RESEARCH, EDUCATION & MEDICINE
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F R O M T H E M E D I C A L L I N E
60
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SPRING 2014
Don’t Connect the Dots
DAN medics and researchers answer your questions
about dive medicine.
Q:
I was diving last week from a
liveaboard in the Bahamas. Each
day I did around four dives and
never experienced any problems. I waited
24 hours before flying home, and I felt
completely fine during the flights. Now after
being home for three days, I woke up this
morning feeling terrible. My joints ache, I’m
dizzy, I have a headache, and I feel weak.
Some of my experienced dive buddies are
confident this is decompression sickness
(DCS). What does DAN think?
A:
It is a natural human tendency to try to
establish cause and effect or to “connect
the dots.” It is helpful to consider
possibilities, but it can be counterproductive
to self-diagnose or assign blame too quickly.
A health-care professional must provide an
actual diagnosis, and the pertinent facts must
be viewed objectively and within the proper
context.
Certainly joint aches, headache, dizziness and
weakness are among the signs and symptoms
associated with DCS, but we must evaluate
those signs and symptoms in the context of the
facts. This diver reported no symptoms after
diving. The surface interval prior to flying was within the
recommended guidelines (a minimum of 18 hours after
multiple dives). Think about why it is considered safe to
fly after waiting the recommended time: Studies show
that after that period nitrogen levels in the body are no
longer sufficiently elevated to cause symptoms during a
routine commercial flight. If by some odd chance a diver
had enough residual nitrogen to cause a problem, the
symptoms would likely occur during the altitude exposure.
This diver did not report any signs or symptoms during
her flights. The chances of nitrogen having anything to do
with this diver’s symptoms are essentially nonexistent.
Most divers understand, at least intellectually, that
a diver can do everything right and still sustain a
decompression injury. However, most seem to have
difficulty accepting this concept when it actually occurs.
The overwhelming number of cases diagnosed as
DCS have no discernable cause (other than breathing
compressed gas at depth and subsequently returning
to the surface). But divers often try to find some factor
to blame. This is speculation, however, and can be
counterproductive.
If you experience symptoms after diving please do not
decide on your own what the diagnosis should be. Get
a medical evaluation. DAN is available for consultation
with medical professionals as well as directly with
divers. Always consider your symptoms within a proper
context — don’t connect the dots.
— Marty McCafferty, EMT-P, DMT
STEPHEN FRINK
