BENT

What is "bent", "the bends", "dci", decompression sickenss?

http://www.diversalertnetwork.org/medical/articles/article.asp?articleid=65


I have some disturbing news. Sunday we went diving again and had a fantastic first dive which was my 6th since getting back in the water. However, we chose not to quit while we were ahead and went on a second dive did not go so smoothly.

We took Mike's zodiac over to Vashon Island to dive at KVI tower which is one of my favorite dive places up here. The visibility was great and when I first dropped down, I found a sandy patch on the bottom where I could experiment with my bouyancy. I am still having problems with bouyancy and getting my weighting right. I am on the heavy (negatively bouyant) side but then I am having major bouyancy fluctuations in my suit because it is too big. After adding and dumping air out of my BCD for a few minutes, I finally got to a point where it felt pretty good and I could go enjoy the dive which I did. I would have to say that it was my best dive yet out of the 6! We saw lots of life (dirona nudibranchs, glassy tunicates, sea cucumbers, sea stars, big plumose anenomes. sponges, ling cod, various fish, crab, and a large octopus sleeping in its den!)

On the way up I had a little bit of a problem with the air vcnting out of the suit. I had to hold on to the anchor line but because there was some slack in the line, it just kept going up instead of keeping me down for a safety stop at 15 feet. The dive was to a maximum of 77 feet for 33 minutes dive time under the water.

When we got out, Harley and Mike inquired if I wanted to do another dive. I said sure seeing it was still light out. We left the KVI tower dive sight and sped across Puget Sound to Redondo on the mainland where we put the boat in. By the time we got there, the daylight was starting to fade a little and Harley had to jump out to go use the bathroom. When he returned, Mike had to go (I didn't because I wear Depends when diving). When he returned, the light was starting to fade more which concerned me a little but I was not anticipating it to be a long dive. I thought we would surface before dark.

I was the first one into the water as Harley helps me get all setup and then I wait for Mike and Harley. I was cold while waiting (I had a minor leak and got a little damp but did not realize until later). So while I waited for them to get their gear on and enter the water, I started doing jumping jacks in the water and running in place to warm up. I looked down at the anchor line and noticed it disappear within just a couple feet. The visibility was not great at the surface which made me a little apprehensive. Meanwhile the light continued to fade out as the sun began to set. I thought about totally aborting the dive and letting Mike and Harley go while I waited in the boat. But that would only kill more time and delay the dive. Plus, I would probably get cold waiting. Rather than going through the hassle of having them take off gear and get me out of the water, I chose to just brave it out.

When they rolled into the water, I asked Harley what was the plan. He signed that we were going to snorkel over to the dock and drop down. "Great!", I thought. I would have a reference for going down in such low visibility and darkness. I figured it was pretty shallow under the dock and antcipated exploring the plethora of life that is normally found growing on the dock pilings. It seemed like a plan that I would be okay with. In the worst case scenario, I could grab the piling if I was having a bouyancy problem again while surfacing. (about the visibility too....it is common for it to be stirred up at the top but clear once you drop down which is did. Therefore, I used all these thoughts to comfort myself and brave the low light/night dive which I had really planned to exclude from my return to diving.)

When we dropped down I had to stay within a foot of the piling for visual reference so I would not get disoriented. Once at the bottom, we did not go under the dock but away from it which was not what I had schemed out in my mind. "Ok", I thought. "Everything will be fine." So I followed and went along for the ride. At 51 feet we came upon a small stack of tires which had some cool life growing on it and surrounding it. At one point near this tire structure, my mask began to flood with water and became a quarter to one half of the way full. "Alright, just don't panic. It is no big deal. You know how to clear it out." I was kneeling on the ground and next to the tires. However, when I first tried to clear the mask, my technique did not work. Further, I started to swallow the water that was going up my nose. I was not breathing in, but when I tilted my head back to clear the mask, water entered my nasal passages when I stopped blowing out! This has happened before since the onset of facial paralysis while eating soup and drinking water since. So it was not the first time I experienced this sort of choking phenomena. At first it set me into a little panic. If I cannot see I am sort of screwed so I had to clear the mask. But when I tilted my head up to clear the mask, I started choking on water. It is times like these that your ability to survive hinges on keeping a cool head and having faith and confidence in yourself that you can solve the problem. So that is just what I did and kept trying until it was cleared. Then I gave myself a few moments to relax before continuing on. When the situation first happened I got Harley's attention and was very uncomfortable. I wanted to go up but then I solved the problem and all was fine again. I did not want to surface from 51 feet in the fading light with a leaking masking and swallowing water. That just would not have been good and may have caused me to freak out (too many factors to deal with at once).

We continued down and came upon an old boat with an octopus in its den underneath. It was cool but I got tired of trying to shine my light that only extended so far into the crevase and trying to maintain a neutrally bouyant to position to see it. Thus, I looked around the boat for a little bit. Did I also mention that the bouyancy was especially challenging for me? I spent a lot of the time landing on my knees which was frustrating. My trim is off and my legs seem to sink lower than the upper half of my body which makes swimming efficiently underwater bothersome.

I started with about 2450 PSI (pounds per square inch) of air in a steel compact 80 tank. I noted when I got down to 1200 or 1150 PSI which was less than half my air. According to my dive plan , half of the amount of air means it is time to head back and ascend to a shallower depth. I tapped Harley and thought he saw my guage and air. Yet, he remained fixated on the octopus while Mike was a few feet deeper taking pictures. By now it was pretty dark and if the light from either buddy shined in my eyes it was greatly disorienting. I chose to just stay next to the sunken boat and octopus to wait a few more moments. The boat was small so I looked within the structure a little bit.

Remember that I was having bouyancy problems so I did not really want to venture around too much. Between handling the light in one hand and alternating between the inflator hose for my bouyancy and guage telling me my air and depth in the other, and every so often dropping my light to fiddle with the inflator hose with both hands (because I have discovered my hand is a little weak and sometimes I am not fully pressing the inflator button) I was fumbling around. This was not good as it became more dark under the water and my air was becoming less at depth (57 feet). I did NOT want to run out of air at that depth, try to ascend, and then be left with having to manually inflate my BCD in the dark which is a problem with my facial paralysis. Therefore, I wanted to turn back and ascend to shallower depth NOW!

At 1050 PSI I tapped Harley on the head and waved my light to get his attention off the dang octopus. I showed him my air and tried to sign in the darkness that I wanted to go back. He pointed in the direction of a rope along the bottom which I sort of remembered. I went up to the tires which was at 51 feet and then next thing you know I was at 63 feet in the direction Harley pointed. It was too dark for me to tell which direction went to a shallower depth. I looked at my guage and I was now down to 950 at 63 feet with no idea which direction to go to get back! I was lost.

Now I love Harley to tears but on land he is not the most efficient of navigators. If I am not paying attention and playing the "Lola - gps", he most often goes the wrong way. At 63 feet and 950 pounds of air I did not want to go the wrong way! I really did not want to ascend within the water column but I felt at that point we had no other choice. My panic level was starting to build and I wanted out of the situation before it became worse. I signalled to him to go up. I know that was confusing because he knows I am not comfortable doing that and prefer to follow the slope to ascend to a shallower depth. Frustrated, I signed a couple times "PLEASE help me go up!" I needed help because first of all, it is hard for me to ascend like that without some kind of reference point. Further, it was now dark and even more difficult for me to find my reference and go the right way.

In order to do ascend together and not loose him, I had to grasp his shoulder strap with my right hand. That means I had to drop my light hanging from my side. In the other hand, I had to manipulate the inflator hose. I did not have a free hand to monitor my guage for air, depth, and ascent rate. I had to look up through the darkness to try to see my bubbles. I had no idea how much air I was at so I grabbed the regulator on his pony bottle a started breathing off of it to ensure I would have enough air.

As a result of all this, the air in my large drysuit did not vent out quickly enough and we made a fast ascent. Harley was not too happy and understandably so. On the surface we snorkled over to the dock and dropped back down to the bottom at 15-17 feet for our 3-5 minute safety stop. It was shallower because the tide had gone out while we were underwater.

Immediately upon getting back in the boat Harley said he was "BENT" which is decompression sickness from excess nitrogen bubbles that form in the blood. He was starting to feel some affects already. He breathed off of Mike's O2 bottle for quite a long time after the dive and back at the condo. By monday morning he was feeling shifting of an arthritic type of pain all over his body. He went to work that afternoon and by 6 pm (24 hours after the dive) he was not feeling any better so we called DAN (Diver's Alert Network) and went to the hyperbaric chamber at Virginia Mason in Seattle.

He was in the chamber all night (8 hours) for a depth of 60 feet. He did not like it in there and said he felt very weird and achy. He slept all day yesterday and began to feel better yesterday evening and was well enough to go to work later this morning.

68 hours later I am feeling pretty good. I did not seem to get bent so I did not go in the chamber with Harley. At 12:30 or 1 am this morning, the pinky on my right hand became numb and thing finger has swollen for some reason. We have no idea what it is from and if it is in fact an NF2 related thing. We were told that after 24 hours if I did not feel anything, I was pretty lucky and unaffected. I did not feel anything at 48 hours either.

So what now?

Harley is to abstain from diving for a month and needs a checkup with a diving physician before he returns, he is to rest and not engage in strenuous activity for a week, and drink plenty of fluids (none containing alcohol). The decompression sickness could recoccur so he is to take it easy.

How about me?

After the dive, stenuous activity can encourage the bends. Therefore, I did not go to the gym at all yet and will not do my run this week which normally is on tuesday. Yesterday I also rested with Harley and took a long nap as I did not get consistent or enough sleep while at the hospital.

I asked Harley if he thought it would be okay if I go lift weights today but he was not too thrilled with the idea and told me to just take it easy which is a hard thing for me to do.

The situation is not sitting well with me and I am having a hard time. It bothers me to have caused Harley pain, to go to the hospital, to miss work, and to miss his 3 workouts for the week. I did not like seeing him in a hospital gown on a gurney and hooked up to oxygen and a monitor. I have always been on the other side of the fence and have been the one in the hospital or sick. It is difficult to be on the other side and must have been awful for Harley and my family to see me like that (especially for Harley and our friend KC when I woke up from surgery vometing, convulsing, and yelling; and when my sister heard me yelling in the background when the nurse had called them in the lobby).

Alright....now down to the nuts and bolts.....

How could this have been avoided and what is to learn?

Well there is a GREAT deal we have learned. First things first, I should not have engaged in a second dive in low light conditions before I was ready. I should have called it but instead of being assertive, I was passive and went for the ride. One would not write a book without first learning grammar and how to spell. We skipped steps and you cannot skip steps (especially when your life is at stake). The second thing MAJOR thing is lack of communication. We did not have a good dive plan. It was not clearly discussed (or at least relayed to me) exactly what we were doing, where we were going, what maximum depth we were going to, and at how many PSI we were going to turn back and head to a shallower depth. Had all that information been clearly understood, we would not have encountered the problem.

So lots of things to think about over the next month.