The Bends

Contributed by Craig

by Craig Morton

Ask any scuba diver what is the one thing they fear most when diving and they will tell you it is the bends. However, if you get a group of divers together they will no doubt joke that '... we will probably all end up bent sooner or later!'. I myself often joked to friends and family that 'I'll probably just end up bent ...' and like most divers I used to think that it would never happen to me ... but it did. I got bent.

The bends or decompression illness as it is medically known is generally caused when a diver surfaces too quickly from depth. Air contains 80% nitrogen, which at the surface is inhaled and exhaled without effect. At pressure this nitrogen is forced into the bloodstream and if a diver ascends from depth without allowing sufficient time to 'off-gas' nitrogen bubbles can form, leading to the bends.

The tell tale signs of the bends can be easy to dismiss when not severe. Sore joints, shortness of breath, and tiredness, and in my case this is exactly what happened.

It all started back in March (23/3). Daylight savings was drawing to a close, and as this was the last club twilight dive for the season, we decided to do something special. A few quick calls and we managed to arrange a special charter to do a night dive on the 90ft (26m) J Class Submarine.

I had first dived the sub a few weeks earlier and must say as my first wreck dive it was nothing short of fantastic. Needless to say I was very excited about the prospect of a night dive on the wreck. The divers that night were Anthony, Colin, Chris, Kerry, Armen, David, Mark and myself (Craig).

Mark (my wife's brother) had never dived the site, so I suggested we buddy up and stay close together. The dive was fantastic, and I would recommend it to anyone who gets the chance to dive it at night. After 32 minutes of cruising around the sub, we returned to the shot line, and decided to head on up. Now prior to entering the water, we had agreed that on ascent we would come up very slowly, staying at eye level the whole way. Like most well laid dive plans, that was not to be.

As we began our ascent, Mark's fin got tangled in the shot line. I signalled to him to halt, and dropped back down to untangle him. Once free, I signalled for Mark to continue the ascent. What I should have done was return to his eye level so we could ascend together. Instead I was about a foot below Mark's fins. Looking up, I noticed that Mark was too busy watching his new dive computer in his left hand, which of course meant he wasn't dumping the air from his BCD. Without thinking, I grabbed Mark's fin and climbed up him, yanking on his inflator to dump his air. Unfortunately, that meant I wasn't dumping my air. I grabbed my inflator and yanked hard, dumping the air in my BCD, just as my tank broke the surface. My only thought at that stage was 'Oh Shit! That's not good.'.

I had no idea how long it had taken us to rise, but I knew that it was far too quick and we had neglected to do a safety stop. The problem with dumping your air of course is that you tend to plummet, and before we regained our buoyancy we had returned to 10m. It was then that I glanced at my computer which was telling me to do a deco stop at 3m for 3 minutes. I grabbed Mark and gave him an OK signal which he returned, but as my light shone in his mask, my heart sank. I saw blood.

We returned to 3m and made a deco stop on the shot line. Lucky for me I had my regulator in my mouth, as I think I may have broken the world record for repeating a four letter word beginning with 'F' the most times in 3 minutes.

As soon as we hit the surface I ripped off my mask, grabbed Mark and hysterically said 'Are you OK? Are you OK? You've got f**ken blood in your mask!'

Mark replied 'Yea, I had a nose bleed earlier and may have blown a little hard to re-equalise on the way back down. It's nothing.'

We returned to the boat, and were some what quiet on the return trip to Portsea. I remember sitting there, sick to my stomach (or maybe that was the swell) thinking '... Im bent, I'm bent, I just know it ...'

By the time we returned to the pier, I had talked myself out of it and I joked with Mark that 'We need to have a little chat about ascents later'. We still had no idea how fast we had ascended, but obviously weren't seriously bent. We drove to Rosebud for an after dive BBQ where we simply stated 'Well we F*cked up, but at least we are lucky and didn't get bent.' Mind you, in the back of our minds we were starting to wonder.

The next day at work, I think Mark and I spoke about half a dozen times on the phone. We had downloaded our dive computers to discover we had gone from 20m to the surface in just under a minute. I also spoke to everyone I knew with diving experience, asking them 'How do I know if I'm bent?' and 'What are the signs of the bends?' In the end, everyone agreed that if we were bent, surely we would know it.

I remember feeling tired, a bit achy and a little short on breath, but I simply put that down to a late night, the strain of the dive, and well I'm the first to admit I am not the fittest bloke in the world. Over the next few days, I think I talked myself into and out of the bends several times. In the end I simply dismissed it as being tired and over-stressed.

Mark developed sinus trouble which more or less prevented him from diving between that night in late March and now, but I wasn't so lucky. Feeling nothing that I thought was out of the ordinary, I continued diving. My next dive was only 5 days later.

Over the next two and a half weeks, I completed 3 dives in the lead up to the Easter trip. While I can't remember any specific pain, I do remember that I was left exhausted after each dive. The Easter weekend was a different story altogether.

Over the 3 days I was at Port MacDonnell, I completed 3 (short) ocean dives in big swell, and 3 dives in Ewen's ponds. Mark, still complaining of sinus trouble and the onset of a possible cold, only completed one dive in Ewen's ponds.

Several times across that weekend I experienced extreme tiredness, muscular and joint pain, shortness of breath and chest pain when breathing deeply. I felt the worst during the time I spent with the family at Mt. Gambier. Once again I ignored the symptoms, putting it down to late nights around the fire. Oh and I may have consumed a couple of drinks at night ...

Now two or three days after returning from Port MacDonnell, I began to wonder why I was still not feeling right. Finding it hard to concentrate at work, I went to see my family doctor. I explained my symptoms, mentioning that there could be a slight chance I was bent. She examined me and finding nothing wrong suggested that I was simply run down and I should return if I felt worse over the next few days.

Well that night I came down really sick with the worst case of gastro I can remember. At that stage I figured I had simply caught the bug that was going around Port MacDonnell (several people were sick over the Easter weekend) and that was all that was wrong with me.

In the month since I returned from the Easter trip, I have completed 3 dives. All of them reasonably shallow. The last dive was only 5.4m which was last Saturday May 15th.

The Friday before my last dive was the club night at Springvale. Colin mentioned the up and coming tour of the Hyperbaric Chamber at the Alfred, and passed around some information booklets. Mark and I had a little joke that maybe that is where we should go. Mark, still having sinus trouble and the odd dizzy spell must have taken it a little more seriously than I.

Saturday afternoon while I was lying on the couch to exhausted to move I received a call from Mark. His opening comment was 'Guess where I've been? I've just spent the afternoon at 18m breathing 100% pure oxygen ...'

Now I must admit I was a little shocked at first, but still ended up joking with Mark that 'Maybe I need to go there as well ... my shoulder is a little sore after my dive this morning ...' and then simply went back to sleeping on the couch.

It wasn't until Sunday morning that I realised something was wrong. I woke with aches and pains in my shoulders and elbows, and my breathing was very shallow, feeling restricted when I tried to take a deep breath. Walking around the house picking up my 2 year olds toys for 10 minutes left me feeling dizzy and I had to sit down before passing out.

Even at this stage I was still prepared to dismiss the signs. I said to my wife 'I still feel achy today' to which she responded 'just call the Alfred would you, you won't be happy until you do ...'

When I shrugged at that remark, she dialled the Alfred, asked for Hyperbaric and put the phone to my ear.

After a brief conversation, it was suggested that I come in for an examination. I was also told to bring a book. Once there I explained my situation and history to the doctor including the fact Mark had been in the day before and was my buddy on that dive back in March. Needless to say, he suggested I also needed a stint in the chamber.

Next thing I knew my wife, my 2yo and I were having a quick tour of the chamber with the nurse explaining what I would be doing, and how the whole process would work. Then we were beginning a 5 hour stint in the chamber.

Treatment consisted of the room being pressurised to 18m where a nurse placed a plastic helmet over my head and I breathed pure oxygen for a period of time before having a 5 minute break and then more oxygen. This process was repeated through out the dive as we moved to 9m then slowly returning to the surface. The nurse was stuck in the chamber with me for the entire trip. As the nurse is breathing air at pressure during the dive, she has to breathe pure oxygen for the last half hour to avoid getting bent herself.

Now the one thing I must say is that the staff at the Alfred were fantastic. Everyone I met (and I probably ended up meeting everyone) was super friendly, and I could see that they all liked to have a bit of fun, enjoying their work, but being serious when they had to.

Over the next five days I would have a total of five dives in the chamber. The first a 5 hour dive, followed by 2 two and a half hour dives and 2 two hour dives. The first 3 were to 18m and the subsequent dives to about 10m. Time spent sitting in the chamber is nothing short of boring and I managed to read two and half books during my time there.

It wasn't until about the third session that I realised just how bad I had actually been. Most of the aches and pains subsided and I found that my lung capacity had probably doubled. As I think back I realise that all this time I had been suffering from decompression sickness but ignoring the symptoms. Once they had gone I realised what normal should be.

The doctor explained to me that I had most likely received a slight case of the bends that night in March, and because I had kept diving I had aggravated the condition (returning to the water when bent is not a good idea). Mark was lucky. As he had only dived once since that night, he only required two sessions before being given the all clear.

On my last day of treatment I spoke with another diver who got bent on a dive on Monday. He had been diving near the heads in 36m, and realising he was low on air, only made a one and half minute safety stop on the way up. That night he felt the aches and went straight to the Alfred. He was lucky and was discharged after only 3 treatments.

Now there are two important lessons to be learnt from Mark and my experience. The first is knowing when to assist a buddy and when to let them go. If a buddy takes off on a fast ascent ... let them go. You need to put your own safety first. It is better for one of you to end up bent than both of you.

The second lesson is probably the more important of the two. If you think you may be bent, don't wait, don't ignore it, just go straight to the Alfred. There is no cost involved as it is covered by Medicare. It is better to just check than do what I did.

As I sit here writing this story I have just finished my 5th day in the chamber. The doctor thinks there should be no long term side effects, and I should be able dive again in the future. I have to return as an out-patient in about 4 weeks at which time I am hoping I will be given the all clear to dive again (I also can't fly for at least the next month).

I still have a few aches and pains, and even typing this has left my arms feeling like I have just spent a day digging in the garden. In reality I came off easy. I shudder to think what might have happened if I had ignored the signs again, or if I had done a deep dive over the last 2 months. Maybe I wouldn't be here to tell the tale, or even worse ... maybe I wouldn't be able to dive again!!

For more information on the Hyperbaric unit at the Alfred, refer to their website