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Dive Trip Gone Wrong: Warning Signs of Decompression Illness


Scuba Diver Swimming
Scuba Diver Swimming

My buddy and I dived six out of seven days on my last dive trip. Our profile allowed an hour of dive time with two-tank dives and the recommended interval. We usually dive every other day at the end of the trip, but our last two diving days were successive due to weather.

On the last dive, we started our return to the boat with half a tank of air left, stopping around 7.5m to observe the area. I was briefly separated from my buddy as I followed a tilefish before continuing my ascent and making my safety stop in view of the other divers and our Divemaster. I may have slightly shortened my safety stop to get back to the Divemaster in time to follow along to the boat.

After surfacing and removing my BCD, I developed frontal chest pain. It was unusual, but I thought it was a muscle strain from removing my BCD. My left hip was somewhat painful and hindered me while getting out of the water, but that is normal. When I sat down in the boat, my chest and hip pain were gone. I took off the rest of my gear, and while moving around the boat, I felt my left leg slightly give way.

Back at the hotel, things seemed normal. I showered and stored my gear but then noticed the muscles in my left thigh twitching and showed my buddy. After checking the internet for decompression illness (DCI) symptoms, I determined that it was likely fatigue causing my twitching. I hydrated and ate some carbohydrates, but I noted I did not need to urinate, which was strange. As time passed, I was still unable to urinate despite the urge.

It became clear that something serious was happening, and I considered that I was likely having DCI symptoms. I went to the island’s hospital, where I received high-flow oxygen and intravenous hydration. Thankfully they also placed a urinary catheter to give me some relief. The examining physician determined I had a loss of sensation in my legs, especially heat sensitivity, and muscle weakness in my left quadriceps.

I had delayed getting care for nearly eight hours, and due to the island having no hyperbaric chamber, I did not receive recompression treatment until the following evening, more than 24 hours later. I am a primary care internal medicine physician, so I should have known to get help from a dive specialist as soon as I had strange symptoms. Treatment entirely resolved my symptoms six months after the incident, but If I had sought treatment earlier, my recovery might have been quicker and the treatment possibly less intense.

In medicine, we have a saying from the aphorisms of Sir William Osler: “A physician who treats themself has a fool for a patient.” If something is wrong after diving that might be DCI, I encourage you to quickly get on oxygen and seek an evaluation right away by a practitioner familiar with DCI.

Gas Management 101

This article was originally published in Scuba Diver ANZ #57.

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