On March 27th, I received a phone call from one of my best friends/dive buddies, there was break in the weather to go offshore. I had just returned from a family emergency in Texas (my father had come down with meningitis, he was scary sick, but all better now.) As this was a very last minute trip, and I was still playing catch up with my business, I didn’t have my gear ready. My friend said he would handle tanks, food, etc. All I had to do was get my own gear ready. I was hesitant to go(last miute and rushed), but after all the stress I had been under, I really needed to kill a fish. I agreed to go, finished my work day, and attended a dive club meeting.
While at the dive club meeting I split pitcher of beer with a buddy. After the dive club meeting I went home and loaded all of my gear in the car. I forgot my weights and my pony bottle (but didn’t realize until we were on the boat). It was about midnight to bed, to be up at 3am and on the water by 4am.
I didn’t sleep well and thought I could catch some sleep on the boat. Once on the boat, I couldn’t fall back to sleep so I took turns driving with one of the other guys.
Once we arrived on the first spot, I started getting geared up and noticed that I was without my pony or my weights. However, there were enough extra weights to stuff down my new wetsuit (had only dove it once before), and it was possible to continue to dive. The decision to dive without the pony was not the safest or recommended way to dive in those depths; thank god it wasn’t a life or death decision for me that day.
My 1st dive ~160 was very uncomfortable, occupied with adjusting to the new wetsuit and the shifting of loose weights in the wetsuit. I didn’t shoot any fish, but could have shot a 20lb jack. I was holding out for something bigger.
Second dive ~170 was a spring, I felt more comfortable but figured that it would be an off day. I didn’t shoot any fish, nothing worth shooting gave me the right angle freeshaft angle(spring dive).
Third dive was a wreck in ~150, I missed a shot on a 23lb jack. We backdove the same wreck trying pick up another jack, this time I shot two mangos. After the 4th dive I sat on the deck and slept until Team B surfaced. That was unusual for me. The fifth dive was on a spring ~150, I missed a grouper. When I got back in the boat, started stripping off my gear and digging the weights out of my suit. It was really difficult, peeling off my wetsuit completely exhausted me. Once I was out of my gear, we had to reposition gear and the cooler ( a 320 full, mostly of ice). I couldn’t budge the cooler; I mean I felt like I was giving it all I had. I sat down on the cooler and collapsed (the time from exiting the water to collapse was maybe 7-10 min).
The left side of my body went limp and numb, I felt like a wet noodle. My speech was slurred; my eyes were rolling in the back of my head uncontrollable and intense nausea. When the guys moved me off of the cooler to beanbags (Esearider bean bags are the choice way to travel when twisted up on the deck of a boat) on the deck, my back seized. The guys were on the horn with USCG and hauling ass to get in. I was coherent through all of this, I felt like I was trapped inside a shell unable to control my body. The bottle of O2 had been left in the truck, so they set me up with richest mix available (38%). After ~45 min from exiting the water- things were 95% better; like a light switch. Instead of feeling like I might be die, I felt like I had spent 3 days of diving in the MG. With dramatic improvement in condition, I decided to just ride the rest of the way in rather than take a chopper ride. Once we returned to the dock I went to BayFront ER, was put on O2 and a re-hydrate IV. It was decided that I needed a chamber ride, so I was prepped and loaded into a Bay Flight helicopter, and flown to Florida Hospital in Orlando. Before the flight they gave an injection to help with nausea, I was out cold in less than 10 min. Apparently I woke up before the flight was over and became “combative” so they whacked me with more sedative; couldn’t tell you one way or the other as I don’t remember. I slept through almost the entire chamber ride. I slept on the car ride home, and I slept the whole following day and night. When I woke up and finally shook off the sedative, I felt like I had been in a car accident. I hurt all over, but nothing compare to my back. Every muscle in my back, shoulders, and triceps felt like they had been beaten with a baseball bat. I was so sensitive that I could barely wear a t shirt. Hugs from my daughter were excruciating. Some other symptoms lasted for a couple days that included my left eye twitching and the occasional stutter. The pain decreased daily but took almost 2 weeks to subside. The diagnosis was Type 2 neurological hit. 6 months no diving, and that when I return, it should be slow and shouldn’t exceed recreation depths.

Now before everyone jumps to conclusions, on every dive I cleared deco (if any) and then did 2 min @20fsw and 2min @10fsw. All but one of my dives had SI of 1.5 hour except 1 at one hour. I did not violate my computer (Nitek HE 1.6). The other guys on the boat and my buddy followed the same profile as I did and were fine. I should have stopped diving after the first dive when I didn’t feel comfortable, but I didn’t listen to myself. I wasn’t doing any diving that day that I hadn’t done before. Looking back on it the whole day really frustrates me.

Contributing factors:
Lack of planning
Stress from family emergency
Alcohol consumption/ dehydration
Sleep deprived
No o2
New wetsuit
No weight belt
My ascent rate was higher than normal not as controlled
Age
Weight


I didn’t really talk about what happened to anyone for about 2 weeks and then only my closest friends that I know had been down the same road. I was very ashamed of being one of those guys who got bent instead just being happy I was alive. Maybe it was more that I had to face the fact that I screwed up, and didn’t want to accept it. It really knocked the spirit out of me. Over the past couple of months I have spoken to many about my experience and learned a lot. One thing I learned was that I could have suffered incontinence. I would much rather that day be remembered for getting twisted and not for pooping myself. I can start diving again in October. I plan to start shallow and stay shallow for a while and hopefully work my way back up to the grounds. My style of diving will be much different, much more conservative. I am even giving free diving a serious consideration. I don’t need to go deep as often as I need to be able to spend time with my family.
I am looking at around $30,000 -$35,000 in bills, the helicopter ride alone was $20,000. I am still working with insurance and DAN, to get everything sorted out. Other than being a royal PIA, the process is going mostly smoothly. I'm feeling pretty happy about my ROI with Divers Alert Network.
I didn’t post this to show that I am a bonehead or cone. I guess I got complacent somewhere along the way. Maybe by sharing this story someone will learn from my mistakes. I don’t think I did any one thing wrong, I think it was a bunch of little wrongs that added up to an avalanche.

Chris

Wow, Chris......thanks so much for sharing your experience. We can all learn from what you posted.

WOW glad it worked out for the good, that dehydration is bad new for divers. It has happened to several people that I know and all had hydration problems.


Roland

Allowing others to learn from your situation is a BIG deal.

Can't thank you enough for posting it.

Chad

Only major FUBAR I see here is leaving the O2 in the truck. That certainly was bad & might have made the whole thing much less of an incident.

Roland is right about hydration, I think. I have never seen any scientific studies, but there is a wealth of anecdotal evidence to support dehydration as a major contributor to DCS.

You stayed within your computer & Nitek He is pretty conservative (I have one). I do have a question: did you have a high O2 scrub mix in the pony? That also might well have prevented this.

As has been said, thanks very much for the post. This really is good for all of us to read.

Only major FUBAR I see here is leaving the O2 in the truck. That certainly was bad & might have made the whole thing much less of an incident.

Roland is right about hydration, I think. I have never seen any scientific studies, but there is a wealth of anecdotal evidence to support dehydration as a major contributor to DCS.

You stayed within your computer & Nitek He is pretty conservative (I have one). I do have a question: did you have a high O2 scrub mix in the pony? That also might well have prevented this.

As has been said, thanks very much for the post. This really is good for all of us to read.

I normally scrub, but didnt have my pony :banghead:

Thanks for posting- I did a study with DAN at the chamber at Duke and it was fascinating- and glad I did it my way instead of yours.

They told me hydration was not as big a factor as people say. The majority of issues are from that hole-in-your-heart-valve thing (PFO). It might be worth getting tested for that.

Age and weight are probably the biggest factors. Fat absorbs like 10x the nitrogen of lean tissue- and lets it out slower. Those of use >40 also have increased risk- I wasn't any less lean than other guys in the study, but had far more bubbles appear in the tests they did (but still didn't get bent).

Thanks for sharing details that may save someone the same experience. Enjoy the recovery time with the family!

I've always been amazed at how secretive everyone gets when it comes to discussing these incidents. I commend Chris for the candid decription of the entire string of events. It can happen to any one of us at anytime. It is important that we all are reminded of the risks from time to time. Thanks Chris.

Man, that is gnarly. Glad you are OK Chris.

Thanks for the detailed account Chris and glad you are doing much better.


Dago.


toecheese,
That would be PFO.

That's some scarry stuff.
Iv'e done some stupid things, Such as 250' plus dives with a hangover and neon yellow pee. Yea, stupid.
Probably one of my worst fears is a serious type two hit.
Thanks for sharing, Take care everyone.

Chris,
Thanks for the post. I've never had anyone I know get bent and it was good to hear everything that happened leading up to the actual occurence. Glad you came out of everything alright. As a new diver it's a great opportunity for me to learn from. Thanks and again we're all glad your alright.

Thanks for sharing your story Chris.

Chris, Glad to hear your alright. Thanks for sharing it.

Dan

Great topic Chris! Most people don't want to discuss it because they feel that it shows they did something wrong or that they are a bad diver. It is better to examine the circumstances to try to figure out what could have been done better.

Not to suggest that we shouldn't take precautions, but I've pretty much come to the conclusion that if you dive as much as we do you are going to get bent (to some extent) eventually. I've seen too many good divers get randomly bent doing things well within the limits. Some people also seem more predisposed to it. The doctors often cannot explain to the diver why they got bent. ALWAYS carry O2 - it prevents and seems to speed the relief of symptoms.

I've always been amazed at how secretive everyone gets when it comes to discussing these incidents. I commend Chris for the candid decription of the entire string of events. It can happen to any one of us at anytime. It is important that we all are reminded of the risks from time to time. Thanks Chris.

Well said, Howie...

Thanks for sharing your story, Chris!!

Not to suggest that we shouldn't take precautions, but I've pretty much come to the conclusion that if you dive as much as we do you are going to get bent (to some extent) eventually.

NO GETTING BENT IS NOT PART OF THE GAME! We cannot become complacent, especially when diving deeper than the recreational limits.

This was a good sharing of a bad experience. A little self critical analysis can go a long way. Here we have: stress+ rushing/no planning + incomplete gear + missing scrub bottle in 160+fsx + dehydration + lack of sleep + beer the night before = lots of contributing factors that could have been avoided.

It's hard to talk about these subjects because we have to face our own mortality, usually at our own hands. Thanks for sharing, I know it wasn't easy, you may have kept someone from hurting themselves.

Chris thanks for sharing. People who dive alot often get complacent; this is a great reminder not too. The tragedy about this story is that it probably could have been avoided.

Thanks for sharing, Chris. A buddy of mine got bent a while back. He dove the same profile as I. Dehydration seemed to be the biggest factor.

At what depth of diving should one consider using an 02 bottle to scub out? Just a question I have been wanting to ask and here seems to be the thread to get answered. For instance, after doing some bounce dive in the grounds all day, 100-130' range, on your last dive would it give you a large margin of added safety on you safety stop to switch over to the pony bottle?

Sobering report Chris. Glad to hear you're OK.

Gerald

At what depth of diving should one consider using an 02 bottle to scub out? Just a question I have been wanting to ask and here seems to be the thread to get answered. For instance, after doing some bounce dive in the grounds all day, 100-130' range, on your last dive would it give you a large margin of added safety on you safety stop to switch over to the pony bottle?

Whenever you put yourself into significant deco obligations, O2 scrubbing will help significantly. You cannot use oxygen for scrubbing deeper than 20 feet, and you should get the proper training before doing ANY 02 scrubbing deco procedures.

At what depth of diving should one consider using an 02 bottle to scub out? Just a question I have been wanting to ask and here seems to be the thread to get answered. For instance, after doing some bounce dive in the grounds all day, 100-130' range, on your last dive would it give you a large margin of added safety on you safety stop to switch over to the pony bottle?

What inlet said, If your using a pony for a redundant air supply then it should have the same mix as your back gas. If your not putting yourself very far into deco then it's safer IMHO to just extend your safety stop rather than carrying a deco mix that cannot be used at depth.

Glad you are going to be ok. I have always wondered about the cost of that kind of incident. If you are willing share in the future, it would be interesting to see how all the insurance stuff shakes out. Here's to a complete recovery! :beer:

...that hole-in-your-heart-valve thing (PFE?)...

I think you mean PFO (patent foramen ovale).
BTW, I hope you fully recover Chris. Thank God for you. It sounds like you had a real close one there.

Chris, good to hear a happy ending to your adventure. there are so many variables that even the experts cannot explain most cases of the bends, but there are many things we can do to reduce the risk, and many more which can increase the risk. Most of us do things that increase the chance and when done together it becomes exponential, pushing us to a hit. I have been hit severely twice, the first time I ended up at DAN, the second here in La at West Jefferson (one of the best hyperbaric units in the world). Both times I was in less than a 100fsw and well within the limits with no DECO limits broke. The first time Absolutely no reason for the hit could be found, the second many small things added together brought me down. Give your body plenty of time and follow up with specialist in the field of dive medicine not just hyperbaric. Good luck in the future.

Chris,
Geez man! I'm glad your OK...Anytime you have a "sobering" experience it's hard to share as one does'nt know what reactions they'll recieve....SFP's brotherhood makes it apparent that our kinships run deep and true....
I'm outta the saddle with the ticker episode til Jan.:mad:.I feel your pain brutha..Thanks for sharing..I for one feel any experience we all share whether good or bad make us all the more aware our sport can be dangerous and is to be treated with respect......keep yer chin up and Thanks again...:D

Wow, that must have been scary. Thanks for sharing!

Deffinetly gets you thinking a lot more. Thanks for sharing your experience. Glad everything came out ok:toast:

Thanks for sharing that. You very well may be saving one of us from a similar experience with your sobering tale, it's easy to get complacent until something like this comes to light.

Makes me want to stay in the shallows ! Stress has got to be high on the factor list. It seems to be the cause of everything. Matter of fact, its friday, think I'll go ahead and knock off !:whistle:

Glad everything turned out ok Chris...let us know if the Dr has any more clues as to why you got hit..... lots of guys get bent doing everything correct and following their computers. IMHO the depths you dove may have been the biggest factor.

Mike

If it were me- if I stayed in my computer limits and didn't do anything stupid- then I'd get checked out for the PFO.

It occurs in up to 30% of divers. Since we didn't know about it until recently- the dive tables are probably more conservative because those that don't have it could do more bottom time. Since the tables were done without screening out PFO...

Blood can flow in both directions with Intra-atrial shunts at various phases of the cardiac cycle and some experts feel that a large atrial septal defect (PFO) is a contra-indication to diving. In addition, a Valsalva maneuver, used by most divers to equalize their ears during descents and ascents, can increase venous atrial pressure to the point that it forces blood containing bubbles across the PFO into the arterial circulation. Thus the usual filtering process of the lungs is by-passed.

Especially since you took a type II hit (where the next stop for unfiltered bubbles is the brain), I'd see about getting tested for it.

I did a study at Duke (they were trying to get us bent), where I had category 4 bubbles going through my heart (cat 5 is so many that they can't hear the heart valves). Because of that I had to get dopplered to see if any were passing into the other side of my heart- I watched on the screen as it was nice and clear. That still isn't the full test (which is relatively simple I think), but makes me feel better.

Article on someone who Type IId, and found out he had PFO.

http://www.travel-dive.com/pfo-probably-feeling-ok

I took a pretty painful right arm hit a few weeks ago. After I get all my bills in the mail and see if DAN steps up to the plate (preferred member for over 5 years) I want to write a detailed story like this about my experience. It takes balls to open yourself up to public scrutiny like that. Nice read Chris.

Wow thats one heck of a story man. Im glad everything turned out ok for you in the end, it must have been a scary situation to be in. We run lots of dive accident calls down here in the keys. The two best things to try to do while you are on the boat in a case like that is high flow 100% O2 and lie completely flat. I know it really sucks to lie on a hard surface like a boat deck for an extended period but it is the best may to keep those nitrogen bubbles from going some place they shouldnt go. The standard treatment pre-chamber for us is simple, supine position (flat), high flow O2 and fluids. If you can knock out the lying flat part and the O2 before you hit the dock youve got the more important of the 3 knocked out already. High flow O2 is essential because it greatly helps in the dissipation and replacement of nitrogen bubbles from your body. I think its awesome that so many people are becoming educated and carrying O2 on their boats now. Another thing I can say is do your best to make sure that the hospital knows about a possible dive accident before you arrive. Dont always count on Coast Guard to do everything, their job is to get you in in a timely manner if needed. In some of these smaller hospitals like down here in the keys, they dont always have a chamber staff on site, sometimes they are on call. The sooner they know about it quicker it can go up and running. Good luck on your recovery, and hopefully you will be back in the water soon. - John

Thanks again! Education is extremely important

Excellent thread and very informative.Thanks for sharing your experience and lots of luck on the continued recovery.

Glad you made it alright. Good post.

Sorry to hear about your experience and I hope everything goes well for you. Thanks for sharing the story especially for noobs like me.

I've never dove Scuba so this is REALLY informative to me, especially hearing about it before I take my classes will help keep my eyes open. What kind of depth do you have to reach before you have to start worrying about the bends?

Sorry to hear about your experience and I hope everything goes well for you. Thanks for sharing the story especially for noobs like me.

I've never dove Scuba so this is REALLY informative to me, especially hearing about it before I take my classes will help keep my eyes open. What kind of depth do you have to reach before you have to start worrying about the bends?

33fsw is 1 atmosphere. When one goes below 1 atsphr., one CAN get bent.

Sorry to hear about your experience and I hope everything goes well for you. Thanks for sharing the story especially for noobs like me.

I've never dove Scuba so this is REALLY informative to me, especially hearing about it before I take my classes will help keep my eyes open. What kind of depth do you have to reach before you have to start worrying about the bends?

The Doc and Dan both told me that most of thier bends patients were diving depths greater than 80fsw. But givn enough time and air you could get bent in less than 60.

Making the noob mistake of holing your breath on the way up from 30' would get you too, wouldn't it?

Making the noob mistake of holing your breath on the way up from 30' would get you too, wouldn't it?

Most definitely. NEVER hold your breath while ascending on scuba.

Making the noob mistake of holing your breath on the way up from 30' would get you too, wouldn't it?

No, that would not get you bent, but it would give you a serious lung over-expansion injury.

Making the noob mistake of holing your breath on the way up from 30' would get you too, wouldn't it?

Absolutely, that would be called a cerebral gas embolism.........bad stuff. In addition to the air escaping the lung(s) and getting stuck in bad places, the air you breathe in with each breath escapes out the site of the rupture and becomes trapped between the lung and the lining the lung is surrounded by. This causes an increasing pressure in the chest and basically causes the lung to collapse. Treatment of this condition is very basic, and consists of a large bore catheter inserted between your 2nd and 3rd rib. This releases the pressure and enables the lung to be inflated again. I dont know of any boats that carry this equipment so if you are far offshore you are kinda SOL.

No, that would not get you bent, but it would give you a serious lung over-expansion injury.

:redcard::p:p:p

Nanny-nanny-boo-boo!

Relapse,

I appologize. I was unaware this condition could be brought on by holding your breath. I meant no disrespect and wasn't trying to come out as the "smarter" one. I guess I assumed you were referring to general injury from holding your breath rather than a "bends" type injury. Sorry again.

Contributing factors:
Lack of planning
Stress from family emergency
Alcohol consumption/ dehydration
Sleep deprived
No o2
New wetsuit
No weight belt
My ascent rate was higher than normal not as controlled
Age
Weight

Chris

Thanks for sharing, most people I know that have been bent, got bent for a reason whether they want to admit it or not. Most of them ascended uncontrolled way to fast, for one reason or another. Deco and safety stops are no good if you fly up the first off the bottom and nuclei start to form. I get yelled at for ascending so slowly and doing a minute or two on all deeper dives, but the way I see it, I've never been bent.

Good luck with the bills

Jason

33fsw is 1 atmosphere. When one goes below 1 atsphr., one CAN get bent.

One can actually get bent shallower than 1 atm, but it would have to be a very looong time on the bottom.

Relapse,

I appologize. I was unaware this condition could be brought on by holding your breath. I meant no disrespect and wasn't trying to come out as the "smarter" one. I guess I assumed you were referring to general injury from holding your breath rather than a "bends" type injury. Sorry again.


MJP-I didn't even think of it like that.:toast:

I only knew because I read about a kid who was not certified and held his breath coming up from, if I remember correctly, 15fsw, and got an embolism (if I remember correctly again).

No sweat bro.

I read about a kid who was not certified and held his breath coming up from, if I remember correctly, 15fsw, and got an embolism (if I remember correctly again).

Yes, embolism/air expansion. Getting bent is nitrogen bubble formation in tissues. Very unlikely at 15 feet.

Yes, embolism/air expansion. Getting bent is nitrogen bubble formation in tissues. Very unlikely at 15 feet.

OK, so embolism is not considered a DSC effect? Are you sure? Seems like I remember something about that in my openwater training.:whistle:

Can't nitrogen also make it to the brain, since blood does go to the brain and blood contains nitrogen and when nitrogen wants to escape, the brain tissue is one of the softest tissues in the body?

Yes, embolism/air expansion. Getting bent is nitrogen bubble formation in tissues. Very unlikely at 15 feet.

From DAN website:

the lungs will progressively increase in volume until the elastic limit of the alveoli is exceeded and lung injury occurs.

This forces gas into one of three locations:

1. the space within the chest cavity (pleural space), a condition known as pneumothorax;
2. the tissue planes within the lung itself (interstitial space), from where it may travel into the space around the heart, the tissues of the neck and the larynx (mediastinal emphysema); or
3. the blood.

In this latter condition (arterial gas embolism, or AGE), gas bubbles can pass from the pulmonary capillaries via the pulmonary veins to the left side of the heart, and then to the carotid or basilar arteries (cerebral arterial gas embolism, or CAGE). While this explanation appears reasonable, it is not completely satisfactory. Since lung tissue is extremely compliant, one would expect the interstitium of the lung and the vessels within it to be subjected to the same increase in pressure as the alveoli. The vessels might therefore be expected to collapse, preventing gas from entering.

I believe that nitrogen is a gas present in the blood when diving and if surfacing to quickly will try to escape no matter where it is in the body.

Yes, embolism/air expansion. Getting bent is nitrogen bubble formation in tissues. Very unlikely at 15 feet.

And BTW, getting bent is not when nitrogen bubbles get into the blood, it's when the bubbles form and try to escape before the lungs can expell the N at it's regular pace.

And another little tidbit:


Actual volume changes may be less than this because of the effect of the surrounding chest wall to provide some rigidity and protection for the lung. However, if the same vertical change occurred from a depth of 66 fsw/20 msw, the 0.5 atmosphere of depth change would only result in a 16 percent reduction in pressure and a 20 percent increase in lung volume, and would be less likely to cause lung injury. Boyle's law thus explains why abrupt changes in depth while in shallow water can be far more hazardous than equivalent changes of depth in deep water.

Makes the 15fsw thing seem a little more likely doesn't it?

Here is the link to the site where the sublect is discussed. If I am wrong I will admit ti, but if my comprehension is correct (and it may not be:absolut::D), getting bent at 15fsw is entirely possible.:toast:
http://www.diversalertnetwork.org/medical/faq/faq.asp?faqid=145

Good god man... Air embolism and decompresion sickness are not the same thing. Please delete this nonsense.

From DAN's medical dictionary online:

Arterial Gas Embolism -- Also referred to as AGE, a condition in which gas bubbles enter the arterial system and cause damage by blocking blood flow to vital organs, most commonly the brain. This is generally caused by air passing through the walls of the alveoli into the bloodstream.

Decompression Illness -- Also referred to as DCI, decompression illness is a term to describe dysbaric injuries related to scuba diving. This diagnosis stems from the uncertainties in many cases about the mechanistic causation of neurological symptoms. Moreover, it is sometimes impossible to differentiate clinically between neurological DCS and AGE. An alternative approach has been suggested in which the clinical manifestation of a patient's decompression syndrome is described without attempting to determine the pathophysiology. The term "decompression illness" (DCI) is suggested to encompass all manifestations of diseases following a reduction in ambient pressure, such as ascending from a dive.

Decompression Sickness -- Also referred to as DCS, a syndrome caused by bubbles of inert gas forming in the tissues and bloodstream during or after ascent from a dive. DCS is manifested in two major forms, DCS I and DCS II.

DCS I -- Decompression sickness involving only muscle and joint pain, fatigue and/or skin symptoms (itching, rash).
DCS II -- Decompression sickness that includes symptoms involving the central nervous system, respiratory system or circulatory system.

"Bent" is DSC. Not DCI or Embolism.

From DAN's medical dictionary online:







"Bent" is DSC. Not DCI or Embolism.

So, are saying that nitrogen,
if one has ascended too quickly and nitrogen has moved into bubble form,
and the gas has expanded into the lungs to the point of expansion injury
and starts to back up into the blood
This forces gas into one of three locations:

1. the space within the chest cavity (pleural space), a condition known as pneumothorax;
2. the tissue planes within the lung itself (interstitial space), from where it may travel into the space around the heart, the tissues of the neck and the larynx (mediastinal emphysema); or
3. the blood.

That the nitrogen will not make an escape through the blood vessels in the brain?
basilar arteries (cerebral arterial gas embolism, or CAGE)

Here in this definition, the affect I am speaking of is used in the definition of Dysbaric osteonecrosis. So, now we know that the phenominon exsists even if you think it doesn't.

Dysbaric osteonecrosis is the death of a portion of the bone that is thought to be caused by nitrogen embolization (blockage of the blood vessels by a bubble of nitrogen coming out of solution) in divers.


The DAN dictionary states "Decompression Sickness -- Also referred to as DCS, a syndrome caused by bubbles of inert gas forming in the tissues and bloodstream during or after ascent from a dive. DCS is manifested in two major forms, DCS I and DCS II." That is to say, "two major forms" not, " the only two forms". These are and can be related and symbiotic depending on the severity of the lung injury.

I'll appreciate your not starting with the derogatory comments until you yourself have thought it through. There is no reason to argue if we both can learn something, right?

Good god man... Air embolism and decompresion sickness are not the same thing. Please delete this nonsense.

You may have been thinking that I was talking about an air embolism, but that was not the case. I was talking about nitrogen.:sleeping:

So, are saying that nitrogen,
if one has ascended too quickly and nitrogen has moved into bubble form,
and the gas has expanded into the lungs to the point of expansion injury
and starts to back up into the blood
This forces gas into one of three locations:

1. the space within the chest cavity (pleural space), a condition known as pneumothorax;
2. the tissue planes within the lung itself (interstitial space), from where it may travel into the space around the heart, the tissues of the neck and the larynx (mediastinal emphysema); or
3. the blood.

That the nitrogen will not make an escape through the blood vessels in the brain?
basilar arteries (cerebral arterial gas embolism, or CAGE)

Here in this definition, the affect I am speaking of is used in the definition of Dysbaric osteonecrosis. So, now we know that the phenominon exsists even if you think it doesn't.

Dysbaric osteonecrosis is the death of a portion of the bone that is thought to be caused by nitrogen embolization (blockage of the blood vessels by a bubble of nitrogen coming out of solution) in divers.


The DAN dictionary states "Decompression Sickness -- Also referred to as DCS, a syndrome caused by bubbles of inert gas forming in the tissues and bloodstream during or after ascent from a dive. DCS is manifested in two major forms, DCS I and DCS II." That is to say, "two major forms" not, " the only two forms". These are and can be related and symbiotic depending on the severity of the lung injury.

I'll appreciate your not starting with the derogatory comments until you yourself have thought it through. There is no reason to argue if we both can learn something, right?


Hey relapse,
The info in your post is correct, but you may have misinterpreted part of what it is saying. The "gas" that is being referred to in the beginning of your post is not the nitrogen in your bloodstream, but it is the air inside your lungs after you have inhaled. Not exhaling upon descent causes the air in your lungs to expand until the limit of lung expansion is reached, causing a rupture in the lung. As your post stated there are 3 possibilites for places this air can go. As for your question about the air bubbles making their way to the brain, they absolutely can if they enter the bloodstream. This is the reason for laying a dive patient completely flat - we want to take away the effect of the bubbles "floating" up the bloodstream and into the highest point - the brain. Once the bubbles near the brain, they are distributed through smaller and smaller vessels until they become stuck. Now whatever tissue relies on bloodflow from that vessel becomes necrotic (dies).
Although cerebral gas embolism and decompression sickness are two different conditions caused by two different things, they may very well cause they same problems. Hope this may have helped to clarify some things and wasnt too confusing:confused:

Hey relapse,
The info in your post is correct, but you may have misinterpreted part of what it is saying. The "gas" that is being referred to in the beginning of your post is not the nitrogen in your bloodstream, but it is the air inside your lungs after you have inhaled. Not exhaling upon descent causes the air in your lungs to expand until the limit of lung expansion is reached, causing a rupture in the lung. As your post stated there are 3 possibilites for places this air can go. As for your question about the air bubbles making their way to the brain, they absolutely can if they enter the bloodstream. This is the reason for laying a dive patient completely flat - we want to take away the effect of the bubbles "floating" up the bloodstream and into the highest point - the brain. Once the bubbles near the brain, they are distributed through smaller and smaller vessels until they become stuck. Now whatever tissue relies on bloodflow from that vessel becomes necrotic (dies).
Although cerebral gas embolism and decompression sickness are two different conditions caused by two different things, they may very well cause they same problems. Hope this may have helped to clarify some things and wasnt too confusing:confused:

Thanks for posting that up.:toast:

I by no means am a doctor or a professional in any other regard where anything to do with decompression is concerned, beyond my own experience and that of those whom I know.

i am trying to get my mind around all this (talk my way through it) so that I may understand it better. But when someone tells me I am wrong and posting "nonsense" without an alternate or opposing explanation, all I can do is dive deeper into my own research, even if my conclusions may be a bit off.

As you seem knowlegable, I have a more thought out, linear shaped question:

If air has expanded beyond the lungs, and is reintroduced to the bloodstream, and the same blood contains nitrogen built up at depth, could the nitrogen embolism be possible in the brain?

If so, isn't this a form of DCS? No sarcasm intended.

But when someone tells me I am wrong and posting "nonsense" without an alternate or opposing explanation, all I can do is dive deeper into my own research, even if my conclusions may be a bit off.I didn't mean for it to come off sounding harsh and you said you didn't want to argue so I used the word please and then posted the exact definitions.

It sounds to me like you are not visualizing bubble formation from a dissolved gas in the bloodstream. These bubbles can start out as microscopic and stay very tiny blocking only the tinyiest capilaries. DCS.

If you were in there, you could see the bubbles from an embolism. They are caused by trapped air expanding in a cavity. It's busting a hole in your lung in the case of a pulmonary embolism, or having air pushed back in to a vessel as a bubble. AGE or DCI which is the umbrella diagnosis that includes pulmonary air embolism.

I am not at all trying to start an argument. These are defined terms. Defined seperately and exactly as previously noted.

I didn't mean for it to come off sounding harsh and you said you didn't want to argue so I used the word please and then posted the exact definitions.

It sounds to me like you are not visualizing bubble formation from a dissolved gas in the bloodstream. These bubbles can start out as microscopic and stay very tiny blocking only the tinyiest capilaries. DCS.

If you were in there, you could see the bubbles from an embolism. They are caused by trapped air expanding in a cavity. It's busting a hole in your lung in the case of a pulmonary embolism, or having air pushed back in to a vessel as a bubble. AGE or DCI which is the umbrella diagnosis that includes pulmonary air embolism.

I am not at all trying to start an argument. These are defined terms. Defined seperately and exactly as previously noted.

Ok, understood.

Can you define:

nitrogen embolization, and

cerebral arterial gas embolism?

Thanks, Jlittle.

Thanks for posting that up.:toast:

I by no means am a doctor or a professional in any other regard where anything to do with decompression is concerned, beyond my own experience and that of those whom I know.

i am trying to get my mind around all this (talk my way through it) so that I may understand it better. But when someone tells me I am wrong and posting "nonsense" without an alternate or opposing explanation, all I can do is dive deeper into my own research, even if my conclusions may be a bit off.

As you seem knowlegable, I have a more thought out, linear shaped question:

If air has expanded beyond the lungs, and is reintroduced to the bloodstream, and the same blood contains nitrogen built up at depth, could the nitrogen embolism be possible in the brain?

If so, isn't this a form of DCS? No sarcasm intended.


I am far from being a doctor myself, but being a paramedic who loves the water its nice to keep your knowledge up to date. To answer your question, I would say that an "air" embolism is possible. Whether it be the air that has escaped your lungs and entered your bloodstream, or the nitrogen in your bloodstream. Picture yourself ascending from a dive, you forget to exhale and blow out a lung. You **** a brick (who wouldnt) and haul ass up to the surface. Well now we have two problems, a cerebral gas embolism, and mosty likely dcs. Is it possible for one of those bubbles to make its way to the brain? Definitely, better hope theres a chamber nearby.:eek:

OK, so embolism is not considered a DSC effect? Are you sure? Seems like I remember something about that in my openwater training.:whistle:

Can't nitrogen also make it to the brain, since blood does go to the brain and blood contains nitrogen and when nitrogen wants to escape, the brain tissue is one of the softest tissues in the body?

Sorry, I forgot to respond to this post earlier. First off, dont let the term embolism confuse you. An embolism is a blockage in a vessel by an embolus. An embolus can be a bunch of things, the most common being a blood clot. Dont think of an embolism as being just air, because most of them have absolutely nothing to do with air. That being said, cerebral gas embolism is called so for a reason. The word "gas" in the name tells us that the embolism is caused by a "gas". So now we have a blockage of a blood vessel in relation to the brain (cerebrum). Now we go back to DCS. As we all know, DCS equates to nitrogen bubbles expanding in the bloodstream too rapidly to be dissolved and yadda yadda..... Now we have all these little bubbles floating around, and they work their way into vessels that get smaller and smaller until they become lodged. Is it safe to say that all these little bubbles are embolisms? So back to the original question, yes...an embolism is an effect of DCS, and yes, these nitrogen bubbles may travel to the brain, and get lodged in there somewhere, at such a time the individual experiencing the DCS will show signs and symptoms identical to a stroke....since afterall it basically is a stroke;)

Sorry, I forgot to respond to this post earlier. First off, dont let the term embolism confuse you. An embolism is a blockage in a vessel by an embolus. An embolus can be a bunch of things, the most common being a blood clot. Dont think of an embolism as being just air, because most of them have absolutely nothing to do with air. That being said, cerebral gas embolism is called so for a reason. The word "gas" in the name tells us that the embolism is caused by a "gas". So now we have a blockage of a blood vessel in relation to the brain (cerebrum). Now we go back to DCS. As we all know, DCS equates to nitrogen bubbles expanding in the bloodstream too rapidly to be dissolved and yadda yadda..... Now we have all these little bubbles floating around, and they work their way into vessels that get smaller and smaller until they become lodged. Is it safe to say that all these little bubbles are embolisms? So back to the original question, yes...an embolism is an effect of DCS, and yes, these nitrogen bubbles may travel to the brain, and get lodged in there somewhere, at such a time the individual experiencing the DCS will show signs and symptoms identical to a stroke....since afterall it basically is a stroke;)

Thank you, sir! I feel more edumacated. I appreciate your attention to someone less wise than yourself:o

I don't know where you are geographically, but if I can ever help you, I will.
Roger:BoomSmilie_anim:

Thank you, sir! I feel more edumacated. I appreciate your attention to someone less wise than yourself:o

I don't know where you are geographically, but if I can ever help you, I will.
Roger:BoomSmilie_anim:

Thanks roger:smthumbup:

Thanks roger:smthumbup:

So... just so I will know, where are you?

Im in the keys, I live in Islamorada.

Im in the keys, I live in Islamorada.

OOOOHHHHHH! A new friend in the Keys! Is there a landing strip in Islamorada?:awink:


Have wings...will travel. :-)

Actually there is.....but its private.

Theres always in water recompression to consider as a last resort...:eek::eek: