Bent Again!

MadsL

Help...

I'm getting sick of this - I have just returned from Galway after the third time in the chamber. (Thanks Peadar!)

My first bend was after a rapid-ish ascent from 11-15m (max 18m, Ave 11m, 28mins) - it took two sessions two weeks apart to clear up the symptoms (tingling fingers and achey shoulder.)

Looking back (three months previous) it may have been related to bend like symptoms after a dive in Malta to 35m 30mins (normal ascent but slightly pinky mucus I spat up after the dive - I had very very mild bend symptoms that night, a mottled look to my shoulder and tingles, but they cleared up after a day - I flew home and had no other symptoms)

So I have just taken a three year break from diving...

Until I was in Hurgahda, Egypt last week and just couldn't resist. First two days were too windy, but eventually I took the following two dives on the house reef; 10.4m for 57 min, 2.30 surface interval followed by 17m for 46 min (Ave just 8.0m!)
Next day I couldn't dive as I was flying and wanted the full 24hr no-fly time just in case.

Just at the edge of perception I had achey shoulder and tingles (very very mild) but thought I was being paranoid. On the flight home I had the dreaded "here we go again feeling". Another trip to Galway.

So what now, after being advised everything from "give it two weeks" to "never dive again!"

Should I look for a PFO test and eliminate a cardiac shunt. Switch to Nitrox on Air computer. Give up diving.

After getting a bend on my last dive profile, alright slightly reverse profile but nothing that dramatic, I am spitting bullets. The two lads in the chamber before me made a rapid ascent from 55m and not a bother on them!

Anyone know of a diving doctor/specialist that might help me figure out this damn thing. Any advice welcome.

ethanf

Looking back (three months previous) it may have been related to bend like symptoms after a dive in Malta to 35m 30mins (normal ascent but slightly pinky mucus I spat up after the dive - I had very very mild bend symptoms that night, a mottled look to my shoulder and tingles, but they cleared up after a day - I flew home and had no other symptoms)

Any history of lung damage? pmeumonia? scar tissue? Have you had a chest xray?



Just at the edge of perception I had achey shoulder and tingles (very very mild) but thought I was being paranoid. On the flight home I had the dreaded "here we go again feeling". Another trip to Galway.

Computer strap too tight? Stab too tight? Tensioning shoulder muscles subconciously? Enough sleep? Lots of beer night before? Dehydrated?


Should I look for a PFO test and eliminate a cardiac shunt.

33% of people have a PFO, so maybe its worth a look.



Switch to Nitrox on Air computer. Give up diving.

After getting a bend on my last dive profile, alright slightly reverse profile but nothing that dramatic, I am spitting bullets. The two lads in the chamber before me made a rapid ascent from 55m and not a bother on them!

Anyone know of a diving doctor/specialist that might help me figure out this damn thing. Any advice welcome. [/B][/QUOTE]

www.scubaireland.com check dive medical officers or drop them a line. They will point you towards a dive specialist .

dublinbay

Originally posted by ethanf
Looking back (three months previous) it may have been related to bend like symptoms after a dive in Malta to 35m 30mins (normal ascent but slightly pinky mucus I spat up after the dive - I had very very mild bend symptoms that night, a mottled look to my shoulder and tingles, but they cleared up after a day - I flew home and had no other symptoms)

Any history of lung damage? pmeumonia? scar tissue? Have you had a chest xray?



Just at the edge of perception I had achey shoulder and tingles (very very mild) but thought I was being paranoid. On the flight home I had the dreaded "here we go again feeling". Another trip to Galway.

Computer strap too tight? Stab too tight? Tensioning shoulder muscles subconciously? Enough sleep? Lots of beer night before? Dehydrated?


Should I look for a PFO test and eliminate a cardiac shunt.

33% of people have a PFO, so maybe its worth a look.



Switch to Nitrox on Air computer. Give up diving.

After getting a bend on my last dive profile, alright slightly reverse profile but nothing that dramatic, I am spitting bullets. The two lads in the chamber before me made a rapid ascent from 55m and not a bother on them!

Anyone know of a diving doctor/specialist that might help me figure out this damn thing. Any advice welcome.

www.scubaireland.com check dive medical officers or drop them a line. They will point you towards a dive specialist . [/B][/QUOTE]

Sorry guys, posted from internet caff, ethanf was logged on instead of me.

MadsL

Thanks Jack

Any history of lung damage? pmeumonia? scar tissue? Have you had a chest xray?

I'm a former smoker so have had pneumonia, pluerisy and bronchitis over the years...chest X-ray was clear 3 years ago though (you need a cert for diving in Malta)

Computer strap too tight? Stab too tight? Tensioning shoulder muscles subconciously? Enough sleep? Lots of beer night before? Dehydrated?

Thought about this one. My semi-dry was being worn in both incidents and is a little tight in the wrist, may be a factor...???
Enough sleep and hydrated - in a Muslim country too much beer was an expensive option ;-)

33% of people have a PFO, so maybe its worth a look.

Anyone been tested for this, what should I ask my GP? or should I try an Anesthetist??

Peace

Originally posted by MadsL
Anyone been tested for this, what should I ask my GP? or should I try an Anesthetist??

An article up on www.Divernet.com (actually a couple) talk about PFO:

CAN I BE TESTED FOR A HOLE IN THE HEART?
I would like to move to decompression diving over the coming year and want to take a PFO test to make sure I don't shunt bubbles and bend myself. Could you give me any details about costs, waiting lists, places to have it done etc?

Answer:
PFO (patent foramen ovale) testing is not easy. The area of the heart that is looked at is almost lying against the backbone, so the scan or echocardiogram has to be done looking at the heart from the gullet.

The diver has to swallow a probe under sedation until the atrial septum can be seen. A defect/flap in this area is what is looked for. Some agitated water (with bubbles in) is injected into the diver and the scan looks for any bubbles crossing abnormally from the right to the left side of the heart. This is also done with the diver performing a valsalva.

For a diver, the test would have to be done privately and would cost around £400. It is best performed by a consultant knowledgeable in diving medicine.

There is then a problem with interpretation. Small PFOs are probably not significant and only those greater than 10mm are thought to increase risk of decompression illness. This is not exact and work is still ongoing to find the exact relationship between PFOs, their size and DCI.

If you had a PFO, would it stop you diving, limit your diving or would you ignore it?
In general, PFOs are probably not worth looking for until after a problem has developed and the test is recommended by a doctor trained in diving medicine. This will be the case at least until we have more knowledge of how much they increase the risk in a well diver.

Personally i had some symptoms of haveing a bend once... but i'll never really konw. I had done a dive to about 40meters for 30minutes and on the deco i got really cold. I had tinglingi in my hands/fingers and it was a bit disconcerting! The symptoms stopped when i surfaced but i'll never know for sure.

Looking at your dive profiles it might be best to go get checked out before diving again... If you are bending then you never know where a bubble will form... spinal bends can leave you in a wheel chair and neural bends... are not a good thing. Also nerve damage to the surrounding tissue can occur leading to loss of feeling/use of affected areas.

As an aside, what was the galway chamber like.. any fit birds.. worth getting bent??

Borzoi

Originally posted by MadsL

.....but eventually I took the following two dives on the house reef; 10.4m for 57 min, 2.30 surface interval followed by 17m for 46 min (Ave just 8.0m!)...

Commiserations on getting any form of deco illness, but can I ask a n00b question.

PADI OW teaches, that the first dive of the day should be the deepest, and all subsequent dives should be to the same depth or shallower. What, if anything, were you using to get around this 'rule'?

bigfeller

Originally posted by Peace
As an aside, what was the galway chamber like.. any fit birds.. worth getting bent??

Am sending the bill for a new keyboard, the current one is drowning in spitted cofee!

Peace

Originally posted by Borzoi
Commiserations on getting any form of deco illness, but can I ask a n00b question.

PADI OW teaches, that the first dive of the day should be the deepest, and all subsequent dives should be to the same depth or shallower. What, if anything, were you using to get around this 'rule'?

There is no statistical proof that reverse profiles increase your chances of getting DCS. However it will reduce your bottom time significantly due to residiual nitrogen loading. This is why its reccomended for deepest dive first.

You can use your PADI tables to plan repetitive dives... wheteher they are deeper shallower or the same depth.

Mick L

Originally posted by Borzoi
PADI OW teaches, that the first dive of the day should be the deepest, and all subsequent dives should be to the same depth or shallower. What, if anything, were you using to get around this 'rule'?

The subject of reverse profiles and whether they make a difference or not is not a hard and fast rule according to some reports. The difference seems to be whether or not you use a dive computer. If you do, the computer should be able to handle the reverse profile and compensate. If you're using tables however, PADI for example have stated that the data used to create the tables has been derived from deepest dive first profiles so that's what users should stick to.

Reverse Profile study
Reverse Dive Profiles Workshop, Smithsonian Institute

Divernet News

DAN

Also, some PFO research by DAN

MadsL

PADI OW teaches, that the first dive of the day should be the deepest, and all subsequent dives should be to the same depth or shallower. What, if anything, were you using to get around this 'rule'?

I was using a Suunto Favor (as was the PADI instructor I took the two dives with)
The instructor admitted that it was a theorethical 'problem' that it was a reverse profile, but neither computer gave us grief and we surfaced with about 30 min no-deco left (I think - I'll check when I get home)

Assuming I continue to dive after the six-month break, is diving on Nitrox & Air computer going to give enough of a safety margin? Any one any idea if rebreathers are safer for long shallow dives and would give me a better chance of not getting bent again? (have to sell the car to buy one of course!)

Mick L

I think switching to nitrox instead of air, or switching to a rebreather are not the solution to the problem. You can get bent on these just as easily as Open Circuit Air depending on what you do with them.

If your computer didn't complain about your dives, and everything else was done properly then something else is wrong, possibly as has already been mentioned a PFO which may make you more susceptible to DCS. If possible, you should determine what it was that caused the bends and address that, i.e. a PFO, rapid ascents (I'm assuming from your post that the rapidish ascent you mentioned wasn't ICBM launch type rapid and you didn't miss any deco stops) or other possible causes that have been suggested may have contributed, such as dehydration, hangover, etc.

As the previous posters have said, contact the CFT medical people or DAN Europe for advice before you do anything.

NordicDiver

MadsL

I read this with shock, i have read it a few times and i am having a feeling it is all a joke or that you are very stupid.

Your dive in Malta 35m 30min (and normal ascent you say, no deco? You deserve getting bent if you had no deco after that dive).

As Jack says 1 of 3 has a small or smaller hole between the two heart chambers. We all had this before we where born. This is something you/your doctor should have checked out before you started diving again after your first accident, if you think/know you where well inside all limits, depth/time and ascent rate.

And then having 2 more accidents ?

"The two lads in the chamber before me made a rapid ascent from 55m and not a bother on them!"



I hope all understand that it’s NOT just to go to the chamber and be "fixed" when you screw up.

Jan-E.
With no involuntary chamber trips.

Peace

If i were you MADSL i'd make sure everyone in the house empties the bath after them. It sounds like if you slipped and fell into it when there's water in it... you could come out with a bend.:eek:

MadsL

Originally posted by NordicDiver
MadsL

I read this with shock, i have read it a few times and i am having a feeling it is all a joke or that you are very stupid.

I posted for advice, not to be insulted. As this isn't a joke, you obviously haven't read it properly.

Your dive in Malta 35m 30min (and normal ascent you say, no deco? You deserve getting bent if you had no deco after that dive).

heard of computers? Multilevel dive, we spent probly 10min at 35m, then a long slow ascent with an extended safety stop(I was diving with a Master Instructor btw)

You deserve getting bent...

My, aren't we on a high horse...

As Jack says 1 of 3 has a small or smaller hole between the two heart chambers. We all had this before we where born. This is something you/your doctor should have checked out before you started diving again after your first accident, if you think/know you where well inside all limits, depth/time and ascent rate.

I know what a PFO is...thanks for drawing me a picture. I ascribed the bend to the rapid ascent naturally enough, so No, we didn't take a PFO test, I took a long break from diving instead. Incidentially have you had a test if you think it is so vital? Read the article, the research is at a very early stage. Certainly too early for non-medical people to be saying this is what my doctor 'should' have done.

And then having 2 more accidents ?

Where do you get this from?
Sequence:
1. Malta. Very mild slight bend like symptons. Cleared up.
2. 3 months later Rapid-ish ascent in Ireland. Chamber for treatment.
3. Two weeks later Symptoms came back (I wasn't diving) Chamber for more treatment.
4. 3 year break from diving.
5. Two dives in Egypt. Very mild bend symptoms. Chamber.

"The two lads in the chamber before me made a rapid ascent from 55m and not a bother on them!"

I'm making the point that there is not always logic. By your reasoning these lads 'deserve' to have been bent. My frustration is trying to understand the cause of my bends, as DCS is not a logical condition.

I hope all understand that it’s NOT just to go to the chamber and be "fixed" when you screw up.

There you go again...'screw up'. So getting a bend is always someone's 'fault' because they are 'stupid'. Hmm. That horse is getting very high again.

Jan-E.
With no involuntary chamber trips.

I wish you none, but I hope that should you get bent that you will appreciate the fact that the lads and lasses at the Galway chamber are non-judgemental and recognise that ANYONE can get bent under ANY circumstances. Attitudes that say 'you screwed up' or 'you were stupid' kept people off 02 and out of chambers for longer than necessary. And stop with the smug attitude, that signoff is about as impressive as me saying 'I don't have cancer'.

NordicDiver

1. I am sorry to hear that it is not a joke.

2. Yes I have heard about computers and “the wheel”. I saw 35meter 30minutes and should have known it was a multilevel dive when you said normal ascent.

3. If you where at 35m for 30 minutes you would most likely get bent.

4. Where I come from, you would be checked for PFO after your first accident, multilevel dive 18m 28min average depth 11 meter. Did you give your dive profile to your dive doctor?

5. Sorry my fault, 2 accidents and one you possible should have been treated for.

6. When someone get blown up from 55meter and ends up in chamber. And then you are saying: “not a bother on them” …
Then some divers may think that it is NOT a problem to get bent “they will fix us in the chamber” and will dive deeper than they should?

7. Yes, SCREW up is what you have done when you and your buddy get blown up from 55 meter.

8. Not all, but a lot of the sport divers that end up in chamber is because of their own fault.

9. The sign off was more as an internal sentence to a few of the guys that know me. As a commercial diver I have had hundreds of chamber trips but all voluntary. Sorry for that.

What kind of multilevel tables do you use? Computer, “the wheel” or other tables?
On the Suunto Favor computer you can set the computer for more conservative times. The setting A2 is the most conservative setting at sea level. For your next dive try with A2. The Suunto manual recommend this for divers with previous history of decompression sickness.

Jan

daveg

Nordic, MadsL is looking for advice not insults. We have all gotten along very well on the scubaboard. Let's keep it that way.

MadsL

Originally posted by NordicDiver
1. I am sorry to hear that it is not a joke.

Thank you.

2. Yes I have heard about computers and “the wheel”. I saw 35meter 30minutes and should have known it was a multilevel dive when you said normal ascent.

normal as in not rapid

3. If you where at 35m for 30 minutes you would most likely get bent.

Agreed, sorry fo the confusion

4. Where I come from, you would be checked for PFO after your first accident, multilevel dive 18m 28min average depth 11 meter. Did you give your dive profile to your dive doctor?

He, as did I, ascribed the bend to the rapid ascent. This is why I am looking for a decent dive doctor as I mentioned.

5. Sorry my fault, 2 accidents and one you possible should have been treated for.

I would characterise this as ONE accident and then a bend during a normal diving profile.

6. When someone get blown up from 55meter and ends up in chamber. And then you are saying: “not a bother on them” …
Then some divers may think that it is NOT a problem to get bent “they will fix us in the chamber” and will dive deeper than they should?

Let me be clear - These divers were NOT bent. The chamber was a precaution. I used this as an example of how 'unfair' this was and that there was no logic to DCS symptoms.

7. Yes, SCREW up is what you have done when you and your buddy get blown up from 55 meter.

Now you are just being arrogant, these divers (I understand from hearsay, not the incident report) blew up as a result of equipment problems (rebreathers) and heavier than expected currents. As I understand it they had no option but to make an fast ascent without deco.

8. Not all, but a lot of the sport divers that end up in chamber is because of their own fault.

Where do you pull this figure from? Every equipment failure, accident, unforseen circumstance is 'their own fault'. Interesting point of view.

9. The sign off was more as an internal sentence to a few of the guys that know me. As a commercial diver I have had hundreds of chamber trips but all voluntary. Sorry for that.

OK

What kind of multilevel tables do you use? Computer, “the wheel” or other tables?
On the Suunto Favor computer you can set the computer for more conservative times. The setting A2 is the most conservative setting at sea level. For your next dive try with A2. The Suunto manual recommend this for divers with previous history of decompression sickness.

The favor was set to A1 (I was 30min inside the no-deco limit anyway)

dublinbay

Where do you pull this figure from? Every equipment failure, accident, unforseen circumstance is 'their own fault'. Interesting point of view.

On ANY dive the dive plan should err on side of safety. Equipment failure does happen of course but 99% of the time you will find the said kit was not cared for properly
i.e. a diver from a well known Dublin club using a new Halcyon DSMB had a rapid ascent when he inflated it with his drysuit hose. He complained that the dsmb was dangerous only to have the salt deposits on his inflator hose pointed out to him as the reason for the hose "locking" on to the dsmb valve. Kit failure or laziness?

Accidents happen. I have seen many a cup get knocked from a table by some clumsy person. But who placed these cups at the edge of the tables? When planning a dive sufficient back up for the dive should be used. My drysuit is my back up buoyancy, and if diving a single I always wear a side slung 3 ltr .

Why dive a borderline weather fc? Why deco dive on a current? Why deco dive a computer when a square profile is much safer? Why dive air when nitrox is much safer? Why dive beyond 40m on air when trimix is much safer?

Every dive I have done was always in the unforseen realm. But experience and knowledge helps me prepare for the unforseen. Slowly slowly catchee monkey.
You seem to be open and honest about your dcs problem. Now try to be open to the above. There are a lot of old divers, a lot of bold divers but no old bold divers.
Too many divers engage in pissing contests about air consumtion and depths. Sooner or later these guys have equipment failures or unforseen circumstances. I dived to 70m for 15 mins on mix after which a guy from my club went to 70m on air on a single just to say he dived 70m also. So as you see, eq failure and unforseen circumstances are usually directly related to the level of muppetry,tardiness,childishness and downright stupidity being displayed at the given moment.

Peace

Originally posted by dublinbay
So as you see, eq failure and unforseen circumstances are usually directly related to the level of muppetry,tardiness,childishness and downright stupidity being displayed at the given moment.

Harsh but true...

I'd also take a look at the way PADI training is approached. Often if someone makes a bouyant ascent (due to lack of bouancy skills) people take a softly softly approach to the diver afterwards. It even says so in the manual to help divers feel at ease and not to aportion blame... or something like that i'm paraphrasing here. The bare facts are that if you tell em something like "no worries, you'll get em next time" the diver may or may not learn something the accident. It should be pointed out to people in no uncertain terms that the ball has been dropped, in what manner the ball was dropped and how to keep from dropping the ball in future. Also that the ball is very much that divers responsibility and noone elses.

Accidents don't just happen... there is a cause and an effect and a lot of times the cause can be identified and avoided before hand.

One bend - fine people can get a bend even when doing everything right.
Two bends - Hmmm ok, there's something wrong here.
Three bends - WTF?

So what now, after being advised everything from "give it two weeks" to "never dive again!"

The "What now" is get a full physical from a qualifed doctor who specialises in diving medicine. I'm just reiterating the saged adivce that has been handed out further up in this thread.

Don't throw the toys out of the pram just because you get a kick up the arse... the kick up the arse will often teach you a lot.