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Dear all, I thought after reading the correspondence about shoulder pain coming on within 30 mins of a dive and the message about Kevin Gurr's skin bend after a dive, I would make the following comments: 1. I am surprised that no-one has made any comments about an arterial gas embolus. Generally, any effects like this coming on within 30 minutes of surfacing could well be due to gas embolus. 2. Why? you may ask? I would be prepared to put quite a lot of money upon the fact that Kevin Gurr has a patent foramen ovale and I think that it is not out of bounds that some of the other people reporting symptoms may also have a PFO. Wilmshurst et al. found a 100% incidence of PFO in those people who get skin bends within 30 mins. of surfacing from a dive. (Wilmshurst et al. Lancet 1990; 336; 1071-2). Moon has also done research in this area. Yes, I am aware that 27% of all people have PFOs but that 27% of all dives > 15 metres do not result in bends but what is forgotten is that during a dive (and especially some of the rather deep depths that are being talked about here) the diver is getting dehydrated and this is known to exacerbate the problems with bubbles (note I did not say DCI). (If people wish, I can tell them a couple of stories here that I have personally witnessed). For those of you determined to dive whether you have a PFO or not (and you may prefer not to know) I would advise that you take fluids on the dive with you and learn to drink underwater. The O2 saturation should be as high as possible within NOAA limits at all times during the dive (rebreathers here we come...) and I would make sure that you dive at all times within the tables - for those of you wondering about tables etc. Bill Hamilton of Hamilton Research in Tarrytown is probably the world expert. The only other thing is to make sure that the bubbles don't get to the brain or the spinal cord... :-) Chris. Chair, National Diving Medical Committee Medical Advisor to Technical Diving International. *************************************************************** * Dr. Chris. Edge * Tel. +44-865-275-338 * * Glycobiology Institute * Fax. +44-865-275-216 * * Oxford University * e-mail chris@gl*.ox*.ac*.uk* * * South Parks Road * 100117.3646@co*.co* * * Oxford OX1 3QU U.K. * * ***************************************************************
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