Alternative to Chamber?

[bamamedic]

Of course, just to throw in the whole legal-medical aspect, at least in the United States. Usually, under some sort of "Good Samaritian" law, a lay person stopping to help an injured person isn't held responsible in case of further injury or worsening of the injured person's condition, as long as his or her conduct is held to be reasonable, prudent, and within accepted standards. Attempting to provide IWR might be very well defined as not being within "accepted standards" because it's not generally recommended as treatment for DCS, especially when provided by one untrained in that sort of thing.

Perform it on yourself all you want, but if you're thinking of implementing your plan for your dive partners, you might want to consider the liability you're opening yourself up to.

 

[tgsmith]

Thanks to GrayWhale for the original post and getting this started. Thanks to DCBC and Gene for the info.

A little over a year and a half ago, I suffered 8 stress fractures in addition to stress reactions in my hips(3 in right foot metatarsals, 1 right tibia, 1 right fibia, 1 right patella somethingmajiger, 1 left femur, 1 left tibia). Being a US Marine, stress fractures aren't uncommon but 8 is quite abnormal. We did all kinds of testing for genetic/hormonal issues and couldn't find anything, in addition my bone density scan came back normal(***!?). I never really considered DON as a potential reason and I'm certain the plethora of Navy/Army docs I've seen never looked for it. I'm now on the verge of being medically retired at the young age of 24, however I'm also finally progressing through rehab with hopes of being able to run again and get back into the operational forces. That's funny, because if it was DON....uhh, well I'm now heavy into decompression diving whereas I was still in no-deco profiles when I got hurt. Part of me wants to give my doc some of those documents and ask her to look for DON, while the other half is screaming, "Not now! You've got another chance to get to the fleet and DON would surely end your chances..."

How apparent is DON in testing? I had a bone density scan, X-rays, a couple bone scans(Where you are injected with radioactive kool-aid ) What I'm asking is would it pop out to docs, or would they have to be specifically looking for it?

I might be doing my normoxic trimix when I head back down to cave country in december

Safe Diving,
Tyler

 

[DCBC]

Thanks to GrayWhale for the original post and getting this started. Thanks to DCBC and Gene for the info.

I'm now heavy into decompression diving whereas I was still in no-deco profiles when I got hurt. Part of me wants to give my doc some of those documents and ask her to look for DON, while the other half is screaming, "Not now! You've got another chance to get to the fleet and DON would surely end your chances..."

How apparent is DON in testing? I had a bone density scan, X-rays, a couple bone scans(Where you are injected with radioactive kool-aid ) What I'm asking is would it pop out to docs, or would they have to be specifically looking for it?

Hi Tyler,

Early detection of Femoral Head Necrosis, usually involves MRI testing of the shoulder joint (where it often first shows its ugly head). Commercial divers who have a good hyperbaric physican often plan MRI inspections if they routinely dive deeper than 15 M (regardless of mixture). I find this shallow depth limit quite telling... I'm not saying that this is routinely done by the vast majority of commercial divers, but it was recommended to me by the Docs at DCIEM and I have found it wise to follow there advise in the past (I'm still here). MRI allows the diagnosis of FHN much earlier than x-rays.

Dysbaric osteonecrosis is usually the result of hyperbaric injury and is relatively rare. It can however remain undetected for years regardless of the detection methods used. A history of hyperbaric exposure that is greater than 30 M is a risk factor, but shaft lesions are usually present with hip pain (although I understand that all early DON lesions in divers are pain-free).

Obviously an accurate diagnosis between FHN and DON is essential for preliminary management and can only be made by an orthopaedic surgeon who is knowledgeable about both conditions. From what you said about your diving profile prior to the accident, I doubt you are at risk. I recommend that you speak with a hyperbaric physician about your future risk factors. Hope this helps.