{"id":27039,"date":"2024-06-03T14:31:15","date_gmt":"2024-06-03T18:31:15","guid":{"rendered":"https:\/\/world.dan.org\/?post_type=dan_alert_diver&p=27039"},"modified":"2024-06-03T14:31:21","modified_gmt":"2024-06-03T18:31:21","slug":"the-cryptic-patch","status":"publish","type":"dan_alert_diver","link":"https:\/\/world.dan.org\/id\/alert-diver\/article\/the-cryptic-patch\/","title":{"rendered":"The Cryptic Patch"},"content":{"rendered":"

After getting my dive certification in 1992, I was instantaneously addicted.\u00a0Being young, obsessed, and convinced of my immortality, I was not the most conservative diver, but I had no issues with decompression sickness (DCS) for my first decade of diving.\u00a0I battled breast cancer between 2003 and 2006; after my treatment (chemotherapy and four surgical procedures), I became far less of a daredevil. <\/p>\n\n\n\n

I was every bit as addicted to diving, however, and when I had my first experience with skin bends (cutaneous DCS) in 2008, I was diving multiple times per week in San Diego, California.\u00a0My first hit \u2014 an itchy patch on my abdomen \u2014 happened on a liveaboard after my fourth dive of the day.\u00a0My hit seemed more unlucky than unlikely; I was diving a conservative profile and had cleared my decompression obligations.\u00a0But it wasn\u2019t a fluke. <\/p>\n\n\n\n

I experienced skin bends \u2014 the same presentation in the same location on my abdomen and, curiously, always after diving in a drysuit \u2014 several more times during 2008, even following extremely conservative profiles. After multiple DAN calls and medical consultations, I was no closer to understanding why this was happening. <\/p>\n\n\n\n

\n
\n
\"The
The author on board a California dive boat after enjoying a dive.<\/figcaption><\/figure>\n<\/div>\n\n\n\n
\n
\"The
The author diving on the HCMS\u00a0Yukon\u00a0in San Diego, California\u2019s wreck alley, one of her favorite local advanced dives<\/figcaption><\/figure>\n<\/div>\n<\/div>\n\n\n\n

Due to the timeline, presentation of my symptoms, and the types of diving I was pursuing, physicians suspected that my propensity to develop skin bends was associated with my cancer-related surgical history and associated scar tissue rather than a cardiac defect, such as a patent foramen ovale (PFO). The consensus was that an echocardiogram was unlikely to uncover a cardiac issue, so it wasn\u2019t urgent to pursue testing. I felt reassured and was becoming adept at preventing skin bends through a blend of nitrox use, extremely conservative profiles, avoidance of drysuit squeeze, and extended safety stops, so I didn\u2019t bother to get tested.  <\/p>\n\n\n\n

Over the subsequent 15 years, I uncommonly experienced skin bends, probably because I spent more than my fair share of time performing long safety stops out of caution.\u00a0Then a friend who had been diving with a large PFO for years suffered a devastating stroke (PFO is thought to be a risk factor for ischemic stroke). Shaken, I finally reached out to my friend Dr. Douglas Ebersole for advice. After a lengthy discussion and the extraction of a promise from Dr. Ebersole to act as my surgeon if needed, I was ready to move forward with testing. <\/p>\n\n\n\n

I contacted the hyperbaric department at the University of California San Diego, knowing what to expect because the procedure had been recently described in \u201cThe Possibility of a PFO\u201d (Third Quarter 2023 Alert Diver<\/em>). Three months later, I watched nervously as my ultrasound specialist performed a transthoracic ultrasound with a bubble study, trying earnestly to impress him with my Valsalva technique (intended to increase the test\u2019s sensitivity for PFO detection).\u00a0My results arrived days afterward: They were perfectly normal, with no evidence of intracardiac shunt.<\/p>\n\n\n\n

I was flooded with a mixture of emotions.\u00a0I felt relief, of course, knowing I didn\u2019t need to consider surgical closure of a cardiac defect. But I also felt a little frustration, knowing that there was nothing I could just fix. If I wish to avoid that itchy patch of skin bends, I will always have to dive conservatively. <\/p>\n\n\n\n

Regardless, I\u2019m grateful to have an answer to the question that has always been in the back of my mind. I suppose more obligatory time spent hovering in shallow water is not the worst penalty after all.<\/p>\n\n\n\n

<\/div>\n\n\n\n
\n\n\n\n

\u00a9 Alert Diver<\/em> \u2014 Q2 2024<\/p>","protected":false},"excerpt":{"rendered":"

After getting my dive certification in 1992, I was instantaneously addicted.\u00a0Being young, obsessed, and convinced of my immortality, I was not the most conservative diver, but I had no issues with decompression sickness (DCS) for my first decade of diving.<\/p>","protected":false},"featured_media":27038,"template":"","dan_alert_diver_categories":[480],"dan_alert_diver_issues":[491],"class_list":["post-27039","dan_alert_diver","type-dan_alert_diver","status-publish","has-post-thumbnail","hentry","dan_alert_diver_categories-member-to-member","dan_alert_diver_issues-q2-2024"],"acf":[],"yoast_head":"\nThe Cryptic Patch - DAN World<\/title>\n<meta name=\"description\" content=\"After getting my dive certification in 1992, I was instantaneously addicted.\u00a0Being young, obsessed, and convinced of my immortality, I was not the most conservative diver, but I had no issues with decompression sickness (DCS) for my first decade of diving.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/world.dan.org\/id\/alert-diver\/article\/the-cryptic-patch\/\" \/>\n<meta property=\"og:locale\" content=\"id_ID\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"The Cryptic Patch\" \/>\n<meta property=\"og:description\" content=\"After getting my dive certification in 1992, I was instantaneously addicted.\u00a0Being young, obsessed, and convinced of my immortality, I was not the most conservative diver, but I had no issues with decompression sickness (DCS) for my first decade of diving.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/world.dan.org\/id\/alert-diver\/article\/the-cryptic-patch\/\" \/>\n<meta property=\"og:site_name\" content=\"DAN World\" \/>\n<meta property=\"article:modified_time\" content=\"2024-06-03T18:31:21+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/world.dan.org\/wp-content\/uploads\/2024\/06\/Q2_32_Member2Member-1200x600-1.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1200\" \/>\n\t<meta property=\"og:image:height\" content=\"600\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:description\" content=\"After getting my dive certification in 1992, I was instantaneously addicted.\u00a0Being young, obsessed, and convinced of my immortality, I was not the most conservative diver, but I had no issues with decompression sickness (DCS) for my first decade of diving.\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"4 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/world.dan.org\\\/alert-diver\\\/article\\\/the-cryptic-patch\\\/\",\"url\":\"https:\\\/\\\/world.dan.org\\\/alert-diver\\\/article\\\/the-cryptic-patch\\\/\",\"name\":\"The Cryptic Patch - 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