Second Episode of Skin Bends

[ljwillia]

I had my first diagnosis 3 years ago in Cozumel. I was diving air. Since then, I've been diving nitrox, not on air tables. I was nervous about not knowing my tissue loading so set my computer for the correct mixture and made sure to dive very conservatively. I'm a recreational, vacation diver so we only have a chance to dive twice/year. I have not had a recurrence until this week.

I was back in Coz over Thanksgiving and once again, on my 4th day of diving had the exact same symptoms. My Nitrox mix was 32 on my first dive and 36 on my second. My first dive of the trip was a max of 80' but didn't stay long. I much prefer the tops of the reefs and generally hang out between 45'- 30'.

I decided to see a dive med Dr. when we got home but can't find one in my area. I'm wondering if I should be evaluated for a PFO. If it turns out I have one what does that mean? Can it be repaired? I love diving and don't want to give it up. I would be happy to limit my dive depths since I prefer a shallower dive anyway.

Are skin bends a precursor to something worse or only if you ignore it and keep diving? I'm 61 and have more adipose tissue than I would like Honestly, it's probably not going anywhere. Not horribly overweight, just...soft.

 

[grantctobin]

Outside of a PFO, Dehydration and poor general health would be my guesses given the dives and profile described. Fortunately, most PFO quite fixable.

 

[OTF]

Can you upload computer profiles of the sequence of dives that bent you?

It does sound like there's something unusual if you're displaying symptoms on "normal" dives. Don't ignore DCS symptoms. Did you call Divers Alert Network for advice or a doctor reference? They can provide free referrals and qualified medical advice. It's definitely time to see a dive medicine specialist. Maybe a remote consult if there really aren't any near you.

For what it's worth, I know several divers with known or suspected PFOs who still dive, they just plan their dives exceptionally conservatively. Like running gradient factor 40/60, ascending SLOW, always taking some extra hangtime, staying hydrated, staying warm, no heavy activity post dive, etc.

 

[Stoo]

I'd also be interested in knowing more about "you". Body type, diet, smoker etc? And what else you do when you're away... booze, sleep habits etc.

But for sure get checked out for a PFO. There are reasons to get it fixed outside of diving.

 

[michael-fisch]

IBut for sure get checked out for a PFO. There are reasons to get it fixed outside of diving.

Outside of having strokes and migranes?

Michael

 

[Stoo]

Outside of having strokes and migranes?

No, I think that about covers it.

 

[ChuckP]

I too would love to see the dive profiles for the week. Do you see the Dr here (cozumel)? There has to be a dive Dr on the east coast close to you and I would certainly seek one out to get a real opinion.

Maybe @Duke Dive Medicine will read this and give you some direction

 

[Duke Dive Medicine]

I had my first diagnosis 3 years ago in Cozumel. I was diving air. Since then, I've been diving nitrox, not on air tables. I was nervous about not knowing my tissue loading so set my computer for the correct mixture and made sure to dive very conservatively. I'm a recreational, vacation diver so we only have a chance to dive twice/year. I have not had a recurrence until this week.

I was back in Coz over Thanksgiving and once again, on my 4th day of diving had the exact same symptoms. My Nitrox mix was 32 on my first dive and 36 on my second. My first dive of the trip was a max of 80' but didn't stay long. I much prefer the tops of the reefs and generally hang out between 45'- 30'.

I decided to see a dive med Dr. when we got home but can't find one in my area. I'm wondering if I should be evaluated for a PFO. If it turns out I have one what does that mean? Can it be repaired? I love diving and don't want to give it up. I would be happy to limit my dive depths since I prefer a shallower dive anyway.

Are skin bends a precursor to something worse or only if you ignore it and keep diving? I'm 61 and have more adipose tissue than I would like Honestly, it's probably not going anywhere. Not horribly overweight, just...soft.

Good morning,

Do you have photos of the skin rash, or can you describe it?

We are probably the closest facility to you who can evaluate you from a diving perspective. I pm'd you our contact information.

Best regards,
DDM

 

[ljwillia]

Can you upload computer profiles of the sequence of dives that bent you?

It does sound like there's something unusual if you're displaying symptoms on "normal" dives. Don't ignore DCS symptoms. Did you call Divers Alert Network for advice or a doctor reference? They can provide free referrals and qualified medical advice. It's definitely time to see a dive medicine specialist. Maybe a remote consult if there really aren't any near you.

For what it's worth, I know several divers with known or suspected PFOs who still dive, they just plan their dives exceptionally conservatively. Like running gradient factor 40/60, ascending SLOW, always taking some extra hangtime, staying hydrated, staying warm, no heavy activity post dive, etc.

I did not call DAN this time around. The first time I talked to DAN. They recommended, and I went to the hospital on Coz. The doctor there told me it was a classic presentation. Since the presentation this time around was identical I followed the same advise as last time; stop diving, hydrate, rest.

I did contact them when I got home to see if they could provide a referral. The doctor's name they provided is an anesthesiologist. I haven't contacted him.

As for uploading my computer, I need to download it first. Haven't done that yet.

 

[ljwillia]

Good morning,

Do you have photos of the skin rash, or can you describe it?

We are probably the closest facility to you who can evaluate you from a diving perspective. I pm'd you our contact information.

Best regards,
DDM

I didn't take pic's this time around. I did in 2017 but I no longer have them. The rash was light. Not the large purple welts I saw in pictures of people with a much worse case. Mine was almost like hives, predominately on my torso. The symptom that first got my attention was the deep ache in my breasts. That's how it started last time.