World Diving Review

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Scuba Diving Article of the Month

Teenager Scuba Diving accident and survival-Part2

Be sure to read first how my scuba diving accident started.

However the second day when I could talk again, I could give more information to the doctors who eventually concluded to a DCS but you will see later this conclusion was partially wrong.

So they put me inside the chamber and recompressed me to the equivalent of 18 meters (most chambers are able to propose such treatment if you don’t pass the limit of 40 meters). I was still unconscious but again a miracle happened: I had the reflex to equalize my ears all the way down. Actually during such treatment in most case the patient will get severe injuries on its ear drums; and obviously it will happen if the person is unconscious. So it is extremely rare that in a “natural reflex” the patient is able to equalize I mean able to pinch his nose and blow through it. It seems I had to do it 3 times down to 18 meters. Then according to the table after 1h30mn at 18 meters with alternate breathing of normal air or 20% O2, they put me up to 9 meters at a rate of 3 meters in 10 minutes. Then they have to keep me at this pressure with 30% O2. Still unconscious I started to convulse, my mum was crying thinking it was the end… To respect the procedure everything was recorded by a fixed camera in case of death. My parents have the movie at home but up to now they don’t dare to watch it. As no doctor was with me inside the chamber they decided to stop the treatment for a while and send me back to the hospital for resting my body because I couldn’t stay on the military navy base as a civilian.

At the opposite of normal conclusion, my convulsions were not due to oxygen toxicity but to overheat. My whole body was at 40C so, like a baby with fever, I started to convulse. The explanation about the overheat is still not clear but the brain specialist is thinking that my brain was in so bad conditions that it could not regulate anymore my body and the nitrogen bubbles were moving inside the brain without any control.

After few hours, it was during the night and my mum was sleeping at that time, I was back to the chamber still unconscious (or sleeping, here no one can tell). This time a doctor came inside the chamber with me in case… They put me down again at 18 meters and again the same thing happened: I was able to equalize by myself. Then again going up to 9 meters and same thing happened: I started to convulse. But interrupting the treatment a second time was not an option to eliminate the bubbles inside my body. This time the doctor gave me an injection to relax my muscles and avoid the convulsions. My body was extremely hot but under close monitoring. After 4 hours and 45 minutes the first treatment could end. It was 2am in the morning. Robert was still here!

I was sent back to hospital for a good rest. At 7am I opened my eyes for the first time. I could talk with difficulty and eat my breakfast with some help but still my right side was not moving. I could not feel anything on my skin. My face was like if you removed all my muscles. I couldn’t smile…

At 10am the ambulance drove me back to the chamber with Robert, my mum, brother and sister who were very happy with the improvement of my condition. Again a treatment of 4hours45 was decided. As I was conscious this time I could put the oxygen mask myself. At 9 meters this time nothing happened. Immediately after the treatment I started to feel my right side. I could move a bit my fingers and shake the doctor’s hand but without any power in my hand and my wrist. I tried to write but it was a disaster and this gave me a big headache. I had to be patient.
See below an example of my writting:
AntWritting

Only Thursday after the treatment (one per day) I could feel a bit more muscles from my right leg, from my wrist also so I could shake a bit harder the doctor’s hand to thank him. On Friday they changed the treatment and had to stay only 2 hours 15 minutes. This time improvements were obvious so I could sit down much longer than before without having strong headaches. But still I could stay in this position only… 15 minutes. Then the doctor asked me to walk. He helped me to stand up and I was holding the bars on the side of the chamber. I had a strange feeling of being heavy and unsteady. My head was shaking side by side and I had the feeling I could crash my whole body on the floor like a wreck so I kept on holding my mum who was next to me. Then to finish the exercises the doctor asked me to close my eyes and try to walk straight to test my balance. No comment!

The next morning after the treatment I could eventually lift my right leg and my right arm for few seconds and I could walk more steadily but still with some help. This time I could sit down 30 minutes but afterwards I had to lie down because it was my limit. Then I walked back to the ambulance alone with someone next to me in case…

The next 2 days were like “resting days”. After each treatment I could see improvements on my right side but my handwriting and my balance took more time to recover. They became normal only on Monday morning. Also I could pass the test of balance with my eyes closed (put one foot in front of the other then close your eyes and stay like that for 1 minute). I succeeded at the third attempt!!!

I was discharged from Semporna’s hospital the day after – one week since the accident. After such treatment it is advised that you can take the plane 3 months after the last chamber according to the books. But according to many specialists you can, in theory, take the plane 72 hours after the last chamber. To play safe and after discussion with the specialist my dad decided to stay with me one more week while my mother, brother and sister went back home.

I took the plane on 31^st of August and luckily could start the school on time!

Few conclusions and comments:

I was always within my limits and within the recreational dive tables. My dad even gave me his first dive computer so I had a good idea about the remaining time at depth, the accumulation of nitrogen, the depth itself and so on. The trigger event was not a DCS but something which should happen on the land not underwater. Actually I was victim first from a brain stroke. So I had to abort the dive as quickly as possible but what is not clear still today is that the complications came from the DCS. Why I had so much nitrogen in my blood after less than 15 minutes at around 18 meters?

First we thought it was due to my heart murmur. But actually this is not a physical murmur (the 2 bloods can communicate through a small hole between the 2 ventricles) but only a functional one. It means the blood is doing some noise while passing through my arterial ventricle so nothing on this side.

We eventually suspect, but without obvious proof, that a nitrogen bubble passed by the upper chamber of the heart which contains a potential or actual defect known as a Patent Foramen Oval or PFO. Then if this bubble stays small it is not a problem but when you make an ascent (from 26 to 18 meters) the bubble will grow and if you are not lucky this bubble is located right in your brain at the time of your ascent which blocks the blood coming to the brain. Then a stroke is there. Then the rest is only consequences of this event…

Finally it has been decided that I will not do more than 2 dives a day during our next vacations until I reach 18 years old. According to many specialists even though we have followed the common standards, there is still a bigger risk of dive accident as long as the growth of your lungs and heart are not finished especially if you do many dives a day below 18 meters.

Last but not least I would like to thank again the whole team from the dive center in Semporna together with the Navy Base Medical Officers who did a fantastic job. I am recorded as the youngest surviving diver in this chamber with the number 62 since 2006.

I strongly recommend you to read the articles in the coming weeks regarding the disease mechanisms in diving.

I wish you safe and enjoyable dives.