The Silent Injury

[JE]

AKA: Asceptic Bone Psorisis

I was given a physcial recently, & my doctor had taken extensive X-rays. He had shown me were minute areas of bone deteriation, resulting from excesive decompression. What happens, is that your bone marrow eventually deterioates to a powder. This a very serious consideration to anyone who does a lot of diving. I am not a doctor, but we do have some cave divers on this forum who are, & it would be helpful if they could enlighen us as to what we should be concerned about, during our dives & deco, especially as it relates to EANx & mixed gases. I am not trying to discourage anyone, but only hoping to educate ourselves as it relates to an activity we all enjoy. In the meantime, watch out for those rabbits, some of them may be in heat-!
Happy Easter & good diving where-ever you are.

JE 8)

[Cindy]

Hey Jack, what you are speaking of is rarely seen in recreational divers and is most often seen in people who were hard hat divers. I would seek the opinion of another MD as I would hate to see him misdiagnose something. I am sorry for your problems, I hope your Doctor was wrong. From what I understand it is caused by damage to the capillaries of the bone over time. It's not so much caused from long decompression but the frequent improper or too rapid decompression. I am not a Hyperbaric MD so I'm not an expert. Again I would not ever depend on one MD opinion of any disorder that severe. Please seek another Doctor through DAN or anther groups advice. It's more often refered to as dysbaric osteonecrosis. When I took a hyperbaric course they told me that we may see more of this disorder in recreational divers that do a lot of technical diving as they age. Another good reason to not blow off those few extra minutes of deco or focusing your decompression on getting out of the water as quickly as possible. People forget this stuff can have long term affects. I hope it turns out well for you Jack. Good luck and I hope you can find someone who can care for your disorder correctly, Cindy Butler

[JE]

Hey Cindy,
Thanks for your Response>......I don't really have any issues with this malady, but some time ago, I had a physcian show me some X-rays he had taken of a very small area, with soft bone tissue, & he had related how excessive deco will actually break down our bone marrow into a powder. At that time, I was diving maybe 5 days a week over in the Branford area, during my residence in Gainesville, over a 6 year period. My average decos were in the vicinity of 2 plus hours, while diving on air-! A lot of dives in the Little River system especially. Again, I am not too worried about this, but I simply wished to inform those who are doing a lot of long & deep dives. I think today's divers are a lot more educated in EANx & Mixed gases, & the decos have been reduced drastically. I know of at least one heavy air explorer making extended decos on air, & I would encourage him to learn & to use todays mixtures. 35 minutes @ 20' is a big difference than two or three hours at the same stop-! Anyhow, I am healthy & fine, & will be seeing you guys in the water soon with lots of new gear-!
Take care,

Jack

[Genesis]

Yeah, that's a very not-funny thing to end up with..... no marrow = you're dead, eventually, and not in a fun way either.

The theory is that it is caused by "bends" to the tissue in the bone marrow, cutting off blood flow there. Like any other DCS incident that tissue dies, but the problem is that there are no pain receptors in there, so you don't feel "bent".

Focusing on getting out of the water fast is not a good idea...... and neither are really aggressive schedules. I do my share of deco but the last thing on my mind is seeing how fast I can get out, and the shape of the curve is very important as well.

This, as Cindy pointed out, is not something often seen in recreational divers, but it does show up from time to time in commercial guys who are at it for work. If you do have something like that show up from your doc though get a second opinion right away, because if its real, you do need to know about it - its definitely not something to fool with. The bad part is that its one of those things that shows up 20 years down the road.... it will be interesting to see if some of the proponents of the more aggressive schedule "options" end up wtih trouble from this in the future.....

[oldguy]

In my earlier days in chamber ops in commercial diving, it was known as aeseptic bone necrosis. In our deck slang, "bone rot without infection". It is now generally referred by the name mentioned by Cindy in her post above. I have seen some long bone x-rays of saturation divers in the North Sea that present the condition clearly. I was not aware of it presenting in older technical divers. Interesting.

[Gary]

One thing I read suggested it was rare in divers that had never dove deeper then 165' (on air) or deeper the 400' on helium - and was more common with divers that had a known bend. Also that is was probably a result of inadequite decompresion of the longer halflife tissue groups though other explainations have been suggested.

[michael-fisch]

Also that is was probably a result of inadequite decompresion of the longer halflife tissue groups though other explainations have been suggested.

Duh, no *hit man!
Bone Marrow and the hollow bones that produce it are probably the slowest tissues that exist in the human body. They also are the tissues with the lowest "M" values.

Michael

[curtschu]

Hal Watts! How is he doing. If there is a better subject of study for this discussion. I don't know him.

Curt

[CaptainSpeleo]

Hal Watts is about 70 years old now. As far as I know, he's still diving, but I don't know to what extent. I haven't seen him in several years. I took my advanced deep air(240') course with him in 1987. "40 Fathom Grotto" was my second home for about 3 years after that. I was really into the deep air thing back then - 268' in Eagles Nest and 304' at Andros Island. Those suicidal diving days are far behind me.

[GWNDWN]

Stayed at Hal's last December. He's definately still diving deep air, not to mention running every morning....I can only hope to be in the same condition at that age....uhhh or this age for that matter.