This diver made four dives on air, approaching the no-stop limits of his dive computer but making 3-min safety stops. After two days the diver suffered a skin bend, sought treatment for it and stopped diving.
An American male diver (age 46) went on a diving holiday in Cozumel. He made four dives in two days, all on air, with maximum depths ranging from to 51 ft (15m) down to 89 ft (27m), and all total dive times just over one hour long including 3 minute safety stops at the end of each dive. He felt no symptoms after the first day and went to eat dinner. Later that night he got up to pee at 11:30pm and felt soreness in his ribs but he put it down to probably sleeping oddly on his pillow. He went back to bed and felt fine in the morning so he made two more dives. The pain came back noticeably about an hour after surfacing from the last dive but this time it burned/itched just a little and he noticed a blotchy rash on his torso (see photo). The diver had read a case study about skin bends in Alert Diver magazine and remembered the blotchy rash. He went to the dive shop, they supplied him with oxygen, then after a few minutes the rash almost went away and the pain was reduced.
By now convinced this appeared to be a case of skin bends, the diver went to the hospital and was assessed by a DAN-affiliated medical doctor who confirmed the diagnosis. The doctor conducted a neurological exam to rule out more serious signs of decompression sickness then advised the diver to not dive again before flying home. Two days later the rash and soreness returned so the diver once again saw the DAN doctor and this time was given more oxygen, plus he was hydrated with an IV. The rash dissipated, the soreness resolved and the diver flew back to America where he is now recovering (some residual soreness remains).
He writes “I will be apprehensive the next time I dive – but I am planning to use only nitrox and stay away from the limits of my computer. After 25 years of diving, I guess I am finally getting old!”
“After 25 years of diving…” I know there are many divers in the same boat and this case serves to remind us that decompression sickness does not always have a clear cause. In this particular case, the diver seems to have made all the right decisions. First, he was a member of DAN and recognized his injury from reading Alert Diver. Next, he accepted oxygen at the dive shop, then sought out medical advice from a doctor familiar with diving medicine. Then he took it easy and didn’t dive again, (even though he wanted to). Finally, he returned home and reported the incident to DAN so others might learn from it.
The good news is that in all likelihood he will soon have recovered fully and can file this away with his other diving stories. If, for some reason, symptoms persist then a quick call to the DAN Medical Helpline on +1-919-684-2948 is all it takes to find the nearest diving doctor.
While many divers trust their dive computers completely, the fact is that no dive computer knows who is wearing it, they all simply estimate no-stop limits based on a theory, and that theory may have been tested on people who were physically different to the diver wearing the computer today. Although probably none of us like to admit it, the average diver is not as young as we all once were and this diver’s plan to dive more conservatively sounds like a prudent approach for avoiding another uncomfortable and inconvenient skin bend.
Peter Buzzacott, MPH, Ph.D.