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Weird comment from a scuba doc



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Old 10th January 2008, 12:52   #11 (permalink)
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Re: Weird comment from a scuba doc

DISCLAIMER: I am not a medical expert, I am just sharing my experience

Quote: (Originally Posted by jhaaja) View Original Post
My wife got a minor dcs hit with some skin symptoms and minor balance problems in some tests.
As has been said, problems with balance are generally not minor. I am glad she recovered.

Quote: (Originally Posted by jhaaja) View Original Post
This is how the story goes. My wife got a minor dcs hit with some skin symptoms and minor balance problems in some tests. She took on Navy 6 table run in the chamber and all symptoms resolved. The doc banned diving for one month and wanted to do a check-up medical after one month.
This sounds overly conservative, which is, as far as I can tell a trend in DCS incidents. Last year I and two people I know had DCS incidents, we all received varying advice about our return to diving. I realize that every hit is different, but, just a sampling suggests that its really guesswork.

Person 1: Presented with elbow pain, crackling sound in ears. Two USN Table 6 rides, all symptoms resolved. Doctor advised not to return to diving for 2 months.

Person 2: Presented with extreme joint pain in shoulder and sub-cutaneous emphysema. One USN table 5, one USN table 6, all symptoms resolved. Doctor advised not to return to recreational diving for 6 months, technical diving for a year.

Person 3: Presented with vision problems and back pain. Two USN Table 6, One USN Table 5, all resolved. Doctor advised not to return to diving for 6 months.

This seems like a pretty wide range of advice. I know at least in my case that DAN agreed that the recommendation of the doctor "seemed very conservative". A second opinion said basically the same thing. All of the above people were back in the water within three months, all are fine after some very deep and challenging dives.

Quote: (Originally Posted by jhaaja) View Original Post
OK, she went to the check-up and the doc found that everything was normal. Then he started the weird part. He banned all gas changes (like EAN --> O2). The reason was that when you are switching regs you kinda like rise 5m in the water column (or go to an altitude of 5000m)
I am not sure what he is objecting too here. Is it the change in PO2 between mixes that is the concern? If so, and keeping in mind that I am in no way an expert, it seems like this is a misunderstanding of the physics behind partial pressure.
If the concern is a physical change in depth (ie: diver removes reg for mix one and slowly ascends due to positive buoyancy while switching to mix two) that seems like a training issue. I was always taught to maintain a constant depth during a gas switch and have the new mix ready to go so that the time without a regulator is short.

Quote: (Originally Posted by jhaaja) View Original Post
And this happens during the few seconds when you donīt have any reg in your mouth during the gas switch...
Sounds like a concern about an AGE or some other expansion injury, if so, it still comes back to what I would consider to be a training issue. The diver should maintain a constant depth and remember to exhale when the regulator is not in place, we teach this in OW.

Just some thoughts, like I said, I may be wrong.
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Old 10th January 2008, 14:40   #12 (permalink)
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Re: Weird comment from a scuba doc

I month is probobly a pretty reasonable amount. Standard practice would be 2 weeks after resolution of a 'pain-only' non-neurologic type hit. One month FOLLOWING RESOLUTION of any neuro or more severe symptoms. Pretty standard.

I think a previous poster was right in saying that he probobly got mixed up and was talking about sudden nitrogen changes in gas, as in isobaric counterdiffusion. Obviously a change to pure O2 would not have this effect. So maybe a bad example, but the thought process may have been correct.

Just some thoughts
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Old 11th March 2008, 01:52   #13 (permalink)
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Re: Weird comment from a scuba doc

Hey!
Can I recommend a new Doctor? You can try mine.
When I asked to be referred for a PFO test, he smiled and said I should try golfing, because it was fun too.
Somebody pass me that stick..
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Old 11th March 2008, 06:41   #14 (permalink)
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Re: Weird comment from a scuba doc

I would also recommend another doctor .
I had a minor bend 2 years ago (tingling in arm) When I went back for the check up a different doctor told me "That using a ccr was not a good idea due to high O2 levels & that diving anything other than 21% was just asking to get bent !" This being one of the doctors at Whipscross Chamber .
She doesn't work there anymore
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Old 11th March 2008, 06:51   #15 (permalink)
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Re: Weird comment from a scuba doc

The doctor in my wifes case does not have any hands on experience on diving and even less when it comes to diving with gases...

Maybe we all should start Golf

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Old 11th March 2008, 12:25   #16 (permalink)
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Re: Weird comment from a scuba doc

I was on a trip to Cyprus to do some long stuff on the Zen. On returning to the hotel I was confronted with an overwhelming sense of fatigue, shivers and confusion. The symptoms were so severe I started to get scared.
To cut a long story short, I rang DAN ( https://www.daneurope.org/eng/english_.htm ) who put a diving doctor on the phone immediately and went through all the symptoms, profiles and gases. Without doubt, the most professional and comprehensive service I have received for free.
Fortunately I wasnt bent, unfortunately I has septic tonsilitis.
Never the less, I wont hesitate to get their advise in the future.

Might I suggest that you contact them, get their opinion and, if your as impressed as I was with the service, join their organisation.
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Old 11th March 2008, 19:17   #17 (permalink)
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Re: Weird comment from a scuba doc

Quote: (Originally Posted by trimix) View Original Post
Hey!
When I asked to be referred for a PFO test, he smiled and said I should try golfing, because it was fun too.
Maybe s/he has a very profound insight into the nature of risk and the whole PFO palaver
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Old 11th March 2008, 19:32   #18 (permalink)
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Re: Weird comment from a scuba doc

Quote: (Originally Posted by divetheworld) View Original Post
I was on a trip to Cyprus to do some long stuff on the Zen. On returning to the hotel I was confronted with an overwhelming sense of fatigue, shivers and confusion. The symptoms were so severe I started to get scared.
To cut a long story short, I rang DAN ( https://www.daneurope.org/eng/english_.htm ) who put a diving doctor on the phone immediately and went through all the symptoms, profiles and gases. Without doubt, the most professional and comprehensive service I have received for free.
Fortunately I wasnt bent, unfortunately I has septic tonsilitis.
Never the less, I wont hesitate to get their advise in the future.

Might I suggest that you contact them, get their opinion and, if your as impressed as I was with the service, join their organisation.
Thanks for the reply! Avtually me and my wife have been for years DAN members. We contacted DAN first and received some info from an italian doc. After that they got into contact with this finnish doctor. My wife good a good evaluation and good treatment but the words after that were funny. Those words did not have anything to do with DAN though.

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Old 13th March 2008, 00:34   #19 (permalink)
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Re: Weird comment from a scuba doc

I have heard of this type thing a couple of times before from my doc, but I asked her for an explanation immediatly when I heard it. The logic my Doc applied was very simple...she related the bends to poor bouyancy control and stated that a repeated DCS injury in short time frame could lead to more sevear symptoms etc.

So if your not gas switching you're within recreational limits and less likely to get bent. The not using nitrox bit was because I was having ear problems as well and she said it was most likely hyperoxic middle ear syndrome ( it has another name but I cant think of it right now) andd there was also some fluid in there too. So she also told me to take a month off so that I didn't compound the problem... I didn't listen to her and I compounded the problem significantly!!! I eneded up taking 6 weeks off and my ears continued to give me problems for about 3-4 months after.

But that's just what my doctor said and not someone who specializes in dive medicine...so who knows.
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