A TALE OF TWO SCUBA DEATHS (invitation to further discussion)

[markmud]

Thank you Ken Kurtis for starting this thread with your article. I enjoyed reading it and the responses given. I enjoyed the medical related posts.

I have been a witness to people who are in my age group dying (my wife and I are about 58). A neighbor, a coworker, and a distant family member. They all died recently.

A few years back a customer of mine, who was involved in a high stress career told me that his peers were not making their retirements--they were 55 to 65. They were dying.

A friend and some acquaintances are/were ER doctors. For them, as I witnessed their lifestyle, it was a high-stress career. I am speaking of the physical demands of their job. Not the mental demands--they rarely spoke of the mental strain caused by not being able keep a child alive during the Golden Hour. They rarely spoke of their actions while trying to save a victim of crime.

As for the other guy who was featured in Ken's article, well he had a death wish. He may have rationalized otherwise, but death wish it was.

markm

 

[Kevrumbo]

Eerily prophetic, and so depressing to discover in the Scubaboard Archives, the history about a similar ncident over five years ago --and a sobering realization how this prior account quoted below in her own words, might be the actual explanation behind the recent mystery & tragedy of Lynne's Disappearance:

(posted Jan 4 2010) So, Saturday, my husband and I did a planned staged decompression dive at Whytecliff Park in Vancouver. The plan was a max depth of 130 and no more than 15 minutes of deco (which we knew we wouldn't reach). We were diving 25/25, with O2 for deco gas. We used scooters to get out to the wall, and the deep portion of the dive was uneventful. We averaged significantly shallower than our plan (which is not unusual) and actually had only about five minutes of mandatory decompression when we left the wall at its top, at about 50 feet.

We started swimming toward shore, and I was following the reciprocal heading we had used coming out. Peter wanted to get us shallower, following the deco plan, so I signaled that I wanted to get on the scooters, because my thought was that, rather than swim and do deco in midwater, we could follow the contour up if we could move faster. He didn't understand why I wanted to get back on the scooters, and he signaled to move up to 20 feet, which was our gas switch depth. I okayed that, but didn't move up as fast as he did, so he disappeared from my view. I am now in midwater with no visual reference and have lost visual contact with my buddy.

I have had serious problems with vertigo in midwater since I started diving, and only about a year ago did someone give me the key -- rapid head movement with no visual reference will start me tumbling. Since I got that piece of advice, I haven't had an episode. But on this dive, I was really worried about losing Peter, because we were both on scooters, in fairly poor visibility. If I continued to motor without being able to see him, it was highly likely we'd get separated, as we'd been disagreeing on the heading all along. If I didn't get on the trigger, we were SURE to be separated, because I could hear his scooter motor running, and it would only take seconds to be unable to see one another. So I began looking for him actively, which involved rolling up on my side and turning my head repeatedly . . . and sure enough, after a couple of iterations, the world broke off its moorings and began tumbling and spinning, and I lost all sense of where up was.

In every prior event like this, I have ended upon the surface. I knew I couldn't afford to do that this day. I couldn't use the scooter, because I didn't know which way was down -- but I knew if I exhaled and vented, I'd sink. The bottom was no deeper than 50 feet, and I was a lot safer hitting it than hitting the surface. I was clawing at the water with my hands, completely disoriented and trying desperately to use the tools I've gained from cave training to get myself sorted out -- where were my bubbles going, and how did my drysuit feel? I finally got to where I knew I was going down, and began trying to arrest my descent and overshot, and yo-yoed badly a couple of times before I got things under control. I could see Peter flashing my hands at one point, but there was NO way I was going to try to look up at him. (I should have given him a "hold" signal, but I didn't have enough processing power at that point to think of it.) Finally, at about 30 feet, I got stopped, got stable, got my breathing and my heart rate under control, and could begin to try to dive again.

Lessons learned:

1) I KNOW I can't search for a buddy in midwater. I shouldn't have tried. If you can't stay where I can see you, you need to stay where you can see me, and be aware that it's YOUR problem at that point.

2) I got it stopped. I could never do that before. I have gained tools from other training that were directly applicable here. No training is ever wasted.

3) It is useful to be able to decide quickly what the biggest danger is. In this case, it was being too shallow. Being too deep I could deal with, and was going to be limited in any case by the hard bottom. Once I decided shallow was bad, I knew what I could do to avoid it, even if I didn't know where I was.

4) If you have a weakness, don't ever think it's been overcome. It can sneak back and bite you at the most unexpected times. Constantly work on the things where you have problems (or, as my wonderful cave instructor said, "Just because you aren't good at something isn't a reason not to do it. It's a reason to do it more often."

http://www.scubaboard.com/forums/ne...-learned/318124-vertigo-deco.html#post4948568

I don't have any issues with vertigo in any setting other than diving. But I have a lousy sense of balance -- I could never walk a balance beam in school, even if it was only 4" off the ground. I'm intensely dependent on my eyesight for orientation, apparently, and when I'm deprived of it (or when the visual input doesn't make sense, as inside a wreck that's lying in some weird position) I'm a bit of a mess.

It takes a very definite set of circumstances to get me into trouble these days. I have to be in midwater, in poor viz, in motion (not just hovering), and lose sight of my entire team. Thank goodness, all those things together don't happen very often.

Probable cause due to Vertigo and Exertion Hypercapnia/Dyspnea in Scuba diving activity; with resulting unrecoverable Dizziness & Disorientation, Narcosis & Incapacitation --finally leading into Unconsciousness.

 

[Ken Kurtis]

. . . and a sobering realization how this prior account quoted below in her own words, might be the actual explanation behind the recent mystery & tragedy of Lynne's Disappearance . . .

Every since the vertigo issue was brought up, the suspicion in the back of my mind was that the vertigo might possibly be a key player in explaining what happened. And although this archived post isn't the proverbial smoking gun (past performance is no guarantee of future results . . . aka, facts not in evidence) it certainly does provide a history and experience in Lynne's own words that would help us start to make sense of this. In that respect, perhaps it also provides a bit of closure.

- Ken

 

[Rhone Man]

Not to be gruesome, but I am a little surprised that Lynne's body has not yet surfaced. Correct me if I am wrong, but I had always understood that after someone has been dead for several hours the body starts to release gases. I just assumed that eventually her drysuit would fill and she would float up?

 

[Kevrumbo]

Every since the vertigo issue was brought up, the suspicion in the back of my mind was that the vertigo might possibly be a key player in explaining what happened. And although this archived post isn't the proverbial smoking gun (past performance is no guarantee of future results . . . aka, facts not in evidence) it certainly does provide a history and experience in Lynne's own words that would help us start to make sense of this. In that respect, perhaps it also provides a bit of closure.

- Ken

Ken, respectfully then in closure --the differential diagnosis would be "Rule Out Vertigo as precipitating cause (?)".

I'm sure that Lynne Flaherty MD (May She Rest In Peace) would concur, "When you hear hoofbeats, think of Horses --not Zebras" :

In making the diagnosis of the cause of illness in an individual case, calculations of probability have no meaning. The pertinent question is whether the disease is present or not. Whether it is rare or common does not change the odds in a single patient. ... If the diagnosis can be made on the basis of specific criteria, then these criteria are either fulfilled or not fulfilled. — A. McGehee Harvey, James Bordley II, Jeremiah Barondess

Despite all her knowledge, skill, ability & experience Scuba diving, and courageously managing the Vertigo handicap all these years as well --Tragically she just couldn't overcome and recover this time on her last dive. . .

Again, eerie & frightening thoughts in Lynne's own foretelling words:

. . .I don't think it's necessarily the case that no one should look around on deco -- but if you're susceptible to vertigo, as I know I am, it's a definite risk. Most divers I know have never had vertigo, and often don't even understand what I'm talking about when I describe what happens to me in midwater. . .

. . .It is true that probably the most common cause of vertigo while diving is unequal pressure in the ears. Mine is not due to this, because it can come on quite suddenly while remaining at the same depth. But it does seem to be related to rapid head movement. . .

. . .And yes, I can use the bubbles going up each side of my head to stabilize myself, as well as how my feet feel in my drysuit and how my gear feels on my body. But it takes a little time to check all those things and integrate them, and during the few seconds it takes me to do that, my personal experience is that I am tumbling violently. It's very unpleasant. Of course, the kicking and clawing I do actually CREATES the instability I think I have (but don't), so it's really important to suppress the urge to do those things. . .

. . .I could have made this whole thing a bit smoother if I'd had enough bandwidth to signal Peter that something was wrong, or even to give a "hold" signal. But for the time the vertigo was going on, I have everything I can do to cope with it; there was nothing left with which to think of signaling anybody. The first "outside" thought I had was when I saw Peter flash my hands, and my thought at that time was unprintable, but to the effect that no way was I going to look up at him!. . .

. . .We don't learn without stretching a little, but occasionally the ocean bites back and tells you [that] you overestimated yourself . . .

http://www.scubaboard.com/forums/ne...-learned/318124-vertigo-deco.html#post4948568

 

[AfterDark]

It isn’t hard to develop a theory based on Kevrumbo's post of Lynn’s post that on her last dive she may have experienced vertigo, and may have dealt with the vertigo in a similar fashion, that is going negative but, this time a down draft current was one too many balls to juggle.

 

[Kevrumbo]

It isn’t hard to develop a theory based on Kevrumbo's post of Lynn’s post that on her last dive she may have experienced vertigo, and may have dealt with the vertigo in a similar fashion, that is going negative but, this time a down draft current was one too many balls to juggle.

And Rule Out Ox-Tox (?) if she was on Nitrox32 --Also include the stress anxiety realization of an uncontrolled vertiginous descent past MOD in a downcurrent. . .

 

[AfterDark]

And Rule Out Ox-Tox (?) if she was on Nitrox32 --Also include the stress anxiety realization of an uncontrolled vertiginous descent past MOD in a downcurrent. . .

I don't intend to rule out anything.

 

[gypsyjim]

Developing a theory is just that, exploring one option. Researching one possible scenario is not ignoring other possibilities, unless you try close the door on other options by stating that this one theory is not a theory, but the fact.

All this is speculation, and theorizing. That is all anyone has without more evidence.

 

[Kevrumbo]

Developing a theory is just that, exploring one option. Researching one possible scenario is not ignoring other possibilities, unless you try close the door on other options by stating that this one theory is not a theory, but the fact.

All this is speculation, and theorizing. That is all anyone has without more evidence.

Victim had stated Acute History of Vertigo. "Rule Out Vertigo " --meaning it can't be proven or disproven at this time without further diagnostic test or evidence (and may never be resolved in this instance), but even from a incomplete Medical Diagnostician's perspective, it still is the most likely causal condition for the dive accident.

Dismissing it all as "lamentable speculation & theorizing" serves no objective purpose, and at worst smacks of denial. . .