Welcome to ScubaBoard, an online scuba diving forum community where you can join over 205,000 divers from around the world discussing all things related to Scuba Diving. To gain full access to ScubaBoard (and make this large box go away) you must register for a free account. As a registered member you will be able to:
Participate in over 500 dive topic forums and browse from over 5,500,000 posts.
Communicate privately with other divers from around the world.
Post your own photos or view from well over 100,000 user submitted images.
Gain access to our free classifieds marketplace to buy, sell and trade gear, travel and services.
Use the calendar to organize your events and enroll in other members' events.
All this and much more is available to you absolutely free when you register for an account, so sign up today!
If you have any problems with the registration process or your account login, please contact the ScubaBoard Support Team.
Nov 2011. Galapagos. Day 5 of diving, all Nitrox. Normal, easy dive. Max depth 80 ft/41 minute dive. Water temp 56-60 F. Safety stop normal. 1000 PSI as I began ascent.
If I remember correctly, I felt short of breath on the way up from 15 ft. At the surface, I could not breathe, was wheezing heavily, but fortunately surfaced at the Zodiac and just grabbed the rope. Leaned forward and started coughing. Am told I never went blue nor coughed any blood. Handed up my weight pockets when no one else could get them out. Unclipped my BC and the rest is pretty fuzzy. The other divers removed my BC and fins. I don't remember that. They pushed and pulled until I was laying over the side of the Zodiac where I remained until I could breathe again. I don't remember being pulled up, but do remember laying there wheezing and trying to breathe. 30 minutes later I got 10 minutes of oxygen at my insistence. I seemed fine. It was 36 hours before I could get to a doctor, partly Galapagos and partly lead dive guide thinking nothing was wrong. Breathing was relatively shallow the whole time and the next morning, my left 'lung' hurt continually. I was quite anti-social after the accident.
Exams revealed decreased lung function, no reaction to what should have been pain on my skin, loss of balance and no sense of taste. 6 days of chamber treatments, a few days wait to fly and then 2 days in a mainland hospital for a battery of tests to rule out cardio problems, PFO, etc. There are none. Blood pressure ran very high during chamber treatments, but one Duke doctor told me on the phone he thought I had a pulmonary embolism instead of an AGE hit. Result: More stress. I opted to trust local physician instead and am glad I did as he was right and the Duke doctor wrong. (Not DAN related, btw...they were great!) By Day 3 or 4, I had to take tranquilizers to go into the chamber. Galapagos is lucky to have a dive doc like Gabriel Idrovo.
I am 53 and had never had high blood pressure, as recently as May 2011 at my last check up. But for the last year, I have not been as physically active as I had been before that. Blood tests reveal my cholesterol is elevated, a first. Less healthy diet, less physical activity for the last year mostly likely a huge factor. And me thinking my experience/familiarity would compensate. (PS...have lost 10 lbs with 10 lbs more to go before I'll dive again.)
Fluke series of events may have been the specific cause. I took prophylactic Sudafed (bad move) in the AM which increased my heart beat which caused a spike in my blood pressure which, along with some existing congestion in my lung I was not aware of, caused a pulmonary edema which caused a severe bronchial spasm which caused shortness of breath on final ascent after safety stop which caused the lung expansion injury which allowed the gas bubble to escape into my artery and travel to the brain. Cat scan with dye showed the bubble 2 weeks post accident.
Last year, I had lots of congestion/sinus problems. 5 different specialists all said nothing was wrong. It's pretty clear to me now that the source of my congestion is gluten. I am allergic to gluten and had indulged 2 weeks prior to diving.
I feel very lucky to have survived the #2 cause of death in divers and to have recovered 100%. But now, the challenge is psychological. At the moment, I can't imagine diving any more than I can imagine life without diving.
The dive before this one was at Wolf where currents are usually fairly strong. My mask kept fogging, so about 25 minutes in, I thumbed the dive, alerted the dive guide and ascended on my own. Zodiac stayed with group bubbles, so I had to use my Dive Alert and SMB at the surface. I can't help but wonder how I would have handled it if I had surfaced alone with no boat in sight. Not sure I could have ever gotten my breath floating on my back. I literally could not breathe. Grabbing that rope allowed me to lean forward and cough. Hard not to think about it though.
Lessons Learned: NEVER surface alone. Do NOT eat gluten period. Be in shape or don't dive. No Sudafed, etc. Insist on what you suspect should be done in the event of an emergency. I wondered if I should have oxygen all the way back, but didn't insist. If someone else had been in my position, I would have insisted on a conservative approach for them, but did not for myself. I felt like I didn't want to be a bother. I didn't want to spoil everyone else's fun. I learned that in this position (the victim), I don't think clearly and certainly not up to normal par. When someone asked if I was okay, how was I to really know?
I discussed this at length with DAN docs post accident. With fluid on my lung and congestion, apparently it only takes mis-timed breathing on ascent to create the expansion. And gluten is something they are now looking into more proactively partially inspired by this specific accident. I could have saved myself a lot of money on docs (not to mention perhaps this accident) if I hadn't thought my only gluten consequences were digestive tract related. Had even seen years ago how my tinitis cleared up by going gluten free. Have read about the many difficulties it can result in, but thought that applied to others. Thought I had only an intolerance, not full blown celiac.
Last edited by sinduda; January 18th, 2012 at 07:46 PM.
So has anyone out there had a scare of this caliber and continued to dive? I'm a deer in the headlights right now. Would appreciate hearing from those who moved forward. Would appreciate knowing if anyone else can connect the dots between gluten and congestion.
Close call there indeed and a long ways out. Pseudoephedrine is often used by divers, but there are risks. Dive buddies should never separate, true - always ascend together, as going up is no guarantee. And yes at least one member here survived a similar hit and returned to diving. I'm going to ask Jax to look here as she is more up on this.
You might also post in the Dive Medicine forum for feedback from physicians there.
Great news for vacation divers who cannot talk themselves into buying a personal CO tank tester!
>> Rent one for a week or longer here <<
Now let's see more CO readings in your trip reports, ok...??
She is back and diving. While hers, and a few others were deemed Immersion Pulmonary Edema, I'm sure they had some of the same "Oh, sh!t" feeling you have.
"Equality of opportunity or equality of outcome?
One is consistent with a free people and the other requires a police state. Pick one." ~Cool Hardware52
I, alone, am responsible for my health and safety, my actions and inactions.
"If a small thing has the power to make you angry, does that not indicate something about your size?" ~Sydney J. Harris
She is back and diving. While hers, and a few others were deemed Immersion Pulmonary Edema, I'm sure they had some of the same "Oh, sh!t" feeling you have.
Great news for vacation divers who cannot talk themselves into buying a personal CO tank tester!
>> Rent one for a week or longer here <<
Now let's see more CO readings in your trip reports, ok...??
I did read through both the IPE threads and found some, not all, similarities. Flots am...in spite of 1 neurologist, 1 surgeon and 1 radiologist reading the cat scan, I was informed today by the most credible of sources that it is impossible that it would show up 2 weeks post accident and after the chamber treatments. So I will take the cat scan to a dive doc next week for another consult. Nothing about this was simple and perhaps my reluctance to get back in the water at this point comes from not fully understanding what happened in the first place. My response to this news tells me how 'fresh' it still is, too. Psychological impact aside, without being truly clear on the cause, it seems impossible to know how to prevent in the future.
ps update: Spoke with the US Radiologist who looked over my images. She says it's a gas embolism still visible, that it absolutely is not a blood clot nor was it a fat embolism. Added that it probably had not yet fully absorbed, but if I had a new cat scan, she doubted anything would be visible. So hmmm.
Last edited by sinduda; January 21st, 2012 at 05:13 PM.
She is back and diving. While hers, and a few others were deemed Immersion Pulmonary Edema, I'm sure they had some of the same "Oh, sh!t" feeling you have.
"Equality of opportunity or equality of outcome?
One is consistent with a free people and the other requires a police state. Pick one." ~Cool Hardware52
I, alone, am responsible for my health and safety, my actions and inactions.
"If a small thing has the power to make you angry, does that not indicate something about your size?" ~Sydney J. Harris
I did read through both the IPE threads and found some, not all, similarities. Flots am...in spite of 1 neurologist, 1 surgeon and 1 radiologist reading the cat scan, I was informed today by the most credible of sources that it is impossible that it would show up 2 weeks post accident and after the chamber treatments. So I will take the cat scan to a dive doc next week for another consult. Nothing about this was simple and perhaps my reluctance to get back in the water at this point comes from not fully understanding what happened in the first place. My response to this news tells me how 'fresh' it still is, too. Psychological impact aside, without being truly clear on the cause, it seems impossible to know how to prevent in the future.
ps update: Spoke with the US Radiologist who looked over my images. She says it's a gas embolism still visible, that it absolutely is not a blood clot nor was it a fat embolism. Added that it probably had not yet fully absorbed, but if I had a new cat scan, she doubted anything would be visible. So hmmm.
Maybe the question to be asked is, "What would look like a gas embolism in a cat scan?"
I would recommend you report your first post and have this moved to Diving Medicine. With that ongoing study At Duke (did you see the post on that?), they can bring some hellacious resources to bear.
"Equality of opportunity or equality of outcome?
One is consistent with a free people and the other requires a police state. Pick one." ~Cool Hardware52
I, alone, am responsible for my health and safety, my actions and inactions.
"If a small thing has the power to make you angry, does that not indicate something about your size?" ~Sydney J. Harris
Maybe the question to be asked is, "What would look like a gas embolism in a cat scan?"
I'd recommend leaving interpretation of medical diagnostic images to a well-trained radiologist. Depending on the type of scan +/- contrast, air/bone/blood/soft tissue will look a certain way.
@sinduda: Thanks for sharing your story.
Did your treatment team specifically report findings of pulmonary edema? The reason I ask is that it's possible for a lung over-expansion injury to give rise directly to AGE.
FYI, I would not be so quick to attribute the incident to a diet containing gluten. Celiac disease (CD) is a real condition, but it's getting over-hyped in media/tabloids nowadays. Diagnosis of CD often entails assaying the blood for specific antibodies. However, the most accurate test involves a biopsy of the small intestine. Be aware that it's easy to mistake acute viral gastroenteritis for CD.
5Likes
LinkBack URL
About LinkBacks
Reply With Quote
Originally Posted by Jax
