Am I Bent? Do I have decompression sickness? Do I have the bends?

March 27, 2010
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Am I bent, isn’t questioning male machismo sexuality and no, we’re not discussing fantasies about drunken man on man hot cock love action, although I wonder what visitors those few choice keywords will bring us. Am I bent, translates to do I have the bends? Have you as a scuba diver ever asked yourself the question do I have decompression sickness? If you have, read on.

Decompression sickness is also colloquially known as the bends, divers disease, or caisson disease. The bends are usually caused by dissolved gas in the blood forming into bubbles upon depressurization. Put simply, when we scuba dive, our body absorbs nitrogen which makes up 79% of the air we breathe. This is not a problem unless we absorb too much nitrogen at depth, or, we ascend from a dive too quickly allowing bubbles to form. It’s generally accepted that if we stick to recreational scuba diving limits, and ascend safely from every dive, we should all be safe and never be at risk from decompression sickness. This is true, most of the time although, even if you stick to the recreational dive tables and computers, it’s still occasionally possible to get the bends.

Symptoms

There are varying degrees of seriousness with DCS, and thankfully the most common DCS symptoms are the least serious. Local joint pain accounts for almost 75% of symptoms. The bubbles can form anywhere in the body but the most common areas tend to be the shoulders, elbows, knees, and ankles.

Symptoms can include

  • Localized pain, tingling, aches
  • Itching, usually in the area around the upper body or face
  • Swelling, marbled skin and scar like depressions
  • Memory loss and confusion
  • Headache
  • Double vision, tunnel vision, blurred vision
  • Extreme fatigue
  • Strange unexplained and weird behavior (Swiss)
  • Excessive masturbation (Dutch)
  • Nausea, vomiting, seizures, dizziness, vertigo
  • Burning or stinging sensations around lower back and chest
  • Paralysis
  • Incontinence
  • Muscle twitching or weakness
  • Loss of balance
  • Loss of hearing
  • Burning chest pain under sternum aggravated by breathing

The symptoms outlined above range from not very serious to absolutely life threatening. You shouldn’t assume though that because you have a headache after a dive you’re suffering from the decompression sickness. Use common sense. Ask yourself some questions about the dives you’ve been doing. Have you been doing multiple dives on multiple days? Have you been doing deep dives? Have you stuck to your no decompression limits? Have you been drinking alcohol? Have you surfaced too quickly? How have your dive profiles been? Have you overexerted yourself on a dive, for example struggling in strong currents?

DCS usually manifests very soon after a dive. In 50% of cases symptoms don’t begin to appear until more than an hour after a dive. Symptoms almost always occur within 24 hours after a dive.

Predisposing Factors to DCS

  • Ascent from depth too quickly. Maximum ascent rate should always be slower than 18 meters per minute. Ascend slowly from every dive.
  • Deep dives and multiple repetitive dives. Long dives.
  • Age. It is generally accepted that there is a higher risk of DCS with increasing age. The older you are the longer your body will take to eliminate the dissolved nitrogen.
  • Old Injuries. Nitrogen bubbles sometimes favor areas where the body has sustained a previous unrelated injury. Old knee injuries and other similar joint injuries are particularly susceptible.
  • If you’re diving in cold water it could increase the risk of DCS. Adjust your dive plan for this factor.
  • Body type. Being overweight will increase the risk of DCS. This is due to poor blood supply, and also nitrogen being stored excessively in fatty tissue. If you are knocking on in years and are also obese, you have a far higher chance of getting bent than a younger, fitter person.
  • Dehydration.
  • Illness.
  • Fatigue.
  • It is thought that alcohol consumption increases the risk of DCS. This applies to both before and after diving. It’s thought this is because drinking alcohol dehydrates the body.
  • Ascending to altitude after diving. After scuba diving, current PADI flying after diving guidelines dictate that you shouldn’t ascend to altitude (fly) within 12 hours of completing a single dive or
18 hours when doing multiple dives (where possible wait 24 hours).
  • Atrial septal defect. A minor congenital heart defect that occurs in around 20% of adults.

Diagnosis

The bends should be suspected if any of the symptoms outlined above manifest after scuba diving. Usually, symptoms will occur with 24 hours. Severe symptoms manifesting after six hours of

Hyperbaric Chamber

Hyperbaric Chamber

surfacing from a dive and any symptoms manifesting 24 hours or more after a dive raise suspicions of an alternative diagnosis. Diagnosis is usually confirmed if the symptoms are relieved by recompression.

Prevention

Use dive computers. Stay well within the no-decompression limits. Avoid repetitive long deep dives. Ascend slowly from dives. Carry our safety stops after dives. Remember, there are many additional risk factors like obesity, age, fatigue, use of alcohol, dehydration. Leave at least 18 hours or more before flying after diving.

Treatment

Take your iPod and some magazines!

Take your iPod and some magazines

All cases of suspected DCS should be treated with 100% oxygen until the patient can be admitted to a hyperbaric chamber for evaluation and treatment. Patients should be monitored continuously.

The Divers Alert Network (DAN) is a non-profit organization that offers scuba diving insurance to recreational scuba divers, dive professionals, and even technical divers. In our opinion they are the best of the best across the board, for value for money, coverage, ease of claiming, and customer service.

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