DCI and freediving

[Simos]

Simos, at 43 and believing age to be a major contributing factor to DCI I wont be sailing down that route.

I wouldn't worry too much if I were you omega3, there are no documented cases of 43 year olds with DCI from freediving. Should be fine. :crutch

You'd make a bit more sense if instead of 'dramatic' entries into the discussion and references to 'myths' and this 'Herbert fella', you clearly stated your views and position (if any) on the subject.

You might have some valid points that need to be brought to the discussion, but it's a bit hard to see between all the rest of the noise.

The points on Herbert's attempt and lack of hyberbaric chamber on site is irrelevant in my opinion and should be left out. None of us was on that team, we don't know how the options were weighed and it was, as it turned out, a private attempt. Now whether AIDA would have let the attempt go ahead is another story but it never came to that (if I were AIDA, I would have a think about that though).

If you think for example AIDA should be making mandatory having hyberbaric chambers on site for competitions of a certain status or max depth, it's another story and a more meaningful discussion.

 

[ThomasB]

And the troll quickly disappeared...

 

[trux]

@ Trux. 1oo's? Where? genuine proven cases and treatments, evidence. Apart from freedive websites this info seems to be scarce.

Documented cases...next to none. Really, pearl divers in the 50`s. See Japanese journal of hyperbaric medicine 2001 and tell me that is not vague.

OK, I understand that someone who is not interested in the topic may be thinking the DCS is no problem at freediving, but really do not understand how someone apparently an expert may claim there are no documented cases, when there are dozens of them well mediated, and several times more of documented cases not so notorically known.

If I focus only on the well known cases, then besides the latests case of Herbert, the first big case was that of Benajmin Franz, then that of Carlos Coste, Christian Maldame, or lately Branko Petrovic. Also other top freedivers were treaded in hyperbaric chambers after showing DCS symptoms - for example Patrick Musimu, Eric Fattah, or Sam Kirby to name just some of those discussed here on DB. Also the latest accident of Martin Stepanek might be associated with decompression according the MRI diagnostics. All of the freedivers were treated in hyperbaric chambers, and their cases are well documented, so if you are interested, you may be able to obtain the documentation.

You can also contact Dr. Richard Vann at DAN, who collected some data of DCS at freediving, and may be willing to share them. Personally, I have send him a dozen of cases for closer investigation, and I know he had many more.

There are also dozens of scietific studies adressing the topic of DCS at breath-hold diving. Although the oldest of them are indeed based on the data collected from amas and pearl divers, the newer ones are based on modern diagnostics, and on recent data. I list some of the studies at Apnea.cz here (but the list is not complete - I am aware there are studies not yet in my database): DCS @ APNEA.cz

The physiology and pathophysiology of human b... [J Appl Physiol. 2009] - PubMed - NCBI
[Central nervous system involvement ... [Sangyo Eiseigaku Zasshi. 2003] - PubMed - NCBI
Central chemoreflex sensitivity and sympathet... [J Appl Physiol. 2008] - PubMed - NCBI
Decompression sickness following repeated breath-hold dives
divess.htm
Nitrogen tensions in brachial vein blood of Korean ama divers
http://docs.ksu.edu.sa/PDF/Articles34/Article340661.pdf
http://www.journalarchive.jst.go.jp...urnal=joh1996&cdvol=43&noissue=1&startpage=56
Diving to Great Depths
Decompression sickness following seaw... [Res Sports Med. 2007 Jul-Sep] - PubMed - NCBI
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Medscape: Medscape Access
Science Links Japan | Decompression illness caused by breath-hold dives.
ingentaconnect Neurological Disorders After Repetitive Breath-Hold Diving
Can Freediving Cause DCS?
[Central nervous system involvement ... [Sangyo Eiseigaku Zasshi. 2003] - PubMed - NCBI
Nitrogen tissue tensions following repeated breath-hold dives.

 

[Fondueset]

The Force is Strong with this One

 

[trux]

... and as for the portable deco-chamber, I believe the team of Herbert certainly considered that option too. The cost is not extreme, but the problem of portable chambers is that they usually do not permit any treatment of the patient or manipulation with him, so in case of the need (for example loss of consciousness, CPR, etc.), the chamber needs to be decompressed, which may actually cause even more harm than no recompression at all. Besides it, portable chambers typically allow only small overpressure, which may not be sufficient for extreme deep dives of this kind. And then, using the portable chamber could considerably delay and complicate the transport to the hyperbaric clinic, again causing more harm than help.

So I do not think we are in the position to judge whether Herbert's team decided well or not when they opted for the direct air-lift, and against using the portable deco-chamber. And I do not think that the cost played a role in Herbert's case. More likely it was a rational decision.

 

[omega3]

Not quite but there was a great bbq under the bridge that i had to tear myself away from the pc for.( Wife is a bit worse for wear but should survive) as *I said, looks like a lot of thought *has gone into this. What i think is ...If A definite *problem ie dci has been identified in whatever manifestation then it would be rational to take necessary precautions for the event. To not do this would give the impression of foolhardy behaviour and support of which is the same. Dci in all its manifestations being far from easily understood in trigger, identified, treated etc. it is a broad claim to able to diagnose as such and just as foolhardy to treat as such . If adequate knowledge is not there to either identify/diagnose /treat a problem then it is chance. That is all very well for an individual but irresponsible to sponsor, market, advertise profit from etc. Money better spent on research perhaps but more like blood from a stone if the money is rolling in and it is accepted. Doppler and ultrasound I have been involved with to monitor gass in circulation, however this is not through barotrauma but normal gaseous exchange in the lungs in set conditions. Short term varying tissue uptake time/pressure/work/type. Work not being a big factor in freediving surely! maybe so i have no idea if they are of use but can admit it ,however *it did look great watching hundreds of bubbles going through my heart and listening to them in the armpits. If dci is a result of barotrauma then this should be identified/addressed to obtain the cause as dci is broad spectrum in its manifestation as is a resultant barotrauma, chicken egg maybe?Is there a predominant manifestation type? Nobody is naming any,just blanket "DCI" Therefore if dci is a known issue(as claimed here) in freediving it appears foolish to me to conduct it without access to adequate treatment and libellous where business support is involved. Simply *making money out of someone's risk taking. To not acknowledge it is a license to carry on making profit,to heck with the consequences. Circus aside what you choose *to do to yourself with known risks is your own business but also then keep it private. Simply put, there are as many manifestations of dci as there are causes/triggers, *Let alone barotrauma identification cause etc (the easy ones like "his lungs are coming out of his nose and mouth" or the other biggies dont seem to be featureing here. Hint, this one falls under signs and symptoms and should be treated on the relevent treatment table depending on which ones are being used ... Easy!)and everyones favorite SWB and if these are the "knowns"to proceed with dive and not have the best facilities in place is chance.. To bring money into it... . In my view this is relying on luck. There would appear to be a hefty reliance on luck
In freediving and very little knowledge in consequences or reason except in how deep one can go and how long one can hold their breath. It is little wonder there a void in information here as it would appear commercially non viable/usefull except in the advertising and marketing industry associated with. Showbiz!! This lot should put some money back into it instead of leaving enthusiasts to deal with it with the only source of info being tests on a seal in the 40's or pearl divers in the 50's (apparently some "fell over" and " some died" ) weighty evidence indeed! It's a lose lose situation to identify DCI as a problem and not put support in place as is to not identify it and not have support in place as is to have support * in place , not be able to identify and correctly treat etc. this behaviour can only go so far under the banner of new ground, emerging issues, the unknown etc as folk go deeper (which DCI has no regard for or repets etc)to maybe prove a theoretical/personal*limit, break *it etc with no heed for what is generally accepted/known in the public domain if to be regarded as a specialist/professional and not foolhardy. *It is by no means just freediving that this behaviour is evident but many amateur "extreme" sports/practices and many pro ones too, boxing being a classic example. *Is it this reasoning that makes them "extreme"?*
Everybody loves a risk taker.*

To summise.*
low altitude evac etc.... On the cheap!!

There is no substitute for an onsite chamber twin lock bibs with the option of saturation with qualified diving doctors. These are containerised units these days.

Trux... That took days of google no doubt. I believe your impression of hyperbaric medicine is dated... Mid 70s at a guess. Thanks for trying anyhow but if you can't convince me being all for it contrary to popular opinion, who can free divers convince this is an issue.


O2 is fine for transport to the chamber and making that crucial decision of wether or not the casualty is a chamber case.*

This is what all divers require with DCI

Anything else is on the cheap

In water stops...done away with
Sur d 02 ... Done away with
Air evac... Done away with
Well in the modern environment. Still killing folk elsewhere I believe.
Catch up I hear? Looks like this could be the way forward in freediving with in water stops on 02
Here is one for *all who have suffered from a "dCI" freediving.... Did you stop diving given that reoccurance is highly probable? Or maybe push on?

Cost vs what ?
You tell me?


It's not my fight ... DCI in freediving is a myth. If dci is a proven issue correct treatment should be demanded. This is not new ground outside of freediving.

Here, wet your appetite boys n girls if you really need a chamber!
This lot are just up the road from me. I am currently using one of their newest systems...very nice!

Home › Divex Global

What is there to not understand about the treatment of DCI?


Back to the bridge, it's goat stew tonight! 3 times the same thing, I'm feeling lucky!

 

[trux]

If A definite *problem ie dci has been identified in whatever manifestation then it would be rational to take necessary precautions for the event.

DCS as well as barotrauma and other possible problems at freediving are real, but those are real even at almost every ordinary recreational scuba dive too. Still it does not mean that at every such recreational scuba dive there is a floating hospital on the site with a team of expert physicians on standby.

Work not being a big factor in freediving surely!

I do not understand what you mean and how much you know about freediving and about DCS. While at No Limits dives there may not be big effort needed, at all other disciplines there is much more effort (work) involved than any tech diver can imagine. Or do you really think that descending with fins to 125m and coming back in 3 minutes is no work??!

Then, if you are really an expert on DCI as you seem to claim, aren't you aware that the level of CO2 is a very important factor for DCS and for N2 narcosis, and that it is one of the main reasons the workload underwater is considered a risk? Do you understand that a freediver, even the one doing an effortless No Limits sled dive, is loaded by CO2 much more than any tech diver even under the worst workload can ever be?

Trux... That took days of google no doubt. I believe your impression of hyperbaric medicine is dated... Mid 70s at a guess. Thanks for trying anyhow but if you can't convince me being all for it contrary to popular opinion, who can free divers convince this is an issue.

No idea what you are speaking about. It ony shows clearly that you did not open a single link from those I posted, otherwise you would have to see that almost all of them were published after 2001, with a bigger number after 2007. I did not google them out, they come from the Apnea.cz database that collects documents via RSS from diverse publishers of scientific literature. If I start googling, I'd show you ten times more links, but it likely has no sense because you seem to be persuaded you are smarter than all the teams of expert scientists, and know for sure that DCI at freediving is a myth.

 

[omega3]

Yes. I now understand,,,at a sponsored event, cameramen/advertising/management team etc. are more important and the element of "DCI" adds to the performance risk factor.

Thanks, clear as day now... good luck with that.


Trux, this is one of your links

Decompression sickness following repeated breath-hold dives

Read the lead in sentence. Check out the references, absorb the treatment

My time is being wasted now.

have a good un!

 

[Fondueset]

Well I feel better. This noise has been made constructive by Trux. Omega's posts contain a somewhat chaotic mix of messages. First there is decrying the ostensible recklessness of 'sled diving'. I will refrain from expressing an opinion - except to say I believe this activity is separate from other forms of free diving.

More problematic is the assertion that DCS in free diving is a 'myth'. I suppose it is possible to define most anything in a way that makes it possible to deny it's existence - but my understanding is that DCS is a collection of highly varied symptoms associated with rapid changes in blood-gas volume during ascent from depth - hence the term 'De-Compression-Sickness.'

 

[Giobbi]

.. If you filter out Omega3 its really interesting reading, thanks.

 

[trux]

Trux, this is one of your links

Decompression sickness following repeated breath-hold dives

Read the lead in sentence. Check out the references, absorb the treatment. My time is being wasted now. have a good un!

Omega3, I do not want to descent to invectives, but have to admit you make it very hard for me. I've sent you 17 links to works speaking about DCS in freediving. 15 of them are from 2001 or later, and 10 of them are newer than 2006 or 2007. Only two documents are older than 2000, and only single one of them, for historical reference, is from 1964. But you find nothing better than backing your claims by exactly the oldest document that was written in the time when competitive freediving did not exist yet, and when doctors still almost believed human cannot descend beyond 50m.

Now tell me more about your wasted time.

 

[omega3]

Fellows, we moved on from DCS to DCI over 10
years ago.

Trux. That example is your document backing your claim
Have a look at it.

Well anyway, if I was at a sponsored/commercial event even as a bystander
And there was a risk of DCI I would demand a suitable treatment system in place.

Honestly it's there and you can do it.

Good luck

 

[ThomasB]

Fellows, we moved on from DCS to DCI over 10
years ago.

Trux. That example is your document backing your claim
Have a look at it.

Well anyway, if I was at a sponsored/commercial event even as a bystander
And there was a risk of DCI I would demand a suitable treatment system in place.

Honestly it's there and you can do it.

Good luck

Omega, any chance you sell one?

 

[Mullins]

if I was at a sponsored/commercial event even as a bystander
And there was a risk of DCI I would demand a suitable treatment system in place.

Choice of safety equipment is generally determined by the level of risk, not by the fact that the risk exists at all. I like the thought of somebody making demands as a bystander though. You tell 'em!

 

[trux]

Fellows, we moved on from DCS to DCI over 10 years ago.

Hmm, that's new to me. Finally, it looks like you are not that big expert on DCI/DCS as you attempt to appear as.

From Wikipedia (and you can find similar definitions on other sites as well):

DCS is commonly known as the bends, and is caused by a drop in pressure causing gas to come out of solution in the body's tissues and fluids.

DCI is a group of disorders, usually understood to mean both DCS, and air embolisms. Barotrauma is also associated to rapid assent, but is due to overexpansion of the confined air in the lungs as a result of holding ones breath which causes it to pop - see pneumothorax.

So when we speak about decompression problems at freediving, DCS is better suited, since an ascending barotrauma is by definition not a problem at freediving (though there may be perhaps some exceptions at packing freedivers with strong bloodshift). Diverse other types of barotrauma, oedema, or injuries induced by packing or by strong diaphragmatic contractions, or by a barotrauma in collapsed parts of lungs, are also an option, but when we speak about nitrogen (or at freediving increasingly likely also about the CO2) gas bubbles, DCS is a more suited term than DCI. I see no reason why it should be over 10 years ago. If you can explain, I am one ear.

 

[omega3]

ThomasB.... What do you need?

@ Mullins... Or I wouldn't be there to watch the spectacle/circus of someone
Trying to kill themself, or want any part of it. By your reasoning there is no risk as there is no adequate treatment in place/available, ergo DCI in freediving is a myth!

Trux... How's that wheel coming along? Take a look at the original post 3rd paragraph. Particularly congested sinus. Could it be feasable that squeeze resulting barotrauma offers a viable direct pathway for air to enter the circulatory system, assited by overpressure with equalisation?

The topic is DCI in freediving. Maybe you can get that changed to read DCS!

Who said they were an expert? this is bread and butter stuff. I am flattered mind. Assumption, we all know what that is the mother of!

Have a great week

 

[Mullins]

You're trying a bit too hard there omega3, and making no sense. It's clear there were several systems in place and Herbert did get treatment. His dive profile was designed to reduce DCS risk, he did immediate deco on O2 following the dive and when he still wasn't well he was taken to hospital.

 

[omega3]

Gentlemen, fellows, buddies
Please accept my humblest sincere apology. I can see now that you are struggling and in need of a lot of help. Mullins, I did try hard but obviously not hard enough.

its a case of (pic 1)


and not as you previously thought(pic 2)


and a great deal of (pic 3)

Let me be the first to tell you that DCS is being phased out this was due I believe to issues with signs and symptoms relating to treatments. Here is a link(not googled) to one of the world leaders in hyperbaric medicine in which you can see what the new format is like.

Diving doctor, hyperbaric oxygen therapy and decompression chamber London | Londonhyperbaric.com

As I said this started coming in over 10 years ago. Wikipedia and google are not ideal sources of information.

Let me continue...

 

[omega3]

to make no (pic 1) about it

If you are going to dive and risk (pic 2)

You need one of these (pic 3)

The newer ones are nicer. It is a living chamber mind(pic 4)

 

[omega3]

As to flying please see DMAC flying after diving DMAC 07 rev. 1 March 2001
reccomendations Caution 2 if you are in any doubt.

It may interest you that I have several of the full dive treatment schedules of divers killed by diving doctors. Think about that before you lay your trust blindly in someone elses hands.

If risking getting (pic1) for (pic 2) Insist on (pic 3)