My Experience with DCS

[bullfrog]

People talk about no danger from aggressive hydration, don't forget about immersion pulmonary edema. probably more of a risk than hyponatremia (low sodium) from excess water intake.

[Nitrogenius]

People talk about no danger from aggressive hydration, don't forget about immersion pulmonary edema. probably more of a risk than hyponatremia (low sodium) from excess water intake.

So you are saying that there is a correlation between hyperhydration and IPE ?
Do you have some input on that ? Articles to read..
So far as I knew everyone was still in the dark what causes it..
That'd be very interesting..

[Jax]

Side topic Alert!! Deco chambers not available?

http://local15tv.com/news/local/scub...d-away-from-er

Scuba diver almost dies; turned away from E.R.
By Modupe Idowu Monday, April 18th 2016

MOBILE, Ala. (WPMI) — It is alarming to hear and think about. Emergency diving accident patients have been turned away from some Florida hospitals despite having the equipment to treat them. Local 15 News spoke to one patient who almost died waiting for care in Florida. Doctors say most decompression illnesses can be treated with hyperbaric oxygen therapy. It can save a life in the event of a diving accident. Every year thousands of tourists travel to the Florida panhandle to scuba dive into the beautiful waters, but options for hyperbaric oxygen therapy are limited. Local 15 News discovered one small hospital in Mobile, Alabama is handling the majority diving injuries from the Florida panhandle.

Eric Badamyan travelled from Russia to Ponce De Leon, FL to scuba dive at the Vortex Springs resort with friends.

"He showed me, trained me a couple times, tell me what I need to do and then we do free diving, free fall," said Badamyan.

The dive took a turn for the worse.

"I couldn't handle it," said Badamyan. "I feel like I'm not going to breathe."

Badamyan was pulled to shore unconscious and could not breathe on his own. He suffered an arterial gas embolism, an illness with stroke like symptoms.

"So the stroke of the brain caused primarily by paralysis on his right side," said Registered Nurse Julio Garcia. "He couldn't move his right arm or right leg."

He was rushed to Panama City's Bay Medical Sacred Heart in critical condition. For nine hours, doctors searched for a hospital with recompression chambers in the area to treat Badamyan. He was later airlifted to Springhill Medical Center in Mobile. Garcia treated him.

"He was very much in danger of losing his life or having permanent neurological symptoms," said Garcia.

Badamyan and Garcia credit the hyperbaric oxygen therapy for his survival. Just like a stroke, the longer it takes to get treatment, the worse the condition can get.

"We treat them by causing the pressure to increase and by providing 100 percent oxygen," said Garcia. "This helps get rid of that [air] bubble and provides oxygen to the tissues. And it was little response after the first treatment."

The next day, Badamyan went in the chambers for a second round for several hours.

"Within the first five minutes of getting into treatment pressure, he was able to move," said Garcia. "It was like watching a miracle happen. It was incredible."

Badamyan was able to move his arms and legs.

He said," It was hard to move to move my fingers and hands like now I can control my hands."

Badamyan was eventually able to walk.

"Thanks [to] all the boys who helped me out, who called 911," said Badamyan. "I just realized how close I was to death."

Garcia claims Badamyan could have received the same lifesaving treatment at Bay Medical Sacred Heart in Panama City. The hospital has its own chambers, but sent Badmayan to Mobile for treatment. Garcia believes it is a growing trend among Florida hospitals. As a result, Garcia said a number of Florida's diving patients are treated hours away at Springhill Medical Center.

"There's none in the Florida panhandles, none until you get to Orlando that will treat scuba divers in the state of Florida," said Garcia.

Recently, Florida Hospital Orlando closed its doors to patients with diving injuries, according to Garcia.

He claims SMC treated at least 15 diving injuries from the Florida panhandle in 2015.

Dr. Bernard Eichold of the Mobile County Health Department said money and hours of operation play a part for hospitals that decide to shy away from treating diving injuries. Emergency treatments take time and can throw off outpatient sessions.

"It would be nice if the panhandle Florida hospitals who have chambers would set up a rotation and say this week, we will man the chamber 24 hours for this day and the next," said Dr. Eichold. "Like in some cities, they rotate the emergency room calls."

Garcia is concerned for tourists and first responders.

"More importantly to me, [is the welfare of] the public safety officers such as your sheriff's office, your police officers who are doing a service for the public," said Garcia. [What] if they get injured scuba diving and the performance of their duties as a police officer."

According to the Emergency Medical and Treatment Labor Act Law, both private and public hospitals cannot deny patients emergency care. And if a hospital is unable to stabilize a patient, then a transfer should be implemented.

"They have the service. They just won't treat scuba divers. There are over 10 to 12 facilities between Mobile and Tallahassee, Florida that provide hyperbaric services, but they choose not to treat the diving injury," said Garcia.

He said sessions range from less than five minutes to eight hours long. A Bay Medical Sacred Heart spokesperson said the facility in Panama City is not equipped or staffed to treat diving injuries.

The website reads, "We specialize in non-healing and problem wounds as well as selective emergency conditions."

The hospital provided this statement:

Bay Medical Sacred Heart hospital does not treat dive accident victims. The hospital has a hyperbaric oxygen tank for the treatment of wound care patients, but it is not a 24/7 program and is not staffed or equipped to provide the very specialized care needed for diving accidents.

Sacred Heart Hospital released this statement:

Since 2006, the Wound Care Center operated by Sacred Heart Hospital in Pensacola has offered hyperbaric oxygen therapy for persons with chronic wounds. Our Wound Care Center has two mono-place (single person) hyperbaric chambers, but they are not designed for treatment of decompression sickness. The center has never treated decompression illness and in the past 10 years, we have not been asked to provide emergency care to a diver suffering from decompression illness.

Garcia said he has reached out to Alabama and Florida Lawmakers for help.

Congressman Bradley Byrne's office released this statement:

"My staff and I are aware of the serious problems posed by the lack of hyperbaric care throughout the Gulf Coast. We are proud to have a great facility and dedicated team at Spring Hill Medical Center, but I recognize that more options for care are needed. My office has been in contact with the appropriate agencies about this very issue, and we look forward to finding a solution that ensures divers on the Gulf Coast receive the timely, appropriate care they need."

[FW]

Side topic Alert!! Deco chambers not available?

WOW! Someone needs to get a similar article in the paper about the DCS death at Ginnie, and also Tammy's story.

[Nitrogenius]

Very sad..
Not surprising to me though..
I got my taste of the medical system within the US after returning to San Diego with (later quite clear) Dengue fever..
Before as German citizen I always thought of the US medical system being way advanced and just having issues getting the right treatment to the poor and underinsured..
Since then I know different as guess what I do have a PRIME health insurance which would have covered ANY Treatment at ANY cost!


Nevertheless I could have died as well.. I also looked into the laws of doctors treating bad or f..ing up, and it turned out you are only entitled to a compensation when you actually would have incurred permanent damage, so as long as you make it out after all ( no matter if it was all sole depending on your own effort and research) and you could have died... No responsibility.. Zilch!


I received the wrong medication (causing diarrhea as a very common side effect) while maintaining hydration is the number one goal when having Dengue..
Fast testing either for Malaria or Dengue was not available in the whole area (despite the fact that San Diego is only few miles north of the border and guess what Dengue is not uncommon right south the border in that area as well)
And I got various answers on when to expect the test details from the staff of the private clinic ranging from 2 days to a good week..
Well I got them after about 17 days when I was already back in Germany from a lab in Utah..
Probably shipped there in whatever conditions and the test results were accordingly.. all inconclusive...
It was just very clear the way the sickness evolved that it in fact was Dengue..


I probably only did survive because on my own decision I decided to stop the sh..ter Malaria med, got on an emergency hotline of my insurance and the doc then guided me towards the right Malaria med (as at this point it also could have been Malaria which needs to be treated asap to ensure a potential full recovery) which then I demanded the next day from the doc I went to.
Well from the doc? I didn't even ever see the guy.. Whole treatment and contact was administered by nurses..


If I had known I would have stayed in Mexico as I am now 100% sure to be able to receive better treatment there..
Lesson learned from that on my end.. If I ever get sick during my frequent business trips to the US.. Get the f... out of there as quickly as possible to ensure getting a proper treatment..

[tstormdiver]

Side topic Alert!! Deco chambers not available?

http://local15tv.com/news/local/scub...d-away-from-er

Scuba diver almost dies; turned away from E.R.
By Modupe Idowu Monday, April 18th 2016

MOBILE, Ala. (WPMI) — It is alarming to hear and think about. Emergency diving accident patients have been turned away from some Florida hospitals despite having the equipment to treat them. Local 15 News spoke to one patient who almost died waiting for care in Florida. Doctors say most decompression illnesses can be treated with hyperbaric oxygen therapy. It can save a life in the event of a diving accident. Every year thousands of tourists travel to the Florida panhandle to scuba dive into the beautiful waters, but options for hyperbaric oxygen therapy are limited. Local 15 News discovered one small hospital in Mobile, Alabama is handling the majority diving injuries from the Florida panhandle.

Eric Badamyan travelled from Russia to Ponce De Leon, FL to scuba dive at the Vortex Springs resort with friends.

"He showed me, trained me a couple times, tell me what I need to do and then we do free diving, free fall," said Badamyan.

The dive took a turn for the worse.

"I couldn't handle it," said Badamyan. "I feel like I'm not going to breathe."

Badamyan was pulled to shore unconscious and could not breathe on his own. He suffered an arterial gas embolism, an illness with stroke like symptoms.

"So the stroke of the brain caused primarily by paralysis on his right side," said Registered Nurse Julio Garcia. "He couldn't move his right arm or right leg."

He was rushed to Panama City's Bay Medical Sacred Heart in critical condition. For nine hours, doctors searched for a hospital with recompression chambers in the area to treat Badamyan. He was later airlifted to Springhill Medical Center in Mobile. Garcia treated him.

"He was very much in danger of losing his life or having permanent neurological symptoms," said Garcia.

Badamyan and Garcia credit the hyperbaric oxygen therapy for his survival. Just like a stroke, the longer it takes to get treatment, the worse the condition can get.

"We treat them by causing the pressure to increase and by providing 100 percent oxygen," said Garcia. "This helps get rid of that [air] bubble and provides oxygen to the tissues. And it was little response after the first treatment."

The next day, Badamyan went in the chambers for a second round for several hours.

"Within the first five minutes of getting into treatment pressure, he was able to move," said Garcia. "It was like watching a miracle happen. It was incredible."

Badamyan was able to move his arms and legs.

He said," It was hard to move to move my fingers and hands like now I can control my hands."

Badamyan was eventually able to walk.

"Thanks [to] all the boys who helped me out, who called 911," said Badamyan. "I just realized how close I was to death."

Garcia claims Badamyan could have received the same lifesaving treatment at Bay Medical Sacred Heart in Panama City. The hospital has its own chambers, but sent Badmayan to Mobile for treatment. Garcia believes it is a growing trend among Florida hospitals. As a result, Garcia said a number of Florida's diving patients are treated hours away at Springhill Medical Center.

"There's none in the Florida panhandles, none until you get to Orlando that will treat scuba divers in the state of Florida," said Garcia.

Recently, Florida Hospital Orlando closed its doors to patients with diving injuries, according to Garcia.

He claims SMC treated at least 15 diving injuries from the Florida panhandle in 2015.

Dr. Bernard Eichold of the Mobile County Health Department said money and hours of operation play a part for hospitals that decide to shy away from treating diving injuries. Emergency treatments take time and can throw off outpatient sessions.

"It would be nice if the panhandle Florida hospitals who have chambers would set up a rotation and say this week, we will man the chamber 24 hours for this day and the next," said Dr. Eichold. "Like in some cities, they rotate the emergency room calls."

Garcia is concerned for tourists and first responders.

"More importantly to me, [is the welfare of] the public safety officers such as your sheriff's office, your police officers who are doing a service for the public," said Garcia. [What] if they get injured scuba diving and the performance of their duties as a police officer."

According to the Emergency Medical and Treatment Labor Act Law, both private and public hospitals cannot deny patients emergency care. And if a hospital is unable to stabilize a patient, then a transfer should be implemented.

"They have the service. They just won't treat scuba divers. There are over 10 to 12 facilities between Mobile and Tallahassee, Florida that provide hyperbaric services, but they choose not to treat the diving injury," said Garcia.

He said sessions range from less than five minutes to eight hours long. A Bay Medical Sacred Heart spokesperson said the facility in Panama City is not equipped or staffed to treat diving injuries.

The website reads, "We specialize in non-healing and problem wounds as well as selective emergency conditions."

The hospital provided this statement:

Bay Medical Sacred Heart hospital does not treat dive accident victims. The hospital has a hyperbaric oxygen tank for the treatment of wound care patients, but it is not a 24/7 program and is not staffed or equipped to provide the very specialized care needed for diving accidents.

Sacred Heart Hospital released this statement:

Since 2006, the Wound Care Center operated by Sacred Heart Hospital in Pensacola has offered hyperbaric oxygen therapy for persons with chronic wounds. Our Wound Care Center has two mono-place (single person) hyperbaric chambers, but they are not designed for treatment of decompression sickness. The center has never treated decompression illness and in the past 10 years, we have not been asked to provide emergency care to a diver suffering from decompression illness.

Garcia said he has reached out to Alabama and Florida Lawmakers for help.

Congressman Bradley Byrne's office released this statement:

"My staff and I are aware of the serious problems posed by the lack of hyperbaric care throughout the Gulf Coast. We are proud to have a great facility and dedicated team at Spring Hill Medical Center, but I recognize that more options for care are needed. My office has been in contact with the appropriate agencies about this very issue, and we look forward to finding a solution that ensures divers on the Gulf Coast receive the timely, appropriate care they need."

I had to use the chamber in Valdosta, GA.

[Nitrogenius]

I had to use the chamber in Valdosta, GA.

This is a good discussion. I actually would not have expected it being that bad overall in regards to Deco chambers given the vast amounts of diving going on in the state of Florida and not being in a developed nation..
So it seems that one is well advised to treat all Fl diving as "dives in remote areas" and at least have some additional Oxygen supply handy for a potential lengthy transport to a chamber..

[phillip1]

drinking a lot before the dive has way less of an effect on dehydration than hydrating 7 hours or so prior, if I am going to do a big dive I drink a lot at dinner the night before and I eat light. Obviously I drink a lot the day of the dive but your cells get more hydration by what you ingest 7 hours earlier that all of a sudden chugging a liter of water right before a dive.

[Nitrogenius]

drinking a lot before the dive has way less of an effect on dehydration than hydrating 7 hours or so prior, if I am going to do a big dive I drink a lot at dinner the night before and I eat light. Obviously I drink a lot the day of the dive but your cells get more hydration by what you ingest 7 hours earlier that all of a sudden chugging a liter of water right before a dive.

Actually if you had not started hydrating well in advance of a dive chugging lots of water right before a dive will not help at all but rather be counterproductive..
I also start the evening before..
The body can only intake about a glass of water per hour.. the rest only gets flushed through..

[bullfrog]

People talk about no danger from aggressive hydration, don't forget about immersion pulmonary edema. probably more of a risk than hyponatremia (low sodium) from excess water intake.

So you are saying that there is a correlation between hyperhydration and IPE ?
Do you have some input on that ? Articles to read..
So far as I knew everyone was still in the dark what causes it..
That'd be very interesting..

Pulmonary. edema is the right side of the heart pumping more blood into the lungs than the left side is pumping out thus they get edematous. You treat it with lasix to get rid of fluid i.e. dehydrate you. Immersion pulmonary edema is not common enough to be studied.Start a poll here if we have enough people who have experienced it and ask them if they drank water on purpose to offset their chance of dcs before their episode of IPE.