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John Heimann (jheimann@sc*.dn*) wrote: > Yesterday I heard that Wes Skiles (well known Florida deep cave > explorer) has been suffering from severe osteonecrosis... > > Do any cavers on the list (Bill Mayne?) have more information on Skiles' > problem and what specifically caused it? I saw Wes Skiles at the NSS-CDS workshop last weekend. Nothing was said about him having a problem. He seemed to be getting around okay and was diving Sunday. > Is anyone aware of hard information > (or even lore) on avoiding osteonecrosis, other than limiting exposure or > being conservative with decompression profiles? The cause(s) of osteonecrosis are unknown. The small number of incidents such as a high rate showing up from a single extreme decompression, such as crew members who have escaped from sunken submarines, are of little value. There has been speculation for a long time that the cause is not related to decompression but to the initial compression. Since it only shows up much later and you can't have decompression without compression in diving it is hard to separate the effects. More nearly anecdotal evidence is that decompresssion in aviation, which can result in bends, does not lead to osteonecrosis. This is mentioned in support of the theory that compression is the actual cause. Some lore I heard from Sheck Exley this weekend is that someone has recently published a paper theorizing that the cause is neither compression nor decompression, but exposure to high partial pressures of oxygen. If so this would meant that decompressing on oxygen may lead to problems down the line. Sheck did not put much stock in this theory. He actually mentioned it in the context of saying that some things in journals are off the wall or at least highly speculative. I discussed decompression programs with both Sheck Exley and John Crea. I gave them each a copy of mine and Sheck is sending me his, which is called something like "Dr. X's Decompression and Dive Planning". When I get it and have time I'll try to post something about it. John Crea does not distribute his program, and the adjustments he makes to halftimes, increasing the halftimes of off-gassing compartments, are a trade secret. By the way, I also had the chance to discuss the rash I had after a decompression dive last week with some experts and the concensus was that it was not skin bends, although skin bends can occur when diving wet. Also exertion after a dive isn't a likely factor in skin bends. Bill Mayne
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