I got bent (NHZ)

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Mateo1147
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I got bent (NHZ)

Post by Mateo1147 »

Please read this entire post before posting a comment. I am most interested in constructive advice on ways to make dive days like this one less [sarcasm]“exciting”.[/sarcasm] I am posting this for the education of other new divers like myself. At the end of this day I had 213 dives total. Looking back through my log book I came across a day in Bonaire that had six dives. All of those dives were with 32% Nitrox and nice big surface intervals. I guess you just never know……..
On Sunday March 10th I took a DCS hit to my left upper arm. What follows is as much information as I can remember and believe is pertinent. All dives were done using air. I had five hours of sleep prior. I had been out the night before but was not hung over or dehydrated. I had a 16oz. Mocha before breakfast and drank hot tea and water with my breakfast. My dive buddy, “ Jane “ was never more than six feet + or – from my depth on all three dives. She reported no signs of DCS. All dives had a 15’ safety stop at the end. I was using an Oceanic VEO 1.0 dive computer set to DSAT for the algorithm.
The day was scheduled as a three tank boat dive starting from Shilshole marina. The first dive started at 10:50 on Shangri-La. This dive ran a max depth of 54’ for 65 minutes. During the first surface interval I consumed two bowls of Soup and approximately 12 ounces of coffee. The second dive started after a surface interval of 1:31 on China Wall. This dive ran a max depth of 96’ for 54 minutes. I ran up a 12 minute deco obligation at 10’. At the end of this dive I ascended the buoy line to 11’ and ran through my obligation. One thing of note was that the boat kept pulling on the line so that it would rise and fall. As the line would rise I would descend to stay below my ceiling. When the line would start to fall again I would rise back up to 11’. This happened five or six times while I was off gassing. I made five or six mini descents and ascents between 11’ and 18’. The third dive started after a surface interval of 1:40 minutes at the Alki fishing reef. This dive ran a max depth of 70 feet for 44 minutes.
After we arrived back at the dock I helped unload all the tanks and most of the other gear onto the dock. It was 12 minutes of above average exertion. Once my gear was lugged up the dock and loaded in the car I left the marina. Within five minutes of leaving the marina my arm was noticeably sore. I mentioned it in a phone call to my girlfriend. About forty minutes later I stopped for some gator aid as I thought it could be some cramping from dehydration. By the time I got to Monroe the pain had increased and I pulled over and called DAN for a medical consult. At this point my arm had a constant ache from what felt like the inside of the upper arm bone. The pain was not outrageous but much more than a strained muscle or tendon. This was roughly two hours from the onset of symptoms. Upon their advice I turned back and went to Virginia Mason for an assessment. In the end I spent seven hours in the chamber starting at around 01:00 Monday and two more hours on Tuesday afternoon. The symptoms took a long time to respond to the initial treatment and returned full force on Tuesday morning. After Tuesday afternoons’ treatment my arm was still sore but Ibuprofen was able to keep things in check. By Wednesday morning all signs of pain were gone and have stayed away.
Looking back at this day I see a few red flags:
• No actual water to drink except for 8oz. or so during breakfast.
• Way too much caffeine!
• Lack of sleep and or being less than fully rested.
• Not using 32% Nitrox since I do have it available to me.
• Deepest dive second. This was questioned before leaving the dock but it was due to slack current window.
• Short surface intervals.
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Re: I got bent (NHZ)

Post by Nwbrewer »

Holy crap Matt, glad you're ok.
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Re: I got bent (NHZ)

Post by cardiver »

Thanks for the info. Glad you're okay!
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Re: I got bent (NHZ)

Post by Don-B »

Good to here your o.k. Matt.
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Re: I got bent (NHZ)

Post by pogiguy05 »

Glad to hear your OK and thanks for the info. I know it will help if ever it happens to anyone else. Strange that it only effected one part of your body so that is definitely something to remember.
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Re: I got bent (NHZ)

Post by fmerkel »

Just to add to the confusion: if you show up at VM with body pain after a dive and with DAN insurance I think there's about a 90% (anecdotal evidence based on limited experience but some experience none the less) chance you are taking a chamber ride.

That was a pretty aggressive group of dives. The work afterward moving equipment around didn't do you any favors.
A couple of questions:
1. Were you carrying a camera or any object that put a static specific load on the affected arm for the dives?
2. Did the affected arm get 'over worked' (right handed or such) carrying tanks after the dive? There is Doppler evidence for increased micro-bubbling in overused joints after a dive.
3. Did you do a deep stop on your deco dive?

Note - the info that 'basic' computers gives you to go to 10 feet for x minutes after a 'deco obligation' is almost but not quite useless. There are better ways of handling 'recreational' deco. I almost never do deco and am not a tech diver but I have encountered those algorithms on my computers and thought they were questionable from the outset. I pay attention to deco but I ignore how the manual indicates it should be handled.

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Re: I got bent (NHZ)

Post by Dusty2 »

Glad it worked out but sure messed up your week.
I would say lack of sleep is a factor as well as the activities from the night before. Caffeine can have an effect as well as alcohol. DCS doesn't have any hard and fast rules it effects everyone differently and undeserved hits happen all the time. Frequently in times of stress or over exertion. I wonder, when you were hanging from the line for your deco was that the arm you were using? If so that could factor in because that would be the highest part of the body and bubbles will always travel upward and perhaps get caught there? 96 feet for 54 minutes seems long for a second dive and the 10 minute deco indicates that. IMHO the nitrox would have helped prevent this.

Some computer programs are really silly. My first computer was like that it would tell me to do X minutes at 10 feet then tell me to descend to 20 feet for the 3 minute safety stop?????? :eek:

At any rate Glad there are no residual symptoms
Last edited by Dusty2 on Sat Mar 16, 2013 7:05 pm, edited 1 time in total.
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Re: I got bent (NHZ)

Post by CaptnJack »

To me, the first dive was NBD.
I would consider the 2nd and 3rd dives of the day very aggressive profiles. The surface intervals were adequate, but you had a deco dive on the 2nd dive, only air to decompress, and then a borderline deco dive on the 3rd with only 1:40 SI.
I don't think the fluids you drank were the problem, nor the lack of rest, nor doing the deepest dive 2nd. Its really just a matter of being marginally offgassed after dive 2, having a modest SI, and then piling on a bunch more nitrogen on dive 3. Air was a horrible gas for this kind of trip.

The 2nd and 3rd dives, on air, would have bent me like a pretzel too. Glad its fully resolved.
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Re: I got bent (NHZ)

Post by Mateo1147 »

fmerkel wrote:Just to add to the confusion: if you show up at VM with body pain after a dive and with DAN insurance I think there's about a 90% (anecdotal evidence based on limited experience but some experience none the less) chance you are taking a chamber ride.

That was a pretty aggressive group of dives. The work afterward moving equipment around didn't do you any favors.
A couple of questions:
1. Were you carrying a camera or any object that put a static specific load on the affected arm for the dives?
2. Did the affected arm get 'over worked' (right handed or such) carrying tanks after the dive? There is Doppler evidence for increased micro-bubbling in overused joints after a dive.
3. Did you do a deep stop on your deco dive?
1. No.
2. I would say that my arm did get over used during the gear shuffle. I have a past hand injury that makes my left arm non-dominant and it is visibly less muscular if you look closely enough. I did a bunch of poking, prodding, pushing and pulling with my arm while on the phone with DAN to try and make sure that this wasn't musculoskeletal pain from the gear shuffle.
3. No.
PM me with your suggestions on ways to handle recreational deco if you would please. Thanks!
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Re: I got bent (NHZ)

Post by fmerkel »

With those answers I'm kinda in Jack's camp.

This certainly is not a guaranteed answer but if you are going to do any kind of deep dive, then a deep stop is prudent to incorporate into your dive profile, more so if you are actually incurring deco. Deco obligations are somewhat computer specific and HOW a computer handles a deco profile on multiple dives can be wildly different between computers.

Some Deep Stop reading: (I'm not PM'ing this as I think it worth reading for those not familiar with the concept.

Deep Stops: Can Adding Half the Depth of A Safety Stop Build in Another Safety Margin?
http://www.diversalertnetwork.org/defau ... ews&id=514
Deep stops for recreational diving
http://www.scubaboard.com/forums/ask-dr ... iving.html

In addition to the deep stop I would ignore the 10' stop idea. That's 1/3ATM! I wonder who came up with that? It seem to be universal in basic computers. In addition if you are near the surface surge becomes increasingly difficult to deal with the shallower you are.
After the deep stop my ascent slows....way.....down, and I do a much more protracted Safety/Deco stop in the 15-20' range. Often my computer snaps out of deco during this process. I still do a protracted safety stop. I consider 3" to be a minimum on a non-deco dive and generally do 5". Even from there I try to ascend slowly.
Of course all this is dependent on gas supply. Hopefully you take that into account.
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Re: I got bent (NHZ)

Post by Nwcid »

fmerkel wrote:
In addition to the deep stop I would ignore the 10' stop idea. That's 1/3ATM! I wonder who came up with that? It seem to be universal in basic computers.
I am not disputing what you are saying here but I think it might be a misunderstanding. From one of my instructors apparently one of the issues is not understanding exactly what the computer is telling you.

I have not been in Deco before so I can only go on what I have read. The GF and I were diving Veo 100 which are very similar to the Veo 1. According to the book for the 100 it will show you different depths to stop at and how long to stay at each depth.

Upon entering Decompression Mode, you should begin a safe
controlled ascent to a depth slightly deeper than, or equal to, the
Required Ceiling Stop Depth indicated (Fig. 25a) and decompress
for the Stop Time indicated (Fig. 25b).
• The UP Arrow and Deco Bar will flash if you are more than
10 feet (3 meters) deeper than the Required Ceiling Depth.
• Once within 10 feet (3 meters) of, and below, the Required
Ceiling Depth, both Arrows and the Bar appear solid.

The amount of decompression Credit time that you receive is
dependent on Depth, with slightly less Credit given the deeper
you are. You should stay slightly deeper than the Required Stop
Depth indicated until the next shallower Stop Depth appears.
Then, you can slowly ascend to, but not shallower than that
indicated ceiling Stop Depth.
Main Display information includes - Current Depth, Required
Ceiling Stop Depth/Time, Total Ascent Time (and Mode icon),
and applicable Bar Graphs.

Total Ascent Time (Fig. 26a) includes Stop Times required at all
ceilings and vertical Ascent Time calculated at 60 feet (18
meters) per minute below 60 feet (18 meters) and 30 feet (9
meters) per minute above 60 feet (18 meters).


So unless I am reading this wrong it does not tell you to go to 10' but is telling you when you are within 10' of where you need to stop.
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Re: I got bent (NHZ)

Post by Tom Nic »

Thanks for telling your story.

Different computers handle "recreational" deco (a term I use to mean a non planned, non technical trained, deco obligation) VERY differently. I have seen three buddies doing very deep air profiles, all three go into deco, and one computer has a guy hanging at 10' for 10+ minutes, and the other's computer clearing them after a long, slow ascent with many stops from 50 fsw on up.

Under the right conditions I do think it is helpful to know what your computer looks like and how it behaves when you incur a deco obligation. I believe Bob Bailey has a good article on his web site that touches on this.

Of course the best way to handle recreational deco is to not do it, but them you know that.
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Re: I got bent (NHZ)

Post by fmerkel »

Anyone have a link to that article Rodale's did years ago fixing a half dozen computers to a board and subjecting them to multiple dive profiles? Or something similar?
It was pretty interesting. If I recall right, on the first dive they kinda agreed. On the 2nd dive they were all over the place as Tom indicates.
Read Bob Bailey's article also. It will add to the [Deep Stop] information and incorporates those concepts.
http://nwgratefuldiver.com/articles/deco.html
Last edited by fmerkel on Sat Mar 16, 2013 8:17 pm, edited 1 time in total.
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Re: I got bent (NHZ)

Post by Nwcid »

Here are all of his articles, http://www.nwgratefuldiver.com/articles.html
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Re: I got bent (NHZ)

Post by Nwbrewer »

I recommend this -

Even for those not doing planned deco, it's great information for every diver to have.
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Re: I got bent (NHZ)

Post by LCF »

It would be very interesting to see the profiles, or even to know what the average depth for the dives was. But if you went into deco by your computer on the second dive, it's pretty clear that you spent a significant amount of time fairly deep, because the long surface interval after the first, fairly shallow dive, should have offgassed a significant amount.

At any rate, I don't think this is what folks generally call an "undeserved" hit, because the dive profiles sound fairly aggressive for three dives in a day on air.
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Re: I got bent (NHZ)

Post by kdupreez »

Thanks for sharing Matt! Not a lot of people actually have the courage to share this with the public, so I applaud your actions to share and i'm really happy everything turned out OK!

I do agree with some of the previous posters that your first dive was on the cusp of the recreational limits and your surface intervals and follow on dives were fairly aggressive for our cold waters and on air.

Doing only about 1.5 hour interval after a deco dive and then again riding so close to the limits on short intervals is pretty aggressive and this is not an un-deserved hit.

And by that I dont mean you deserve it :) Its simply a term used that sometimes people stay well within the recreational limits and get hit due to something like a PFO and we call that un-deserved because it was so far outside of the limits, its a fluke.

But in this case, the dives (without seeing the profiles) seem very aggressive and I'm not gasping in surprise that you took a hit.

Also, sounds like your deco obligation was only completed in 10ft, at the max gradient and not knowing your computer settings/algorithm, its not something thats advised in modern day technical diving circles. we typically start decompressing deeper and complete the shallow stops at around 20ft to slow off-gassing and try to stay well below the gradient/over pressurization limits.

I also agree all of this combined with your yo-yo deco stop and lack of sleep and dehydration and above average post dive exertion was a good recipe raising your risk levels for being hit.

You have to realize that the minute you hit the surface, thats when the pressure differentials are at their biggest and thats the biggest danger zone of the dive to get hit when you over exert.

I've taken a right arm hit including skin bends before and the only thing i did different that day was aggressive ascent profile (only doing minimum required shallow stops, ala pure bhulman style) and over exerting on the surface because I was in a rush.

Seeing your actual dive profiles would be very very interesting! could you share those?

And complete side track question, are you technical diver trained? i.e. trained in decompression procedures and decompression diving?
Last edited by kdupreez on Sat Mar 16, 2013 10:07 pm, edited 3 times in total.
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Re: I got bent (NHZ)

Post by renoun »

We frequently discuss long duration dives (hour plus) that even if they start deep have long periods spent in the shallows. In this region we are culturally shore divers and for many people a boat dive is unusual. Our shore dives are usually multi-level dives with plenty to see in the shallows while many boat dives are likely to generate square profiles. I would postulate that folks used to shore diving may dive much more aggressive profiles off a boat with more rapid ascents and less (whether intentional or not) pauses at intermediate depths. I suspect that somebody accustomed to happily looking for PSL's in the shallows for fifteen minutes might adopt a different attitude about time if they are hanging off an SMB or anchor line staring at their computer. You have discussed your run times and SI time. Were your ascents more abrupt than previous dives you didn't have issues with?
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Re: I got bent (NHZ)

Post by Mateo1147 »

renoun wrote:We frequently discuss long duration dives (hour plus) that even if they start deep have long periods spent in the shallows. In this region we are culturally shore divers and for many people a boat dive is unusual. Our shore dives are usually multi-level dives with plenty to see in the shallows while many boat dives are likely to generate square profiles. I would postulate that folks used to shore diving may dive much more aggressive profiles off a boat with more rapid ascents and less (whether intentional or not) pauses at intermediate depths. I suspect that somebody accustomed to happily looking for PSL's in the shallows for fifteen minutes might adopt a different attitude about time if they are hanging off an SMB or anchor line staring at their computer. You have discussed your run times and SI time. Were your ascents more abrupt than previous dives you didn't have issues with?
I heartily agree with you about the different ascents when diving from shore or boat. It's very easy to come up nice and slow when looking for critters. My ascent rates on this day were generally not any faster than when shore diving.
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Re: I got bent (NHZ)

Post by Mateo1147 »

Nope.
Last edited by Mateo1147 on Sat Mar 16, 2013 10:39 pm, edited 1 time in total.
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Re: I got bent (NHZ)

Post by Mateo1147 »

Thank you to all the previous posters that linked articles on deep stops, multiple stops and ascent rates. They will make for good reading while banned from the water. :partyman:
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Re: I got bent (NHZ)

Post by Mateo1147 »

Nwcid wrote:
fmerkel wrote:
In addition to the deep stop I would ignore the 10' stop idea. That's 1/3ATM! I wonder who came up with that? It seem to be universal in basic computers.
I am not disputing what you are saying here but I think it might be a misunderstanding. From one of my instructors apparently one of the issues is not understanding exactly what the computer is telling you.

I have not been in Deco before so I can only go on what I have read. The GF and I were diving Veo 100 which are very similar to the Veo 1. According to the book for the 100 it will show you different depths to stop at and how long to stay at each depth.

Upon entering Decompression Mode, you should begin a safe
controlled ascent to a depth slightly deeper than, or equal to, the
Required Ceiling Stop Depth indicated (Fig. 25a) and decompress
for the Stop Time indicated (Fig. 25b).
• The UP Arrow and Deco Bar will flash if you are more than
10 feet (3 meters) deeper than the Required Ceiling Depth.
• Once within 10 feet (3 meters) of, and below, the Required
Ceiling Depth, both Arrows and the Bar appear solid.
So unless I am reading this wrong it does not tell you to go to 10' but is telling you when you are within 10' of where you need to stop.


You are mostly correct. The small up or down arrow is what tells you that you are within ten feet of your stop depth. The actual number displayed is your ceiling for that stop. I just tried to pull a screen shot of that page off my users manual but no such luck.
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Re: I got bent (NHZ)

Post by Zen Diver »

Mateo1147 wrote:
Looking back at this day I see a few red flags:
• No actual water to drink except for 8oz. or so during breakfast.
• Way too much caffeine!
• Lack of sleep and or being less than fully rested.
• Not using 32% Nitrox since I do have it available to me.
• Deepest dive second. This was questioned before leaving the dock but it was due to slack current window.
• Short surface intervals.
I think you nailed. Just to clarify, nitrox doesn't add safety unless you dive it on air tables/computer setting. Most people tend to use 32% to get longer bottom times, which negates any potential hazard reduction.

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Re: I got bent (NHZ)

Post by CaptnJack »

fmerkel wrote: In addition to the deep stop I would ignore the 10' stop idea. That's 1/3ATM! I wonder who came up with that? It seem to be universal in basic computers. In addition if you are near the surface surge becomes increasingly difficult to deal with the shallower you are.
Haldane!
Seriously as far as I know all of the Oceanic computers have a pretty aggressive "neo-Haldane" model which gives no credit for deeper stops/off gassing. A Suunto would have had MUCH longer 2nd dive stop times, probably close to 25mins which is about double the Oceanic.
Zen Diver wrote: I think you nailed. Just to clarify, nitrox doesn't add safety unless you dive it on air tables/computer setting. Most people tend to use 32% to get longer bottom times, which negates any potential hazard reduction.

Valerie
On air, the 2nd dive is a deco dive even without the first load of nitrogen earlier in the day. (assuming the average depth was around 70ft which is typical for China Wall in my experience). On 32% this profile would have been a no-stop dive even being the 2nd dive of the day.
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Re: I got bent (NHZ)

Post by Mateo1147 »

CaptnJack wrote: Haldane!
Seriously as far as I know all of the Oceanic computers have a pretty aggressive "neo-Haldane" model which gives no credit for deeper stops/off gassing. A Suunto would have had MUCH longer 2nd dive stop times, probably close to 25mins which is about double the Oceanic.
I noticed this on a dive at TTN to the bottle field. I was crossing 45 feet on ascent looking at critters and the computer rolled on one more minute of deco. I thought to myself seriously? No credit yet? I didn't start getting any credit until we reached the eel grass at 15-20'. That was a first dive and the second was to the junkyard and all was well.
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