DCS - 2 months later???

[DandyDon]

I'm not sure if I should know who Dr. Kay is, but is it someone who deals with a large number of DCS cases and would have seen a widely varying range of symptoms?

He does the video linked in my Sig: Doc's Diving Medicine Home Page

 

[TSandM]

but I don't believe that we can rule it out,

Three medical professionals, one of whom has been involved in diving for a long time, and one who specializes in DCS, have said that it CAN be ruled out. I suppose we could all be wrong.

 

[DandyDon]

Three medical professionals, one of whom has been involved in diving for a long time, and one who specializes in DCS, have said that it CAN be ruled out. I suppose we could all be wrong.

:lol:​

I saw a movie once about an asteroid wiping out Dallas TX - it could happen. :dunce:

 

[Dr Deco]

An asteroid could certainly hit Dallas. But if it did, you would not notice the results until three weeks later.

Fortunately, I do not live in that part of the world anymore. Actually, I am back in London again.

 

[DocVikingo]

I have a hard time imagining DCS could ever be an issue in the typical OW certification setting, much less months later. But what do I know. This is a question for DAN, not for ScubaBoard.

[NOTE: Based in part on PMs between pteranodon (Daniel) and myself]

Hi pteranodon,

To me, the central issue here lies in your comment, "From reading through the replies, I got the impression that every layperson on the board, including myself, can throw their 2 cents in, but what good is that for a person in need of a qualified opinion?" A most excellent point, indeed, Daniel.

This has been an issue for many years, one that we grappled with while I was a Medical Moderator of the Diving Medicine forum a long time ago.

There's really only two choices: (1) To limit responses to medical inquiries to qualified personnel whose credentials have been reviewed by those who run the board or (2) Allow medical questions to be addressed by all who wish to reply. The people who operate the board believe that the latter choice is the better.

And you are quite correct, all manner of posters are entirely free to give advice, even if it's misguided, incorrect or even outright dangerous. I have openly lamented this on the forum on a number of occasions, including quite recently (e.g., see post #30 in the following thread http://www.scubaboard.com/forums/diving-medicine/231960-ear-drops-help-equalize-3.html ). For better or for worse, this is what occurs by having these forums open to all. On their behalf, management has posted a "sticky" warning users of the Ask Dr Deco and Diving Medicine forums of this obvious possibility and indicating the value of contacting DAN, especially in medical emergencies (http://www.scubaboard.com/forums/diving-medicine/76408-attention-please-read.html). And, there are moderators who can, and do, remove material that is offensive or clearly harmful.

BTW, you might be interested to know that when you contact DAN you first, and often only, speak with a paraprofessional, (e.g., registered nurse, diving EMT). And they often simply thumb to the equivalent of DAN's medical FAQs (online at Divers Alert Network : DAN Medical Center : Medical FAQs) and read or email it to you. They are frequently quite busy and give the briefest possible reply. For understandable reasons, DAN provides very limited direct physician access. As such, the answers received from one of the experts on the Diving Medicine and ask Dr Deco forums are likely to be longer and more informative than the responses from DAN, even when both are in essence correct. Moreover, links to previous board threads on the topic, professional magazine and journal articles, and other sources are often given on the forum, another nicety not usually provided in a DAN reply.

You indicate, "Perhaps it would help if it was more obvious who is a physician and who is not." There is something to recommend this, although most physicians know nothing of SCUBA and its related medicine. Based on their titles, board names and just hanging around these forums it soon becomes obvious who the physicians are and their level of expertise in diving medicine. Some list their qualifications in their profiles, while others, like I who write anonymously for Undercurrent (Scuba Diving Magazine for Serious Divers, Undercurrent Reviews Dive Resorts and Scuba Diving Equipment) and who, by that publication's basic policy, cannot be identified or identifiable, do not. There are a number of defensible reasons not to publicly display one's professional specifics on a message board forum.

In any event, if it is one's preference to go to DAN with matters such as this original inquiry, that is a perfectly understandable and legitimate choice. However, inquirers should feel free to post their diving medicine questions to one of these forums if they so choose without being summarily chided to take them to DAN, and particularly not by those who really don't have the knowledge to appreciate if and to whom the inquirer might most appropriately be sent. Often, as happens to be the case in the present thread, coming here first can save both DAN and the poster time, effort and money. Moreover, while the question is being sorted out, it also can reduce anxiety.

IMHO, the Diving Medicine and Ask Dr Deco forums are of incalculable value, even if annoying and unnecessarily time-consuming at times due to being open to all.

Thanks for your willingness to discuss this important issue in a non-defensive and intellectually honest fashion.

Regards,

DocVikingo

 

[Dr Deco]

Hello Readers:

DocVikingo has made a very fine reply. I might add a few words.

DAN and the FORUM

The purpose of DAN is to provide with rapid replies to answers questions regarding specific problems with the caller and DACES. The “Ask Dr Deco” forum was started in 2000 to answer – by email – general questions concerning the physiology and biophysics of decompression. I do not answer medical questions, as there are professional here who have responded since the beginning on clinical aspects of DACES. (I do not have much clinical experience and am not trained in medicine.) I also do not answer queries concerning diving techniques since most readers are more experienced than I am.

Every diver should know the nature of DAN and its phone number.

What Do we Do Here?

I am a research scientist with considerable experience in barophysiology, having started in 1969. I have worked in a laboratory setting with mice, rats, rabbits, sheep, goats, pigs, and humans as subjects – not all subjects ding the same thing. This has been in both hyperbaric and hypobaric (altitude) realms.

If you have a question in physiology of decompression, I will give it a go. In the cases where I have little to no knowledge, I either say so or do not reply at all. My replies here will generally be better than those from DAN will since they are not researchers and work only from knowledge gained from a book.

My replies are most often not rapid; I do not sit by the computer station in my home office - I am not always home. Currently, I am again away in London [until July] and in a different time zone.

Dr Deco

 

[ggunn]

Three medical professionals, one of whom has been involved in diving for a long time, and one who specializes in DCS, have said that it CAN be ruled out. I suppose we could all be wrong.

A question does occur to me, though. Hypothetically, if a person were to take a mild DCS hit and either ignore or not recognize symptoms, and therefore not get treatment, what would/could happen? Would the bubbles eventually dissolve, or could the person unexplainedly keel over dead a week/month/year later?

 

[Dr Deco]

Hello ggun:

No, you would not keel over dead a week later. There is no week-long “incubation period” for DCS.

If we talk about a time period of a couple of hours, historically bad events gave happened, during the construction of the Eads (St Louis) Bridge (about 1869) across the Mississippi River. There are records of individuals surfacing from the caisson, going to a bar with their buddies, and keeling over an hour later.

What happened? These unfortunates had a release of gas bubbles from muscle and fat tissue into the venous side of the blood stream. As the minutes ticked away, these bubble arterialized (found their way into the arterial system. They then embolized the heart and brain and death ensued.

Decompression procedures were not understood at that time. Only a “blow up” could cause something like that to a diver today.

Dr Deco

 

[Hemlon]

DW850...

Did you ever stop to think that your dizziness may be due to ear issues? (You said you had a hard time equalizing.)

And that your fatigue might be related to Hep A? (Which you claim to have contracted durng this trip.)

 

[ggunn]

Hello ggun:

No, you would not keel over dead a week later. There is no week-long “incubation period” for DCS.

Fair enough, but do "mild" DCS symptoms, if left untreated, eventually go away?