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In a message dated 96-06-12 07:17:47 EDT, you write:
>Subj: Re: Report on a medical occurrence
>Date: 96-06-12 07:17:47 EDT
>From: atikkan@ix*.ne*.co* (EE Atikkan)
>To: GarlooEnt@ao*.co*
>
>You wrote:
>>
>>Esat,
>>First of all let me back up a bit-this is not a Flame exercise.
>>we don't know each other
>Wrong Hank!
>We know each other from the Wahoo, as a matter of fact I helped you
>deal with two DCS cases on the Wahoo a few years back.
{
BTW on the Texas Tower wasn't:that someone who wasusing a computer & ran into
problems on the second dive of the day???}
\ (On a Coimbra-Tx
>Tower weekend where you all ran out of O2 & had to use our deco O2 for
>treatment)
Well i apologize also, i am probably the worlds worst with names.
>& i should have prefaced my remarks to you with that
>>statement.
>>you are absolutely correct we are doing the hindsight thing here, & it
>should
>>be easier to do that way.
>>my objective is not to point out that someone f-up but is there a
>reasonable
>>explanation & can it be avoided in the future?
>>
>>if she used a computer that made computations for various levels
>achieved
>>then it is possible that the computer table is (dare i say it) flawed.
>
>Let us get this straight - Despite the diagnosis the probability that
>this was a true case of DCI is vanishingly small. Particularly given
>the fact that no relief was reported during hyperbaric treatment on
>Table 6.
NO how about YOU get this straight--- as per YOUR POST- after the 2nd day of
diving she developed "BLOTCHING,etc."
[by the way you never mention where this occurred???
you also admit that dcs is not an exact science- well guess what- neither is
the diagnosis in all cases. & even in this case it seems that at this point
there are some doctors (not pseudo meds like me) that feel that she was bent.
Esat you know what ?
it does not matter that they have nothing other than the backwards look to go
on. It also does not matter that the girl & you are in denial over the whole
thing!
what does matter is that shedid have some symptoms -for whatever reason they
did not respond the way we would have expected them to respond, & the final
med conclusion was that she was Hit.
now if you accept that & go back over the dive profile that YOU posted &
compare it with
KNOWN & ACCEPTED (not just by me) dive tables, you can begin to see a
POSSIBLE(because nothing in this sport is exact)reason for her to have
developed a problem.
>As for flawed, the algorithm has been around & probably has more dives
>than DECOM.
Esat correct me if i am wrong please, but didn't Bhulman come out with or
wasn't the original tables used in computers changed to a more conservative
table. BTW i would tend to agree that relatively speaking DECOM is new but
the NAVY-CANADIAN-BRITISH
tables might actually have more dives on then than you computer.
>>[[ by the way please run this profile of the three dives on the Navy
>tables i
>>think you might be surprised]]
>
>Hank - that is absolutely assine. The violation/non violation of Table
>parameter when using a computer can only apply toe dive 1. Repet dive
>calculations with translation of Computer tracked dives to Table
>tracking is not an acceptable algorithm.
HOLD ON
maybe we are not understanding each other here.
if you take a series of dives & do them on a computer profile & then run the
same comparison on any other table -are you saying that it's not an
acceptable comparison???
i'm not sure i follow you logic here please explain you meaning.
>>if you are not familiar with the DECOM program try DR x or any of the
>other
>>widely accepted alternative programs.
>
>The word widely accepted may be hard to define here. I know many many
>divers & diving professionals who don't use either. Thus widely
>accepted is nothing but a nebulous adjective butressing the favorite
>algorithims of a given segment of the diving community.
>
> (how about Canadian or British) i think
>>you will find that in all of these(just a guess on my part since i
>didn't
>>work them out) she should have spent more time "SAFETY" hanging.
>Safety hang is jut that. A 3-5 non required stop @ 10-15 ft. A legacy
>of Andy Pilmanis who in one series of studies showed reduced Doppler
>bubbles (precordial) in those that did a stop compared to those that
>did not following the identical dive profile. The results may be
>significantly different today with the new slower ascent rates.
Esat i'm going to skip this & save it for anther time if we talk about it.
>>
>>just an aside i have always felt the term safety hang is a bullshit
>way of
>>avoiding the recognition of decompression requirements.(we don't need
>to get
>>into this one).
>
>I think that we may at least agree on that one. Safety stops??
>
>>
>>the general treatment on the boat that i work on (the Wahoo) is to
>treat the
>>situation as a DCS problem (o2,water,rest,no further dive)
>
>Again you are Monday AM QB'ing.
>The subject did not report an anomaly. The anomaly surfaced only after
>repetitive inquiries RE: perceived mood change.
>
>And as it self-cleared & since it does not truly fit most any
>description of DCI related S&S, it was not invoked.
>
>> if the individual
>>improves then the likelihood of DCS is pretty obvious. in either case
>>we also
>>would stress an MD to do an examination.
>
>
>As improvement occurred in the absence of O2, the above conclusion does
>not apply.
>>
>>yes you are correct this is not an exact science & the possibilities
>there
>>for anyone in any physical condition to get hit in some way.
>>
>>what i was really trying to point out was one that was made to me
>awhile back
>>& that is that the assumptions that we make based on one table may not
>be the
>>same for all.
>>that being the case then the next question is which one is correct (if
>any
>>are)?
>
>That obviously is a matter of probabilties - that is irrespective of
>what Table/algrothim U use, the probability of a hit never vanishes.
>The question is, is that a daily probability, a series probability or a
>cumulative probability (just musing).
>
>>if the tables are in question which one would you follow?
>>i have chosen to follow one that "appears" to be more conservative.
>>is it right???? so far!
>>
>
>Again, your premise has been that this was DCI.
>I am not convinced, nor is the patient. The two physicians that
>actually examined the patient hands on & treated same were not
>convinced either.
you forgot that in you orig post the final evaluation was that she had " Type
II DCS with skin & lymphatic involvement" .
>Hence: An exact science it is not.
dive on on hank
>
>
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>From atikkan@ix*.ne*.co* Wed Jun 12 07:17:37 1996
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><GarlooEnt@ao*.co*>; Wed, 12 Jun 1996 07:17:36 -0400
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><GarlooEnt@ao*.co*>; Wed, 12 Jun 1996 04:17:25 -0700
>Date: Wed, 12 Jun 1996 04:17:25 -0700
>Message-Id: <199606121117.EAA08351@df*.ix*.ne*.co*>
>From: atikkan@ix*.ne*.co* (EE Atikkan )
>Subject: Re: Report on a medical occurrence
>To: GarlooEnt@ao*.co*
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