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I would not wish my experience on
anyone, but I learned some lessons
that will hopefully help others:
1. Ensure you are well hydrated prior
to diving. Think about adding a
few days at the beginning of your
trip to recover from travel.
2. No matter where you dive, ensure
you have DAN membership and
a dive accident insurance plan.
Without DAN, the $60,000 flight
and $10,000 hospital bill would
have come out of my pocket.
3. When traveling outside the
country, check the local medical
facilities and their capabilities.
Don’t assume because they are
called a “hospital” they can provide
a necessary level of care.
4. If anyone goes through this
type of situation, make sure
someone is with him at all times.
Having someone clear-headed to
communicate on your behalf is
important.
5. Know the procedures for
contacting DAN; the closest
chamber may not be available to
you, and they will facilitate the
arrangements you need.
AD
Medic’s Perspective
Mace’s case reinforces many good points for divers to note. While it is true dehydration is a
known risk factor for DCS, it is scientifically impossible to state it as the reason Mace was bent.
Connecting the dots between dehydration, bubble formation and growth, and DCS can be an
elusive task. The intrinsic mechanism of injury in DCS is pretty well understood, but its exact
trigger is not nearly as clear.
The main suspect in this case is probably the overall exposure. There is no “mild” second
dive to 127 feet; proof of this is a symptom onset, progression and natural evolution consistent
not only with neurological DCS but also with a spinal cord hit, typical for considerable exposures
with significant inert gas loads and inadequate offgassing.
Rhabdomyolysis is not a common complication of DCS, and its etiology and role in this
particular case might not have a clear explanation. It is a delicate medical condition requiring
immediate intervention to prevent serious complications resulting from acute renal failure.
Mace’s case only emphasizes the importance of a thorough medical approach to DCS; had
the rarity not been detected, he could be now facing the systemic consequences of irrevers-
ible and lifelong kidney damage.
The exotic nature of a location can be both its charm and a nightmare; the comforts offered
might be the exception to the rule around you. When planning a trip, consider and plan for
potential problems. DCS is not the only risk divers face, and while DAN is always here for you, it
cannot comprise your entire emergency action plan.
—Matias Nochetto, M.D., DAN director of operations and outreach
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