Muscle injury from mild untreated DCS?

[Saturation]

Good info, Saturation.

So if I have it right, microbubble-related injury to muscle is conjectured occur, but only in severe DCS.

Moreover, the damage is self-limited once bubbles resolve and the condition is tracked via the presence of such proteins as myoglobin.

Thanks,

Doc

Hi DV, Yes, a more sensitive marker is CK, plus the usual ALT and AST fractions. For additional info, the subfraction MM and MB can be assayed. Neuman has written about this quite a bit and I've seen it in clinical DCS as the only objective finding to suggest a DCS event. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=8259140&query_hl=6&itool=pubmed_docsum Although Neuman concludes its value specifically to AGE, the paper describes the results as seen in various cases of severe DCS, where AGE is the the most significant manifestation of injury. I would draw CK in all suspected cases of DCS.

 

[DocVikingo]

That is very informative.

Thanks for taking the time.

Doc

 

[crispix]

Yes, thanks for the additional information. I started feeling better rapidly beginning a few days ago. (It's about 3 weeks post injury.)

 

[DocVikingo]

Hi Crispix,

Good news that you are feeling considerably better.

As regards the additional info, IMHO it has little direct relevance to your situation. The research addresses severe DCI, particularly arterial gas embolism (AGE), a condition you clearly did not sustain.

As discussed, mechanical irritation of connective tissue rather than microbubble activity in muscle appears to be the best explanation for your complaints.

Regards,

DocVikingo

 

[Rick Murchison]

... mechanical irritation of connective tissue ...

What the Doc means is you "pulled" something, most likely while honking the gear around
Rick

 

[DocVikingo]

Eloquently put, Uncle Ricky ; )

 

[Rick Murchison]

Eloquently put, Uncle Ricky ; )

Why thank you sir... In addition to "Lower Alabama," I can even translate that medical stuff to "Boatswain's Mate" if needed, but the "bad word checker" would never let it fly here
Rick

 

[Dr Deco]

Hello crispix :

Sorry for getting to this so late; I was down on Catalina Island for the Decompression Physiology class.

DCS

As all of the respondents noted, the minimal nitrogen dose and the duration of time following the dive both argue against your problem being on of DCS. Most likely, the problem is one of overuse myalgia (muscle strain) secondary to moving gear around. Tight straps on gear can also cause pains such as you describe.

It is common for divers to ascribe aches and pains to DCS when diving is involved. One should always have a high index of suspicion when diving is involved. However, as I have said on many occasions, the population has a whole has aches and pains and most have never gone diving in their entire lives. Thus, there are certainly many ways to acquire joint and muscle pains in this world. We are looking at “post hoc ergo propter hoc” (“after this therefore because of this”).

DCS pain simply does not persist in the manner you described; this was commented on by other responders.

Muscle Bubbles

There certainly are many decompression gas bubbles that form in muscle tissue (and fat tissue, as well) following some dives. This is observable in animals with dissection.

Muscle bubbles are why Doppler ultrasound bubble detection is an unsuccessful prognosticator for joint pain DCS (“the bends"). If gas bubbles only formed in connective tissue, we could [probably] easily detect them and determine that joint pain DCS was imminent. They are masked, however, by torrents of microbubbles released from muscle capillaries.

Their presence is easily detected by flexing the arms and legs and monitoring for bubbles in the precordial position (over the heart) with a Doppler monitor. This is especially prominent during decompression to altitude.

What is so surprising is that even when many decompression gas bubbles are detected, the individual notices nothing. There is generally no pain, fatigue, lethargy – nothing. In fact, even with Grade IV bubbles on the Spencer-Johanson grading scale, there is not even the notice [symptoms] of joint pain DCS [it occurs in less than 50% of the instances].

Dr Deco :doctor:

 

[DocVikingo]

Hi Mike,

Thanks for joining it.

May I take it from your statement, "What is so surprising is that even when many decompression gas bubbles are detected, the individual notices nothing. There is generally no pain, fatigue, lethargy – nothing. In fact, even with Grade IV bubbles on the Spencer-Johanson grading scale, there is not even the notice [symptoms] of joint pain DCS [it occurs in less than 50% of the instances]," that no damage is being done to muscle by these bubbles?

Thanks,

Doc

 

[cudachaser]

I have an instructor candidate that has an excellent paper on on Compartment DCS. Muscle sure enters the equation. Briefly stated, " Small bubbles in the muscles are interpreded as lactic acid" You will get sore