News regarding my DCS Type II "Hit"

John Rawlings · Post by **John Rawlings** » Thu Aug 24, 2006 5:52 pm

Well.....as many of you know, I took a type II DCS hit back in June while diving down in San Salvador and the specific cause was unclear. Both of my computers had cleared me to surface, yet within 15 - 20 minutes after surfacing my arm had gone numb and my legs would no longer function properly. After multiple days of chamber rides I was able to walk out of the hospital on my own and undergo a few more days of chamber rides as an out-patient.

After making it back home, at my request my local doctor sent me in for an echo-cardiogram. I needed to see if I had a PFO (Patent Foramen Ovali), which is a hole in the heart that we all have at birth that closes up in most of us. Apparently as many as 1 out of 5 people live out their lives with a PFO and never even know they have one. PFOs are the most likely suspect in unexplained hits such as mine.

Well......I have one.

The PFO that I have is very small and probably would have never been detected if I hadn't taken my hit. I had such a strenuous time exiting the water following my second dive of the day that that was the key that pointed toward a PFO, since they open at times of heavy exertion. I spoke with the folks at DAN today extensively and the PFO was the final piece of the puzzle that put it all together for them....apparently as you age PFOs that have been closed can again open in the right situation, which is apparently what happened to me. The speculation is that as I climbed that rapidly bouncing ladder, while heaving my huge camera system up to the deckhand, (all at a high rate of speed because of another injured diver on the deck that needed fast medical attention), I may have briefly held my breath while I was pulling myself upward. This scenario have have caused the PFO to briefly "flash" open, allowing a small shower of nitrogen bubbles to erupt in the opposite direction that they should have and ultimately enter my spinal column.

So....what does this mean for me and diving? Well, my current plan is to re-enter the water at the end of my 6 month hiatus (the beginning of December). My gas choices will be Nitrox or Trimix, and on most, if not all, of my dives I will choose to use my rebreather with a constant high PO2 level rather than diving on open-circuit gear. I will also choose to carry stage bottles with me, containing my normal bail-out gas as well as pure O2. Those of you that have dived with me will know that is really NOT a big change anyway! HA!

Time will tell, but I suspect that my days of 300 ft + dives are over. My own common sense is telling me that it makes more sense for me to be using normoxic gas mixtures (same level of O2 as in air) rather than hypoxic mixes (substantially lower level of O2 than normal air) that are used for deeper dives beyond 200 feet. Linda Bowen, the co-publisher of ADM, told me this the other day -

"John....you don't need to do any more of that deep crap....it's time to leave that for the younger guys....you don't have to prove anything to anyone!"

Well....Linda's a good friend....she's probably right....but I'm still grappling with the issue. It's kind of difficult to stare your own mortality and fallibility in the face....I can't say that I like it very much!

Eventually, I'll arrive at the answer that is right for me.

In the meantime......once again, if any of you clowns out there aren't covered by DAN or some other dive insurance you are making a big mistake....one that you just never know if or when it's going to leap up and bite you.

- John

Tangfish · Post by **Tangfish** » Thu Aug 24, 2006 6:07 pm

John, I'm extremely happy to hear that you've finally narrowed the cause down. It must have been frustrating as heck to wonder for all this time what actually caused this horrendous experience.

Also, I'll be happy to hang out with you at 200' and shallower $\:D/$

sparky · Post by **sparky** » Thu Aug 24, 2006 8:03 pm

You guys see why I love john so much
although I have never had the pleasure fo meeting him yet.

Thanks john for Shareing this infermation with us as usal you speak and we learn.

my prayers are with you on this john
Sparky

DiverDown · Post by **DiverDown** » Thu Aug 24, 2006 8:13 pm

Well John, This experience that you are currently are going threw has been a huge learning tool for all of us at NWDC. I know that With my recent "hit" and your current recovery has been has been valuable to us. Wether some have gotten DAN, or mabey rethunk there diving style. Unfortunatly things like this happen and you never want it to happen to you. The good thing is that there have been quite a few members joining lately that are definetly experts in the scuba/rebreather field. This site is turning out to be a fantastic resource for the local diving community.

I for one am looking foward to a dan02/advanced02 class in sept.

A valuable tool for rescue divers and above, or just good general knoweldge. I also see that members have a plethera of choices now use different instructors.

Curt McNamee · Post by **Curt McNamee** » Fri Aug 25, 2006 7:33 am

John- I will be waiting for you at waters edge with my KISS when you are ready to get back in the water. That day will be here before you know it $\:D/$ .

Sincerely,

Sounder · Post by **Sounder** » Fri Aug 25, 2006 8:04 am

Thanks for your post John - I know you'll miss your deep dive days, but you've got lots of memories. I think "going with your gut (or in this case, your doctor's and friend's gut)" is the right thing to do. 200' is STILL quite deep... "deep enough."

Your "wait time" will pass quickly - just think of it as the ultimate surface interval! Thank you for sharing your experience and wisdom with us.

Zen Diver v1 · Post by **Zen Diver v1** » Fri Aug 25, 2006 10:15 am

Curt McNamee wrote:John- I will be waiting for you at waters edge with my KISS when you are ready to get back in the water. That day will be here before you know it $\:D/$ .

Sincerely,

Well, I may not have a rebreather, but I'll wait with a KISS for you too!

:hello2:

-Valerie

Curt McNamee · Post by **Curt McNamee** » Fri Aug 25, 2006 10:31 am

Zen Diver wrote:
Curt McNamee wrote:John- I will be waiting for you at waters edge with my KISS when you are ready to get back in the water. That day will be here before you know it $\:D/$ .

Sincerely,
Well, I may not have a rebreather, but I'll wait with a KISS for you too!

:hello2:

-Valerie

Looking back at that post now, it does look a little strange. Please, don't anyone take the idea behind that post wrong

.

I think Val's idea will work very well and I could incorporate in the bigger picture like this: I will be at a dive site with my really neat rebreather (KISS Classic) to greet John back to diving and standing there also will be Val that has offered to give me a big KISS at waters edge.

Sounds like fun to me

Zen Diver v1 · Post by **Zen Diver v1** » Fri Aug 25, 2006 10:36 am

I'll make sure I brush my teeth that day!

:smt038

John Rawlings · Post by **John Rawlings** » Fri Aug 25, 2006 10:51 am

Curt McNamee wrote: I think Val's idea will work very well and I could incorporate in the bigger picture like this: I will be at a dive site with my really neat rebreather (KISS Classic) to greet John back to diving and standing there also will be Val that has offered to give me a big KISS at waters edge.

Sounds like fun to me

Now wait just a doggone minute! Give YOU a kiss? I thought that the kiss was supposed to be for ME!!!!!

All kidding aside, special thanks to ALL of you for your kind words and support. And to Sparky, a man can't ask for anything more special than your prayers....thank you!

- John

Zen Diver v1 · Post by **Zen Diver v1** » Fri Aug 25, 2006 11:01 am

John Rawlings wrote: Now wait just a doggone minute! Give YOU a kiss? I thought that the kiss was supposed to be for ME!!!!!

- John

Okay, to keep the peace, I'll brush my teeth, use mouthwash, and kiss both of you! $\:D/$

-Valerie

Tangfish · Post by **Tangfish** » Fri Aug 25, 2006 12:39 pm

You guys can exchange kisses, but can someone bring me a carrot? (my last avatar wouldn't have had a hard time garnering kisses)

Tom Nic · Post by **Tom Nic** » Sat Aug 26, 2006 8:11 am

Hi John,
Just found this thread after a long day of diving... My prayers are with you as well, and I am happy that the probably cause has been found. Knowing is ALWAYS better than not knowing, especially in cases like this. Funny, I had just finished reading about PFO (Patent Foramen Ovali) in my Dan O2 class a few days ago. I suppose the one in 5 that have this wouldn't ever know it without something not so pleasant happening. I know that you will dive, and dive safely, and have a blast doing so. Wow... what a "sit back and reflect, pause and look forward" kind of time this is... almost always valuable, seldom done.

Again my special thanks to you and Diver Down for sharing your stories. I know they have impacted and influenced many divers on this board.

I think you guys should get a cut of Dan policies that have been sold as a result! $\:D/$

Hope to see you in the water sometime, but I'll pass on the kisses for now!

Tom Nic

John Rawlings · Post by **John Rawlings** » Sat Aug 26, 2006 8:57 am

Tom Nic wrote:....but I'll pass on the kisses for now!

Tom Nic

I cannot even BEGIN to tell how how disappointed I am at that! HA!

Thanks for the kind words, Tom! It always helps when friends talk to the Lord on my behalf.....and I shall always appreciate it.

- John

Joshua Smith · Post by **Joshua Smith** » Sat Aug 26, 2006 2:57 pm

Wow- I just got back to town and found this post. John, I'm happy you've discovered the likely cause of your hit. I'm glad to see your reaction is mostly planning how to accommodate this knowledge into your future diving. Sounds like you have a sensible plan in place- and I'll be more than happy to dive with you above 200', any time, any place! (But no kisses!)

John Rawlings · Post by **John Rawlings** » Sun Nov 19, 2006 6:17 am

ADM issue 24 is now "in the mail" to subscribers. For those interested, one of the articles in this issue is about the events surrounding my DCS Type II "hit".

I should be able to get back into the water soon......

- John

BASSMAN · Post by **BASSMAN** » Sun Nov 19, 2006 10:42 am

John?
Maybe you can come dive with us at the Hood canal weekend in December!

John Rawlings · Post by **John Rawlings** » Sun Nov 19, 2006 11:44 am

BASSMAN wrote:John?
Maybe you can come dive with us at the Hood canal weekend in December!

Sorry.....I can't make that particular trip.

peo · Post by **peo** » Mon Nov 20, 2006 12:33 pm

Thanks for writing and posting openly about your incident. An open atmosphere for talking about accidents and incidents is a great thing to build, and I applaud you being a role model in this context.

I'd be interested in knowing a bit more about your profile on the dive when it happened, and the dives leading up to it (assuming you were diving the days before too), if you feel comfortable sharing this.

John Rawlings · Post by **John Rawlings** » Mon Nov 20, 2006 4:16 pm

peo wrote:Thanks for writing and posting openly about your incident. An open atmosphere for talking about accidents and incidents is a great thing to build, and I applaud you being a role model in this context.

I'd be interested in knowing a bit more about your profile on the dive when it happened, and the dives leading up to it (assuming you were diving the days before too), if you feel comfortable sharing this.

Hi, Peo!

Here's the exact dive sequence for the three days:

Arrived at San Salvador by air from Nassau, Bahamas, on Sunday, June 4th, around 8:00 AM after a flight of less than 1 hour. Our group made 1 dive later in the afternoon that day after 2:00 PM local Bahamian time.

Sunday, June 4th:

Dive 1: 41 minutes, max depth: 126 FSW, 78 degrees F.

Monday, June 5th:

Surface Interval: 17 hours 33 minutes.

Dive 1: 34 minutes, max depth: 129 FSW, 77 degrees F.

Surface Interval: 1 hour, 30 minutes.

Dive 2: 43 minutes, max depth: 86 FSW, 81 degrees F.

Surface Interval: 2 hours, 55 minutes.

Dive 3: 46 minutes, max depth: 101 FSW, 79 degrees F.

Tuesday, June 6th:

Surface Interval: 16 hours, 43 minutes.

Dive 1: 37 minutes, max depth: 134 FSW, 77 degrees F.

Surface Interval: 1 hour, 17 minutes.

Dive 2: 47 minutes, max depth: 88 FSW, 80 degrees F.

During all dives our typical profile was to head immediately down the wall and then slowly work our way upward at an angle across it so that I could shoot upward toward the surface at whatever photo subjects we found. I would typically make a stop around 75 FSW or so for 2 - 3 minutes as a "recreational deep-stop" (HA!).

As is typical of Caribbean diving once you reach the top of the wall you have sand flats and coral heads ranging between 60 and 25 FSW and we spent time there just cruising around and off-gassing. By the time I hit the down line both computers had cleared me on all dives, and I then hung out at 15 FSW for 5 minutes watching the fishies swim by and the girls crawl up the ladder above me. $\:D/$

Nothing was really that different from hundreds of dives I have done before....except the surface conditions, lack of equipment assistance, and medical issues that are described in the article.

- John