No, the damage is done and only certain of the symptoms like the superficial
pain from still existing bubbles go away. Using high ppo2's gets oxygen to
the areas blocked by the reaction to the dcs and the immune response and
shunting that you mention below so the victim regains some lost ground, but
the answer is as you suggest - no.

-----Original Message-----
From: SRSCHIRATO@BK*.co* [mailto:SRSCHIRATO@BK*.co*]
Sent: Tuesday, October 02, 2001 1:40 PM
To: OEA51@go*.co*; wgrogan@dc*.ne*; icallicrate@ho*.co*
Cc: techdiver@aquanaut.com
Subject: RES: Re: [E-CAVERS] BIG Bull and Squeeze


>From the message below:

"You may be confusing the "oxygen challenge", whatever that is, with a test
>> >of pressure.  The test of pressure is done in a chamber when DCS is
suspected.
>> >If the victim feels better when pressurized to say, 30', then the pain
is
>> >probably DCS and NOT something such as overuse or a bruise.  If there is
no
>> >improvement at 30' or 60', then the problem is NOT DCS.

Question: should all DCS symptoms disappear when the victim is recompressed
(therefore eliminating the possibility of DCS if the victim does not show
any improvement during the "pressure test")? My question is related to an
article about the immune response to bubbles and symptoms of DCS even after
the bubbles were already treated.

Regards, Sergio

-----Mensagem original-----
De: terry michael [mailto:OEA51@go*.co*]
Enviada em: segunda-feira, 1 de outubro de 2001 21:50
Para: Wendell Grogan; Isaac Callicrate
Cc: techdiver@aquanaut.com
Assunto: Re: Re: [E-CAVERS] BIG Bull and Squeeze


Sorry I disagree, Any discussion is good. In my personal experience many of
the "chamber folks" don't know sh*t. Most divers are totally unprepared for
the DCI reality. Those silly little DAN boxes are a complete joke in my
opinion and so is the previous post with all the useless rhetoric.


-----Original Message-----
From: "Wendell Grogan"<wgrogan@dc*.ne*>
To: "Isaac Callicrate"<icallicrate@ho*.co*>
Cc: techdiver@aquanaut.com
Date: Sun Sep 30 15:27:57 PDT 2001
Subject: Re: [E-CAVERS] BIG Bull and Squeeze

>Agree
>Wendell
>
>Isaac Callicrate wrote:
>>
>> I have replied in private to people about pushing their ideas or fourth
hand
>> information on issues that they have no experience/training/insight etc.
and
>> feel like this one deserves some public response.  I dont feel like
dusting
>> off the ancient texts to quote specific lines but will in private if
>> neccessary.  I want to make one thing very clear, this is definately
>> personal opinion but I think most agree with this.  If you think you have
a
>> serious diving or hypo/hyperbaric problem then need to seek immediate
>> medical attention.  If their is no hyperbaric unit in the area have your
>> physician call Duke or NEDU.  If you think because you are a TDI Deep
Air,
>> IANTD Tech Scooter, EMT, DMT, Paramedic, Firefighter, Smokejumper,
>> Paratrooper, Chamber Tender, Italian Free-Diver, PADI Combat Swimmer,
Rescue
>> Swimmer,MS Certified Systems Engineer, Rescue Diver, American Oilfield
>> Diver,and on and on, that you have the right to give medical
consultation,
>> or develop treatment protocol you are big time wrong and deserve all the
>> liability that you just earned. Differential diagnosis - screw you.  Good
>> Samaritan my ass.  If you dont have the certificate on the wall of your
>> clinic shut your c--k holsters. You arent helping anyone.  If you are not
a
>> UMO, DMO, UHO, HMO, or whatever, someone with diving/hyperbaric medicine
>> specialty/sub, than you need to say to the diver that reports not feeling
>> right, "buddy, you should go to a chamber" - THE END- Giving the guy a
Neuro
>> is a nicety for the chamber folks but chances are that your neuro isnt
going
>> to be worth a shit as a baseline so save the time, call EMS, and give
them
>> your O2 bottle.  I am sure that there are plenty of folks waiting to
scream
>> their exceptions about how they were to far out for USCG response and
they
>> developed In Water Recompression protocol with a Full Face Mask and two
72s
>> of O2 - Good job-.  We do make dives where someone on site is going to
have
>> to make the call and I hope they are educated enough to make the right
one.
>> You would have to press me pretty hard to put a SCUBA diver back in the
>> water after reporting symptoms.  If you are within cell phone range of a
>> country that speaks English, talk to someone that knows better than you
or
>> your instructor.  If you are doing serious expedition/scientific diving
you
>> better already have someone available.  I have seen some really astute
>> speculations and guestimations about diagnosis/treatment in the last few
>> days.  Im sorry Ive been working and havent had a chance to respond.
>> Between Navy Dive Manual, NEDU Reports and DAN/Duke research you should
have
>> enough available information to at least give some factual advice no
matter
>> how inappropriate you speaking about it is. Please run to the library or
>> phone to find some quotes to devalue the credibility of what I am saying.
>> At least you will be educating yourself and others instead of causing
>> injuries.
>>
>> >From: Jsuw@ao*.co*
>> >To: E-CAVERS@ya*.co*, FLTechDiver@mikey.net
>> >Subject: Re: [E-CAVERS] BIG Bull and Squeeze
>> >Date: Thu, 27 Sep 2001 23:52:08 EDT
>> >
>> >'Symptoms persisted on or off O2, which is what's
>> >called an O2 challenge that is what all but eliminates
>> >DCS not a neuro exam.'
>> >
>> >Cliff:
>> >
>> >Oxygen challenge?
>> >
>> >One way to differentiate between AGE and DCS is that AGE may improve
>> >quickly
>> >with the use of O2.  For example, an unconscious victim may regain
>> >consciousness.  DCS is progressive, meaning its symptoms may get worse
over
>> >time, and may NOT show improvement with the use of O2.  (Even though
oxygen
>> >is beneficial as a first aid treatment.)
>> >
>> >You may be confusing the "oxygen challenge", whatever that is, with a
test
>> >of
>> >pressure.  The test of pressure is done in a chamber when DCS is
suspected.
>> >If the victim feels better when pressurized to say, 30', then the pain
is
>> >probably DCS and NOT something such as overuse or a bruise.  If there is
no
>> >improvement at 30' or 60', then the problem is NOT DCS.
>> >
>> >Among other possibilities, vertigo is often associated with inner and
>> >middle
>> >ear problems.  For example, rupturing an eardrum will allow water to
enter
>> >the middle ear.  This can result in immediate and severe vertigo until
that
>> >water is warmed to body temperature.  Once the vertigo passes, healing
and
>> >prevention of infection are concerns that preclude diving for a short
time.
>> >Other kinds of aural barotrauma may also occur.  These may require other
>> >type
>> >of medical treatment.
>> >
>> >Vestibular DCS involving the inner ear causes vertigo, difficulty with
>> >balance, nausea and vomiting.  I suspect this was what you had,
especially
>> >since you did show improvement after a period of time on oxygen.
>> >
>> >Please understand that having one kind of DCS or even one kind of
>> >barotrauma
>> >does not mean you don't have another.  Vestibular DCS, or any aural
>> >barotrauma can result in permanent hearing loss.
>> >
>> >Denial is a real issue in treating DCS.   I recommend you at least call
DAN
>> >to discuss what happened and get a real medical opinion.   Ideally, you
>> >should have sought treatment immediately.
>> >
>> >The information I just provided is discussed in my recreational level
>> >(PADI/NAUI) rescue diver course.  I do not have a medical background.
In
>> >my
>> >opinion, if you are going to be doing tech dives, you need to have
enough
>> >background to recognize the risks, and to know the signs, symptoms, and
>> >first
>> >aid for dive injuries, not to mention emergency management and
prevention.
>> >Actually, that is true regardless of the diving you choose to do, but
since
>> >the risks are greater in technical diving, it is even more necessary to
>> >have
>> >the proper understanding.
>> >
>> >Best,
>> >Jan
>> >
>> >In a message dated 9/27/01 9:26:10 PM Eastern Daylight Time,
>> >cavecliff@ya*.co* writes:
>> >
>> >
>> > > Gina, Ania, Chris Toedt, William Wolk, Ray Blanchard,
>> > > Lesley Jacques, Jo, Al, Rich Lesperance, Will, Cathy,
>> > > Wendy and Butch (William please reasure him, all these
>> > > post's he can read, but he can't type) and anyone
>> > > concerned that I missed.
>> > >
>> > > Thankyou for your concern.
>> > >
>> > > All of my previous posts were on my palm phone using
>> > > the graffiti alphabet and the tiny keyboard screen and
>> > > that fat black toothpick in the dark in the back of my
>> > > bus parked in back of a certain dive shop in deerfield
>> > > beach.  Which I explain for the simple reason that my
>> > > previous posts were a neurological test in and of
>> > > itself.  This post I'm using a KEYBOARD what a
>> > > concept.
>> > >
>> > > Name's have been omited below, by design, those who
>> > > know, don't post and don't put 2+2 together and post.
>> > >
>> > > We splashed off the boat (I the instructor and a
>> > > student)  My gas was 16/40, 50 and 100.  Planned depth
>> > > was 210ft.  I was carrying the rope to the float ball,
>> > > we got to about 170' could see the sand, no wreck.
>> > > All three of us looked, this is when I noticed the 4th
>> > > diver, or ooooooh sh.... that's a shark, a MFB Bull
>> > > shark, one guy thought he saw the wreck, my money was
>> > > on the shark, after his lead didn't pan out we headed
>> > > in the direction the shark discopeared, ah ha the
>> > > wreck. Eight minutes into the dive and a vigorous
>> > > swim, during which I let the up line go cause I wasn't
>> > > making any progress.  My max depth was 190, we did no
>> > > major penetrations and called the dive at 20mins at
>> > > about 170'.  The shark sighting made me want to stay
>> > > with the others.  The student while deploying the lift
>> > > bag, totally lost bouyancy and by the time I checked
>> > > my depth guage it read 60' I stabalized bouyancy, shot
>> > > my bag, switched to 50% added a couple minutes to my
>> > > stop and regained my composure.  The other two looked
>> > > to have reached 20' and then I saw one dragging the
>> > > other down back to about 40'.  The remainder of deco
>> > > was uneventful at 20' I switched to 100% O2.  Reading
>> > > from my slate;
>> > >
>> > > left 170'        20"
>> > >
>> > > Bouyancy event
>> > > switch to 50% (actually 54%)
>> > > Stable at 64' by 25"
>> > > Left 64'      at 31"
>> > > Left 50'      at 33"
>> > > Left 40'      at 37"
>> > > Left 30'      at 41"
>> > > Switch to 100%
>> > > Left 20'      at 48"
>> > > Left 10'      at 58"
>> > > hand over hand slow crawl to the surface.
>> > >
>> > >
>> > > No problems getting on the boat, approx. 10 minutes
>> > > later the other two divers returned and my symptoms
>> > > started, Dizzyness, sat down, then sat on deck, got on
>> > > O2, laid on the deck on O2 and if you asked me, the
>> > > boat was going in circles.  No improvement on O2.
>> > >
>> > >
>> > > After the Capt. docked the boat the TDI instructor
>> > > trainer, DMT, EMT chamber operator for 4 yrs for NOAA,
>> > > 4 yrs for Marathon, cohart of Hyper Dick, did the
>> > > exams(not just some guy who happened to be around),
>> > > using a cuff and stethascope checked heart, lungs
>> > > performed tests.  No other symptoms other than
>> > > dizzyness and nausea.  No pain in joints no headache.
>> > > Symptoms persisted on or off O2, which is what's
>> > > called an O2 challenge that is what all but eliminates
>> > > DCS not a neuro exam.  I also explained my symptoms to
>> > > my previous TDI tech instructor(adv nitrox and deco)
>> > > and the dive shop owner where I was parked. BTW I was
>> > > driven in my bus by the student, I couldn't stand.
>> > > All who heard or saw the facts first hand, agreed.
>> > > Mild barotramua to inner ear.  Two hrs after 95%
>> > > recovery.  Now 32 hours later I feel 100%, I drove the
>> > > bus from Deerfield Beach up 95 and over to Orlando, no
>> > > symptoms, no pain
>> > >
>> > > It's over, I'm fine.  LL post away...
>> > >
>> > > Cliff
>> > >
>> > >
>> > > =====
>> > > Clifford Sifton
>> > >
>> > > Two dreams "to discover a new cave system" AND
>> > > "to discover a new wreck"
>> > >
>> > > 215-432-8007
>> > >
>> >
>> >
>> >Visit my web page with underwater and other photos at
>> >http://members.aol.com/jsuw3/index.html
>> >
>>
>> _________________________________________________________________
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>>
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