Tim Ingersoll:
Just returned from Cozumel. Seven day trip staying at the Presidente with wife and kids. Got bent.
Took the first day off from diving and did the family thing. Started the day with a workout at the resort gym. Did the same workout I do here at home. Twenty minutes of cardio and then 40 minutes with the weights. Had a few drinks that night. Nothing out of control. Drank water before turning in. Drank plenty of liquids the next morning. Dove with Aldora as usual. Drank a pint of water on the ride out. First dive Palancar Gardens. Max depth: 105 feet. Most of the dive spent between 60 and 80 feet. Duration 70+ minutes. Interval was almost two hours. Drank a pint of water at the interval and another on the boat out. Second dive was max depth of approximately 80 feet for 70+ minutes. Most of the dive spent at or above 60 feet. I dive with two computers a Suunto Fusion and an Oceanic Veo 200. The Oceanic never had a problem with my profile the first day. The Suunto called for a five minute deco stop at fifteen feet. It cleared in less than three minutes. I stayed at the safety stop for a total of seven minutes.
That night I had approximately four alcoholic drinks. Once again, two glasses of water before bed, Juice and water with breakfast. Two cups of coffee. Water on the boat ride out. First dive was Colmbia Normale. Once again max depth approximately 105 feet. Duration a little over an hour. Most of the dive was spent between 60 and 80 feet. Water at the surface interval of approximately 2 hours. Second dive was max depth of 80 feet. Most of the dive was between 50 and 60 feet. Duration was over an hour. My Oceanic said no problem. The Suunto called for a three minute stop at 15 feet. I stayed five minutes.
Upon returning to the boat my left shoulder immediately started to hurt. Dull ache consistent with a muscle sprain. I blew it off as just that (Nobody gets bent after four dives right?). The pain subsided somewhat but was still notceable for the remainder of the day. I self-medicated somewhat with alcohol (yeah, yeah, I know). I posted a thread under the "Ask Dr. Decompression" category and received responses later that day basically telling me not to be stupid and get it checked out. The most effective post was "Denial is the last step before recovery." I still didn't want to believe I got bent. I woke up at 2 in the morning and believed it. The pain was worse.
Tim
This is a good report. I can empathise with you. I too got bent in Cozumel; a mixture of cowboy DM antics and probably, and more to the point the drinking that I did before and after the dive. I learned a valuable lesson and now don't even have a snifter whilst diving. I learned the hard way, but as Neitsche said ' What doesn't kill you makes you stronger'. I qualify the following statement from research as a PADI instructor and a bachelors degree in Sport Science and Sports Physiology.
I would like to point out a couple of things thought that could have also contributed to your DCS. Firstlty and well documented (forgive me if I am repeating any of what has previously been posted, I only just found the thread with 17 pages). Exercise before and after diving. This should be avoided. When you exercise the body of course warms up and the the blood pressure naturally rises to transport more oxygen rich blood around the body. You indeed put your muscles and tissues ynder further pressure by increased load and exertion. Imagine what is happening and you can equate it a bit like ascending too quickly. The tissues that have absorbed nitrogen are under pressure at depth, you ascend slowly, slowly decreasing the pressure on the tissues, off gasing all the time. If we ascend too fast (change in pressure gradients) the nitrogen may leave the tissues and enter into the bloodstream as bubbles. It is of course when these bubbles travelling in our bloodstream get caught in the joints or worse still get into the heart that the situatuion is serious.
You may say I know all this so why is he telling me. Well as the tissues at sea level are at 1 ATM, as are the surrounding blood vessels. As we exercise our body warms and the tissues are put under pressure. Light aerobic activities, like walking and swimming, mildly increase heart rate and redirect blood from organs to muscle and associated tissues. Before a dive, such exercise will not affect nitrogen uptake. After a dive, it would be expected to promote safe off-gassing and inhibit bubble formation and expansion. In fact, some studies suggest light exercise decreases the incidence of DCS.
However, vigorous aerobic exercise, like hard running or strenuous hiking, produces pronounced changes. Markedly increased temperature, blood flow, and oxygen use within tissues immediately before a dive could result in an undesirably rapid uptake of nitrogen upon descent. After a dive, such exercise or an exhausting surface swim to the boat could contribute to a dangerously accelerated elimination rate.
DANs Medical Centre website suggests a two-hour delay after exercise as a minimum guideline for diving and considers four hours safer. Since vigorous postdive exercise almost surely is more pernicious than pre-dive activity, additional conservatism seems warranted. Some studies suggest that while the biggest increase in risk may occur within an hour or two of arduous exercise just before and just after a dive, risk likely remains somewhat elevated up to six hours.
Of course, the number and frequency of dives on any trip will bear on the degree of conservatism that would be prudent. For example, after 3-4 days of diving deep walls, youll want to be more cautious than when doing only a single shallow dive and then returning home.
Dehydration and exerciseinduced pain are exercise-related factors that can prove problematic. Risk statistics consistently show a sizeable association between dehydration and susceptibility to DCS. Perspiration due to vigorous exercise, especially in hot weather, can further the fluid loss already inherent in scuba. Given that joint pain is among the most common symptoms of DCS, injuries to joints and muscles provide fertile ground for confusion between DCS-related pain and exercise-induced discomfort. Avoid them, and the unnecessary chamber visits they may occasion.
The best advice is moderation. Stay well hydrated and warm. Avoid strenuous exercise of any type for 4 and 6 hours before and after diving, respectively, but remain mildly active between dives and for a while after the last dive. Reduce anxiety and confusion about symptoms of DCS by knowing the location and characteristics of your pre-dive aches and pains, and be alert to changes in their nature or intensity.
IF IN DOUBT AND AS A MATTER OF COURSE DITCH THE PRIDE AND GUZZLE SOME OXYGEN. IT WON'T HURT IF YOU DON'T HAVE DCS BUT IT WILL HELP IF YOU DO.
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