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To: techdiver@opal.com
Subject: Re: Re[3]: Australian O2 protcol.
From: J Shepherd <jms@fe*.ed*.ac*.uk*>
Date: Mon, 19 Dec 94 16:21:24 GMT
> Jason
> 
> #	In water, and therefore variable pressure, recompression,. would 
> #lead to the bubble leaving a known lesion site, and potentially 
> #re-sticking somewhere else, possibly a lot worse.
> 
> Not if it was stuck in a capillary and ends up in the venous return 
> to the heart. In this case it will probably just get trapped in the 
> lung like all the other bubbles (allegedly).
>
	IF it just ends up in the venous return, sure. IF this that and
the other too,... IF you have a large autocthonous load of which you
remove a significant proportion, you may wind up with a pulmonary bend
(choke), some may sneak through to the heart *again* and wind up in the
arterial supply (especially likely on a long hang - I've posted before
about the French studies but I'm buggered if I can find the reference).
That would *possibly* convert an otherwise painful but not life
threatening bend into a neurological one.



> 	The theory against IWR, as based on this theory, is *very* 
> *very* sound. The difficulties with applying it are;
> 
> #	It doesn't seem to be true. As a previous poster has commented, 
> #there is a large and growing body of opinion which says that bubble
> #formation triggers DCI but is not necessarily involved in the 
> #continued development of the lesion; and also, IWR seems (based 
> #strictly on reports and discussions based here) to work. Which it 
> #shouldn't. So the theory is probably wrong!
> 

	Both these bits were mine...


> Ummm... are you getting at what I think? 
> 

	What are you thinking?

> I naively continue to believe that bubbles and DCS are related. 
> Immediate recompression (whether chamber or IWR) CAN result in an 
> instant reduction in symptoms. If bubbles ain't involved and it's all 
> down to those clotting factor thingys then I just can't see why the 
> pain goes away so fast.

	Yes. The above statement includes - involved in the causation of
DCI but not the continued development of a lesion. It is well known that
a strong characteristic of DCI is a relatively late onset (several
minutes). The 'new' or rather 'more complex' theory goes something along
the lines of;

	Ascend from dive
	Critical bubble formation
	Critical bubble location
	Trigger some reaction
	trigger something with the complement
	waffle waffle
	er don't know really

	It's obvious why recompression helps in stages 1-3, but after
that, you're right, whay should reco. help? Check out the last stage...
:-)

	 Getting cynical about it all yet?

> 
> #	Jason. Stuffing his turkey with Haggis, not Lamb. :-)
> Curious, just who suggested stuffing lamb with haggis?
> 
> Bob Talbot

	Isn't lamb just inside-out haggis, anyway?

	Chicken Dundee, rather like a chicken kiev, only not.

	Jason.

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