Help please! DCS or something else?

[Louie]

Dear all

I did a week's diving holiday last week (followed all the instructions, made necessary safety stops for each dive and used a computer). I got on the five hour flight 26 hours after the last dive and was fine (other than an upset stomach). A day later, I noticed occassional mild tingling sensation and stiffness in some of my fingers. I'd written it off as the result of carrying heavy gear and struggling with my wetsuit all week.
I still have the tingling in my fingers but nothing really bothersome - I don't notice it unless I think about it.
Should I be worried or just wait and see what happens?

Thanks for your help.

Louie

 

[DocVikingo]

Hi Louie,

Although carefully following safe diving practices does not make one immune to DCS, it does greatly reduce the probability. Given that a diver keeps his computer well within NDL at all times, makes proper ascents with appropriate safety stops, takes adequate surface intervals, stays well hydrated & the like, the predicted risk is extremely low.

You indicate a conservative dive-to-fly time, no experience of signs or symptoms of DCS before or during a long flight, and no notice of the present complaints until a day after returning home. In addition, the tingling sensation and stiffness in some of the fingers is described as mild, occasional, not really bothersome & as not noticeable unless focussed upon.

Given the above in an individual otherwise entirely without signs or symptoms of DCI, it seems extraordinarily remote that such tingling/stiffness is the effect of DCS. Additionally, it is unlikely that any reputable hyperbaric facility would treat a person based on the report provided here.

This doesn't, however, mean that the hand was not in some manner traumatized, perhaps by the handling of gear/baggage, wetsuit donning/doffing etc. It is prudent to monitor such a condition and consult a physician if it becomes bothersome.

This is educational only and does constitute or imply a doctor-patient relationship. It is not medical advice to you or any other individual, and should not be construed as such.

Hope these complaints disappear soon.

DocVikingo

 

[Dr Deco]

Dear Lou

As DocVikingo wrote, this certainly does not seem as if it could be decompression sickness. As he stated, following all of the rules does not make you immune but it does reduce the chances of bad luck. Following all of the rules generally applies to gas loading and unloading, that it, those quantities accounted for in decompression tables (and now, computers).

These do not take into account the effects of micronuclei and their generation. The decompression gas phase does not actually form from supersaturation. Rather it grows from tissue micronuclei or “gas seeds.” These nuclei are generated by the movement of our musculoskeletal system. If you had been lifting heavy objects post dive, this could have generated nuclei that could have grow during the interval post dive when you were supersaturated. The fact that you did not acquire decompression sickness shortly after the dive would seem to rule out this possibility. Most assuredly, flying home after you had a problem would have aggravated the condition. None of these events occurred, however.

DCS is not likely. A better guess is nerve injury from the lifting of equipment, as DocVikingo said.

Dr. Deco

 

[rcohn]

Louie,

I'll just ask if there was any chance of a neck injury? Tingling fingers can be a sign of a pinched nerve in your neck, I have this problem frequently. Stuggling in and out of wetsuits and hoods, constantly arching your neck to look forward during diving, and/or odd neck positions during travel can all bring this on.

Ralph