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Time to dive after recompression therapy

Discussion in 'Ask Dr. Decompression' started by Jake, Dec 14, 2018.

  1. Jake

    Jake Divemaster

    # of Dives: 200 - 499
    Location: CA
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    I'm wondering if there's a standard, recommended duration to avoid diving after recompression therapy is administered.

    A friend of mine got skin bends in February and did three rides in the chamber for about 10ish hours total. She was told to stay out of the water for at least 6 months.

    I'm reading through BSAC's 2018 incident report, and in one case a diver was told to stay out of the water for only 4 weeks following two sessions in the chamber for what appeared to have been semi-serious DCI symptoms (compared to my friend).

    The significant time difference made me curious whether there is any standard in place.
     
  2. Billy Northrup

    Billy Northrup ScubaBoard Supporter ScubaBoard Supporter

    # of Dives: 1,000 - 2,499
    Location: Key Largo / Norcal
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    She is just going to have to call DAN. It's going to specific to that individual me thinks.
     
    miked likes this.
  3. chillyinCanada

    chillyinCanada Solo Diver Staff Member

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    Does your friend carry extra weight? I ask because of my own experience.
     
  4. michael-fisch

    michael-fisch Manta Ray

    # of Dives: 2,500 - 4,999
    Location: Germany
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    I had a bad type 2 hit back in 2014, chamber treatment was delayed due to the 1st hospital that I was flown to being incompetent. 9 hrs after getting my hit I was flown to a chamber at a Croation Naval hospital, 45 seconds after landing my streacher was in the chamber, the door closed and a very nice nurse was asking me how quickly I could equalize while she was holding a 20AWG needle in her hand 90 seconds later the chamber was really hot and already at 2.8 Bar.
    Ist chamber ride a TT6 with 4 O2 extensions. 5 Hours later I was back in the chamber for a TT5. was now able to walk very short distances (Bathroom or coffee maschine and back to my bed). Next day another TT5 and I was now able to walk pretty well, as long as I was looking at my feet, and I was finally able to pee so they pulled my Foley catheter. Last day another TT5 to treat lingering niggles and I was released with a letter from the senior hyperbaric doctor to avoid diving for 3 months. Took almost 6 weeks to loose all the excess weight caused by my damaged tissues swelling with water.
    1st dive after the 3 months were finally over, was a 2hr cavedive in 6°C water with over 40 minutes of deco that worked out very well 2 days before christmass. 2 Dives in the same cave on the next day.
    It took over 3 years before my post treatment habit of occasionally scraping a foot while walking went away.

    Michael
     
    iamrushman likes this.
  5. Jake

    Jake Divemaster

    # of Dives: 200 - 499
    Location: CA
    453
    69
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    She’s already cleared now so need to call DAN any longer. But, I posted this in Ask Dr. Deco in case he might know whether there is any kind of standard. I guess it’s more of a trivia question than anything else, since I would hope folks would follow the advice of the treating physician.
     
  6. Jake

    Jake Divemaster

    # of Dives: 200 - 499
    Location: CA
    453
    69
    28
    I’m not sure, but the dives themselves were unremarkable. 5 of us did pretty much identical profiles in Cozumel, and she is in like traiathalete shape, so the hit came as a pretty big surprise.
     
  7. Billy Northrup

    Billy Northrup ScubaBoard Supporter ScubaBoard Supporter

    # of Dives: 1,000 - 2,499
    Location: Key Largo / Norcal
    301
    129
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    I was thinking DAN collaborating with the original Dr to see if she can get back in the water quicker. But I realized after rereading this was Feb and she would already be back. Sorry, it was early :)
     
  8. chillyinCanada

    chillyinCanada Solo Diver Staff Member

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    I meant her body so the answer is no she doesn't. Where on her body did the skin bends manifest themselves?
     
  9. TC

    TC Miscreant Moderator Staff Member

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    Dr Deco hasn't been around much the past few years, I wouldn't count on a reply from him. And he's not a medical Dr, he is a science type Dr.

    Time to return to diving varies widely. Depends on a whole lot of factors- severity of the hit, cause of the hit, etc. The physicians own experience, or lack of it, comes in to play as well.
     
  10. Duke Dive Medicine

    Duke Dive Medicine Medical Moderator Staff Member

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    Hi Jake, the US Navy used to have set standards: 1 week after treatment for Type I symptoms and 30 days for Type II or AGE symptoms, both assuming that the diver had complete resolution of symptoms with treatment. The newest revision of the Navy Diving Manual is more general, and recommends clearance by a DMO (Navy term for a physician trained and experienced in diving medicine) before returning to diving. The most conservative recommendations that I've heard in my own experience with civilian diving injuries is 30 days after a mild DCS hit, again predicated on the fact that the diver had complete resolution of symptoms. As other posters have stated, a lot depends on the presentation of the symptoms and whether those symptoms resolved with hyperbaric oxygen treatment.

    It seems like there might be more to the story of your friend's experience. Three chamber rides for isolated skin bends seems like a lot, as does waiting six months after treatment before returning to diving. Where was she treated? Did she have any other symptoms? Do you know what type of skin bends she had?

    Best regards,
    DDM
     
    iamrushman, Billy Northrup and Akimbo like this.

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