Puzzlement
Registered
I'm posting in the Basic forum, because there wasn't an accident or near-miss, and nor do I really have a question about dive medicine and physiology suitable for the Marine Science area. I just thought I'd share a short story of pain after diving for divers curious about what happens if you have a suspected bend. Feel free to move the thread if it makes sense.
I dived two dives in Sydney yesterday, the first 46 minutes at a maximum depth of 20 metres and the second 48 minutes at a maximum depth of 17 metres, with an hour on the surface between them. I came within 5 minutes of no-deco time (according to a Suunto computer on the rental equipment, my Oceanic Veo had about 40 minutes but is a shockingly generous computer) on the second dive but never went into deco. No problems with fast ascents and I did safety stops. Finally, I thought, that problem other people talk about where dive time is limited by decompression limits rather than air consumption!
I was out of the water at 5pm and felt perfectly well. About six hours later my shoulders started hurting in a way that felt very much like muscular tension. But it got worse and worse, well past the point where I could rest or sleep. I took paracetemol and much of it went away except for very intense pain in my right shoulder joint. Ibuprofen didn't have much of an effect on it either. It was only at this point that my husband and I considered the bends.
We called DAN (the Australian version). It was 1am and it took them a little while to get the doctor on-call to answer the page. Once we spoke to him he sounded unconcerned about the profile but thought that I would probably need to attend the hyperbaric facility in Sydney. Five minutes later the Sydney specialist on call rang. He said (as we all probably know) that joint pain needs to be assumed to be DCS, but recommended going to a nearer casualty ward first and having some oxygen and then I would transfer in the morning if the pain still seemed like a bend was the right diagnosis. Given the amount of time this took (about 20 minutes of phone calls and waiting), I think I'd call for an ambulance first in the event of neurological or pulmonary symptoms and ring DAN later, although of course I imagine they would have been faster if my symptoms were more severe.
By the time I got to casualty the pain was much improved, but I didn't know if that was the painkillers or a proper improvement. The doctors in casualty knew what DCI was but I don't think had often seen a suspected case. They were most concerned with ruling out an embolism. I wasn't put on oxygen in the end, but I was held until the morning for observation and X-Rays to find out if there was an obvious mechanical reason for what was initially a very unusual pain level for me. I was discharged this morning without a diagnosis from the X-Ray (shoulder joint is fine mechanically, no barotrauma to lungs) but with advice that DCS didn't seem very likely since the pain was nearly gone. The hyperbaric chamber rang my husband at home at about 9am to find out if I was coming in and we said no.
And that's my story. I was pleased all around with the seriousness with which the symptoms were taken, both by the two hyperbaric specialist and the casualty staff. I am glad I called DAN.
I dived two dives in Sydney yesterday, the first 46 minutes at a maximum depth of 20 metres and the second 48 minutes at a maximum depth of 17 metres, with an hour on the surface between them. I came within 5 minutes of no-deco time (according to a Suunto computer on the rental equipment, my Oceanic Veo had about 40 minutes but is a shockingly generous computer) on the second dive but never went into deco. No problems with fast ascents and I did safety stops. Finally, I thought, that problem other people talk about where dive time is limited by decompression limits rather than air consumption!
I was out of the water at 5pm and felt perfectly well. About six hours later my shoulders started hurting in a way that felt very much like muscular tension. But it got worse and worse, well past the point where I could rest or sleep. I took paracetemol and much of it went away except for very intense pain in my right shoulder joint. Ibuprofen didn't have much of an effect on it either. It was only at this point that my husband and I considered the bends.
We called DAN (the Australian version). It was 1am and it took them a little while to get the doctor on-call to answer the page. Once we spoke to him he sounded unconcerned about the profile but thought that I would probably need to attend the hyperbaric facility in Sydney. Five minutes later the Sydney specialist on call rang. He said (as we all probably know) that joint pain needs to be assumed to be DCS, but recommended going to a nearer casualty ward first and having some oxygen and then I would transfer in the morning if the pain still seemed like a bend was the right diagnosis. Given the amount of time this took (about 20 minutes of phone calls and waiting), I think I'd call for an ambulance first in the event of neurological or pulmonary symptoms and ring DAN later, although of course I imagine they would have been faster if my symptoms were more severe.
By the time I got to casualty the pain was much improved, but I didn't know if that was the painkillers or a proper improvement. The doctors in casualty knew what DCI was but I don't think had often seen a suspected case. They were most concerned with ruling out an embolism. I wasn't put on oxygen in the end, but I was held until the morning for observation and X-Rays to find out if there was an obvious mechanical reason for what was initially a very unusual pain level for me. I was discharged this morning without a diagnosis from the X-Ray (shoulder joint is fine mechanically, no barotrauma to lungs) but with advice that DCS didn't seem very likely since the pain was nearly gone. The hyperbaric chamber rang my husband at home at about 9am to find out if I was coming in and we said no.
And that's my story. I was pleased all around with the seriousness with which the symptoms were taken, both by the two hyperbaric specialist and the casualty staff. I am glad I called DAN.
