We would like to introduce your new Diving Doctor – Oliver Sykes from London Hyperbaric Medicine. Every month, Oliver will give you an insight into his knowledge and answer your questions on diving medicine. In addition to being one of the medical team at LHM, Oliver boasts an impressive diving cv, is a PADI Divemaster and a keen reader of Sportdiver magazine. Other doctors will also join us and tell you more about their specialist areas.
Have you ever been in ‘De-Nile?’ (by Dr. Oliver Sykes)
Up until now, Dr Firth’s witty prose has been an entertaining source of information for us all. In last October’s issue I especially like the possibility of us having massive fish eyed lenses after a few million more years of evolution. However, this diving doctor has regenerated in a slightly shorter time scale and, rather like Doctor Who, hopes to retain some of the characteristics of the previous doctor. Geronimo!
I would like to start by asking why divers deny the presence of symptoms of decompression illness? It is as if ‘de nile’ exists only as a river to dive in. For so many people, getting bent means the diver must have done something wrong, took too much of a risk or does not want to hit the panic button and cause a fuss. The truth is that you may have done something wrong, but you could easily not have. Every year we see divers at London Hyperbaric Medicine who did not make a mistake, but were simply unlucky. All tables/computers are based on probability and hence it is important to build in a safety margin if you want to stay safe.
Over the years, I have heard a great many reasons for the classic symptoms of decompression illness and so here are a few pointers to head off the common excuses:
Seasickness gets better when you get on to land. I know it is obvious, but I have heard it blamed even on dry land.
Food poisoning symptoms may well have started before you dive and abdominal pain is unusual in decompression illness.
Hangovers tend to get better throughout the day, not worse, although you may get more tired and no, impaired balance is NOT a sign of a hangover but is a sign of DCI.
It is unlikely to be a heat rash/sunburn/suit squeeze if you did not get hot or did not forget to inflate your dry suit at depth.
Symptoms can only occur once you have done an ascent. True.
Numbness and tingling in the limbs goes away within 10 minutes if you have simply slept on them or take off a tight fitting suit.
Musculoskeletal pains are common after lifting heavy equipment, but if the pain is inside the joint, then ask for help.
Unexpected use of oxygen as part of decompression or ‘just for safety’ can mask symptoms and should probably be discussed with a diving doctor, even if this just ensures that there is an open line of communication. Minor symptoms can evolve into life threatening neurological decompression illness, while at the same time disturbing thought processes, including impaired judgment and reactions.
Any symptoms out of proportion from those that you would expect after diving are always worth discussing with a diving doctor and buddies should assume some responsibility for ensuring this is done.
Despite the possibility of these symptoms we still go diving. Why?
An episode of Doctor Who, called Vincent and the Doctor, reminds me of the need for massive fish eyed lenses:
Vincent van Gogh: It seems to me there is so much more to the world than the average eye is allowed to see. I believe if you look hard, there are more wonders in this universe than you could ever have dreamed of….
Published in Sportdiver magazine February issue. Lookout for more from Doctor Oliver in the March issue.