what's wrong with me ?

[divedivedive]

what's wrong with me ?


I went diving a week and a half ago.. I had 3 dives, one to 54 feet for 22 minutes, the sit was 1hour 2 minutes, the second dive was to 55 feet for 18 minutes. the second sit was 41 minutes, the third dive was to 45 feet for 23 minutes.. during the third dive I was playing with my new bc so I stopped paying attention to what was going on around me, as a result I went up like a missle from 44 feet to the surface.. on the surface I felt like someone punched me and I got a headache almost instantly.. the headache was increasing and my vision was getting more and more blurry.. the headache was at first in the back of my head... I also felt slightly dizzy and a pain on the left hand side of my neck.. I thought I could walk it off but on the third day after no improvement I called DAN suspecting some sort of a light case of air embolism.. they directed me to a decompression chamber.. there I was given a treatment for about 5 hours according to the US navy table 6.. they also took an xray of my chest and informed me that I didn't have a collapsed lung..the following day I didn't seem to have a headache (my sight was still a bit off though). for the next a couple of days the symptoms began to return. meaning neck pain, dizziness, rigging in my left ear (didn't have it before), burryness. I went to see the doctor who treated me at the chamber but he told me to take some tylenol.. for a couple of days I tried tylenol, aspirin, advil, it had no effect.. the dr also sent me to see an eye doctor. the eye doctor examined me and said there was nothing wrong with my eyes..(I did tell him about the diving accident).. on the 4th day my dizziness got so bad that I almost fell once.. now my headache is so intense I can barley stand it.. it feels like somebody punched me in the nose and you wait those 2-3 seconds to recover, to come to but in my case those 2-3 seconds have turned into a week and a half now. life feels like a video game..

I've made a couple of observations though.. for the first a couple of days the headache was moving from the back of my head towards the top and the front, now it's random all over.. the headache is usually not as pronounced in the morning but at the evening hours it gets really bad.. also when it is warm around me it gets worse.. I keep all of the windows open in my apartment, I ride cabs with the windows rolled down and complaining cabbies that they're cold..it seems to help a bit..also if I go for a 20-25 minute jog it seems to ease a little for the next a couple of hours..the neck pain comes and goes.. the vision is blurry when I'm in motion, like walking, riding in a car.. I don't seem to be able to focus my eyes especially from far targets to something up close and vice versa.. also this is when I get dizzy the most.. when I sit still I can focus my eyes from different targets easier... well it takes longer than before but at least it works...sometimes it hurts.. I spoke to the doctor who treated me at the chamber today again and he doesn't think this is diving related and that I don't need another treatment.. he told me to see a neurologist... I will tomorrow..


one thing to keep in mind.. I never ever ever before used to have headaches, never would get dizzy or anything like that.. this is the first time in my life.. another explanation is that I'm getting old or something (I'm 32) but why all of the symptoms appeared right after the dive ?

 

[chrispete]

You may want to contact DAN again and see if they can provide additional help. One thing that strikes me as odd is that, from the reading that I have done, most chambers will keep the therapy up until the symptoms either subiside completely or the chances of any further recovery are very low - yet this doc basically blew you off after the first chamber ride...I'd bring that up to DAN as well.

Mind you, this is simply my opinion based on the info that I have read regarding DCS and its treatment. I'm just a normal Joe Diver, and there may be circumstances involved that may very well render my opinion idiotic.

 

[rmediver2002]

The symptoms you describe, a blow up from 44 fsw / neurological symptoms immediately upon surfacing, sound like arterial gas embolism. AGE is an over-pressurization of the lung tissue resulting in rupture of the alveolar sac, potentially allowing an air bubble to enter into the blood stream. The bubble once in the blood stream can be pumped out of the heart most likely following one of the first two arteries leaving the heart both of which supply blood to the brain. The resulting complications are most often neurological in nature.

The thing that makes an AGE so devastating and a life-threatening emergency is the size and location of the bubble, the only treatment if you cannot absolutely rule out and AGE is immediate recompression… Without 02 the brain tissue will begin to deteriorate and die within four minutes.

Three days after the symptoms present the blockage or air bubble that caused the initial symptoms has already been reabsorbed. I am afraid if this was the cause the damage has already been done. Treatment in a hyper baric chamber at this point may be beneficial for 02 loading of the damaged tissue and could help aid in tissue regeneration but does nothing to help the original cause.

I truly hope your symptoms improve…Good luck in your recovery…

Jeff Lane

 

[BillP]

Howdy divedivedive:

Sounds like a miserable problem. Unfortunately it's virtually impossible to make a diagnosis over the Internet- especially when a hyperbaric specialist who has actually evaluated and treated the patient is having difficulty with the answer.

There are many causes for surfacing with a headache. Your concern about a gas embolism after an uncontrolled ascent was reasonable, but like rmediver2002 pointed out, an arterial gas embolism is a medical emergency that shouldn't wait 3 days. The longer treatment is delayed, the less likely it is to be successful. If a diver has a decompression injury like DCS or AGE, recompression treatments a week and a half later might help a little, but likely not as much as if they had started an hour and a half after the injury.

Some diving related causes for a headache include sinus or ear barotrauma (which can also lead to dizziness and ringing in the ear), stress/anxiety, salt water aspiration, neck strain, cold, mask or tooth squeeze, migraine, or increased carbon dioxide or carbon monoxide for starters. Headaches from some of these causes would go away soon after surfacing, some might persist.

I can't tell you based on your description specifically why your doctor apparently ruled out a decompression injury, but the advice to followup with a neurologist for an evaluation seems sound. If the neurologist doesn't have an answer then if it were me, I would seek the advice of an ENT.

Sorry to not be of more help. Keep us posted on what you find out.

Bill

The above information is intended for discussion purposes only and is not meant as specific medical advice for any individual.