calling for the deco stop at 45ft.I think dehydration was more at play here. I drank fluids before the dive and he did not. As far as not recognizing as classic DCS I have been diving for 30 years, and I have never seen anyone bent. I imagined it as far less acute pain( I guess like an ache). This initially seemed like a Myocardial infarction the way it radiated down his arm and made him sweat. At least I will know more next time.

 

[tracydr]

We also need to know his other dives,surface intervals, nitrox or air.
I agree with the others who say I would have thought DCS immediately based on these symptoms 10 minutes after any dive.