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In-Water Recompression, Revisited

Discussion in 'Diving Medicine' started by Duke Dive Medicine, Jan 20, 2017.

  1. Kay Dee

    Kay Dee Barracuda

    # of Dives: I'm a Fish!
    Location: Here, there, and everywhere
    Thanks, finally, Simon.

    And my life doesn't revolve around posting on forums either, but have had little to do 'outside' the last week or so, stuck at a computer shall we say, and just couldn't let some of what I do not agree with go sliding by. Simply as that.

    But I gave up contacting you via email a long time ago, since you never once replied to the last few I sent, over a long period of time.

    As far as using Kay Dee as a forum name here, I had actually thought you'd be the first to 'out me'! I even stuck a Koala on my avatar to make it easy for Gods sake. And I see MANY other folks using pseudonyms as their forum name, yet you single me out for that. Very funny. Anyway point taken.

    As for Bret, he dives more than he posts, couldn't care less of what others make/say of him generally, and just returned a few days ago from Tonga with simply magnificent photos of whales, and left on another 'excursion' just last Saturday.

    Be that as it may, thanks again for your advice, and lets just leave it at that before this gets too off topic.

    But just to be clear;

    Last edited: Aug 21, 2017
  2. tbone1004

    tbone1004 Technical Instructor ScubaBoard Supporter

    # of Dives: I'm a Fish!
    Location: Greenville, South Carolina, United States
    @Kay Dee I believed I answered all of the questions in your post #201, but I'll go back through and answer again. Part of the reason I hadn't responded was when threads get this big, I tend not to respond unless tagged in a reply and actually tend not to open them up when they get this big unless I get tagged. If you are trying to tag someone, please use the @ and then start typing their name to tag them so it comes up in notifications.

    No offense taken on the capitals, we use them as differentiation at work quite regularly.

    So to answer the questions in that post.

    Why did I ask why you were bending people. The way you had described your activities were that of a formal expedition group. That expedition group was "you", not you as an individual. Formal expedition groups tend to have agreed upon dive profiles for dives and if you were experiencing higher than expected DCS incidents, then there was something clearly wrong with your profiles, of particular curiosity in that was what algorithm you were running at the time. If this was spread across an extremely large number of dives, it could have just been that you were much more active in these kinds of dives than we had expected. 10+ hits requiring IWR, even over 20 years sounds a lot of alarm bells. So again, not you personally, but your expedition group as a whole. The way you described the incidents and the expeditions was that you were part of an organized proper expedition, not happening to do big dives in remote areas with other groups on the same boat. That to me at least is not what I would call an "expedition" even though the dives are quite big. Not normal to have two independent groups "expeditioning" on the same boat at the same time....

    You running the treatment is irrelevant to my questioning which was why they were getting bent in the first place. Merely a curiosity not a critique.
    Acceptable answers that I was curious to here
    • Major storms caused us to have to clip deco short due to dangerous conditions
    • lack of availability of suitable deco gas caused aggressive profiles
    • it was the 90's, we didn't know what we didn't know
    • it was the 2000's, we believed in bubble models
    • we had computers that were proving unreliable
    etc etc. those kinds of answers for a root cause corrective action was what I was asking if you had done.

    The three you had and were involved with directly in the 90's is a reasonable answer to me and not something that I would question again. The other 10+ that occurred between 2002 and 2010 are a very high incident rate to observe, even if you "got around" and while I firmly believe that being on CCR is irrelevant, finding out why they got bent is still of curiosity to me. I don't care that they got unbent, I never want to get "unbent" again because I want to do whatever I can to make sure I don't get bent in the first place.

    Note, all questions you asked were answered in my post #206, this is just a bit longer answer to the same questions.
  3. Dr Simon Mitchell

    Dr Simon Mitchell ScubaBoard Supporter Staff Member ScubaBoard Supporter

    Are you sure you had the right address?

    No one else was criticising me for not responding to a friend!

    I am not questioning Bret's credibility as a diver. But "diving more than he posts" does not excuse the provision of inappropriate medical advice on line, and refusing to change it when multiple true experts point out that it is dangerous. That smacks of pride (and very much caring what others think of him) being prioritized over safety.

    Simon M
  4. boulderjohn

    boulderjohn Technical Instructor ScubaBoard Supporter

    # of Dives: 1,000 - 2,499
    Location: Boulder, CO
    I don't know how much Bret dives or posts these days, since I am not generally in the presence of either, but I have a comment on both..

    Saying that people dive more than they post is a familiar cliché, a common insult to people who are active on the Internet. It is absurd. Two weekends ago I was actively diving all weekend, and I did a total of 3 dives. Two were to 275 feet for a pretty decent amount of time, and one was a 150 foot dive with extended decompression. Three dives. If I sit down for an hour or two on ScubaBoard, I can knock off a dozen posts. For some, the ratio of dives to posts makes me some sort of worthless scum. It means the dives I did that weekend are not worthy of consideration because I post more than I dive. When people use that familiar insult, it says a lot to me.

    As for the second issue, I have talked to Bret for more than a few hours about some meaningful topics, and I will tell you without a flicker of doubt that he cares very much what others make/say of him. For one thing, a major part of his income comes from charging huge fees as an expert witness in lawsuits, and what people make/think of him is critical to that ability. You can be sure that one thing he will not do is publicly admit a mistake for that reason. (I started to give an example, but I will refrain.)
    Last edited: Aug 21, 2017
    Dr Simon Mitchell, Akimbo and cerich like this.
  5. cerich

    cerich ScubaBoard Supporter ScubaBoard Supporter

    # of Dives: 5,000 - ∞
    Location: Georgia
    indeed, the whole "dive more, post less" meme is tiresome. I have a variety of thought on why it is so popular, however it's silly and shortsighted, both for human factors and business reasons.

    In the pre Internet days it was simple for a "name" to throw out " I have 20,000 dives and am the worlds foremost expert, all listen" and some people do. Now you get folks with say 5-6,000 dives going "no you don't, wanna play simple math games pal?" Then you have experts chime in and say stuff like "don't do that what the expert just recommended, here is why". All that stuff bruises egos, and we have EPIC EGO's in the dive industry.

    Frankly I believe in "DIVE MORE, POST MORE!!" Tell the world the fun diving you have been doing!
  6. Akimbo

    Akimbo Lift to Freedom Volunteer Staff Member ScubaBoard Supporter

    Agreed, but there are divers who are too busy trying to make a living. I have a good friend who pays the mortgage doing underwater production IMAX and videography. Working or finding work is more than a full-time job.

    I'm afraid that this is an understatement. There are a few exceptions but they are refreshing anomalies.
    100days-a-year likes this.
  7. 100days-a-year

    100days-a-year Solo Diver

    # of Dives: 5,000 - ∞
    Location: NE Florida
    Not sure if this is appropriate here.....

    Attached Files:

  8. RainPilot

    RainPilot OC/CCR Instructor Trainer Staff Member ScubaBoard Supporter

    # of Dives: I just don't log dives
    Location: UAE
    100days-a-year likes this.
  9. Miyaru

    Miyaru Tec Instructor ScubaBoard Sponsor

    # of Dives: 2,500 - 4,999
    Location: Area51
    Any update on the publishing of the IWR review?
    I'm still very interested!
  10. Dr Simon Mitchell

    Dr Simon Mitchell ScubaBoard Supporter Staff Member ScubaBoard Supporter

    Hi Miyaru,

    Thanks for the reminder.

    The overarching paper with key guidelines on early field management of DCS (which includes some references to IWR) is accepted for the March edition of Diving and Hyperbaric Medicine in 2018. The more detailed review on IWR is still in preparation. It won't be published until next year. Will keep you posted.

    Schwob, boulderjohn and Miyaru like this.

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