Had a disturbing incident yesterday...

[danvolker]

The background ( maybe relevant).....2 months ago while doing a pack sprint on my bike from 25 mph, to get over 30 ---- I torqued so hard it ripped the chain off the rear cluster--meaning full power went to essential neutral, and this threw me over the handle bars----I caught myself, threw myself back at the seat, broke off the seat-post...then crashed at about 30....helmet cracked and did not actually give optimal protection, as the inner liner of the bike helmet had been broken for the previous month, and I had not gotten around to replacing it.... Along with nasty brush burns, the result of the crash was that the crystals in my middle ear dislodged, and I would have the world spin around when I lay down flat.....This was fixed mostly by the maneuver you do to re-seat the crystals, first one side, then the other....say 98% fixed.... I had done 3 or 4 dives at the BHB Marine park since then, in less than 20 feet of water..no issues....Fast forward 2 months....

Yesterday.....

Sandra and I did the Wreck of the Castor ( 110 ft max) on 33% nitrox, I shot video of Goliaths....No real deviation from norm on this dive...very normal profile..10 minute hang......no Narcosis, no weirdness.
The story gets weird on the surface, as apparently I was repeating myself alot when talking with the Captain about a leaky tank valve....like maybe 10 times according to Sandra....I remember one of these....We did a 40 minute SI, then a 50 minute long dive at 55 feet..again on 33%. Everything seemed normal....No pains, no indications of DCS, my body feels good today....

I don't remember all the normal details of the boat ride back to dock....when I got to the dock, and took my gear off the boat, it was time to get my truck--and I did not recall where I had parked it...One of the other divers began walking across the street, and as I watched his direction, I saw my truck over there....So fast forward to driving home with Sandra.....Apparently, I only remember the boat ride out to the Caster, and then to the 2nd site...I have NO RECOLLECTION of first arriving at the Marina, not being able to park in the covered parking garage ( Sandra told me I could not find a space, and had to drive across the street to park)....Also, no recollection of being in the shop and signing the waiver, or of seeing Lynn Simmons ( Owner of boat and long time friend), and no recollection of helping to get tanks out of the boat as the morning trip was unloading--and I helped with that....and no recollection of talking to a few people I used to dive with that had been on this trip...including one that had lost almost 50 pounds ( kind of noteworthy). I kind of remember getting my gear on to the boat, and of it going out the inlet, and then most of the rest of the time I have memories of what was going on....but the time immediately preceding the dive, is gone..... I do remember what I had been doing in the morning, previous to leaving for the dive trip.

If I was an alcoholic, I would explain this as a blackout....but I am not, and have not had alcohol for weeks. I have never "lost" a 40 minute part of a day before...an entire block of time...

The question..... Trust me when I say the profiles were nothing profiles.....Was this an issue of the pressure effecting a brain injury from the bike crash 2 months ago?...If so, could this be pressure induced like a nerve impingement( pressure from the depth), or would this have to be blood vessel leakage for pressure to have an effect in the brain and memory? Can the issue be pressure on nerves -- something that is NOT related to blood vessel leakage in the brain--obviously this ambient pressure issue is the direction I would prefer, rather than an internal pressure issue.

Is it more likely that the issue is related to the bike crash two months ago, or would the medical thinking on this, be to focus more on the profiles and the issues of DCS? I have no pains, though my head does feel a little like I have a mild hangover....

Could the vertigo issue and the crystal movement have some relationship to this memory loss?

As to now, no more memory gaps, thinking is as normal as it gets for me , but I still have only the boat trip and dives in memory, and zero about the tank unloading of the morning trip, all the conversations I was in then, or the time in the shop chatting with Lynn, and signing the waiver...nothing of this....And I have NEVER had anything like this happen before.

I do have DAN Insurance...I could go in the direction of tests......or is this something that is already over with, whatever happened, and no longer an urgent issue.... I opted to NOT do my morning Bike ride, since I don't know if this had to do with blood vessels in the brain ( where I might not want high heart rates)--even though I feel fine, and am not misplacing memories except for the pre-dive ones just discussed.
Similarly, I am thinking it might NOT be advisable to dive on Monday, even if I continue to feel fine, and my mild hangover feeling goes away ( could have been related to sea-sickness that presented in a very different way than ever in the past---??? )


Any ideas?
Thanks,
Dan Volker

 

[SeaHorse81]

Why on earth are you not seeking immediate, face-to-face medical attention??

 

[krawlings]

sound to me like you may have had a mild stroke or MINI strokes (a small blood clot broke free) I strongly advise you to see a neurologist or at least your regular Doctor
All the symptoms you described is what my step father had happen to him on a frequent basis (bad medical history)if you have another episode like that CALL 911 Do not try and reason it out let ER SORT IT OUT IT COULD BE NOTHING OR IT COULD BE MAJOR

 

[danvolker]

Why on earth are you not seeking immediate, face-to-face medical attention??

Most likely I will be calling DAN.....I wanted to get some feedback from the Docs here first, so that I would have a better idea of the landscape of issues I should be considering...this memory loss issue is NOT one of the areas where I have any background or information sufficient to have a sense of what I should be pointing a ER doc at.... I am thinking an MRI is probably in order.....but I wanted to start here.... I don't like the idea of going to a hospital without some knowledge of the tests I should WANT, and the issues they ought to be checking for.

 

[grf88]

Why on earth are you not seeking immediate, face-to-face medical attention??

Have to agree with this. Sounds like you had a pretty serious blow to the head. I had a bike accident when I was 11 that left me unconscious for 36 hours. As a result of the injury I developed petit mal which resulted in lapses of memory and what people described as me going into a trance like state and having no recollection of what happened. Get a referral to a neurologist and get checked out before any more diving. Fortunately by the time I was in my mid twenties the symptoms disappeared.

 

[dumpsterDiver]

If it were your wife, you would be dragging her ass to the Doctor. Hope you feel better soon.

 

[danvolker]

If it were your wife, you would be dragging her ass to the Doctor. Hope you feel better soon.

Thanks DD....more than likely, we will be headed to the ER or somewhere similar, later today...In the absence of knowing anything about this issue yet, I am thinking an MRI is the first test of interest.....but that is also what I have posted here for

 

[PeterNBiddle]

If it were your wife, you would be dragging her ass to the Doctor.

A very clear and succinct way of putting things.

Dan plz let us know what you find out.

 

[TSandM]

I strongly suspect that this has nothing to do with decompression sickness at all. Exactly WHAT it is is unclear. TBI can result in memory and attention problems, and they can be prolonged, but they usually don't present as complete blackouts or perseveration as you describe on the boat (at least not a couple of months later; perseveration is a very common symptom of concussion in the acute phase). On the other hand, it's extremely unusual for a TIA or stroke to present as a pure memory lapse, with no other symptoms.

If you are currently feeling normal, I do not think you need to go to an emergency room, but making an appointment with your primary care MD (or directly with a neurologist, if your insurance permits that) would be very much in order. And I suspect, at the very least, you will undergo an MRI of the brain, and it's probably appropriate.

 

[danvolker]

I strongly suspect that this has nothing to do with decompression sickness at all. Exactly WHAT it is is unclear. TBI can result in memory and attention problems, and they can be prolonged, but they usually don't present as complete blackouts or perseveration as you describe on the boat (at least not a couple of months later; perseveration is a very common symptom of concussion in the acute phase). On the other hand, it's extremely unusual for a TIA or stroke to present as a pure memory lapse, with no other symptoms.

If you are currently feeling normal, I do not think you need to go to an emergency room, but making an appointment with your primary care MD (or directly with a neurologist, if your insurance permits that) would be very much in order. And I suspect, at the very least, you will undergo an MRI of the brain, and it's probably appropriate.

Thanks Lynn,
I am about to call DAN, to see if this insurance will cover an MRI and if they can work with the trauma hospital in Delray that we favor over all other hospitals in the area.

Bill Mee (Bill is a dive buddy that works in biomedical engineering--not a Doc, but better than just asking someone off the street ) --Bill thinks it was an ischemic event caused by a small bubble on the 100 foot dive on the Castor..probably in an area of my brain that had been slightly bruised by the bike crash two months ago....and that it resolved some time in the next several hours, which is why I am feeling fairly normal for me, now.

I am thinking that I must know if I still have an injury site, that would make diving dangerous in the near future....and what the implications would be for long term, and also for cycling....I have done many Anaerobic Threshold level bike rides in the last month and a half ( race pace rides running over an hour at 25 to 30 mph in a pace line)...So just high heart rates has not dislodged clots or been the proximate cause of any memory issues since the crash.....
I did several BHB Marine park dives, all shallower than 20 feet, and with no issues...and no easy chance for bubble formations....

I am not happy at all about this state of affairs.....If I do still have bruising or damage in my brain from my bike crash, I am going to know the when, and if, of total recovery ---the issue of when I can dive to 100 feet again, and the issue of heart rates on the injury site.....eg., potential to move a clot, if any remain, or could re-form.

Lynn, thanks very much for your advice on this..