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| DIVING INCIDENT JUNE 6, 2006 (Updated Nov 20, 2006: Updates just before dive profile pic near bottom) | ||
| Below is an account of a dive that for some reason, resulted in a trip to a chamber. | ||
| The Dive: | Boat Dive - Wreck "Glendora" in Grave Yard, East Side of Amherst Island | |
| Time: 7:00pm, Max Depth 74', Dive Time 40 Minutes, Single Tank-Air, 3000lbs | ||
| Water Temp: 44F, Exposure Suit: Drysuit, Thermal Underwear, Dry Gloves, Hood | ||
| Dive Computer: Suunto | ||
| Surfaced with 800lbs Air, 10 minutes left on computer before deco required | ||
| Safety Stop: 1 min @ 30feet / 1 min @ 20 feet / 1 min @ 10 feet. Although I admit, I did have some trouble in staying consistently at 10 feet for 1 minute. | ||
| Dive itself was uneventful. No problems. At no time was I chilled due to temperature.
I was quite comfortable. At no time was I over-exerted. I had consumed about 750ml of Gatorade on the 45 minute trip out to the dive site. | ||
| After Surfacing: | About 20 minutes after surfacing, I noticed a slight pain in my right shoulder. I just shrugged it off as perhaps straining my neck a bit when I removed my dry suit. | |
| After about an hour or so, I noticed a slight tingling in the finger-tips and the back of my right hand, as well as a little bit more pain in the right shoulder. | ||
| Denying that there might be a problem, I went home, took two Tylenol and went to bed. | ||
| In the morning, the symptoms were still present. By 11:30 am, I began to get
more concerned, because the symptoms were not going away. I decided to call
DAN (Divers Alert Network). They asked me if I was a DAN member (I am), they also asked if I had DAN insurance (I do). Within 10 minutes, DAN contacted the Hyperbaric Chamber at the Ottawa General Hospital and I was speaking with the Dive Physician. I described my symptoms, and the Physician suggested I come to Ottawa for examination & to check in at Emerg. | ||
| The Hospital: | I arrived at the Hospital Emergency at about 2:15pm. The Dive Physician had advised them of my arrival. I had to do the standard paperwork for any Emerg visit. I then met with the Dive Physician who asked me specifics about the dive and my symptoms. He felt that the symptoms were in line with a "Type 1" DCS hit and that Hyperbaric Treatment was advisable. | |
| Before I would be able to receive Hyperbaric Treatment, I was required to have an ECG, chest x-ray (to confirm there was no damage to the lungs), and be seen by the Emerg Physician. It seems that in order to undergo Hyperbaric treatment, you must be 'referred' to the Hyperbaric Centre by a Doctor. | ||
| The Chamber: | By about 4:30, I was in the Hyperbaric Facility. Pretty good time, considering the Emerg room was packed. | |
| I was then briefed, in detail about the treatment and asked several more medial history questions. Since I would be breathing 100% oxygen, I had to remove all jewelry, etc & change into a cotton hospital-green pants & shirt. I also had to wear cotton socks & cap. I was to be given a "Table 5" treatment, which takes 2 1/2 hours. I was then asked "what movie would you like to watch"? Turns out, the chamber has a clear dome, so you can watch TV during your 2 1/2 hour trip. | ||
| I then got in the chamber (it can hold two people, but I was by myself). I was hooked up to a heart monitor, the and door was closed. The Table 5 treatment takes you down to 60 feet. It gets quite warm as you 'descend'. I found that I had to clear my ears about every 15 seconds during the decent. Apparently, this is quite common. The chamber also has a microphone so that you can speak to the chamber operator. | ||
| I then put on a hood so that I could breathe 100% oxygen for 30 minutes at depth. You then are asked to remove the hood for a 5-minute "air-break", where you breathe air. Then it's back on with the Oxygen. I don't recall the specifics of Oxygen / Air Breaks, but you go through several of these at different depths during the 2 1/2 hours. | ||
| While I was in the chamber, after 20 or so minutes, I was asked if my symptoms were better or the same. I had noticed that the tingling was gone and that the shoulder pain was about 95% gone. This is good news and bad news. Good news that the treatment is working. Bad news is that it is probably a DCS injury, since there is improvement. If there was no improvement, then it might just be a muscle pull or strain. | ||
| Upon exiting the chamber, I was asked to fill out a DAN Incident form, which asked for specifics about the dive etc. I was advised to suspend diving for 1 month. | ||
| Driving Home: | When driving home, I had some of the symptoms return. A bit of tingling in the fingers, and a return of the shoulder pain, although not as much as it was earlier. | |
| The Next Day: | The tingling in the fingers had stopped, and the shoulder pain was about 90% better. I had a follow-up phone call with the Dive Physician in Ottawa. He indicated that the shoulder pain may be due to tissues being displaced by the Nitrogen and this should clear up in about a week. | |
| Conclusions: | So...what caused the DCS hit? Was it the cold water? Was it the safety stop of 1 min @ 30/20/10 versus 3 min @ 15? (I had a brief discussion with either the Dive Physician or DAN (not sure which) about 30/20/10, and they indicated that this technique is acceptable). Did I not progress smoothly enough through the 30/20/10 safety stops? No one else had problems on the dive, despite some divers doing the same safety stops as I did. Well....I am about 10 to 15 years older then the other divers, maybe that had something to do with it? | |
| What did I learn from this?: |
(1) Pay close attention to Safety Stops. Be sure you're at the proper depth for the proper amount of time. (2) Join DAN! They had me in contact with a Dive Physician with 10 minutes of calling them. (3) Don't ignore a problem. Be aware of the symptoms of DCS. Call DAN if you suspect you have a problem. | |
| Note Of Thanks: | Thanks to Divers Alert Network and the staff at the Ottawa General Hospital and The Ottawa Hospital Hyperbaric Unit. | |
| Yours in diving....Steve |
| UPDATED........ | NOV 20, 2006 |
| Following are the Post DCS hit events: | |
| June 14, 2006: | Pain in shoulder still present - 2nd Recompression treatment: 2hrs @ 50' |
| June 15, 2006: | Pain in shoulder still present - 3rd Recompression treatment: 2hrs @ 50' |
| June 16, 2006: | Pain in shoulder still present - 4th Recompression treatment: 2hrs @ 50' |
| After last treatment, discussion with Dive Physician: Decide to leave things for a week and see how things progress. | |
| June 23, 2006: | Pain in shoulder somewhat better, although definitely still present. Discussion with Dive Physician in Ottawa suggests that remaining pain is due to tissue damage from DCS hit and should heal over time. This could take several weeks. Doctor also suggests pursuing a PFO Test with family doctor. I mentioned that I am also experiencing dizziness. Doctor suggests taking this up with the Family Doc. |
| June/July | Pain in right shoulder continues, minor tingling in hands. Also experiencing dizziness (same feeling you get when you "stand-up too fast" from a sitting position). |
| July 11, 2006: | Met with Family Doctor to set up a PFO Test. We go over the dive incident, recompression treatments, etc. When I mention dizziness, he says I should take this up with the Dive Physician in Ottawa. Wonderful. |
| July 15, 2006: | (Not sure of date). Called DAN to discuss dizziness. They recommend I get in touch with an ENT (Ear Nose Throat) Specialist, as the dizziness could be an inner ear problem. Called Family Doctor to arrange and ENT. He told me they would send my my appointment by mail. |
| July 24, 2006: | Received ENT appointment by mail. Appointment set for October! I phoned the ENT clinic to try and get an earlier date. I could not. They suggested phoning EVERY DAY and checking for a cancellation. So that's exactly what I'm going to do! |
| July 24, 2006: | PFO test. I was booked for a TTE Test Which checks for the overall health of the heart and the presence of a PFO. There is also another form of the TTE test which involves the injection of gas-filled microbubbles (contrast enhanced ultrasound), which gives more detail. Awaiting results of TTE test. |
| July 25, 2006: | Pain in right shoulder continues to reduce. No tingling in hands for about 3 days now. dizziness is still present, but not as frequent or strong as in prior weeks. |
| July 28, 2006: | Results of TTE test show everything is normal. |
| Aug 28, 2006: | Still have pain in right shoulder. Called Ottawa Hyperbaric Unit to discuss with Dive Physician. Doctor indicated that it may take months to subside, or it may nerver go away. Suggested that if it does not go away in a few more weeks, that a visit to an Orthopedic Specialist may help to determine if there is something else causing the pain. |
| Oct 16, 2006: | Went to ENT (Ear Nose Throat) Clinic today. Had a hearing test and exam of ears. Hearing test showed a slight loss of hearing in left ear. They are also going to give me a ENG test. Not sure of date of the ENG test yet. The appt. date will arrive by mail. |
| Nov 20, 2006: | Received results of ENG test. Everything ok. |
| Nov 20, 2006: | Returned to diving this month. I started with an easy dive in a quarry in 15 feet with Nitrox 32. No problems. I then did a 70 foot dive in Lake Ontario on the wreck The Comet for 20 minutes, again using EAN 32 (Safety stop 2 min at 35 feet & 5 min at 15 feet). After getting back on the boat, I was sick to my stomach. I attributed this to the extremely rough water with 10 foot swells.....other divers were not felling very well either. The third dive I did was to 20-30 feet for about 50 minutes on EAN 32. No problems. |
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 DIVE CHAMBER OTTAWA HYPERBARIC FACILTY (OTTAWA GENERAL HOSPITAL) |
 TABLE 5 TREATMENT. (DARK SHADE = Breathe Oxygen / LIGHT SHADE = Breathe Air (Air Break)) |
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