Well my luck ran out last week. Pictured above is the Cebu recompression chamber where I spent a total of 8 hours in. If you ever have to get in one of these then things are certainly not going as planned. I've been very healthy for traveling for 5 and a half months with only some very minor stomach issues. With just two weeks to go, I rolled snake eyes and got Decompression Sickness, a.k.a "The Bends". Of the millions of scuba divers in the world it hits only about a 1000 a year that are treated --lucky me. I was diving a more aggressive dive profile than I normally do but I was within limits and took care to have extra long safety stops before getting out, but that wasn't enough.
They day started great with nice weather after many days of rain. I had three great dives on Apo Island near Dumaguete, Negros, Philippines. The first one included a brief trip to 130 feet (my deepest dive to date - I had been to 108 feet before with no problems) and then back up to 80 then to the shallows for some sea turtle time. This was followed by a drift dive through a channel with huge schools of Jacks paired up for mating with a max depth around 80 with plenty of time in the shallows and safety stop. We had lunch on a beautiful beach on Apo and I was excited to get back into the water. The third dive was shallower at 60 feet with schools of hundreds of Red Toothed Trigger Fish with the usual extra couple of minutes beyond the recommended 3 minute safety stop and a long time in the shallows. My dive computer was fine with my profile and everything seemed to be good as we headed home.
When I got back to the hotel I noticed that I was dehydrated and that something didn't feel quite right. I stayed away from the beer and made sure to drink a lot of fluids and turn in early. I had a slight tingling sensation in my pinkys and felt a little off, but seemed ok. At 4 a.m. 12 hours after I had gotten out of the water I knew that something was wrong. I woke up and my right arm and hand was sore and tingling as well as having weakness in my grip along with a feeling of strange puffiness, like a small sponge had embedded itself underneath my skin -- not good. I woke up my friend and dive buddy who dove the same profile and was absolutely fine. Both he and the head of the dive shop were both pretty certain that it was just some of the normal pains that sometimes come up, but they didn't dissuade me from seeking treatment and so DAN, (Divers Alert Network) who provide support and insurance for divers, was called at 8 in the morning. DAN told me to get oxygen for a couple of hours and check back in.
I went to the hospital and was put on a bed in the ER with oxygen. Of course this is the Philippines and one of the better career paths for young Filipinos is to become nurses and work abroad. As the only westerner in the ER all of the nursing students came into my area for a chat and to check on me. I had my vitals taken 6 times and was asked about my conditions by no less than 12 people. At one point I was surrounded by about 8 doe eyed nursing students looking at me like I had just returned from a mission to mars, asking me questions about visas and how much money you can make in the US. After the all the attention and getting some O2 I was feeling better and had some lunch. I called DAN expecting them to say that as long as the symptoms were getting better that I was fine -- that is not what they said however. I had a reprieve, but was not "out of the water" yet and I needed to go to a chamber to get evaluated.
At this point panic began to rise. The bends can be fatal or leave people permanently paralyzed. I had been out of the water for 22 hours and the longer I waited the more damage the trillions of hemoglobin sized nitrogen microbubles were causing damage to my circulatory and neurological systems. I had done everything right, this wasn't supposed to be happening, and yet it was. Unfortunately, I was 4+ hours away from the nearest chamber facility, I wasn't able to get into the facility until 8:30 at night. It was very difficult navigating the combination of boats, private vehicles, buses, taxis, and confusing information to get to the chamber.
I went to the recompression chamber on the Lapu Lapu military camp in Cebu, the second largest city in the Philippines. I remember sitting down, explaining my symptoms to the Doctor, and having him tell me: "We are going to put you into the chamber, table 6". I completely lost it at this time and started crying. It had been about 30 hours on and off of symptoms that had started off mild getting worse and worse, with very little sleep, an exhausting trip, coupled with a being in the cold water for 2 and a half hours, plus I was having neurological problems with concentration and dizziness. After I calmed down they put an IV in my hand we climbed into the small steel chamber.
You have to slither into a decompression chamber and lay down flat on a small bench. There is a tiny window and a small light. The door has two latches and looks like a torpedo tube. There is a definite "clunk" sound as it locks tight. Then the air comes in. Compressed air is blown in and you "dive" down to 60 feet. The pressure affects your vision and your hearing, things become muted. The air is damp from your breath and the melting ice that is packed inside to keep it from turning into an oven. Its hot and humid and yet the steel walls are cold and wet. There is an attendant that goes there with you. In my case Technical Sergeant Aga from the Philippine Army, a medic, who does this a couple times a week. He was great as was the rest of the staff there. Once you are a depth, the bubbles go back into solution in your blood and you go through a cycle of breathing pure O2 and air while slowly coming up the the surface over a period of about 5 hours.
At first I kept saying to myself. "I can't believe this is happening." It was one of the strangest experiences of my life. Unlike the hospital which had two little tubes in my nostrils to deliver the Oxygen this was a full mask, a modified fighter pilot mask that encompasses most of your face. Its hard to breath through and the pure oxygen under that pressure can be toxic so your body struggles to breath. You are on for 20 minutes and off for 5 throughout your time in there. Its a cycle that moves from overwhelming to very boring after a couple of hours. To pee there is a modified bleach jug that you use, its pretty intimate in there. The sounds are of you breathing like darth vader, the breaths of the attendant, and the sounds as compressed air is moved in and out of the chamber. After 5 hours following USN treatment table 6, I heard the chunk of the door and the fresh night air came drifted in. I felt much better.
My case was Type I because my symptoms were milder than average; it could have been much worse. I needed a follow up treatment a two days ago for some residual symptoms that probably could have been avoided if I had gotten to the chamber sooner. They said that most of the people that they treat are in much worse shape, partial paralysis being the common sever symptom; as large gas bubbles press up against the spinal column, so I was lucky in that respect. Additionally, I have insurance, and the two treatments only cost $1100 in total -- that is for 3 technicians, a doctor, a hospital, and the chamber itself. Pretty remarkable really, the same thing would probably cost $12,000 in the US. I now have some slight numbness, soreness, and a mild headache. This is good progress after a week and I expect to have a full recovery in a week or so.
After my experience I would offer the following advice: if you dive please get insurance and call DAN if you have questions or concerns-- they are very helpful. Call as soon as you can if you are uncertain, denial is a big problem with decompression sickness and an objective third party is very helpful.
It is unclear what went wrong. Perhaps it was the cold or that I got dehydrated or my surface interval wasn't long enough, or I went too deep, or the extra dive, or something else. My dive computer keeps a record of all the dives and I plan to download the data and send it to the manufacturer and a dive doctor to see what they can determine. Until then I won't be diving. And I am thankful that I am ok after one of the most serious medical events that has happened to me and look forward to being able to dive again, obviously with more caution next time. Thanks to Dave my dive buddy for reassuring me and to Mike and the folks at Adventure Dive, who were very helpful,
If you are curious to know more about the bends read here:
