Decompression Sickness
Also known as The Bends and Caisson Disease, Decompression Sickness is an illness that can affect divers or other people (such as miners) who are in a situation that involves pressure rapidly decreasing around the body.
DCS, as it is commonly know, is caused by a build up of nitrogen bubbles in the body. When we breathe, approximately 79 of the air we're breathing is nitrogen. As we descend in water, the pressure around our bodies increases, causing nitrogen to be absorbed into our body tissues. This is not actually harmful and it's quite possible for the body to continue to absorb nitrogen until it reaches a point called saturation, which is the point at which the pressure in the tissues equals the surrounding pressure.
The problem arises when this pressure needs to be released. In order to release the nitrogen slowly from the body, a diver must ascend slowly and carry out decompression stops if necessary - this allows the nitrogen to slowly seep out of the body tissues and either immediately revert to being a gas or to become tiny harmless bubbles which will eventually become revert to gas. This process is called "Off-gassing" and is normally carried out through the lungs.
If a diver ascends too fast and the nitrogen escapes the body tissue too quickly it becomes bubbles in the body and this leads to Decompression Sickness. The bubbles must normally be on the arterial side of the circulatory system to be harmful - they are usually harmless on the venous side. There are several types of Decompression Sickness:
Type I Decompression Sickness
Type I Decompression Sickness is the least serious form of Decompression Sickness. It normally involves only pain in the body and is not immediately life threatening. It is important to note that symptoms of Type I Decompression Sickness may be warning signs of more serious problems.
- Cutaneous Decompression Sickness
This is when the nitrogen bubbles come out of solution in skin capillaries. This normally results in a red rash, often on the shoulders and chest. - Joint and Limb Pain Decompression Sickness
This type is characterized by aching in the joints. It is not known exactly what causes the pain as bubbles in the joint would not have this effect. The common theory is that it is caused by the bubbles aggravating bone marrow, tendons, and joints. The pain can be in one place or it can move around the joint. It is unusual for bisymmetrical symptoms to occur.
Type II Decompression Sickness
Type II Decompression Sickness is the most serious and can be immediately life-threatening. The main effect is on the nervous system.
- Neurological Decompression Sickness
When nitrogen bubbles affect the nervous system they can cause problems throughout the body. This type of Decompression Sickness normally shows as tingling, numbness, respiratory problems, and unconsciousness. Symptoms can spread quickly and if left untreated can lead to paralysis or even death. - Pulmonary Decompression Sickness
This is a rare form of Decompression Sickness that occurs when bubbles form in lung capillaries. Fortunately, the majority of the time bubbles dissolve naturally through the lungs. However, it is possible for them to interrupt blood flow to the lungs which can lead to serious and life-threatening respiratory and heart problems. - Cerebral Decompression Sickness
It is possible for bubbles that make their way into the arterial blood stream to move to the brain and to cause an arterial gas embolism. This is extremely dangerous and can be identified by symptoms such as blurred vision, headaches, confusion, and unconsciousness.
Other Forms of Decompression Sickness
Extreme tiredness is very common in cases of Decompression Sickness and can sometimes be the only symptom of Decompression Sickness present. It is not know what causes this but you should be aware that extreme fatigue could be a sign of more serious problems. It is also possible for Decompression Sickness to occur in the inner-ear. This is caused by bubbles forming in the cochlea's perilymph during decompression. The result can be hearing loss, dizziness, ringing of the ears, and vertigo.
Symptoms
Decompression Sickness can manifest itself in many different ways and has many different symptoms, but the most common symptoms are:
- Extreme Fatigue
- Joint and Limb Pain
- Tingling
- Numbness
- Red Rash on Skin
- Respiratory Problems
- Heart Problems
- Dizziness
- Blurred Vision
- Headaches
- Confusion
- Unconsciousness
- Ringing of the Ears
- Vertigo
- Stomach Sickness
Risk Factors
Every diver has a different level of risk of Decompression Sickness. Many risk factors are still not fully understood, but there are a few basic factors that doctors agree increase the chance of developing Decompression Sickness:
- Bodyfat
The theory is that nitrogen absorbs more easily into fat, so an overweight diver is at a greater risk of decompression sickness. - Exercise
Interestingly, exercise has both a positive and negative effect. Exercise at least 12 hours before a dive seems to produce proteins that protect the body and decrease the risk of Decompression Sickness. On the other hand, exercise less than 12 hours before a dive can raise the number of gas micronuclei on which bubbles form and this increases the risk of Decompression Sickness. Exercise immediately after a dive increases the risk of bubbles forming as blood pressure is increased and bubbles can more easily be transferred from the venous to the arterial side of the circulatory system. - Gender
Theoretically women should have a higher risk of Decompression Sickness due to the fact that women typically have a higher bodyfat content. However, this has not been proven in studies and it's possible that gender does not affect the chances of suffering from Decompression Sickness. - Age
Generally, older people are at an increased risk of Decompression Sickness. This is due to less efficient circulatory and respiratory systems. - Fitness
Fitness definitely decreases the risk of Decompression Sickness. A fitter body is able to tolerate more physical stress, including Decompression Sickness. - Dehydration
Dehydration causes less blood to be available for gas exchange which makes it more difficult for the body to off-gas, increasing the risk of Decompression Sickness. - Injury and Illness
Injury and illness can affect normal circulation, increasing the risk of Decompression Sickness. - Alcohol
Consuming alcohol before or after a dive accelerates circulation which helps tissues to load with gas. Alcohol also dilates capillaries which can increase the rate of nitrogen released. - Carbon Dioxide
Improper breathing can lead to elevated levels of carbon dioxide which interferes with the bodies ability to transport gas. This will lead to an increased chance of Decompression Sickness. - Cold
It is generally believed by doctors that diving in cold water increases the risk of Decompression Sickness. This is due to the body working harder to keep warm as it becomes colder. Meaning that when the body is warmer it is able to absorb gas normally but as it becomes cold it has difficult offing the gas. - Altitude and Flying After Diving
When ascending on land or in a plane, the atmospheric pressure changes and this increases the chances of Decompression Sickness. It is best not to ascend above 300 meters (1000 feet) or fly after diving. Consult the current flying after diving guidelines to know when it is safe to fly. - Patent Foramen Ovale (PFO) - Hole in the Heart
As a fetus, a baby doesn't breathe and needs a way for blood to bypass the lungs until it is born. The body achieves this by having a small opening in the middle of the heart that allows blood to bypass the lungs. Normally, this hole would close within a year of birth, but in approximately 20-34 of people this does not happen, leaving a permanent opening in the heart. Usually, a flap grows over the opening and there is no effect. However, in some cases the flap allows blood to pass through the opening. This means that bubbles are more easily able to pass from the venous to the arterial side of the circulatory system, greatly increasing the risk of Decompression Sickness. It has been found that a large proportion of divers who suffered from Decompression Sickness had a PFO. - Reverse Profiles
The jury is still out on reverse profiling, or making a deeper dive after a shallower dive. Theoretically it should increase the risk of Decompression Sickness, but this has not been proven scientifically. It would still be better to err on the side of caution.
Prevention
As there are many risk factors, there are also many methods of prevention. Here's a basic checklist that will help you lower your risk of suffering from Decompression Sickness:
- Always ascend slowly and safely from every dive
- Don't push your limits and do all required decompression stops
- Keep physically fit and within a healthy weight range
- Don't exercise within 12 hours of diving
- Don't ascend to altitude or fly immediately after diving
- Breathe normally throughout the dive, don't exert yourself or skip breathe
- Make sure you're adequately hydrated before every dive
- Don't drink alcohol before or after diving and never dive when hung-over
- Get checked out by a doctor to find out if you have a PFO
- Avoid reverse profiling - just in case
Treatment
Immediate on the scene treatment consists of oxygen therapy and basic first aid. This should be followed as quickly as possible by recompression treatment in a recompression chamber. When treating Decompression Sickness the delay in beginning recompression treatment can be the biggest single cause of residual effects.
References
PADI, Encyclopedia of Recreational Diving, 3rd Edition.
Snorkeling in Akumal, Mexico
Akumal Bay is known for its assorted species of sea turtles which use the area for breeding, feeding and rearing their young. This provides an optimal chance to see the animals in their natural habitat, including the many colorful species of fish and plant life.
Snorkeling and scuba diving are perhaps the favorite activities to pursue during a trip to Akumal, but snorkeling is a less physically demanding and technical option. With a brief instruction course and a good area choice, snorkeling is relatively easy for even first-time beginners.
One popular area for snorkeling in Akumal is the Yal-ku lagoon. This area is an extremely rare environment where fresh water meets with salt water from the ocean. The combination of the two types of water is called a "halocline" effect.
Only very specific species can survive and prosper in this halocline bay, and the mixture of salt and fresh water supplies creates an changed appearance of the water itself. Many species found in this area are not found anywhere else in the world, and have been shown on many travel channel specials in recent years.
Casa Cenote is a lagoon featuring mangroves and unusual fish displays. Many snorkelers find the fossils in Cenote at Dosojos quite fun for a day of exploration. Many of the fossils seen at Dosojos date back to Mayan civilizations that once occupied the area.
Snorkel lessons are usually a good idea forfirst-timers prior to going to one of these sites. Although the activity is easy, some find that they are uncomfortable with the equipment or unsure how to best view the underwater scenery while safely using the equipment.
A popular activity for locals and tourists alike is night snorkeling. Typically, a flashlight is used in conjunction with traditional snorkeling equipment for this activity.
Many species which are not seen during daylight hours can be seen when snorkeling after sunset. This is typically because they are night-feeders or resting during the day.
The octopus is a perfect example of this spectacle. Octopuses only come out to feed at after dark, and change color when a flashlight beam is focused on them. Virtually all of the life seen at night are safe for snorkelers, so night snorkeling is a safe activity as well.
Plant life and some types of fish are also luminescent at night. This creates greenish lights glowing either continuously or flashing at night - quite a view for one who is only used to snorkeling during the day!
M Gravlee is a retired newspaper publisher who spends several months a year traveling.
http://vacationsurfer.net/Mexico/
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Scuba Diving in the Cayman Islands – Walls, Galleons and So Much More!
By Mark J Burns
Located in the northern Caribbean Sea lie the Cayman Islands; home to some of the worlds best dive sites, and arguably the best diving to be found anywhere in the Caribbean. Dive sites including the world famous Bloody Bay Wall and Stingray City are known to scuba divers throughout the world.
Vertical walls line all three of the Cayman Islands, and there are currently over 100 named wall dive sites. However, although the main focus of the scuba diving in the Cayman Islands is the awesome wall diving to be found here, there are also a large number of wreck dive sites to be discovered including freighters and even a 475 year old Spanish galleon!
The Cayman Islands are in fact comprised of three separate islands, Grand Cayman, Little Cayman and Cayman Brac. Diving is possible throughout all of the Islands, although the majority of the dive sites tend to be focused around Grand Cayman, predominantly due to its larger coastline.
One of the more unique experiences to be had whilst scuba diving can be found at Stingray City, a shallow natural channel located off the northwest corner of Grand Cayman. Here, the natural channel has become home to a large population of stingrays, which wait to be fed by the approaching scuba divers. This is a genuinely unique opportunity to get up close to these beautiful creatures in their natural habitat, and is an experience which cannot be found anywhere else in the world.
For the fans of wall diving, the Cayman Islands are a true paradise and some of the worlds best wall diving can be found here. Although there are over a 100 wall dives in the Cayman Islands, without doubt the pick of the bunch is the world famous Bloody Bay Wall, which is located off the north shore of Little Cayman.
Starting at a mere 6 meters, Bloody Bay Wall drops off into the deep abyss, reaching depths of over 350 meters in parts. The site itself is in fact a series of separate wall dive sites, each offering supreme coral cover and formations, as well as good levels of marine life. Large Nassau groupers, shrimps, lobsters, jacks and queen trigger fish can all be found on Bloody Bay Wall on a regular basis.
It is possible to scuba dive in the Cayman Islands throughout the year, with only a slight variation in the water temperature. The visibility in the Cayman Islands often reaches in excess of an incredible 50 meters, ensuring some of the best scuba diving in the Caribbean.
Overall, the Cayman Islands offer some of the Caribbean's most unique and exciting scuba diving, ensuring that large numbers of scuba divers return here year after year.
Mark Burns is Director of http://www.Scubaworld.tv - a scuba diving web site, and a comprehensive source of information on scuba diving in the Cayman Islands
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