We always welcome your letters, and we recently
got a good batch of them that are worth sharing
with all readers. (Keep them coming.)
Lowering a Diver's Risk of Lung Infection
Shawn McDermott (Melbourne, FL) has a useful
tale to tell about catching a bacterial infection
in one lung after returning from a Cozumel dive
trip in 2016. "Nasty stuff -- the medics suspected
pneumonia and put me on antibiotics and steroids.
I made a full recovery, but I didn't figure out how
I might have taken sick until later." He guesses it
was due to accidentally inhaling from his BC.
His advice: "When rinsing your BC after your
last dive, fill it up several times with fresh water
and squeeze it dry, and even inflate it with tank air
to dump all the water out. For some reason, on that
December 2016 trip, I actually sucked the air out of
the BC, got some into my lungs, and bingo! A week
later, back in Florida, I had to go to the walk-in clinic.
Coincidence? I don't think so. Was there some bacteria
in Cozumel's fresh water, which isn't potable?"
Ben Davison's reply: Although there have been cases
of people suffering aspergillosis caused by a common
mold, it has usually been associated with some other lung
condition. Shawn was very unlucky to suffer pneumonia,
but it could have resulted from a number of sources - like
sitting near someone who had it on the plane ride home
from Cozumel, for example. Even so, we suggest you
avoid inhaling from any BC that hasn't been rinsed out.
For extra care, use an over-the-counter cleansing solution
mad specifically for BCs, like McNett B.C. Life or Gear
Confusion --and a Correction -- about
Discover Scuba Diving
There was an element of confusion surrounding
instructor-to-trainee ratios in our February article,
"Discover Scuba Diving Is Deadly," regarding
two tragic fatalities during Discover Scuba Diving
(DSD) outings. We should've written, "ought to
be" rather than "supposed to be."
Ken Kurtis, a NAUI instructor and owner of
Reef Seekers Dive in Beverly Hills, CA, was quick
to call us out on it, and wrote, "While I agree with
your underlying point totally, when you've got
someone uncertified under the observation/care of
an instructor, the instructor has no job more important
that doing everything in his or her power to
guard the safety of that person. But you've got the
ratio wrong, and, bad as this was, it makes it sound
even worse. You state the ratio is one to one, but
it's not. NAUI standards (2019 version) allow for
the four-to-one ratio, and six-to-one with a qualified
assistant. I believe PADI is the same.
"What may be upsetting the apple cart slightly
is there's a requirement in the PADI standards that
if you are using a vertical descent line no deeper
than six feet in water where shallow water is not
available (that's why you're using the line), then
the ratio for that specific descent skill is one to one.
But the ratio for the dive itself (and it sounds like
this is what the 13-year-old boy was on) is still four
to one. Whether that makes any sense or not, and
while many of us argue that two-to-one is the limit
of our comfort (we've only got two hands and can
hold one diver in each hand) and that one-to-one
is best, a four to-one ratio is still within standards.
"That all being said, having 20 people in the
group -- if they were all in the water at the same
time, let alone with one instructor -- is way outside
"Also, although you mention DSDs are to be
done in "shallow or confined water," the specific
limit is 40 feet. It sounds like the conditions, specifically the visibility, should have precluded the dive, or at a minimum, forced the instructor to go
with a lesser ratio. From an older version of the
PADI standards, "Good environmental conditions
can enhance the experience, while marginal conditions
may detract from new diver enjoyment and
safety. It's important to make conservative decisions
and use good judgment."
Thanks for the corrections, Ken. And we still
stand by the point made in the conclusion of the
article by Bret Gilliam, founder of the dive training
agency TDI/SDI, that DSD's current standards
are potentially dangerous, and it's time the scuba
industry woke up to that.
Should Dive Guides Be Responsible for
Regarding our death-by-narcosis-focused article,
"Rapture of the Deep," in the March issue, John
Miller (Lubbock, TX) took issue with our implication
that perhaps the dive guide, who didn't
descend to save the sinking diver, was partially
responsible for the man's death.
"First, we need to consider every dive agency's
Rescue Diver training philosophy, as well as that
of Public Safety Diver instruction and other emergency
first-response training: to only have one
"During the briefing, the divemaster most
likely told everyone the maximum depth and time.
Certified divers need to pay attention to the briefing,
and follow the limits set for the dive by paying
close attention to their pressure gauge or dive computer.
The wife and divemaster put their own lives
at risk by chasing a narc'd diver.
I do not believe it was the guide's responsibility
to save this man and his wife. I understand
the wife's desire to do so -- but three people could
have died. As dive professionals, we will do what we can to 'save' bad divers, but not at the risk of
our own lives or that of other divers. One victim is
We asked Bret Gilliam to reply to Miller's take:
"It's a tough call for the divemaster, with several
factors in play that have to be a matter of personal
experience and tolerance for stress, narcosis and
high PO2. If it was me in that situation, I'd have
gone for the rescue and considered the risk to be
minimal. But Miller's comments about divers taking
responsibility for their own actions if they don't
follow the dive briefing are also valid. In today's
world, a huge percentage of divers are not trained
well to a level of independent capability, and lack
much practical experience. That's a fault built into
the dumbed-down curricula, and limited ocean
dives in training."
"The bottom line: Divers should be responsible
for themselves unless they specifically request a
supervised dive outing. But I could not leave a
diver behind in obvious distress."
Causes and Remedies for a Dive-Related
Swimming-induced pulmonary edema (SIPE)
is a medical condition that presents similar symptoms
to drowning, but in fact it is the diver's own
body fluids that are filling the lungs. Joan Eggert
(St. George, UT), a physician now retired from
Intermountain Dixie Regional Medical Center
Wound Clinic and Hyperbaric Chamber, developed
her second case of SIPE on a dive while fighting a current. She surmises it was triggered
by a switch from one prescription drug for high
blood pressure to another, and suggests that divers
with chronic hypertension need frequent evaluations
of the cause and prescribed medications.
"Evidently, 10 years ago it was not appreciated
how many hypertensive patients had a disease in
which the adrenal glands make too much aldosterone,
which leads to high blood pressure and low
blood potassium levels. A beta blocker is the wrong
drug and may harm those diving. Fighting a current
may also lead to 'racehorse hypertension,' which is
why racehorses get pulmonary edema. Divers who
have exercise-induced hypertension should see their
physician about medications to reduce it."
"The treatment for SIPE includes oxygen, a
diuretic (usually furosemide) and pulmonary-end
expiratory pressure, or PEEP for short. One key
point we don't teach divers, but I recommend, is
an upright position, rather than a lying-down position,
allows for easier breathing. Another one is,
you can start "self-PEEP," even in the water, by
pursing your lips as you slowly exhale, feeling like
you are pushing back to keep the air sacs open. It is
hard to self-PEEP when all you want to do is gasp
air, but you will improve much more rapidly. And
finally, evaluate when you want to trade rugged,
cold-water diving for easy, warm-water diving
with no possibility of strong currents."
Check Those Indonesia Flights
"Thanks to the advice in the April Undercurrent (our article "Why You Had Better Confirm Your Flight Itinerary"), I checked all my flights for my
November liveaboard cruise in Indonesia," writes
Harvey S. Cohen (Middletown, NJ). "One flight
was indeed canceled, with no notification."
"I booked Garuda Indonesia (on its website)
from Bali to Maumere and from Sorong to Jakarta.
"When I checked my booking on the website,
there was a red notice that one flight had been
canceled. The other was still scheduled. Now, the
website still shows the canceled flight as scheduled,
so any automatic monitoring service will be
unaware of the cancellation. The only way to find
out is to check a specific booking that's already
"What have I learned from this? When travel
involves flights on a domestic-only airline, book
those flights through the dive operator at your
destination. They are best positioned to deal with
domestic airlines, and they have a direct interest
in getting you there and back. This is especially
important for liveaboards, where it's crucial to
arrive in time for the boat's departure."
Lisa Evans (Fort Collins, CO) also told us she
was notified by NusaTrip, an Asia-based online
travel booker, of a Garuda flight canceled about a
month before her trip last fall. "Notification was September 3 for an October 11 flight. The flight
was from Luwuk to Manado, and they rebooked
me on a flight that would take two days -- the original flight was around 45 minutes. NusaTrip
customer support got me a full refund, which
took a while, and I was rebooked easily."