Did someone put spokes in my Padi wheel or was it my own stupidity that gave me a case of Decompression Sickness? 

I crawl in through a small round hole into a white steel cylinder. There is a narrow bed on each side and I sit on one. Before Peter Atkinson, a Hyperbaric Technical Officer, secures the steel door, the two-patient recompression chamber is packed with five patients and a nurse. Six pairs of legs are entwining across the narrow aisle, we pass around pillows and the oxygen hoses are twisting through the crowd. 

I could do without this experience. My faith in dive tables and computers has gone out the window. None of the divers in the chamber has exceeded their No Decompression Limits! 

"Masks on!" Louise shouts. "Make sure it seals well" The full face oxygen mask feels heavy to breathe. After a test compression to one metre, Peter gets a go-ahead from the nurse. A loud hissing sound fills the chamber and the needle on the face of a large analouge depth gauge starts its journey towards the 18-metre mark. 

I spend the next five hours recalling the events that put me here. Let's go back to the beginning:

Dive number eight on the display, my Suunto Solution dive computer tells me all OK. I'm back from my second three-night liveaboard trip from Coral Sea as a Dive Instructor. In addition to fourteen dives, I have experienced six nights of bad sleep, a couple of good shark feeds and 32 very satisfied customers. I'm happy, but totally worn out and exhausted. Pulling down the sails of our 20-meter schooner, I felt mild pain in my shoulders. I voice my concern to my work mates."You'll be allright, mate" someone says and offers me a cigarette. I smoke one, refuse a beer and use the last of my energy for the 4km pushbike ride home. 

A flu has started the night before, just before my last 28 meter morning dive. I go through all my dive profiles with my computer and find myself safe. "It's just the flu that makes me feel a bit achy" I tell myself before falling into a long awaited undisturbed sleep. 

After a few days of rest I feel slightly better despite the flu. A strange pain appears in my left wrist and my left shoulder feels like I've pulled a muscle. The thought of nitrogen bubbles haunts me. I feel like a weary, but a fewer and a sinus infection offers me a perfect explanation for it. 

Two days later I develop a violent ear infection. Ongoing pains in my wrist and shoulder are worrying me and I see a doctor in Cairns Base Hospital. "I think the aches are just part of the flu" the doctor says, and sends me home with some antibiotics. I ignore the fact that he wasn't a dive physician, and go to bed less worried. 

Seven days after my last dive my eardrum explodes with the preassure of a fully infected middle ear. I curse, but it doesn't help. I rush to the doctor again, this time to a private surgery. I have a discussion about decompression sickness, and my second doctor tells me that it would be too late for treatment. "I'm sure the aches will ease soon, once you get rid of that flu and ear infection" he concludes, sending me home with painkillers and more antibiotics.

Days go by. I spend all my time reading about decompression sickness and going through all past dives and their details. Although I am well within dive tables and all dives were finished without problems, I am starting to find details that promote bubble formation.

I had one square profile dive and one double ascent from 18 meters. On two dives, a large ocean swell had made my safety stop bouncy. I had plenty of coffee between dives to compensate for the lack of sleep. (Coffe is a diuretic and both dehydration and lack of sleep increases the risk of decompression illness.) Suddenly I feel a pain in my elbow... "Am I just imagining all this?" I think. I am still tired, after resting for over a week. "But isn't it normal to be a bit tired and achy when having a flu? Isn't it? Isn't it!?"

At the end of the week my flu is over but the ache in my wrist, elbow and shoulder lingers on. I can't blame the flu anymore, and there is nothing else to use as an excuse. For the third time I take to the doctor's surgery. This time I choose carefully and book a time with Catherine Meehan, a reputable dive doctor in town.

After hearing the whole story, Catherine calls Townsville Hyperbaric Unit, Queensland's only recompression chamber, 350 km's south of Cairns. The doctors in both ends of the line agree: "This man has to be recompressed!" "What!? Are you sure?" I ask. "It has been nearly two weeks from my last dive!" But Dr. Meehan is serious. "Small nitrogen bubbles can get trapped in joints" Catherine tells me. "They get stabilized by getting covered with blood platelets and may sit there for weeks. Recompression is also the only way to confirm the diving relatedness of your symptoms." 

I arrive in Townsville for recompression 13 days late. Ideally recompression should commence within 12 hours of the last dive. "With more dramatic symptoms and a quick recompression treatment usually offers a remarkable and fast relief." Dr. Rob Barnett from Townsville Hyperbaric Unit tells me. "When symptoms are mild or if treatment is delayed, the effect of hyperbaric oxygen is much slower and may require several "dives" in the chamber."

My treatment starts with a five hour "dive" to 18 metres, followed with daily compressions to 9 metres, each 90 minutes long. All treatment includes breathing 100% oxygen. 

After my second treatment the mild ache in my shoulder and elbow is gone, although moving my arm is still painful. "It can take up to 6 months for the pains to resolve" Rob Barnett tells me. The mild ache returns within an hour after walking out of the hospital and treatment continues.

After three "dives" the aches are gone for good but movement still causes pain. Rob Barnett decides to keep me on for a few more days. 

After a total of five treatments, all aches are gone and I'm left with pains associated with moving my wrist or arm. Rob Barnett conducts the final medical. He tells me that many cases of DCI go untreated because of doctors being unaware of the enormous variety of symptoms. I also learn that aches are not always where the bubbles are. "Microscopic bubbles in the brain and the spinal chord can cause all kinds of symptoms." Rob says. "Pains can move from one side to the other and appear almost anywhere in the body. Undetectable bubbles in the brain can cause loss of memory, tiredness and changes in personality."

Rob recompresses 120 divers in his overloaded unit every year. He appears calm about the number. "Our workload reflects the statistical occurence of DCI. We are serving a large area with 1,5 million supervised dives annually." Rob doesn't think that diver's are getting more      "[% of serious, symptoms, signs. Airbrakes?]
What is the main contributor of DCI?
"Repetitive dives create silent bubbles and slow down off-gasing, therefore increasing the risk." Rob says. "But we have to remember the pure mathematical chance of DCI. Dive tables are based on an "acceptable risk". Diving with modern computers or tables means accepting a risk of 1:10.000. Zero risk can only be achieved by not diving" Rob reminds. I return home after five recompressions." 

The pains in my shoulder slowly dissappeared in three months. My wrist continued to give me problems and an MRI (Magnetic Reconance Imaging) revealed damage in the cartilage. "The only way to confirm the reason and type of damage in your wrist, is to do an autopsy." Catherine Meehan told me. I kindly refused. 

Nearly eight months after the accident I feel 100% again and have finally returned to diving. I have done so with slightly less respect for dive computers and considerably more for common sense and small details. I am still convinced of diving being a very safe sport. 

What did we learn? That dive tables alone do not excuse us from using common sense. That a long history of uneventful diving creates a false sense of security. Many "old timers" suffer from "Experienced Diver Syndrome", the feeling of being indistructable. If we want to dive, we must accept the risk.. Lets do so well rested, well fed and well hydrated. 


Lauri Strengell is a 30-year-old Finnish born dive instructor for Padi and SSI.
He started diving in Finland in 1989 and became an instructor in 1994 in Australia.