Possible DCS

[doctormike]

@doctormike You mentioned sinuses, but not being able to obviously diagnosis over internet, the headache I have is most definitely lower centre forehead majority of the time, my ears have also been feeling 'off', not congested just 'off' sometimes and one thing I have noticed the last few days is (excuse the language) hard, painful snot in my nostrils. Could this be sinus related also?

Being a medical moderator here, my primary role is to help people understand basic physiology and anatomy, and review some of the processes in the human body that are affected by diving. I really can't diagnose or suggest treatment over the Internet - not just for liability reasons, but because in most cases the symptoms are so common with so many possible causes that making guesses really isn't very helpful to anyone.

Sinusitis is common, sinus barotrauma during diving is common, headaches have a wide variety of causes. As you can tell, I'm always happy to contribute to these discussions to the best of my ability, but apart from saying that it's possible that sinusitis plays a role, you really need to see an ENT doc for a good exam and maybe imaging to work that up...

Sorry!

 

[Dr Simon Mitchell]

Hi Guys,

I have seen many professionals on here so looking to gain a third opinion from you guys. Just for context of this post I suffer from severe health anxiety, regardless of if any condition is currently afflicting me I am very much anxious about it.

Hello Luke,

Thank you for your very candid admission of the anxiety problem.

With all the limits and caveats of remotely evaluating a medical story in mind, like the other medical people and experienced divers who have commented on your case, I do not believe you have DCS. There are a number of reasons for saying this.

1. The dive was relatively unprovocative. Yes, you transiently acquired a decompression ceiling based on the algorithm used by your computer. But that is a somewhat arbitrary line in the sand that does not represent a sudden incremental change in risk as I think you may perceive. Moreover, you followed a very conservative path to the surface after that.

2. Your symptoms did not present for quite some time after the dive.

3. Your primary symptom (headache) is very non-specific: that is, it can be caused by many things both in diving and in general life. Although headache is part of the constellation of symptoms that may occur in DCS (7% of 3500 cases reported in our Bennett and Elliott chapter on Manifestations of Decompression Disorders had a headache) it would be extremely unusual (indeed unknown in my experience) for the diagnosis to be made on the basis of headache alone.

I do not think your risk in continuing to dive is altered by your circumstances and if it were me I would have no hesitation in resuming diving. Having said that, since DCS can occur in perfectly well divers who have not suffered preceding DCS events I quite obviously cannot guarantee that nothing will go wrong if you dive. It follows that you and you alone have to make your own decisions and take responsibility for them.

One sensitive issue that no one else has mentioned and which I feel needs to be addressed with you is your current suitability for diving in remote locations. It is likely only a matter of time before the tendency to be vigilant and anxious about health issues creates a difficult conundrum in relation to a disorder like DCS which has many non-specific symptoms that can be caused by many things. In particular, it may result in a logistically difficult, expensive and perhaps hazardous evacuation from a remote location if you choose to frequent and dive such places. I do note that you are very experienced, and you do not mention previous problems of this nature. Nevertheless, I think it might be a mistake to get on a boat to Bikini Atoll before you find a way of addressing the anxiety issue. The latter is not an area of expertise for me, but I have no doubt that there are avenues of support and therapy which you could explore. Best of luck with it.

Simon M