TYPE 1 Pain Only Hit

swadiver · 16th June 2009, 21:44

Well................it just goes to show once again that you can do everything right and still take a hit.

DSix and I planned and executed a 25 to 30 min Bt dive on "The RBJ", Pompano Beach, FL. Flat seas, little current and water temp ranging from 76 to 81 deg F made for perfect conditions for this dive to a max depth of 265 fsw. Actual bottom time was 27 min including descent. Most of the dive we spent at about 230fsw. All proceded well on the dive and subsequent deco. However, well into the stop at 15 ft, i began to feel a little "twinge" in my left shoulder. I attributed this to the fact i was holding on to the up/down moving anchor line almost entirerly with my left hand. no big deal.

Total run time was 2hrs + 2 min. My Hammerhead primary deco, set at 10/85 cleared about 15 min before my straight Buhlmann (0 conservatism) VR3
cleared. Usually the VR3 keeps me in the water longer than anyone else, but Don's Shearwater didn't clear until about 9 mins after the VR3. I stayed the additional time with him. Swadiver's age- 52.

about 10 minutes after surfacing, my left shoulder was a little itchy and sore. I went straight into denial and did not utilize the 100% 02 available on my boat. By the time we got back to my house and unloaded the boat about an hour later, the pain had increased and also moved to a sharp pain in my left elbow.

The pain was bothersome but never really bad. Finally, i started on 100% 02 and Advil. The pain went away after about 35 min of 02. I did have some residual sore to the touch feeling in my upper left arm for a day or two after.

Obviously, i should have hit the 02 right away. i know better, having twice had small pain hits before in my right shoulder. Lesson learned and from now on, if i have any doubts, i will get on the 02 asap. i can't really explain why i didn't hit the 02 immediatly.

The funny thing about this incident is that a week before, i had been on the MV Spree diving two dives per day for 3 days, all 200fsw or deeper, and 1 dive per day for 2 more days with nary a niggle. Prior to this dive, i had over a full day off from diving, having dove with my wife for two no deco dives two days before. maybe my left arm going up and down the anchor line for 30 minutes had something to do with it. i don't know.

I don't consider this a big deal, just part of the potential consequences of this type of diving.

netmage · 16th June 2009, 21:58

Quote: (Originally Posted by swadiver)

Well................it just goes to show once again that you can do everything right and still take a hit.

DSix and I planned and executed a 25 to 30 min Bt dive on "The RBJ", Pompano Beach, FL. Flat seas, little current and water temp ranging from 76 to 81 deg F made for perfect conditions for this dive to a max depth of 265 fsw. Actual bottom time was 27 min including descent. Most of the dive we spent at about 230fsw. All proceded well on the dive and subsequent deco. However, well into the stop at 15 ft, i began to feel a little "twinge" in my left shoulder. I attributed this to the fact i was holding on to the up/down moving anchor line almost entirerly with my left hand. no big deal.

Total run time was 2hrs + 2 min. My Hammerhead primary deco, set at 10/85 cleared about 15 min before my straight Buhlmann (0 conservatism) VR3
cleared. Usually the VR3 keeps me in the water longer than anyone else, but Don's Shearwater didn't clear until about 9 mins after the VR3. I stayed the additional time with him. Swadiver's age- 52.

about 10 minutes after surfacing, my left shoulder was a little itchy and sore. I went straight into denial and did not utilize the 100% 02 available on my boat. By the time we got back to my house and unloaded the boat about an hour later, the pain had increased and also moved to a sharp pain in my left elbow.

The pain was bothersome but never really bad. Finally, i started on 100% 02 and Advil. The pain went away after about 35 min of 02. I did have some residual sore to the touch feeling in my upper left arm for a day or two after.

Obviously, i should have hit the 02 right away. i know better, having twice had small pain hits before in my right shoulder. Lesson learned and from now on, if i have any doubts, i will get on the 02 asap. i can't really explain why i didn't hit the 02 immediatly.

The funny thing about this incident is that a week before, i had been on the MV Spree diving two dives per day for 3 days, all 200fsw or deeper, and 1 dive per day for 2 more days with nary a niggle. Prior to this dive, i had over a full day off from diving, having dove with my wife for two no deco dives two days before. maybe my left arm going up and down the anchor line for 30 minutes had something to do with it. i don't know.

I don't consider this a big deal, just part of the potential consequences of this type of diving.

Might I suggest....
a> first and formost - not diving w/ Don...

b> letting go of the upline.... - or if you need contact with it -
c> a jon line.....

**aainslie** · 16th June 2009, 22:06

While Ibuprofen will help with the swelling, aspirin is probably better. Maybe even both. Ibuprofen helps reduce swelling, but Aspiring has the cool effect of also thinning hte blood which helps reduce bruising from DCS.

I try to take an aspirin before and after every deco dive.

**Dsix36** · 16th June 2009, 22:10

[sock puppet mode]
"a>" does not sound like a good idea at all
[/sock puppet mode]

d> Karma - it can be a real bitch

**SteveJ** · 16th June 2009, 22:35

Quote: (Originally Posted by aainslie)

While Ibuprofen will help with the swelling, aspirin is probably better. Maybe even both. Ibuprofen helps reduce swelling, but Aspiring has the cool effect of also thinning hte blood which helps reduce bruising from DCS.

I try to take an aspirin before and after every deco dive.

Not sure about that Andrew. We usually advise NOT taking aspirin and NSAIDs such as ibuprofen. Both can precipitate peptic ulceration and hence gastro-intestinal bleeding.

Both have an antipyretic effect (i.e. reducing fever). Aspirin has an effect on clotting by inhibiting platelet aggregation which could increase bleeding into a site compromised by DCS.

Best Wishes,

Steve

swadiver · 16th June 2009, 22:42

So, is Advil or other NSAID's ok for post Type 1 DCS pain mitagation?

swadiver · 16th June 2009, 22:45

Tim, not diving with Don, whata concept! i do have a jon line but i think better yet, i am going to rig weighted deco lines for the 30fsw stops and shallower hanging from the stern of the boat. less up an down.

netmage · 16th June 2009, 22:49

Quote: (Originally Posted by swadiver)

Tim, not diving with Don, whata concept! i do have a jon line but i think better yet, i am going to rig weighted deco lines for the 30fsw stops and shallower hanging from the stern of the boat. less up an down.

That and a line w/ a big ring, to clip bottles off.... avoid climbing the ladder w/ that crap on... I tell ya, down at Innerspace it was like resort diving... we had a guy free-diving down grabbing cameras and bottles we were done with...

swadiver · 16th June 2009, 22:53

Yeah, i do have an equipment line rigged to clip bottles off. The Spree did the same thing on this last trip with bottles and cameras, just hawled them right up right away. coming up here to go diving soon? Don is gonna make a much better ladder to go with the benches for the boat.

**aainslie** · 16th June 2009, 23:27

Quote: (Originally Posted by SteveJ)

Not sure about that Andrew. We usually advise NOT taking aspirin and NSAIDs such as ibuprofen. Both can precipitate peptic ulceration and hence gastro-intestinal bleeding.

Both have an antipyretic effect (i.e. reducing fever). Aspirin has an effect on clotting by inhibiting platelet aggregation which could increase bleeding into a site compromised by DCS.

Best Wishes,

Steve

huh, that's interesting. i thought the conference on adjunctive measures a few years ago suggested both. I'm pretty sure it mentioned aspirin.

I've always thought of aspirin as deco vitamins!

Here's the abstract from an older book - they specifically mention NSAID's:

Recompression therapy and adjunctive drug therapy for decompression illness (the bends)

Decompression illness (DCI) is due to the presence of bubbles in the tissues or blood vessels following the reduction of surrounding pressure (decompression). It is most commonly associated with breathing compressed gas while diving underwater. The effects of DCI may vary from the trivial to life-threatening and treatment is usually administered urgently. Recompression is applied while breathing 100% oxygen, based on the reduction in bubble size with pressure and more rapid elimination of nitrogen from the bubbles when breathing 100% oxygen. Recovery without recompression can be slow and incomplete and DCI is responsible for significant health problems in areas where recompression is unavailable. Recompression with 100% oxygen has become universally accepted as the appropriate therapy despite the lack of high quality clinical evidence of effectiveness. This review found only two randomized trials. One trial compared standard oxygen recompression to helium and oxygen recompression, while the other compared oxygen recompression alone to recompression and an adjunctive non-steroidal anti-inflammatory drug (NSAID). Both trials suggested these additional interventions may shorten the course of recompression required. For example, the use of an NSAID reduced the median number of recompression sessions required from three to two. We conclude there is little evidence for using one recompression strategy over another in the treatment of decompression illness and that the addition of an anti-inflammatory may shorten the course of recompression required. More research is needed.

In the newer one - this one:

Adjunctive Therapy For Decompression Illness

I'm pretty sure that they give mild favour to the use of aspirin.

Edit - I see that this page supports what you're saying:

DAN Divers Alert Network : Fitness Issues for Divers With Musculoskeletal Problems - Part I

Yay - yet another medical area where the answer is "On the one hand...... On the other hand..." leaving us dummies uncertain as to what's best!!

16th June 2009, 21:44	#1 (permalink)
swadiver jeff addis Join Date: May 2006 Location: southeast florida Posts: 428	TYPE 1 Pain Only Hit Well................it just goes to show once again that you can do everything right and still take a hit. DSix and I planned and executed a 25 to 30 min Bt dive on "The RBJ", Pompano Beach, FL. Flat seas, little current and water temp ranging from 76 to 81 deg F made for perfect conditions for this dive to a max depth of 265 fsw. Actual bottom time was 27 min including descent. Most of the dive we spent at about 230fsw. All proceded well on the dive and subsequent deco. However, well into the stop at 15 ft, i began to feel a little "twinge" in my left shoulder. I attributed this to the fact i was holding on to the up/down moving anchor line almost entirerly with my left hand. no big deal. Total run time was 2hrs + 2 min. My Hammerhead primary deco, set at 10/85 cleared about 15 min before my straight Buhlmann (0 conservatism) VR3 cleared. Usually the VR3 keeps me in the water longer than anyone else, but Don's Shearwater didn't clear until about 9 mins after the VR3. I stayed the additional time with him. Swadiver's age- 52. about 10 minutes after surfacing, my left shoulder was a little itchy and sore. I went straight into denial and did not utilize the 100% 02 available on my boat. By the time we got back to my house and unloaded the boat about an hour later, the pain had increased and also moved to a sharp pain in my left elbow. The pain was bothersome but never really bad. Finally, i started on 100% 02 and Advil. The pain went away after about 35 min of 02. I did have some residual sore to the touch feeling in my upper left arm for a day or two after. Obviously, i should have hit the 02 right away. i know better, having twice had small pain hits before in my right shoulder. Lesson learned and from now on, if i have any doubts, i will get on the 02 asap. i can't really explain why i didn't hit the 02 immediatly. The funny thing about this incident is that a week before, i had been on the MV Spree diving two dives per day for 3 days, all 200fsw or deeper, and 1 dive per day for 2 more days with nary a niggle. Prior to this dive, i had over a full day off from diving, having dove with my wife for two no deco dives two days before. maybe my left arm going up and down the anchor line for 30 minutes had something to do with it. i don't know. I don't consider this a big deal, just part of the potential consequences of this type of diving.
(Offline)

16th June 2009, 21:58	#2 (permalink)
netmage Tim Owens Join Date: Dec 2005 Location: Coral Springs, FL Posts: 1,187	Re: TYPE 1 Pain Only Hit Quote: (Originally Posted by swadiver) Well................it just goes to show once again that you can do everything right and still take a hit. DSix and I planned and executed a 25 to 30 min Bt dive on "The RBJ", Pompano Beach, FL. Flat seas, little current and water temp ranging from 76 to 81 deg F made for perfect conditions for this dive to a max depth of 265 fsw. Actual bottom time was 27 min including descent. Most of the dive we spent at about 230fsw. All proceded well on the dive and subsequent deco. However, well into the stop at 15 ft, i began to feel a little "twinge" in my left shoulder. I attributed this to the fact i was holding on to the up/down moving anchor line almost entirerly with my left hand. no big deal. Total run time was 2hrs + 2 min. My Hammerhead primary deco, set at 10/85 cleared about 15 min before my straight Buhlmann (0 conservatism) VR3 cleared. Usually the VR3 keeps me in the water longer than anyone else, but Don's Shearwater didn't clear until about 9 mins after the VR3. I stayed the additional time with him. Swadiver's age- 52. about 10 minutes after surfacing, my left shoulder was a little itchy and sore. I went straight into denial and did not utilize the 100% 02 available on my boat. By the time we got back to my house and unloaded the boat about an hour later, the pain had increased and also moved to a sharp pain in my left elbow. The pain was bothersome but never really bad. Finally, i started on 100% 02 and Advil. The pain went away after about 35 min of 02. I did have some residual sore to the touch feeling in my upper left arm for a day or two after. Obviously, i should have hit the 02 right away. i know better, having twice had small pain hits before in my right shoulder. Lesson learned and from now on, if i have any doubts, i will get on the 02 asap. i can't really explain why i didn't hit the 02 immediatly. The funny thing about this incident is that a week before, i had been on the MV Spree diving two dives per day for 3 days, all 200fsw or deeper, and 1 dive per day for 2 more days with nary a niggle. Prior to this dive, i had over a full day off from diving, having dove with my wife for two no deco dives two days before. maybe my left arm going up and down the anchor line for 30 minutes had something to do with it. i don't know. I don't consider this a big deal, just part of the potential consequences of this type of diving. Might I suggest.... a> first and formost - not diving w/ Don... b> letting go of the upline.... - or if you need contact with it - c> a jon line.....
(Offline)

16th June 2009, 22:06	#3 (permalink)
aainslie So Cal Tech Diver Join Date: Apr 2006 Location: LA Posts: 589	Re: TYPE 1 Pain Only Hit While Ibuprofen will help with the swelling, aspirin is probably better. Maybe even both. Ibuprofen helps reduce swelling, but Aspiring has the cool effect of also thinning hte blood which helps reduce bruising from DCS. I try to take an aspirin before and after every deco dive. __________________ Andrew Ainslie www.asainslie.com
(Online)

16th June 2009, 22:10	#4 (permalink)
Dsix36 Going Down? rEvo Optima Dolphin Join Date: Aug 2007 Location: Deerfield_Beach,_Florida Posts: 1,943	Re: TYPE 1 Pain Only Hit [sock puppet mode] "a>" does not sound like a good idea at all [/sock puppet mode] d> Karma - it can be a real bitch __________________ THE MORE THAT I LEARN, THE MORE THAT I STILL NEED TO LEARN!!!!!!
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16th June 2009, 22:35	#5 (permalink)
SteveJ Supporting Member Join Date: Mar 2006 Location: Whitby Posts: 218	Re: TYPE 1 Pain Only Hit Quote: (Originally Posted by aainslie) While Ibuprofen will help with the swelling, aspirin is probably better. Maybe even both. Ibuprofen helps reduce swelling, but Aspiring has the cool effect of also thinning hte blood which helps reduce bruising from DCS. I try to take an aspirin before and after every deco dive. Not sure about that Andrew. We usually advise NOT taking aspirin and NSAIDs such as ibuprofen. Both can precipitate peptic ulceration and hence gastro-intestinal bleeding. Both have an antipyretic effect (i.e. reducing fever). Aspirin has an effect on clotting by inhibiting platelet aggregation which could increase bleeding into a site compromised by DCS. Best Wishes, Steve __________________ Dr Steve Johnson North Yorkshire United Kingdom
(Online)

16th June 2009, 22:42	#6 (permalink)
swadiver jeff addis Join Date: May 2006 Location: southeast florida Posts: 428	Re: TYPE 1 Pain Only Hit So, is Advil or other NSAID's ok for post Type 1 DCS pain mitagation?
(Offline)

16th June 2009, 22:45	#7 (permalink)
swadiver jeff addis Join Date: May 2006 Location: southeast florida Posts: 428	Re: TYPE 1 Pain Only Hit Tim, not diving with Don, whata concept! i do have a jon line but i think better yet, i am going to rig weighted deco lines for the 30fsw stops and shallower hanging from the stern of the boat. less up an down.
(Offline)

16th June 2009, 22:49	#8 (permalink)
netmage Tim Owens Join Date: Dec 2005 Location: Coral Springs, FL Posts: 1,187	Re: TYPE 1 Pain Only Hit Quote: (Originally Posted by swadiver) Tim, not diving with Don, whata concept! i do have a jon line but i think better yet, i am going to rig weighted deco lines for the 30fsw stops and shallower hanging from the stern of the boat. less up an down. That and a line w/ a big ring, to clip bottles off.... avoid climbing the ladder w/ that crap on... I tell ya, down at Innerspace it was like resort diving... we had a guy free-diving down grabbing cameras and bottles we were done with...
(Offline)

16th June 2009, 22:53	#9 (permalink)
swadiver jeff addis Join Date: May 2006 Location: southeast florida Posts: 428	Re: TYPE 1 Pain Only Hit Yeah, i do have an equipment line rigged to clip bottles off. The Spree did the same thing on this last trip with bottles and cameras, just hawled them right up right away. coming up here to go diving soon? Don is gonna make a much better ladder to go with the benches for the boat.
(Offline)

16th June 2009, 23:27	#10 (permalink)
aainslie So Cal Tech Diver Join Date: Apr 2006 Location: LA Posts: 589	Re: TYPE 1 Pain Only Hit Quote: (Originally Posted by SteveJ) Not sure about that Andrew. We usually advise NOT taking aspirin and NSAIDs such as ibuprofen. Both can precipitate peptic ulceration and hence gastro-intestinal bleeding. Both have an antipyretic effect (i.e. reducing fever). Aspirin has an effect on clotting by inhibiting platelet aggregation which could increase bleeding into a site compromised by DCS. Best Wishes, Steve huh, that's interesting. i thought the conference on adjunctive measures a few years ago suggested both. I'm pretty sure it mentioned aspirin. I've always thought of aspirin as deco vitamins! Here's the abstract from an older book - they specifically mention NSAID's: Recompression therapy and adjunctive drug therapy for decompression illness (the bends) Decompression illness (DCI) is due to the presence of bubbles in the tissues or blood vessels following the reduction of surrounding pressure (decompression). It is most commonly associated with breathing compressed gas while diving underwater. The effects of DCI may vary from the trivial to life-threatening and treatment is usually administered urgently. Recompression is applied while breathing 100% oxygen, based on the reduction in bubble size with pressure and more rapid elimination of nitrogen from the bubbles when breathing 100% oxygen. Recovery without recompression can be slow and incomplete and DCI is responsible for significant health problems in areas where recompression is unavailable. Recompression with 100% oxygen has become universally accepted as the appropriate therapy despite the lack of high quality clinical evidence of effectiveness. This review found only two randomized trials. One trial compared standard oxygen recompression to helium and oxygen recompression, while the other compared oxygen recompression alone to recompression and an adjunctive non-steroidal anti-inflammatory drug (NSAID). Both trials suggested these additional interventions may shorten the course of recompression required. For example, the use of an NSAID reduced the median number of recompression sessions required from three to two. We conclude there is little evidence for using one recompression strategy over another in the treatment of decompression illness and that the addition of an anti-inflammatory may shorten the course of recompression required. More research is needed. In the newer one - this one: Adjunctive Therapy For Decompression Illness I'm pretty sure that they give mild favour to the use of aspirin. Edit - I see that this page supports what you're saying: DAN Divers Alert Network : Fitness Issues for Divers With Musculoskeletal Problems - Part I Yay - yet another medical area where the answer is "On the one hand...... On the other hand..." leaving us dummies uncertain as to what's best!! __________________ Andrew Ainslie www.asainslie.com Last edited by aainslie : 16th June 2009 at 23:35.
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