When you admit it's not just a sore shoulder
I remember sitting at my computer, thinking about all that ibuprofen I’ve been popping for the last 18 hours… and wondering… why is the dull aching pain in my shoulder still constantly there…
I then start thinking about how I should break out the O2 kit from the garage and test that niggling feeling I’ve been having in the back of my head… Could this be more than carrying a bunch of tec toys down and back from the water, more than the windy, wave filled… wow we should have called it entrance and exit?
Could I be bent?
Yup. Short answer is… yes. With 5 min of that sweet, sweet O2, the dull ache in my shoulder went away. But of course , I tell myself that’s psychosomatic. I stop breathing from that O2 deco bottle… and in about 5 more minutes, that dull shoulder ache comes back. Rinse and repeat two more times. The whole while on a conference call for work, with my mind racing… seriously, how in the world could I be bent? Well after 3x, with the pain always going away on O2… I tell work I need to take care of something and I’m off for the rest of the day, and I head out to the garage to download my dive profile from the morning before, because I know they’ll ask me for details about my dive.
After getting through right away, I start explaining my symptoms the timing, and the dive profile. Yes, it was a tech dive, on my rebreather. Dive went fine. I ran a 1.3 PO2. I was cold at the end of the dive. No real symptoms other than a sore left shoulder starting about an hour after the dive… but who doesn’t have that? As someone who’s torn both shoulders playing volleyball… I often hurt after lugging around dive gear. Anyway, they suggest I go into Virgina Mason. I ask how to get into the hyperbaric chamber, I don’t think I can go directly there??? Nope. DAN advises me to walk into the ER, and tell them I have a diving injury…
So I call my wife, tell her what’s going on… and not knowing how long this might take, call a Lyft to drive me into the ER. Once at the hospital, things went amazingly fast…
I’d guess 45 min total time before I was in the chamber. Once they heard about my diving injury, the triage nurse took my vitals, made me sit down in a wheelchair, and she pushed me back into an ER room… already full of four people. Who took more vitals, blood, got an EKG, and put me on Oxygen… then the ER Doc was in right away. She was great. I again explained my symptoms, which were already abated by oxygen. She called for a chest X-ray, and a COVID test, and a consult with the on staff hyperbaric doctor. Suddenly an X-ray tech is in there, with her cool cart, taking chest X-rays. Then the ER nurse comes back in to check on me; I mention I don’t know if the ER doc & the hyperbaric doc have spoken and could she check… and in walks the hyperbaric nurse. He asked about my dive, and if I’d be up for another one… He explains a nice young woman is downstairs and was about to start her treatment, but when they heard about me, they held off so I could join her.
So if you haven’t heard of a table 6 treatment, it’s the default recompression model from the Navy Diver Manual.
That gives you about 6 hours to contemplate what happened… plenty of time to go over the dive, pre dive, what could have happened for you to bend yourself… and I think I know what happened, so I’ll lay it out for you….
TL;DR If you’re going to run heat during a dive, make sure you have heat at the end, while you’re decompressing
Lots of things went wrong on dive day… for one thing, there were 25 mile an hour winds, that caused big waves, and even “currents” in Lake Washington. We were diving the PB4Y Bomber. A dive I’ve done many times with friends before. This time with the wind and waves, while gearing up, my lights and camera got knocked off my scooter… so we spent about 10 minutes looking for them (& found them). But to get the gear, where it had washed up on shore, I should have taken off my stages, instead I kept the left one on, and carried the extra weight up and out of the water with me… Then as we headed out after regearing, but we lost Mike, & he lost his scooter prop. We surfaced and he signaled for us to continue without him. So we did. Dive time now is around 13:21 But when we headed out east, we went a tad bit too far south, and so when we turned south to intersect the line (at 100′), we were already south of it (& didn’t realize) … so we scootered for a while. As my buddy Guillaume turned us around to head back north, I flipped on my heater to take care of the cold; I thought we might not be finding the bomber today anyway…. But low and behold a few minutes later, we found the line, and had a great dive on the plane.
After we’d had our fill of this gorgeous wreck, we turned the dive and headed home. Uneventful. Deco was easy, and felt comfortable, up until I suddenly felt cold. Oh, yeah that battery pack is drained. Fear not, I have another. I switched e/o cord leads to my second battery pack, and flipped it on… But alas, never felt any heat…. oh well, 15 minutes of cold deco for me. When I was “clean” (theoretically), G had another few minutes left of deco, so I waited for him to clear. And we headed back to the beach.
Decompression profile for the dive
Dive profile from my secondary Shearwater petrel wired to one cell
By this time, the waves were even worse, but boy were we glad to see Mike in his dry suit, there to help us get out. He made the exit process much better than it could have been.
So after we got all our toys back to the truck, and Guillaume showed off his new surface heater connection (for when you’re chatting after the dive), we decided to pack up and forego the usual celebratory after dive beers.
It wasn’t until I started driving home that my left shoulder started bothering me, and I was regretting not removing that other bailout bottle when I went to retrieve my GoPro. I got home around 5p, popped some ibuprofen (800mg), and snuggled up with my pups, after putting away all my scuba toys. Boy was I tired. I lazed around the afternoon, and around 9p, popped 800mg more ibuprofen, and went to bed. But I didn’t sleep very well, and my shoulder kept me from getting a good night’s sleep. I’m a side sleeper, and I prefer my left side…
Woke up in the am, popped some more ibuprofen and started the work day….
Reflecting on what likely went wrong… it was that 15 minutes of cold decompression AFTER 45 min of nice warm on gassing at depth… no bueno. Textbook what NOT to do. Preferably you’d be warm the whole dive, but typically I start cool, do the deepest part of my dive cool, and then turn on my heat when I leave the bottom and start deco.
So I guess the moral of the story, even with plenty of dives under my belt, and doing a bit of extra deco time to keep it “safe”, other factors you don’t think potentially enough about (such as your environment, stress, temperature), can add up to you getting bent.
I’ll be fine. This was a relatively minor hit, with isolated pain in the muscles and joint with extra stress (from leaving that deco bottle attached while I retrieved my camera setup). I feel fine now, with only “normal” soreness in my left shoulder. I have a checkup with the hyperbaric doc in 30 days.
I’m fine now. But 30 days of no diving for me
Should we have called the dive earlier? Probably.
Will I be more cautious with my judicious use of heat in the future (and ensure all my gear is working well)? Absolutely.
Will I add a bit of buffer to the gradient factors I run? Yes. Today I run one computer on 30/85, the other on 15/85. I’m not sure where I’ll land yet, but it will be more conservative.
And in case you’re thinking, I wonder if he has a PFO? I got myself tested years ago when I first started tec diving… just to ensure I wouldn’t get bent. So, I don’t think I have a PFO, (or one that’s easily detectable) anyway…
Stay safe out there folks!
Me in the Gumby suit, with the pure O2 only inside my neck fitted bubble helmet
A few funny anecdotes from the hyperbaric chamber since you read this giant wall of text already.
There are no electronics allowed in the hyperbaric chamber (so bring a physical book, not the Kindle, iPad, and phone like I did 🤦♂️)
They serve you food inside, on your “ride”! There’s an additional small airlock for them to pass in supplies, like water, books, or magazines (see no electronics note above), and “lunch”. But you can only eat lunch during your 5 min air breaks, and with COVID, we had to take alternating air breaks for food / isolation. So eat & drink fast.
As they bring you down to depth, and compress all that air in that tiny room, it gets super warm. I think the EMT in there with us said it can get up to 107′ F (for a few moments, until they cool it back down). I know I was sweating.
The whole chamber isn’t filled with Oxygen, it’s regular air. So you have to wear the gumby helmet above, for them to serve you oxygen for your 25 min on, 5 min air breaks.