DCI and Denial - my little experience.

[Mary]

Two weeks ago I was booked on my first full diving weekend of the season out of Plymouth. I’d been in the water on and off over the winter with my most recent dive prior to this approximately 4 weeks before. I’ve been diving my inspo classic for about 10 months now, have about 50 hours on it and was feeling comfortable enough with it to start thinking about doing my normoxic trimix course over the next few months.

Dive 1 of the weekend was Hand Deeps. Had 1 glass of wine the night before but a couple of pints of squash that morning and a litre of water so I don't think I was dehydrated. 36m max, 45 minutes total runtime. Reef rather than wreck so multilevel profile rather than square. Had it downloaded and looking at it I only spent 18minutes or so below 20 metres. Setpoint 0.7 from surface to 12m on descent then switch to pPO2 1.3 maintained 1.3 until I hit 6 metres on the way back up when I flushed with O2 and did a 2 minute mini safety stop at pPO2 1.6 then ascended without incident. The dive was completely uneventful apart from sneezing a couple of times underwater but I've done this on many previous dives without incident. VR3 gave me a couple of minutes deep stops (like it does if you go over ?30m) however when I left the bottom of the shot (12m) I had several hours no stop time showing and no other stops. VR3 set at 1.25 pPO2 and 10% conservatism. Used a nice lift to get out of the water (no clambering up ladders) and un-kitted fine. I didn't do the second dive as I felt cold, tired and had a little bit of a headache but didn't think anything of it at the time. Left the kit on the boat overnight, went out for dinner but not a big night and in bed by 11pm.

I decided not to dive Sunday as I still felt rotten so unloaded my kit in the morning, had breakfast with a friend then headed home (90 minute drive). Walked through the door then basically fell into bed and slept 4.5 hours, woke up had half a sandwich then back to sleep for another 12 odd hours. In retrospect I couldn't stand on one leg to put my socks on, on Sunday morning but I didn't think anything of it at the time. Went to work Monday, luckily not too busy but I was still feeling horribly tired and it was taking me for ever to the ward round etc. Again I slept 12 hours that night. In work again on Tuesday, similar story, taking me ages to do routine stuff. Eventually when one of my consultants took the piss out of how tired I was by joking I had been up clubbing all weekend I finally twigged something might not be right and phoned a friend who had previously had a DCI to ask him how he felt and he convinced me to phone DDRC. I spoke to Dr Phil Bryson on the phone and he suggested I go get checked out at A&E who then liaised with him and said I should go to DDRC. They suggested I get a friend to drive me or get in an ambulance but not wanting to cause a hassle I drove myself.

I arrived at DDRC to be met by the duty doctor and chamber team (approximately 80 hours post dive by now). I arrived at the chamber honestly expecting to be seen examined and sent home (the doctor I saw at A&E had not seen a case of DCI before therefore I was certain I was going there just to be checked out). He took my history and examined me. As far as I was concerned I was a bit wobbly on my feet as I was so tired. I was adamant that I was not bent and had only gone to DDRC to get the friend I phoned for advice off my back. I was arguing against the on-call consultant and chamber staff that I didn’t want to go into the chamber but eventually just gave up and let them stick me as I was too tired to argue any more. Once in the chamber the persistent headache I had had for a few days was gone by the second air break. I eventually got out the chamber after an US Navy 6 table about 1.30 in the morning on Wednesday morning. I wasn’t unwell enough to need a hospital bed so was put up in a local hotel overnight.

Back at DDRC on Wednesday morning where I felt horribly guilty about getting the on call team in the night before, I was seen and examined by Dr Phil Bryson. On examination I was unable to walk heel to toe with my eyes open and could not do an enhanced Romberg at all. Attempting to do heel to toe with my eyes closed was impossible and I fell over sideways on lifting my foot off the floor. I was still adamant that I was not bent and attributed my being unable to do an enhanced Romberg’s on having had an ligament reconstruction in that knee. He wanted to stick me back in the chamber and after putting up a half hearted objection I agreed basically as I didn’t have the energy to fight so I went back in for another US Navy 6 treatment. I stayed overnight and was back at DDRC to be assessed the following morning.

Thursday morning, by now I didn’t immediately fall over sideways on attempting an enhanced Romberg but was still a long way off actually managing it. I also managed to walk about 2 steps heel to toe with my eyes open. I was still convinced I was not bent and attributed the improvement in my symptoms to having slept nearly 14 hours that night. Dr Bryson wanted to stick me back in the chamber again (not a great surprise to those of reading this but I was severely pissed off by this time), to be honest the only reason I agreed is it meant I didn’t have to go back to work that day as I was on call that evening (ward cover, never a fun evening). I now got to join the main group on hyperbaric oxygen treatments (similar to US Navy 5 treatments). I had one in the morning followed by a 2 hour lunchtime nap and then another treatment in the afternoon. It was after this afternoon treatment that I started to notice I was feeling like me again. The scariest thing was that I hadn’t been feeling like me for so long but I wasn’t aware of it at the time. This was the first time that I actually entertained the possibility that I had actually had a bend.

Friday morning, during my pre-treatment examination I mentioned this and together we worked out what other symptoms I was actually having in addition to balance problems. I was having great difficulty concentrating, a mild persistent headache that resolved with the first treatment, a non existent appetite, a weak short-term memory (especially names), and severe difficulty with multi-stage complex processes. To give you an idea I was struggling to do an “easy” soduku. I had no pains or skin bends. I went on to have a further 2 treatments over that day then was let out over the weekend (although still not allowed to drive yet!).

Back on Monday continuing to show gradual improvement I then proceeded to have twice daily treatments for the rest of last week, having my last treatment last Thursday afternoon (a total of 14 including the 2 US Navy 6 sessions). By the time I was discharged I’m probably 80% back to normal but still have a way to go.

The feeling is my DCI was undeserved and in view of having sneezed I need to be assessed for PFO and undiagnosed lung disease.

The reason I’ve posted this is whilst I’m well aware that doctors are appalling patients, I wanted to raise awareness that not all bends involve pain or skin rashes. Denial was (and still is to a small degree) a major symptom of my bend as evidenced that I managed to bend the decision making part of my brain (as well as other bits). I assumed that being a doctor I would know if I had a bend and as you can see it took me four treatments to even admit it might be a possibility. In retrospect I feel very silly (and had the piss taken mercilessly by friends today - in a nice way I hasten to add) but if I can prevent anyone else taking 3 days to get to the pot having effectively had a stroke it’s got to be a good thing.

Dive Safe

(And don’t give me a hard time if you see me selling stuff in the personal ads – I need to fund a private PFO test. Time is of the essence as I may be forced to emigrate in 4 months time if I wish to continue working in medicine due to this government's horrendous mismanagement of the NHS – I’m not quitting diving until you see me selling my Inspo ). [/font]

[Mal Bridgeman]

That's some "little" experience....hope things turn out fine.
Mal

[Odin]

Thanks for being so honest.
Yes Medics are the worst pt's!
It does sound like a PFO - you contacted Dr. W yet?
Big Hug!
Pauly x
p.s. can I have first dibs on the BOV? (joke)

[Josie]

Hi Mary, sorry to hear that you had a bend, but glad that it's been treated and you are nearly back to normal. Thank you for sharing this. I always assumed that you only spent one or possibly two days in the pot.

Josie

[divegyrl]

Thanks for posting Mary!
Keep getting well,
doctors & nurses are always the worst patients!
Hope it all turns out positive!

[dave archer]

Hope you recovery fully quickly Mary, and thanks for posting.

The more people pose about the denial aspect the more chance those of us reading *might* be less inclined to deny, it seems to me.

Cheers,

Dave.

[Mary]

Thanks for all the warm wishes.

Dave you hit the nail on the head. If by posting my experience I can raise awareness that denial is a REAL symptom , and that not all DCIs present with pain etc then something useful will have come out of this.

[Adrian Kelland]

I reckon the Ceasars salad and white wine helped the most Mary

Now you are back home you can at least relax and enjoy the enforced break.

Adrian

[Hellvet]

Originally Posted by Mary

(And don’t give me a hard time if you see me selling stuff in the personal ads – I need to fund a private PFO test. Time is of the essence as I may be forced to emigrate in 4 months time if I wish to continue working in medicine due to this government's horrendous mismanagement of the NHS – I’m not quitting diving until you see me selling my Inspo ). [/font]

Thanks for the warning!

Brave post, thanks for sharing.

Hope as you say it helps people realise that bends aren't just joint pains and skin rashes - tiredness is one of the first symptoms i had with my cerebral bend, but i didn't even mention it to the chamber when i rang them - it was only when they asked me specifically about tiredness that i connected it.

Take care of yourself, and keep us updated.

(PS Repeat "Any post dive symptom that was not there before going diving should be treated as DCI until proved otherwise"!)

[Foggy]

To echo the others, thanks for posting that, Mary, and I am glad to hear you are recovering.

I think the scariest part is how easy the symptoms you describe could be attributed to other causes - such as tiredness, or pre-existing injury. In some respects I wish we had a clear indicator from our bodies of when we're bent - but it isn't like that.

Hope things go well, and no I don't want those pink tins (it was bad enough hauling them from Nottingham).

Cheers, Paul