Pool Session Incident

[davidbaraff]

To answer your original question, and hopefully calm you down a bit:

(1) Yes, it is certainly possible to injure yourself just from the BCD. (Long story short: I cracked a rib during a discover scuba dive from an overly-inflated BCD, without hitting any obstacles like rocks etc. So I'm positive muscle injuries etc. are also possible. And they might take a long time to resolve, well, 'cause muscles are like that.)
(2) But more importantly, I could imagine a doctor not be able to come to conclusion (1) without being able to rule out all the more serious things, so...
(3) ... absolutely follow all the things Ken Kurtis told you, to be safe.

But in the meantime, relax -- like Ken said (in his layman non-medically-qualified opinion) it's been a week and you're still here. You'll feel better after you do what Ken just advised in his latest post. (Also my layman non-medically-qualified opinion as well).

 

[Aceswild84]

*Disclaimer*
This is based on my own personal situation and is should not be constituted as medical advise*

I was diving in pompano in less than stellar conditions one weekend. On swim out, I noticed that I was breathing rather hard but seemed fine. Had a great dive, but the swim back in was different. My respitory climbed back up on the swim back in and on a full inhale I noticed a pain in my sternum. It only seemed to be there on the full breath. I alerted my buddies who immediatly helped me get back to shore without stressing myself further. I made it home and contacted my GP immediatly because of the pain in the sternum. After my examination, he stated that all my tests were negative and said he believed that the pain I was feeling was from over-expansion of my diaphram during my heavy breathing. He told me to take a few weeks off of diving because the muscle needed to relax and to take some anti-inflammatory's to ease the pain. After several weeks I felt fine and have since been able to make that swim numerous times in worse conditions and felt 100%.

Again this is only my experience with a pain similar to what you have described. Its your body and only you can make that call if you feel back to normal and good enough to dive. If there is any hesitation in your mind, please wait. The ocean isn't going anywhere in the next few month's (Hopefully). Better to be safe than sorry.

Just my thoughts on the matter.

Chase

 

[jar546]

OK, so it has been a week and you are still alive. You went to the ED, was seen by a physician, had diagnostic tests done, then you called DAN and received more advice to see your physician. So go and follow up with your physician OR find a cardio-thoracic surgeon who specializes in barotrauma and see just how much more money the health care system can be taxed by over-reacting to some strained muscles. Maybe an MRI with contrast, maybe a full body scan, maybe PFT's with a lung specialist.

So I don't mean to sound like I am downplaying a potential life-threatening condition but I am not. Sometimes our muscles are not used to doing certain things and they get sore/strained. After a week has gone by, you can still be sore, especially if you have a strenuous job that does not give your muscles a rest. Do you smoke? Did you have a cold recently? Do you sneeze a lot due to allergies?

I just don't see the need to sound the general alarm when you did everything expected of you and more including an ED visit and calling DAN.

Can you tell I am a former disgruntled critical care healthcare worker?

 

[TSandM]

I do agree that, after a week and an ER evaluation, it's unlikely you have anything life-threatening going on. Yes, you could have had some mediastinal emphysema that was missed by both the ER doc and the radiologist who overread the film, but in the absence of any further insult, that's highly likely to have resolved. If you had a small pneumothorax, it's conceivable that it might have expanded, and the only further evaluation I would consider is a repeat chest x-ray.

Make a patient nervous, and he'll begin to think he has every symptom in the medical book. It's actually something we laugh about in medical students; they tend to develop the symptoms of whatever they are studying.

It is not that I want to downplay the risks of panicking and bolting, even in the pool -- it can and has killed people. But a week is a long time, and if you have survived this long and are functional, the likelihood that you have something really serious going on has dropped a lot. A repeat chest x-ray might be reasonable, but after that, just relax.

 

[Duke Dive Medicine]

OK, so it has been a week and you are still alive. You went to the ED, was seen by a physician, had diagnostic tests done, then you called DAN and received more advice to see your physician. So go and follow up with your physician OR find a cardio-thoracic surgeon who specializes in barotrauma and see just how much more money the health care system can be taxed by over-reacting to some strained muscles. Maybe an MRI with contrast, maybe a full body scan, maybe PFT's with a lung specialist.

So I don't mean to sound like I am downplaying a potential life-threatening condition but I am not. Sometimes our muscles are not used to doing certain things and they get sore/strained. After a week has gone by, you can still be sore, especially if you have a strenuous job that does not give your muscles a rest. Do you smoke? Did you have a cold recently? Do you sneeze a lot due to allergies?

I just don't see the need to sound the general alarm when you did everything expected of you and more including an ED visit and calling DAN.

Can you tell I am a former disgruntled critical care healthcare worker?

Your point is well taken. The diver has already been worked up thoroughly and nothing was found. Wouldn't it be a poor utilization of health care resources to get checked again? Sometimes the chest pain gets better after the patient burps. Of course that's after the EKG, ultrasound, cardiac enzymes, and exercise stress test have already been done and billed for.

Decompression illness is a bit of an anomaly to most health care workers. We've consulted on and/or treated several cases of DCS symptom reoccurrence after divers were sent home from the ED when their symptoms resolved on surface oxygen (a big no-no). The OP's case isn't exactly the same, but it has some parallels. Granted, he probably doesn't have an acute process going on, but he has enough of a complaint that he sought help here. Most physicians receive only cursory training in diving accident management, so it's possible that something got missed on his original visit. I think it would be very reasonable, and even advisable, for him to be seen by a physician trained in diving medicine.

Best regards,
DDM

p.s. @Lynne, you know I hold you in high regard so please don't take any offense to any of the above!

 

[TSandM]

I don't take any offense. And in rereading my reply, I realize that I focused on relating the chest pain to the pool session. We know nothing about the OP -- not age, not gender, not medical history or risk factors.

Chest pain can have a myriad of etiologies, some of which are life-threatening and some of which are trivial, and the vast majority of those conditions have nothing to do with diving. I stand by my statements that the injuries relating to diving that would cause mild chest pain as a primary symptom are highly unlikely a) to have remained undiscovered in the ER, and b) to have failed to resolve in a week's time. However, there are a great many other causes of chest pain, and a follow-up visit to a physician because of persistent symptoms is not unreasonable at all.

 

[ascully88]

Sorry this is so late,, hopefully some of you are still on here.
I'm pretty comfortable in water but I was very nervous about the whole prospect of diving. I was worried about the bends. I didn't realize how difficult it was going to be for me to breath underwater so I was breathing really hard. I was somewhat fit but I didn't use the same muscles I do in scuba. I noticed that the pain happened after I finished scuba diving once while I was driving home and the second time while the instructor and I stopped for few minutes to talk in the pool.
I'm better now. The pain has gone away . I noticed that when I was doing something physical the pain would go away (back when it was fairly constant) or perhaps it was me keeping my mind busy. Sometimes when I think about it I feel the pain again. I do have anxiety but I feel like that couldn't be the sole problem as the muscle relaxants helped but my anxiety medication did not. It was helped a lot when I took muscle relaxants. It took a month or so to go away.
If anyone has anymore opinions on this please let me know. Thanks for all your responses as well.