My Decompression Sickness Story
Now, knowing what we do about decompression from the last segment, consider that despite using your computer properly and avoiding decompression (DECO), it is still possible to get decompression sickness (DCS). I know this because it happened to me.
This is the story of my decompression sickness…what I did leading up to getting it, what I felt (or didn’t feel) when I got it, the general treatment plan, the repercussions and what I’m going to do now.
Cozumel, Mexico - October 2024
I travelled to Cozumel with a group of clients and planned to do about 10 dives during the week. On our first day we had two normal dives scheduled. The first was a winding labyrinth of reef structure, where my maximum depth was 75 feet. I was diving with air because I didn’t expect to push my no decompression limits throughout the week (I also absent-mindely forgot to order Nitrox for myself). I ended the 65 minute dive with a 3 minute safety stop.
During the hour and 20 minute surface interval, our boat crew provided us with delicious snacks including fresh fruit, bread and juice. They also provided us with a reusable bottle of water, which I finished along with my snacks.
On the second dive we cruised along a reef shelf at around 50 feet for the majority of the dive. When I saw my NDLs hit 3 minutes on my Suunto (one of the more conservative computers on the market) towards the end of the dive, I signaled to the divemaster that I would shallow up. As I waited for my buddy, I completed my own safety stop and then waited out the end of their stop as well (totaling about 5 minutes of safety stop).
After returning to the hotel I had a coffee to tide me over until lunch. I neglected to drink more water. Around two hours after the end of the last dive I began to notice a mild itch on both sides of my back just above my beltline. I passed it off to bug bites.
My ride in the hyperbaric recompression chamber was a sobering experience; a stark reminder of the inherent risks of the sport I love so much.
We walked in the sweltering heat to a local favorite restaurant. Another two hours later and the itch had become slightly painful. I thought my dive weights had ridden in those spots on my belt and bruised me and I passed off the pain to that.
Two hours later and I began to notice a blotchy looking mark. It was at that point that I became suspicious and called my dive insurance provider. I carefully recounted my day and dive profiles (another good reason to have your own dive computer) to the medic on the phone. With little deliberation he advised me to visit an emergency room immediately. He believed I had acquired a case of cutis marmorata, commonly referred to as skin bends, decompression sickness manifesting in the skin. I hung up and contacted my divemaster from the day for their advice as to which hospital would best treat decompression sickness. In an instant she was already on her way to pick me up (Thank you Blanca!)
At the hospital, a doctor confirmed the DAN medic’s diagnosis and put me on 100% oxygen and administered IV fluids for 2 hours. I was told no further treatment was necessary. I left the hospital without paying a penny, because the visit was fully covered by my dive insurance.
I woke the following day with no bruising or any other symptoms. I attended a check-up appointment with the hyperbaric doctor. He checked my back and felt satisfied the treatment had worked. He then advised me to use nitrox whenever possible and to dive even more conservatively than I already was doing. He also emphasized staying properly hydrated, as this seemed to be a common factor in people experiencing decompression sickness. Lastly he told me I would need to avoid diving for 2-4 weeks. Besides feeling embarrassed, disappointed and all around upset, I felt A-OK physically.
The following morning I decided to join the group on the boat to hang out with the boat captain. As I recounted the story of treatment to the captain during the first dive, I lifted my shirt to show him where the blotches had been. When I looked down, I saw they had returned and were even darker in color than the first night. I again called the dive insurance company, and they advised me to go back to the hospital. As soon as the divers surfaced we moved to shore where a car was waiting to take me back to the hospital (Thank you Paco!).
When I was able to see the doctor, he looked at the blotches and matter-of-factly exclaimed “That’s bad news.” My heart sank. He told me that I would need to be treated in the hyperbaric chamber as soon as possible. And with that he was off to prepare the chamber while the hospital staff prepared me. I was put back on IV fluids and oxygen and laid out on a stretcher. In a short time, a nurse and I entered the submarine-looking hyperbaric chamber together, and the door was sealed.
This is a classic presentation of cutaneous decompression sickness, known commonly as the skin bends.
I spent 5 hours in the chamber, being pressurized to the equivalent of 60 feet of water (about 3 atm). I breathed 100% oxygen, absorbed a liter of IV fluids and watched a couple of long movies. After four and a half hours, they began to depressurize the system very slowly. Once the chamber was fully depressurized I was wheeled out to a hospital room where I would be monitored overnight.
The next morning, I received another visit from the doctor. Satisfied with the treatment’s results, he discharged me and extended my no-dive time to 8 weeks. I walked out again without paying a cent.
What I Learned
The principal lesson I took away from my experience was the difference between decompression (DECO) and decompression sickness (DCS). One does not necessarily beget the other. The former is easily avoidable with the proper planning and equipment. The latter seems much more difficult to define and therefore avoid. DECO resides in a computer model with well-defined limitations. DCS lives partially submerged in the ether.
As a dive instructor of almost 10 years, I have heard many divers recount their stories of DCS, and after my experience I feel some shame for ridiculing those divers. The culture amongst dive professionals seems to harbor the idea that to get “bent” you had to do something stupid…to lose track of your no decompression limits or to ignore them completely, to bolt to the surface, but generally, something stupid. This culture is dangerous, and it probably contributes to the number of cases of DCS amongst recreational divers.
I now believe the general attitude of divers needs to change, because I didn’t do anything stupid. What I did do was neglect to add conservatism to my dive behavior. That’s what led me to getting DCS. I feel this is the most important lesson to take away moving forward…trying to reduce risk through every possible avenue.