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From: HeimannJ on Fri, Feb 26, 1993 5:54 PM
Subject: RE: Deep diving and bones
To: techdiver
I for one worry about osteonecrosis (I first heard about it in Lippmann's Book
("Deeper...")). Rumor has it that Dee Scarr, Caribbean dive industry veteran,
had part of her jaw replaced because of this problem.
Another thing that I especially worry about is neurological damage from
untreated bends, especially "pain only" (Type I DCS). I understand that most
"pain only" bends are typically associated with some degree of neurological
symptoms that often go unnoticed, and untreated, since many people tough out
Type I DCS.
I have had at least two incidents where I thought I might be bent. The first
time I brushed it off as tendonitis, but the second time I called DAN and got a
medical exam. This was only after someone else I knew did a similar profile the
next day and spent a better part of the following week in the chamber for a
paralyzed arm (the Dr. decided I was OK). Although in some cases, like those of
my fellow diver, the signs are recognizable to anyone, in most cases it's the
diver himself who has to recognize the problem and bring it to a Dr.'s
attention.
A serious problem in dive training, both recreational and technical, is that
there isn't enough education on recognizing bends symptoms. When the chamber is
2+ hr drive away, as it is here, there is a strong incentive to convince
yourself that it's only a muscle pain, or that you are really tired because of
the Dramamine. Training in recognizing bends, and in field neuro exams (there
is a description of how to do one in Mount's Mix book), should probably be
required for all technical training courses. I certainly had some training in
my dive rescue course, but that was oriented towards symptoms that were obvious,
like serious Type II DCS or arterial gas embolsim.
_______________________________________________________________________________
From: SCSD::HARVEY::"daemon@fu*.in*.co*" on Fri, Feb 26, 1993 12:01 AM
Subject: Deep diving and bones
To: HeimannJ
Hi folks,
Something I have been thinking about that I haven't seen metioned
on either rec.scuba or this mailing list is hyperbaric osteonecrosis
or pressure related bone disease.
[For those not familiar with it, hyperbaric osteonecrosis is the forming
of lesions in the long bones of the body. It may occur either in the
shaft of the bones which tends not to cause symptoms, or in the head
of the bone where it can cause collapse of the bone structure leading
to arthritic like symptoms and potentially requiring an artificial
joint. It is extremely rare in recreational scuba divers. It can only
be diagnosed by long bone x-rays or maybe MRI scans (?).]
The diving medicine books I have read ("Diving Medicine for Scuba
Divers" by Carl Edmonds et al. and the section in the US Navy
Dive Manual) all mention hyperbaric osteonecrosis as an effect which
afflicts mainly professional divers and whose cause is not fully
understood.
Most texts also mention that it tends to be associated with deep
diving and has been known to occur after a single dive. Some
theories suggest that it may be the result of asymptomatic bubbling
in the bones.
A lot of recent discussion on this list has centered around very
deep diving (by recreational standards) and I am curious to know
if this problem is discussed in mix classes and whether there are any
statistics about its occurrence rates in the technical diving
community. Not that I'm trying to frighten people off technical
diving :-)
Cheers,
David.
______________________________________________________________________________
David Giddy, | Voice: +61 3 253 6388
Telecom Research Laboratories, | Fax: +61 3 253 6144
P.O. Box 249, Clayton, Victoria 3168, AUSTRALIA | Net: d.giddy@tr*.oz*.au*
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