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March 2019    Download the Entire Issue (PDF) Available to the Public Vol. 45, No. 3   RSS Feed for Undercurrent Issues
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Bad Stories about the Bends

how hospital protocol and a boat crew nearly killed divers

from the March, 2019 issue of Undercurrent   Subscribe Now

Rigorously following any computer decompression algorithm isn't any guarantee that you will not get bent. The important thing is to recognize the symptoms of decompression sickness, no matter how minor, and get treatment. However, as these two stories below show, so-called dive professionals aren't always ensuring sure you get the speedy chamber care you need post-haste.

Why Diving in Ontario Could Be Dangerous

What would you think if your spouse, suffering from the bends, was put into an ambulance . . . and then driven past the nearest hyperbaric facility?

That's what happened to David Phelps from Detroit. His wife, Denise, nearly died in 2016 from DCS after a freshwater dive at Fathom Five National Marine Park in Tobermory, Ontario. Their mini-vacation ended in disaster, which might have been mitigated had circumstances - and hospital treatment protocol - been different.

Denise Phelps had logged about 150 dives when she and David went for a wreck dive in Georgian Bay. They'd been underwater about 10 minutes at 33 feet when she urgently signalled to David that she wanted to ascend. She shot past him, and he found her unconscious at the surface. Once Phelps was recovered from the water, David drove their car behind the ambulance carrying her. George Harpur, the medic in charge of Tobermory's hyperbaric facility, was waiting at the door. But the ambulance drove straight on by. The protocol for treating injured divers had recently changed, and it was now necessary to triage them first at a hospital at Lion Head's, 30 miles away.

Time is of the essence when treating DCS -- Phelps's injuries could worsen or even become untreatable later. As the ambulance passed him by, Harpur called the paramedics and eventually persuaded them to turn around, but it took an extra 40 minutes. By now, Phelps was unresponsive and had to be recompressed for many hours before being transferred to Toronto. Her injuries included a rupture of both lungs and five arterial gas embolisms, and she had also gone into full cardiac arrest.

What would you think if your spouse, suffering from the bends, was taken in an ambulance . . . and then driven past the nearest hyberbaric chamber?

Every summer, thousands of divers arrive at Tobermory to explore its 20 wrecks. Since Phelps' case, three more serious diving accidents have occurred there, and in each case, Harpur has spent crucial time persuading the paramedics to go to the hyperbaric center rather than to the hospital at Lion's Head. "Every minute counts," he says. "If you cut off the blood supply to the brain, brain cells start dying within seconds."

Kelly Marcotte, owner of Diver's Den, the sole dive center at Tobermory, says, "It's nerve-racking for us to think a diver may not be allowed to go to the hyperbaric facility to be given the best care possible. The protocols that we have in place with the coast guard and Dr. Harpur are not being considered by ambulance services."

Harpur, who has run the chamber since the 1970s, says neither the Canadian government, Lion's Head hospital staff nor emergency medical services have been able to give him a reason for this change in protocol.

After several months of intense therapy, Denise Phelps learned to walk and talk again, but, even today, she still has issues with shortterm memory, and remembers nothing of the accident at Tobermory.

When You're Bent but the Dive Guides Say You're Not

If you were feeling strange after a dive, you think your liveaboard crew would show at least a little concern, right? Not on the Palau Aggressor.

John Cody, an Englishman in his mid-30s who works in Saudi Arabia, took a trip aboard the boat in early 2018. Immediately after a dive at Blue Corner, Cody felt a growing sensation of pins and needles all over his body. He wondered if he was suffering decompression sickness, but the crew insisted his ascent had not been abnormal, and because he had no sign of any skin rash, he was obviously not bent. Cody thought otherwise but didn't press the point and continued with the diving.

He flew back to Jeddah, his home base in Saudi Arabia, noticing he felt worse at altitude and a little better each time he landed to make international connections on the way. However, by the time he arrived at Jeddah, Cody was in dire straits and needed hyperbaric treatment in a recompression chamber.

A subsequent clinical investigation discovered he had a massive hole in his heart, called a Patent Foramen Ovale (PFO occurs in about 25 percent of the population and is a contributor to bends). Cody thinks the effort of battling with the current at Blue Corner, plus the excitement of seeing the sharks there, probably raised his heart rate to such a level that he suffered a shunt of blood from his venous system to his arterial, and with it, gas in solution that should have normally been evacuated through his lungs.

He has since recovered from both the DCS and the heart surgery, and is cautiously considering returning to diving. But his story should have had a different ending. The Palau Aggressor crew preferred to assume he was not suffering from DCS rather than get him immediate treatment. Moreover, Cody alleges, the Aggressor Fleet got him to sign a document waiver that he did not hold them responsible for any injury he may have incurred.

A case of the dollar taking precedence over the well-being of a customer? Remember Cody's case if you're feeling not-so-great after a dive, and press the crew to get you treatment if you think it's in any way DCS-related.

Tell Us Your Bad Bends Stories

Denial is a common symptom of decompression illness. It's usually done by those suffering the symptoms, because nobody wants to believe they've got an ongoing DCI event. However, have you ever suffered a decompression injury and found that those around you didn't believe you? If so, what happened next? I'd like to know. Write your story and send it to me at BenDDavison@undercurrent.org

-- Ben Davison

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