4 ways to reduce your risk of decompression sickness
How do we reconcile knowing that avoiding DECO doesn’t guarantee avoiding DCS? The answer is risk reduction. By reducing risk at every opportunity we can feel more comfortable relying on the limits accepted throughout the dive industry. These are 4 ways I was told I could reduce risk in my dive behavior, and I am resolved to considering and practicing all of them things in the future.
1) Nitrox
In order to reduce the amount of nitrogen your body absorbs during a dive, you can use air with added oxygen; this is called nitrox. I was told to use the highest percentage of nitrox available for every dive. The doctor explained that using nitrox can confer three benefits (longer bottom times, reduced surface intervals, increased safety), but that you have to choose one. In other words, you don’t get the same safety benefits if you stay underwater for longer and/or reduce your surface interval.
Basically, to reap increased safety benefits you need to dive with nitrox but follow an air profile, while remaining vigilant to the depth limitations of the blend of Nitrox being used. This can be a challenge considering the limitations of air and nitrox are different and require different computer models or dive planning tables. Fortunately, all of these topics are covered comprehensively in the Nitrox certification course, which is required before diving with Nitrox.
2) Dive Conservatively
One of the many hyperbaric doctors with whom I interacted during my experience noted that in looking at the two dives I did before getting DCS, both would lead to DECO if they were considered square profiles.
I said “huh?”
If we assume that on my first dive to 75 feet, that I stayed at that depth for the full duration of the dive (65 minutes), I would find myself exceeding the no-decompression limits. Obviously, I didn’t spend 65 minutes at 75 feet, but using a square profile I could have determined before the dive that it was a slightly more risky profile.
I was advised to consider square profiles when planning my dives in the future, thus significantly increasing the conservatism of my diving.
SQUARE PROFILE: A theoretical profile used in planning, and a very conservative estimate of nitrogen load in the body.
ACTUAL PROFILE: A real-world profile as measured by a computer. This profile is more accurate in terms of recording nitrogen load in the body, but is far less conservative than a square profile.
By either reducing my dive time or the maximum depth of my dive, I would reduce the amount of nitrogen absorbed. The square profile of a shallower or shorter dive would not exceed the no-decompression limits.
3) Hydration
I drank about two liters of water throughout that first day, but most of it was between the two dives when I also consumed a large amount of sugar contained in the snacks provided. The ocean was around 85 degrees (really warm). I drank about three cups of coffee throughout the day. I walked a couple miles in 90 degree heat with 90% humidity. I drank some beers at dinner. All of these things could have contributed to me being dehydrated.
During my initial hospital visit, I was administered 100% oxygen and IV fluids for a couple of hours. (Don’t mind the bird…)
Apparently proper hydration is key…not only should you drink plenty of water, but also replenish your electrolytes using hydration salts. A balanced diet, high-quality rest and moderation in the consumption of alcohol, caffeine and high sugar foods are all important as well, especially before and after diving.
4) Stay cool
This one sounds nearly impossible considering that most of our favorite places to dive are steamy tropical locations, but there are a couple key things to avoid. I was advised to avoid the following things for at least 18 hours (the same time required to wait until flying after diving): hot showers, hot tubs, saunas and steam rooms, strenuous exercise and massages.
Although I didn’t do any of these things, I did walk around town in the heat which could have contributed to the onset of my symptoms. Avoiding all of these things can significantly impact your normal routine, but it may reduce the risk of decompression sickness. I shudder at the thought of a cold shower after some dives, but I’ll settle for room temperature if it means I can reduce risk.
*5) Dive Insurance
Although having dive insurance won’t help you reduce the risk of DCS, it will certainly make your life easier if you have an accident. I can’t stress enough how important it was for me to have dive insurance during my experience. Not only did it relieve stress about whether or not I could afford the treatments (hyperbaric treatment is extremely expensive…think ~$1000/hour, not to mention costly private transport if no hyperbaric facilities are available where you are diving), but they also provided incredible support over the phone. My calls were always answered immediately, and the medics I spoke with were able to speak very clearly and calmly with me about what was going on. (SHAMELESS PLUG WARNING) I personally use Divers Alert Network (DAN), and couldn’t be happier with my experience. DAN’s plans are very affordable and well worth it, even if you only dive once under their protection.
Part of the reason for writing this was to help myself accept that I have chosen an inherently risky passion and work environment and to help you all accept that as well. Understanding that diving involves risk, and accepting it, will allow us to be open to ways to make it safer.
The more important reason for writing this is to help me feel comfortable diving again by educating myself. Ultimately, I’d like to share my experience and hope that you learn from it and become a safer diver. And that you help your favorite dive buddy do the same.
Please feel free to reach out to me with questions about my experience. I was also told by multiple DAN medics that they’re always happy to answer questions even if you’re not a member.