The Skin Bends

[DiverBob]

Has anyone had this or familiar with it? It would seem as though I had a case of it yesterday. My wife and I did 2 tanks a TTN yesterday. First dive was too long at 1:12 min. After a :53 min SI, the 2nd dive was :58, both breathing air and well within non decompression limits. When I got home I noticed a skin rash and what looked like bruising on my lower back and abdomen. The bruising did not have the normal black and purple colors. I felt fine, but now quite concerned. After about 2 hrs, it was almost completely gone. I slept fine and have had no joint pain. This morning the rash and bruising are completely gone. I do have a little bit of a sensitive stomach and not much of an appetite. A call to DAN this morning said it was most likely the Skin Bends and as long as I have no other symptoms, it does not need treatment. He did say that I will be more susceptible to it in the future. Even recommended diving nitrox using air limits. Anyone have any experience with this? I know we several medical people on the board, any thoughts? Thanks, Bob

[LCF]

Was there any sensation associated with this? I know the usual description of skin bends is that they itch or burn.

It would be interesting to see the profiles -- do you have a computer that will download them? If you, in fact, have skin bends "well within no decompression limits" and with well controlled ascent procedures, you might consider setting up a transcranial doppler to determine if you have a PFO (patent foramen ovale, a congenital abnormality of the heart that is associated with a higher risk of skin and neurological DCS issues). I believe they can be done at Virginia Mason.

[boydski]

Most of the cases of "Skin Bends" that I have seen have been on Technical Dive Charters. In those cases, its usually an indication that the diver is pushing his dive profile a bit too aggresively and needs to spend a little longer decompressing (to allow his body to off gas without forming large bubbles) prior to surfacing.

Skin bends often will go away without further symptoms, but is an idication that you had nitrogen bubbling up below the surface of your skin. I would suggest you back off on your dive profiles (longer surface intraval or shorter dive) and/or spend some time on a decompression stop (a very long safety stop 5+ minutes) on your way to the surface. Keep your ascent rates very slow as well.

I just did a very deep dive yesterday, and for the majority of our dive, we used a 10 feet per minute ascent rate to allow our bodies to off gas effectively (while keeping bubble growth in check) on the way to the surface.

Good Luck and I'm glad to hear that you don't have any lingering effects from your "close call".

[airsix]

...also, were you cold? Did you take a hot shower ro warm up?

[loanwolf]

Has anyone had this or familiar with it? It would seem as though I had a case of it yesterday. My wife and I did 2 tanks a TTN yesterday. First dive was too long at 1:12 min. After a :53 min SI, the 2nd dive was :58, both breathing air and well within non decompression limits. When I got home I noticed a skin rash and what looked like bruising on my lower back and abdomen. The bruising did not have the normal black and purple colors. I felt fine, but now quite concerned. After about 2 hrs, it was almost completely gone. I slept fine and have had no joint pain. This morning the rash and bruising are completely gone. I do have a little bit of a sensitive stomach and not much of an appetite. A call to DAN this morning said it was most likely the Skin Bends and as long as I have no other symptoms, it does not need treatment. He did say that I will be more susceptible to it in the future. Even recommended diving nitrox using air limits. Anyone have any experience with this? I know we several medical people on the board, any thoughts? Thanks, Bob

What was your depth's on these dives? Dry suit or wet suit? If dry did you wear the usual thermal's.

[DiverBob]

I was diving dry. I stay nice and warm and rarely do I have any leaks. Deepest was 80 ft on 1st and 78 on the 2nd. The majority of both dives were spent around 40 ft. After looking closely at the profile on the computer, we need to do a much better job of managing our ascent rates. I have also set my computer to a 5 min safety stop now instead of 3. If my body may show more susceptibility to this, a little extra time at the safety stop will help me.

[loanwolf]

Being that it was only your lower back and your waist It sounds like you may have had your rig a little too tight. We get this all the time with our wrists if we tighten the computers down too tight (or anything else that gets too tight). The wight of the unit and the tightness of the belt cuts down on blood flow in the skin region and the nitrogen cannot get out. So you end up with a minor skin bend. Seals if not cut properly will cause this as well. As well if you go from a very thick undergarment to a thin on that offers fare less padding you can get this as well.

Your overall profile does not sound bad at all but hard to tell without seeing the graph of it. Even with a few fast accents to different levels it sounds like you did a overall decent multi level dive plan staying within your computer limits.

The other things that will do it quite easily after a dive are as follows- after the dive, A hot tub or long hot shower, and any physical exertion .

That pretty much takes all the fun out of a good dive day - and the deco rules have to apply or it is a uncomfortable night.

[Domer Down]

DiverBob,

I had a confirmed case of the skin bends last month, and wrote about it in the General Scuba area. Here is the thread:

http://www.nwdiveclub.com/viewtopic.php?f=1&t=9702

I'll add another comment at the bottom of the my thread and throw in a picture of my skin bends. This may help you to know if this is what happened to you.

Fortunately, this is as mild as the bends come. I saw mine as a warning shot to dive more nitrox, hydrate more, and be a little less aggressive with the depth and time.

[DiverBob]

Hi Tom, yes I have been following your post. I had the rash and I also had what looked like bruising, without the colors. I wish that I would have taken a picture, but it was not done for whatever reason. It may have been from the drysuit, but I don't think so. I did start to itch, but I forced myself not to, and the sensation went away quickly. Within a couple of hours the rash and bruising went away and was almost gone by 11pm, about 3.5 hrs after the last dive. What was most difficult for me was the phantom pains. I was constantly evaluating exactly what I was (or was not) feeling. I even had a dream that my left arm was completely numb. It wasn't until I got up out of bed and walked into the kitchen to realize that I was ok. I am going to start diving Nitrox and also be much better about my ascent profile. I am also going to force myself to do much better job with my safety stops and also the ascent from the safety stop.

[Domer Down]

Bob,

I see you are out of Tacoma. I just dove Les Davis this morning. We should dive together soon and reinforce our safe diving practices! Send me a note some time if you're getting in the water.

[Zen Diver]

Being that it was only your lower back and your waist It sounds like you may have had your rig a little too tight.

The trunk and breast tissue is the most common site for the rash/itching associated with skin bends. These symptoms sound bang on.

Valerie