Bad Sunday night: pain after diving

[Gene_Hobbs]

I'll have to think about whether there's any good way to get word out to the ER community that O2 is the FIRST treatment of choice for DCS.

I send this paper (on a regular basis) to the hospitals we get referrals from:

Longphre et. al. First aid normobaric oxygen for the treatment of recreational diving injuries. Undersea Hyperb Med. 2007 Jan-Feb;34(1):43-9. RRR ID: 5514

A lot of faxes and time on my part but I feel like it is worth it.

 

[fisheater]

I send this paper (on a regular basis) to the hospitals we get referrals from:

Longphre et. al. First aid normobaric oxygen for the treatment of recreational diving injuries. Undersea Hyperb Med. 2007 Jan-Feb;34(1):43-9. RRR ID: 5514

A lot of faxes and time on my part but I feel like it is worth it.

Thanks from the diving community.

 

[vixtor]

Puzzlement, I forgot to ask you one thing: is by any chance your Veo a Veo 250 (with dive profile logging capabilities), or do you still have access to the rented one? It could be very interesting if you would be able to post your diving profile in some digital format (or at least as a screenshot).

I am very curious about the real dive profile - how close or how far away it was from the square profile.

 

[Puzzlement]

I've had fairly bad pain in my shoulders when I was a new diver and had to carry my gear on my back a longer distance than normal -- Was this the case for this diving day? Or did you have to haul tanks from the car to a boat? Bad pain doesn't just come out of nowhere.

I guess the major reasons I would have to have joint pain without DCS would be: heavy lifting the day before the dive (Saturday), combined with existing structural weakness in the joint (it has subluxed on several occasions, although not for a few years and never without force applied). Dive day lifting was the normal amount (and it was a boat dive).

I haven't ever had such severe pain that ended up at a single point, but I've certainly had the shoulder-neck area pain reach the same level in the past. (I had no reason to suspect DCS at those previous times, without a recent dive.)

 

[Puzzlement]

Puzzlement, I forgot to ask you one thing: is by any chance your Veo a Veo 250 (with dive profile logging capabilities)

It is a 180. This has downloadable logs but I don't know whether they include samples of the profile and I don't have access to them in any case, not having the data cable. Incidently, the 180 is incredibly generous: it gave me about 40 minutes remaining at depth at the end of my final dive. The Sunnto Gecko that I happened to have on the rental equipment (no I don't have access to it) gave me 5 minutes.

 

[scubadale]

Let me be clear in stating that I am not a physician but would recommend that you not rule out a DCS hit. I am still looking for a recent (in the last two months, for those that can help me locate) article that I read discussing the recovery without treatment of mild DCS. In the meantime I have included the link where I obtained the following information. As for lifting the day before the dive, don't you think you would have been sore the morning of the dive? Sounds like so far you have recovered but link is for your information and to take that knowledge into account if you experience the symptoms again following a dive.

I have bolded the information below for what is most pertinent in this case.

DAN Divers Alert Network : Decompression Illness: What Is It and What Is The Treatment?

" Denial and Recognition

The most common manifestations of DCS are joint pain and numbness or tingling. Next most common are muscular weakness and inability to empty a full bladder. Severe DCS is easy to identify because the signs and symptoms are obvious. However, most DCS manifests subtly with a minor joint ache or a paresthesia (an abnormal sensation like burning, tingling or ticking) in an extremity.

In many cases these symptoms are ascribed to another cause such as overexertion, heavy lifting or even a tight wetsuit. This delays seeking help and is why it is often noted that the first symptom of DCS is denial. Sometimes these symptoms remain mild and go away by themselves, but many times they increase in severity until it is obvious to you that something is wrong and that you need help.

What happens if you don't seek treatment? In severe DCS, a permanent residual handicap may result: this can be a bladder dysfunction, sexual dysfunction or muscular weakness, to name a few.

In some cases of neurological DCS, there mat be permanent damage to the spinal cord, which may or may not cause symptoms. However, this type of damage may decrease the likelihood of recovery from a subsequent bout of DCS.

Untreated joint pains that subside are thought to cause small areas of bone damage called osteonecrosis. Usually this will not cause symptoms unless there are many bouts of untreated DCS. If this happens, however, there may be enough damage to cause the bone to become brittle or for joints to collapse or become arthritic. "

 

[Puzzlement]

Denial and Recognition... In many cases these symptoms are ascribed to another cause such as overexertion, heavy lifting or even a tight wetsuit.

I don't really know how to respond to this. I:

- had severe pain
- phoned DAN
- spoke to two hyperbaric on-call specialists
- went to ER based on the recommendation of the second specialist, spent several hours there and passed on the specialist's recommendations
- was discharged by ER based on their evaluation of the situation and not based on any comments of mine about existing problems (I didn't mention any existing injury or the lifting to them)

And the response is, as far as I can tell, that I've been in denial and put my health just as much at risk as if I'd taken more pain killers and stayed in bed. And perhaps I did and I'm sorry to be angry about this — making a point online has no effect on whether I got hit. But nevertheless I'm acting on medical advice. There's not really a lot more I can do, short of worrying or paying for my own chamber treatment.

 

[Puzzlement]

However, if anyone does have any thoughts on how best to insist on receiving oxygen in ER, I'd be glad to hear them. My experience with medical professionals is highly variable on whether they find patient insistence on an avenue of action severely problematic or not. Normally of course I would not choose a doctor who reacted very badly to treatment discussion and second-guessing of their decisions, but in ER I don't get to choose my doctor. (The doctor I had just didn't comment on the oxygen thing at all. I was assuming that they had some diagnosis and treatment guides they would use in the event of an illness they don't see a lot of, but perhaps this is wrong.)

 

[matjo1]

It does not sound like DCS to me at all. Symptoms of DCS rarely effect mirror image parts of the body (both shoulders) and your symptoms went away much, much, much to fast. Sounds like a "tank lifting injury" Just my oppinion. By the way, good job on calling DAN so fast. That's exactly what you should have done.

 

[dkktsunami]

Puzzlement, Your personal profile does not mention age........I am 64 and just about everything that I do (that is worth doing or is fun) results in pain........