ASD and D

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mrjohndoh

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Hey Doc. I am an instructor with a previous DCS hit. I recently returned to diving after a 16 month break. I am experiencing pain in the same location and mannor as the hit that I took 16 months ago. My recent profiles have been no deeper than 25 feet, with repetitive descents and ascents. Everything I now tells me that DCS should not happen at those shallow depths. After speaking with DAN and a hyperbaric physician, It was concluded that I should be tested for an ASD. My questions: What are the chances of recuring DCS symptoms at such shallow depths and would the presence of a ASD increase the likelyhood of DCS? Thank You
 
Dear mrjohndoh:

ASD :confused:

You mention an ASD (atrial septal defect) although what was probably mentioned was a PFO (patent foramen ovale). They are somewhat similar but not quite the same, and not nearly as common as a PFO.

Atrial Passages and DCS

You mention that you have reoccurring pain, I will guess, in some moveable joint area, and that this occurred before. I would suspect that this pain might appear when you do not dive, of if only when diving, it is related to something specific to diving, such as carrying gear a certain way or the manner in which a strap is position.

The depth of 25 feet is not sufficient to result in DCS unless you were there for hours. I would suspect that this is not the case.

Joint Pain DCS

Joint pain is generally ascribed to an autochthonous gas phase, that is, one that grows in place. An embolic origin of joint pain DCS would require that bubbles also travel to the same local to produce pain in one spot consistently. The random nature of the embolization process makes this unlikely. [Certainly with “flow segregation” and the “Coanda effect” some scheme might be conjured up, but it would really be pushing it. :mean: ) Testing for a PFO, then, would be of little value in this diagnosis.

That is not to say that you do not have a PFO, but joint-pain DCS alone is not a reason to suspect it. I would search for a cause that did not involve barophysiology since it does not appear to be the culprit in this case.

Dr Deco :doctor:

Readers, please note the next class in Decompression Physiology :grad:
http://wrigley.usc.edu/hyperbaric/advdeco.htm
 

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