Hydration, hydration, hydration - bent in Coz

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farsidefan1

Contributor
Rest in Peace
Messages
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Location
Salt Lake Valley, Utah USA
# of dives
200 - 499
8 dives into my Cozumel dive trip I found myself in the "chamber". End of dive trip, couln't even go snorkel with whale sharks. Basically confined to airconditioned, no exercise (thank goodness Villa Blanca's internet service reaches the rooms) drinking tons of water.
I usually plan on doing 4 or 5 dives a day when on a dive vacation (which all my vacations in the last couple of yrs have been).

Here are the facts that lead to my spending a couple of days in the Coz chamber. I am 58, overweight (5' 11" 235 lbs) in fair physical condition (I swim 1.5 miles twice a week and mountain bike up in the Park City area quite aggressivley twice a week with an occasional raquetball game thrown in. I take a couple of meds for hypertension although I have cut them in half since my average blood pressure reading is about 110 over and 73 with a resting pulse of 58. I go on an average of 4 dive trips a year and follow the eat dive sleep routine. Ah one other factor. I had some swelling in my ankles a yr ago and the doctor (who has approved me for diving without reservation) put me on a common water pill. Therein lies the rub. I usually stop taking the water pill before I go on dive trips. for reasons I can only describe as a brain fart I didn't think about it this time. My dive profile was as follows

2 dives 8/16 #1 max depth, 83 ave depth 54.7 39 minutes using 21%
Interval 1:22#2 max depth, 64 ave depth 46 52 minutes using 36% followed by 21:27 hour interval

2 dives 8/17 #1 max depth 80 ave depth 51.5 54 minutes using 21%
interval 56 minutes #2max depth 54 ave 42.8 58 minutes using 21%

20:30 surf interval then 4 dives 8/18 #1 max 91 ave 52.5 53 minutes
interval 55 min. #2 max depth 59 ave 42 6 1 min.then surface interval 5:47
#3 max depth 62 ave depth 42.3 52 minutes followed by surf int on 50 minutes
#4 max depth 40 ave depth 33 54 minutes.
I only used nitrox on the one dive.

2 hours later in hyperbaric chamber. My thanks to DAN whom I mistakenly called even though I had dive assure. They answered my questions and directed me to the chamber. Seriously, thanks!

Other factors: every dive ended with a full 5 minute safety stop between 15 - 20 feet. Very gradual ascent, 30 ft per minute. Drank pleny of water before and after every dive.

After the second dive I experienced some pain in muscles of stomach and chest on left side but it felt like I had perhaps bruised myself leaning over boat. No big deal I thought. pain vanished once I was back in water (till an hour after diving 4th). No tingling or joint pain. Dive was done by 10 pm. Pain all over abdomen began within an hour. I jumped on here to see what the heck was going on. I downloaded my dives so I could peruse them in case the doctor needed the data (and to prove I had not been an idiot - which I had been, remember the water pill?). I caught the taxi and had directions thanks again to DAN. Dr. Pascual Piccalo checked me out and put me in the chamber with another guy to monitor me for 5 hours 48 minutes. I watched "Men of Honor " and "A Knights Tale". Oh and they have great artwork on the outside of the chamber - wish I didn't know that however I think I chose a great place to get bent. The doctor was exceptionally experienced and knowlegeable. I spent the next day in the hospital since I was alone and had no one to watch me then I re entered the chamber for another 2 1/2 hours (Watched "Meet Joe Black" this time. And was sent home although I saw the doctor the next 2 mornings for a checkup and I have been cleared to fly home Saturday at 4 pm.

Other symptoms, in fact what convinced me was bluish bruising all over my abdomen (also back but I couldn't see that) and Dr. Piccolo noticed my eyes didn't
track his finger very well and I couldn't walk a straight line. Oh, and I have never had a drink of booze or coffee. But that water pill, what an idiot.I was dehydrated, no mater how much I drank I peed it away, along with the heat and humidity here.

I hope this helps others avoid making the same mistake, and don''t think you are clear due to lack of tingling and joint pain. Between diveassure and my home insurance this will not cost me anything except lost dive time (which devastates me) and a STRONG suggestion to not dive for 6 months. That last one is the toughest of all. At no time did I push beyond my computer limits. This totally caught me by surprise.

A special thands to the folks at Scubamau who informed my wife (who was in Japan) and actually hauled me to and from the subsequent dr visits along with allowing me to never have to haul my gear around (give it to them, show them how I like it set up once then bingo, I was done except for the diving) They were amazing, going far above and beyond the call of duty. I have never been treated so royally. Mau came and visited me in the hospital to see what else they could do. Thanks again to them.
 
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Thanks for posting and glad it turned out well.
 
20:30 surf interval then 4 dives 8/18 #1 max 91 ave 52.5 53 minutes
interval 55 min. #2 max depth 59 ave 42 6 1 min.then surface interval 5:47
#3 max depth 62 ave depth 42.3 52 minutes followed by surf int on 50 minutes
#4 max depth 40 ave depth 33 54 minutes.
I only used nitrox on the one dive.

I'm not actually surprised you got bent.

Even just the first dive ( 91' for 53 minutes on air) is way off the edge of the SSI tables, and vPlanner calls for an hour of deco.

Are you using tables, a computer or on-the-fly computations for dive planning?

In any case, I'm glad you're OK.

Terry
 
I'm not actually surprised you got bent.

Even just the first dive ( 91' for 53 minutes on air) is way off the edge of the SSI tables, and vPlanner calls for an hour of deco.

Are you using tables, a computer or on-the-fly computations for dive planning?

In any case, I'm glad you're OK.

Terry

Wait, are you sure? He also stated that his average depth was 52.5 feet, which tells me he profiled up under a reasonable plan. My concern would be the lack of sufficient surface interval between dives 3 and 4 (only 50 minutes). I haven't programmed that sequence into my computer, but I'm seeing saturation after dives 1, 2 and 3 that could contribute to the hit after dive 4.

I, too, am curious what computer he was using, and what it was telling him after that multiple dive plan. I'm betting my computer, the ultra-conservative Cobra 2, would have been screaming at me about a minute after my fourth back roll. Which, if there is one benefit to the Cobra 2, is it's required calculated safety stops, that over-rule the obligatory three minute standard.
 
Yes, glad you are ok.
I would also be interested in knowing which computer you where using.
Also, would you be willing to post the actual dive data from your computer? You really can't calculate much from max depth and avg depths.
Thanks for sharing.
 
Wait, are you sure? He also stated that his average depth was 52.5 feet, which tells me he profiled up under a reasonable plan. My concern

Average depth isn't a useful number without knowing the profile associated with it (how long at which depth(s)).

Even if it was 1/2 deep and 1/2 shallow, vPlanner still shows two missed deco stops. I'd also be interested in seeing the dive profile (if it's a computer).

Terry
 
Hello farsidefan1:

Thoughts on Origins of This Problem

Without the ability to perform a Doppler investigation at the time of the incident, I cannot really say what occurred in your body. I can only draw relationships to you and information from the scientific literature and my research experience.

It appears to me that you had quite a few diffuse problems, some of which were neurological. This would lean one towards the supposition that we have a problem associated with arterialized bubbles.

Gas loading analyzes such as you can obtain from a computer are interesting, but DCS is seldom explained adequately by gas load analysis. Readers of this FORUM for the past eight years will note that I always couch my explanation in relation to the free gas phase.

I really doubt that your problem has anything traceable to a “water pill,” eg, Lasix. Many divers could benefit from diuretics since hypertension is under diagnosed in the population. Thus, I posit that many are diving without their “water pill.”

Arterialization

Arterialization is a situation where bubbles pass from the venous circulation into the arterial circulation either through a PFO or though shunts in the lung circulation. Venous bubbles can be especially prominent if the dives involved vigorous activity.

Arterialization is promoted by certain activities such as briefly holding ones breath as they climb the ladder into the boat. Other possibilities are straining when lifting tanks or other heavy gear. These are described as Valsalva-like maneuvers.

You might need to think back if any straining, or lifting took place since it could have instigated this situation. Bubbles could also just pass through, although I would suspect that you would have experienced difficulties before this time.

Dr Deco :doctor:
 
Just returned home tonight. I have a uwatek smartcom console. The average depth is what the computer uses for the dive depth. Often the max depth is only briefly touched so the average depth is the actual figure. I will try to download the dives tomorrow. I have a graqphical representation of each dive showing depth and time. Thanks for the input. As I look at my litttle calculator here at home I'm also not as surprised.

As to physical work load I did walk to and from town (Guidos) which is on the north end of town. Probably about a 5 or 6 mile walk the night before. I was tired and footsore upon return.
 
WebMonkey, the typical Cozumel dive is more or less a check mark profile -- Rapid descent to the deepest point of the dive, and then slowly working the way up to safety stop depth. Average depth of 52 on a 91 foot dive that's an hour long suggests they may have spent a bit more time deep, and possibly not very much time shallow at the end. Although my typical deep tour of our local training site will hit a max of about 95, and an average of 46 or so, and includes about 15 minutes or more shallower than 30 feet.

At any rate, there are a lot of profiles that will give you a max of 91 and a 53 minute run time, and be very reasonable from a decompression standpoint. I think what hit here was multiple dive/multiple days, and four dives on the last day with significant loading and a short surface interval.
 
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