Report on Decompression Illness, Diving Fatalities - Divers Alert ...

Case 6. Delayed Onset of Mild NeurologicalSymptoms — With Residual SymptomsThe diver was a 50-year-old male advancedopen-water diver, in good health and a nonsmoker.He had been certified for seven yearsand had made approximately 150 lifetimedives. He had made three dives in the past 12months. He scheduled a two-day dive weekendin the Great Lakes. His first two dives onSaturday were without problems.He began his second day with an 81-foot (24.3-meter) dive for 32 minutes and a one-hour surfaceinterval. His second dive was a 50-foot(15-meter) dive for 41 minutes, followed by atwo-hour surface interval. His third dive wentto 76 feet (22.8 meters) for 39 minutes. After aone-hour surface interval, he performed hisfourth and final dive to 45 feet (13.5 meters)for 37 minutes, exiting the water at approximately4:30 p.m. He made a total of six divesover two days. All dives were trouble-free,allowable by his computer, and other than alittle fatigue that he described as normal, thediver felt fine.At approximately 3 a.m., more than 10 hoursafter his last dive, he began experiencing tinglingin his right hand. By 9 a.m. the followingmorning, his left leg, from his knees to histoes, began tingling. Shortly after that, bothfeet and both hands were tingling. He alsoexperienced some nausea during this period.Because he felt his symptoms were gettingworse, he contacted the local hospital, wherehe was evaluated and referred for recompressiontherapy. After a U.S. Navy TreatmentTable 6, he experienced full resolution of hissymptoms and had a normal neurologicalexam.The following morning when the diver wokeup, the tingling sensation in his hands and feethad returned. He was referred back to hisoriginal treatment facility, where he was treatedfor a second time. He emerged symptomfree.Over the course of the following threeweeks, however, the tingling in his hands andfeet continued to return for brief periods oftime; it then resolved on its own. More than ayear after his treatment, he occasionally experiencedtingling in his fingers after doing agreat deal of manual labor.It is not unusual for symptoms to persist afterhyperbaric therapy has been completed.Symptoms can often wax and wane beforefinally resolving.Cases 7 and 8. Two Cases of Mild Pain andNeurological Decompression Illness in theSame Diver in One YearThe diver was a 34-year-old male who hadmade a total of 70 dives in three years. A divemaster,he had made nine dives in the past 12months — in the course of one month (May)on the west coast of the United States. He hadbeen in perfect health until March of the sameyear, when he was ill with pneumonia. Thisproduced an asthmalike condition; he used aninhaler. He was on no other medication, was anon-smoker and very active.His dive series consisted of three dives overtwo days. On his first day of diving he went tono deeper than 40 feet (12 meters) for approximately45 minutes. During the second day ofdiving he completed a 40-foot dive, with anhour-plus surface interval. He then made adive to 35 feet (10.5 meters). He made safetystops during both dives on this second day;each dive was at least 45 minutes in duration.His dives were allowable by his computer, andseveral dive buddies were doing the sameprofile. He exited the water at approximately 2p.m. and felt fine. As the afternoon wore on,he began to experience some fatigue, a littlestiffness and soreness in his shoulders, knees,elbows and ankles. He had never experiencedthese symptoms before, but they were mild.The only physical activity he experienced duringthe week was the three scuba dives.106DAN’s <strong>Report</strong> on Decompression Illness, Diving Fatalities and Project Dive Exploration: 2003 Edition