Dive Pacific 171 Oct- Nov 2019



Once in Singapore the diver

was evaluated and ended up

receiving two recompression

treatments. His symptoms

mostly resolved but he did

express to the doctor that he

still had shoulder discomfort

post treatment. The doctor

felt it wasn’t DCS and he was

discharged from the hospital.

Conflicting ‘Do Not Fly’


The diving doctor advised the

diver not to fly for three days,

but DAN advised that this was

insufficient and that he should

wait at least a week before flying

back to Timor given the remoteness

of his destination.

The diver ended up flying home

back there four days after treatment

and upon his return he

advised DAN that he was again

experiencing residual symptoms

in his hip, shoulder and elbow.

The DAN doctors advised

the diver to continue taking

Ibuprofen for several days to

help with the residual inflammation,

remain hydrated, and

refrain from exercising, or going

to altitude. The diver’s condition

did not deteriorate further.

However his improvement was

very slow, to his frustration.

Cost: Emergency Evacuation


DAN comments

While the diver’s symptoms in

this case were mild, they were

persistent. The diver was evacuated

to Singapore and received

two treatments and, unfortunately,

DAN’s advice to avoid

flying for at least a week was not


In many cases divers are cleared

to fly after three days from their

final treatment if they remain

asymptomatic. This is often fine

and many divers following this

advice have no further issues -

although a small number will.

In this case, DAN’s recommendation

was more conservative

than the doctor’s recommendation

as DAN factored in

the remoteness of the diver’s

location. The reason behind this

more conservative approach

stemmed from the fact that once

the diver flew home to Timor,

he would be back in the same

situation should symptoms

reappear: Stuck in a location not

equipped with the necessary

medical facilities or equipment,

including a chamber, to treat his


It is not surprising that flying

prematurely aggravated this

diver’s condition because it is

likely he had residual bubbles in

his system. When divers have

residual bubbles it often takes

a longer time for persistent

symptoms to fully resolve.

This case serves as an important

reminder to adhere to the advice

of DAN as our case managers

factor in all aspects of a diver’s

situation when providing advice.

Visit “Diving Safety” at DANAP.

org for more diving health and

safety information, including

DAN Doc.



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