Should I give up diving ?

[gypsyjim]

Thanks for posting this.
I too am struck by the one commonality to three incidents. All dry suit dives, with @50 warm water dives in the meantime, with no such recurrences in those dives. No medical training, just reading and thinking.
The fact that the last incident of tingling resolved itself w/o the chamber visit is also an interesting factor.
I will just lurk and watch for professional opinions.

 

[reo]

Oops, I should have looked to see where you lived before responding. Divers Alert Network (DAN) has some good information on their website. DAN Europe is based in Italy at +39-085-893-0333.

Ron

 

[ScottBuck]

Not a doctor but I am a paramedic. Have you ever had these symptoms outside of diving? Any new medical conditions no matter how small? Tingling/numbness in your fingertips can be caused by different conditions, although it sounds like a squeeze, can be caused by other conditions. I would get a 2nd or/and 3rd opinion and get a full physical exam including a cardiac check out (stress test), blood work and so on. Diver85 is right not all docs know things about diving, and when you go in and tell a doctor you were diving when the symptoms began he may tunnel vision down the wrong path. And some doctors may only be doctors because they answered the right questions on the test! No one can Dx over a thread on scubaboard, you need to get to a doctor get some test done. you may find out that it is something total different than what you think, or it just could be dumb luck!

 

[scubaren]

I just want to say that I'm not a doctor either.

 

[scubaren]

I too have had tingling and numbness in hands and fingertips after diving. It is spine related with me as well.

 

[TSandM]

Well, it isn't possible to diagnose anything over the internet. But what strikes me is that, if you have been diving for over 20 years, you probably aren't 20 years old any more . . . and arthritis and degeneration in the neck is more common as we age, as are impingement syndromes in the shoulders. I would be seriously wondering if you have cervical disc disease, and something about the position you hold while dry suit diving aggravates it. Although I am not a hyperbaric doc, it is my understanding that it would be unusual for DCS symptoms to be persistent for four days, and then disappear with hyperbaric therapy. Also, the fact that you have had precisely the same symptoms with increasingly conservative dives is somewhat inconsistent with DCS, as well.

 

[ShakaZulu]

Simple, seems to me you have a problem with your left arm, just have it amputated...

 

[ItsBruce]

I am not a doctor either, but when I first read the OP, my reaction was that it was not DCS. I see I'm not the only one.

If it were me, I'd try 3 things a week apart: (1) drysuit dive to 30 fsw for 40 minutes (leaves you at Group "C"), (2) drysuit dive to 70 fsw for 15 minutes (leaves you at Group "D"), and (3) wetsuit dive to 70 feet for 45 minutes (leaves you at Group "I").

The first two are unlikely to produce DCS, so if you have tingling, it is unlikely to be from DCS and you can look for other causes. The third, while not beyond the tables, will help determine if the issue is the drysuit.

Again, you will have to make your own decisions about whether to dive, whether diving is important enough to you to run some tests, etc. I am not giving any medical, legal, marital or other advice. I am merely identifying some tests that might produce data to help identify the source of your problems.

 

[Bubbletrubble]

@photographer: You didn't mention any pre-existing medical conditions. I realize that, due to privacy issues, you may not want to divulge this kind of info on an Internet board. That's OK. Given your history, you (and your doctor) should be trying to rule out any non-diving causes of the tingling/numbness sensation. The etiology of your symptoms could be cardiovascular or neurologic in nature...but certainly aren't limited to those causes. Only a full diagnostic work-up will shed some light on the situation. Tingling/numbness (paresthesia/anesthesia) in the arm/hands can be caused by any number of things: various medications, vitamin B6 toxicity, diabetes, brachial plexus neuropathies, thoracic outlet syndrome, cervical spondylosis, herniated cervical disc, Raynaud's disease, polyarteritis nodosa, pernicious anemia, hypoparathyroidism, low potassium, low calcium, low magnesium, metabolic alkalosis, infection, tumor, multiple sclerosis, ALS, headache/migraine, hyperventilation/anxiety, etc. It's a really long list of potential causes!
If it is true that you are only experiencing your symptoms after diving, then several of these possibilities may be excluded. The fact that your symptoms are asymmetric (specific to left side), peripheral, non-inclusive of the cranial nerves, and lingering (yet not permanent) is also useful diagnostic information.

Along the lines of what TSandM suggested, you may want to try to dissociate DCS from your symptomatology. For instance, you could gear up in your drysuit and execute a 15 foot dive (safety stop depth) in local waters during which you attempt to replicate the most recent dive that gave you the tingling/numbness sensations. Try to reproduce the same pre-/post-dive routine, level of activity, and total bottom time (only at a much shallower depth). If you experience the same kind of tingling/numbness, then I would be more inclined to say that it is not DCS-related. The hypothesis of a degenerative spine condition leading to nerve compression would definitely be one to consider. Then you can work with a physician (internist/neurologist/cardiologist) to figure out what's causing your symptoms. An internist will be requesting bloodwork. A neurologist may request an MRI or do electromyography. A cardiologist would probably be doing an EKG and some sort of echocardiography (transthoracic, transesophageal, transcranial). All of the specialists should be taking a thorough patient history and conducting various physical exams. As always, consultation with DAN might prove helpful.

Be patient. It may take some time to work through this issue.
Good luck with everything...and, if you ever figure out the cause(s) of your symptoms (and you feel comfortable sharing the info), please leave a follow-up post here so that others can learn from it, too.

 

[Saturation]

I concur with TS&M. A common story I hear is I've done this dive, and worse, 1000 of times without issue in the past, and then this. Naturally, you were 1000 dives younger then and things change.

Besides arthritic like issues, which is more common, rarer DCI related changes like PFOs can enlarge or lung shunts can occur spontaneously with age. PFOs seem to be troubling for diving sized ~> 4mm.

Primary Care Diving Medicine


That the docs at the chamber clears the pt to dive each time suggests they did not think the symptoms as severe, but err on the side of safety.

An ideal solution is to get a medical evaluation by a hyperbaric doc to assess which issue is likely the cause.

The nitrox on air tables is not full proof and helps in DCI related issues, but likely will not do anything if it is arthritis related. The dive written off, BT 37 min nitrox32 at 60' is substantially conservative, the NDL ~ 80 min that I would explore none DCS issues with some zeal.

Well, it isn't possible to diagnose anything over the internet. But what strikes me is that, if you have been diving for over 20 years, you probably aren't 20 years old any more . . . and arthritis and degeneration in the neck is more common as we age, as are impingement syndromes in the shoulders. I would be seriously wondering if you have cervical disc disease, and something about the position you hold while dry suit diving aggravates it. Although I am not a hyperbaric doc, it is my understanding that it would be unusual for DCS symptoms to be persistent for four days, and then disappear with hyperbaric therapy. Also, the fact that you have had precisely the same symptoms with increasingly conservative dives is somewhat inconsistent with DCS, as well.