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The DAN address is:
Divers Alert Network
Box 3823
Duke University Medical Center
Durham NC 27706-9980
Phone: +1 919 684 2948
Alan, you give little information about your friend, other than she
suffered a hit and has been told not to dive again. You don't mention
her current condition: the extent of any permanent damage. You don't
mention whether she has been diving long, or whether her hit occurred
soon after she started diving. I will, therefore, not comment on
whether or not I think she should continue to dive.
I have suffered two DCS type I hits. I still dive. In fact, I resumed
diving fairly quickly after both incidents. However, I was able to
identify a number of factors common to both dives that probably
contributed to the hits, and on all dives since, I have taken steps to
reduce those factors. I am now reasonably confident that the hits were
due, in both cases, to me pushing it, and I now dive with extra caution
when I am doing extended exposure dives.
The symptoms, in my case, were pain in the upper arms, and shoulder
joints. On one occasion it was in my right arm, on the other it happened
on my left. The first hit was quite painful; the second much less so.
The pain was similar to when they give you a vaccination injection:
sometimes your arm aches for several hours afterwards. My guess is that
this, too, is due to small air bubbles being injected into your arm, in
much the same way that the DCS pain is due to small nitrogen bubbles
forming inside your arm and joints. In my case, recovery was complete,
and there has been no (noticable) permanent damage.
I consulted with a doctor who specializes in diving medicine and DCS (in
fact, the first thing he told me was that he used to advice Jacques
Cousteau his divers), and spent a great deal of time (over two hours)
asking him detailed questions about what DCS is, about what causes it,
about the likelyhood of further hits, and about what steps can be taken
during a dive to reduce the chance of another hit.
I also consulted, by phone, with DAN.
The doctor made a very important observation. He told me that he could
not tell me what I should do, nor could he tell me what would be best
for me. How could he - he'd only just met me, and knew nothing of me
other than what I'd told him. He knew nothing of my past, of my
succeptability to these problems, or of what kind of diver I am. He was
quite clear about the fact that all he could do was to give me factual
information, and let me make my own mind up about when and how I would
next dive. He would not tell me not to dive again, nor would he endorse
it. (This latter fact proved a real nuisance, because a local charter
company then refused to take me out on their boats.) The doctor admitted
that he had to refrain from endorsing further diving, for liability
reasons.
The folks at DAN were very interested in the facts surrounding my hits.
When I asked them if I should dive again, they responded that I should
wait at least 4 weeks, and then dive very conservatively. When I asked
if this was a "standard" answer they give everyone for liability
reasons, they said yes.
In fact, I dove again after only 2 weeks, but I did dive very
conservatively. My first dive was only to 12m. But I have progressed
back to typical New England diving: repetitive deep deco dives, and
yesterday I made a dive to 50m followed by a dive to 35m, with no DCS
effects at all. However, I am now using much longer deco times, and I
am using 100% O2 on the last stop, as added safety. On repetitive
dives, I am also shortening my dive time as well as lengthening the deco
time. There are other things I am doing, too: I am eating a proper
breakfast before I set off; I am drinking plenty during the day; I have
a new dry-suit that doesn't leak (hence I am warmer during the dive);
and, I am getting a good night's sleep before diving (even if it does
mean going to bed at 7pm so I can get up at 3am).
The result? Successful dives, with no further DCS.
I guess my main point is this: although DCS is relatively poorly
understood, the factors predisposing one to DCS are reasonably clear.
We have the technology to help us minimize those factors (e.g., good dry
suits, O2 or Nitrox 50/50 deco mixes) and some is not expensive (e.g.,
sleep, good food). By deploying this technology, we can still dive
safely, without further DCS.
I guess, Alan, your friend has to ask herself two questions. What is
the risk of additional problems at the site of the existing injury, if
she were to dive again. Clearly, since her injury was spinal, this is
an important question, and she should consider this carefully. The
second question is will she be happy diving more conservatively, and
with increased use of technology? If she's not used to dry-suits and O2
bottles, the extra effort required may outweigh the pleasure derived
from the total activity.
-jr
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