Resolution of symptoms

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dsquid

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I've been reading Sheck Exley's book "Caverns Measureless to Man", and a question came to me based on this passage:

"Worse, John got bent on the dive despite his liberal use of oxygen (a concession to the increased susceptibility to bends of divers more than 40 years of age). He quietly endured the pain and dizziness and decided not to go to a chamber. He did decide, however, not to make such advanced dives anymore, a sad loss to cave exploration."

My question - do symptoms of the Bends ameliorate over time, or is this guy looking at a lifetime of the same levels of pain and dizziness?



 
Those deep and long dies are certainly saturated dives.
The decompression physiology is very complicated and can vary from an individual to another and there also a variability for a single individual.
There are so-called deserved DCS and undeserved DCS; the former is getting bend while diving within conservative profile (can occur if having a patent foramen oval).

There are some factors that may predispose to DCS:

Flying after, or altitude “trip” after diving (in less than 12 to 24 hours )
Maybe Aging
Females tend to have more DCS (More fat in some nice places… :tease: )
Bad physical condition
Exercise 4 hours before or 6 fours after a dive
Dehydration (wearing diving gear in the sun, heated dry suit, drinking a lot of coffee or alcohol)
High level of CO2 (Strong exercise during dives for example)
Cold water, performing heavy exercise during diving
Paten foramen ovale
History of DCS
Scarring (previous strokes, neurological DCS, spine chirurgy…)
Preexistent diseases (pulmonary problems, bad blood circulation in general including
vascular conditions and blood conditions )


And of course there might be some individual variation, of course nitrogen uptake and off gassing is a complex perfusion-diffusion related phenomena. Not everybody is alike.
But such deep dives might be hazardous.

Maybe it might happen again, maybe not.
If going on with such dives, the guy should use more conservative dives and decompression profiles.


fa
 
The question is - if you've already got (relatively) minor symptoms (say, joint pain) and you don't hit the chamber, is that pain going to stay with you - and at the same level - your entire life?

 
Sometimes such symptoms (DCS type 1 "pain only") might disappeared, but in some cases residual joint discomfort or tenderness might occur.
Although those symptoms are not really severe, there is a need for breathing pure o2 and seeking recompression therapy (US NAVY table 5 ) in case more severe DCS would occur and to avoid residual joint symptoms.

Talking about more severe types of DCS: DCS type 2 with neurological symptoms cane leave severe sequels and must be treated efficiently.
But people respond quite good to recompression therapy but sometimes the sequels can be invalidating and will need a quite long reeducation and may perist for life.

Fa

 
Dear Dsquid:

As far as I am aware, these problems do not persist if they are only joint pain. I am basing this on the observations of caisson workers from more than one hundred years ago. We know that the pain did abate. This was in the days before recompression therapy, although the workmen did know that re-exposure to the pressure environment was good for curing the problem.

The problem of neurological DCS is somewhat different. That will persist, but that does not seem to be what happened in this case.

Dr Deco :doctor:
 
Thanks for the response, Dr. D... Very interesting.

Do Neurological symptoms tend to persist due to actual nerve damage that is taking place due to impingment of the bubbles?

And how do the joint symptoms disappear - are the bubbles simply re-absorbed eventually - removing the irritation?



 
Dear dsquid:

The neurologic problems seem to be similar to a stroke. That is, the nerves are damaged because there is a blockage of the blood supply. With a lack of blood, the nerve cells are starved for oxygen and they die.

As far as joint pain is concerned, the injury seems to be of a temporary nature and the bubbles dissolve. If the damage persists for several hours, however, then other factors can enter into the picture. We see inflammation and fluids entering the area around the bubbles. This fluid is not compressible and recompression therapy becomes less effective as the time after the injury increase.

Dr Deco
 
https://www.shearwater.com/products/perdix-ai/

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