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On Mon, 19 Dec 1994, J Shepherd wrote: > The theory that DCI is caused by a bubble lodging somewhere > (discussed in a previous post - there is evidence that this is not > always, or even often, the case), leads to the idea that having a > lodging (and therefore large and critical) bubble somewhere and > squeezing it isn't a hot thing to do. > > You don't immediately (or rapidly, it takes a lot more pressure > and time to redissolve a bubble than that which formed it) get rid of > the bubble during IWR. The treatment causes i) rapid alleviation of > symptoms by compressing the bubble and moving it on, before local > clotting occurs, and cell death begins, and ii) resolution of the bubble > as N2 in the body equilibrates to ambient i.e. zero. > > 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. > > 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! > > But that's why IWR might make you worse anyway. My general opinion about IWR is that theory says it sucks, history says it works, and the path o follow is somewhere in-between. I suggest we apply our thoery to come up with a set of standards for IWR that will maximize the 'probability-of-helping to probability-of-hurting' ratio, and then make it widely known to all divers who might attempt IWR that they should keep VERY careful notes on what happened whenever they DO attempt IWR. These notes could be collected in a common place, then the standards can be modified according to what seems to work and what doesn't. Problem is, people are doing IWR all over the place, they're not ususally following a set method, and their not reporting the details of what happened. That's why we have only 'anecdotal' accounts. I think it would be GREAT if DAN kept data on IWR, but when I suggested it last year, they didn't seem interested. If nobody else will do it, I will volunteer. Aloha, Rich deepreef@bi*.bi*.ha*.or*
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