An Australian living in India, on a 6-day diving holiday in the Maldives, diving ‘safely’ according to her dive computer, suffered decompression illness (DCI) with peripheral neurological symptoms. Total bill: A$11,000+. Fortunately, she was a DAN AP Member.
The Diver: An Australian living in India who was on a diving holiday in the Maldives.
The Diver’s Experience: Experienced with more than 550 dives completed over a 30-year period.
The Trip: A 6-day diving holiday.
- Five dives completed within 36-hours.
- All divers were between 22m and 31m.
- All dives were on air and approximately 60 minutes in duration.
- On all dives the computer was set to default settings with no added conservatism, despite multiple days of planned diving at depths between 20m and 30m.
- Dive 1: 30.6m, 55 minutes, Surface Interval (SI): 1hr 56 mins
- Dive 2: 30.6m, 56 minutes, SI: 5h 18mins
- Dive 3: 22m, 64 minutes.
Day 2. After a surface interval of just under 13 hours
- Dive 1: 31.3m, 60 minutes, SI: 1 hr 58 mins
- Dive 2: 31.2m, 65 mins
Onset of Symptoms
Several minutes after surfacing from the second dive on Day 2, I experienced numbness and tingling on the right side of my body, including my arm, side and leg. The numbness and tingling extended to my left leg and under my right breast. The boat crew commenced oxygen first aid quickly and my symptoms partially resolved after 25-30 minutes, and fully resolved in my left leg after 60 minutes of breathing oxygen. The boat crew contacted the hyperbaric chamber on an island near Male and I was transferred there for evaluation and, if needed, further treatment.
Diagnosis: It was determined that I had decompression illness (DCI) with peripheral neurological symptoms.
Treatment: I underwent two recompression treatments:
Recovery: Thirty minutes into the first treatment my symptoms resolved, except for the abnormal skin sensation of “insects crawling” on my right leg and under my right breast.
After the second treatment, the Chamber declared me fit to fly back to Mumbai after only 24-hours despite having some residual symptoms. I was informed about possible therapy required for symptoms presenting during the flight.
DAN AP on-call staff and the on-call DES doctor both expressed concern at this short period and suggested that I wait a minimum of 72 hours between treatment and flying. Given I had residual symptoms DAN suggested the time should have been significantly extended.
I ended up flying home less than 24 hours after my second treatment. Thankfully my symptoms didn’t worsen on the flight or after the flight but I did still have a numb patch on my leg and some residual tingling in my right leg so I had to undergo further treatments in Mumbai.
- Chamber Treatment 1: US$4,500 / AU$5709
- Chamber Treatment 2: US$2,500 / AU$3282
- Doctor’s Fee: US$570 / AU$748
After returning to Mumbai, the diver received further chamber treatments and other medical services including an MRI, Chest X-Ray, Pulmonary Function Test and an ECG. As a DAN AP Member with dive injury treatment insurance, the costs relating to the treatment of her DCI and transportation were covered by DAN.
TOTAL EXPENSES: US$8,776 or AU$11,519.
DAN AP Brief Analysis
This diver probably worsened the outcome by flying home so soon after her initial treatments, especially with unresolved symptoms. There was also a delay of 4 days between the treatment in the Maldives and subsequent treatments in India.
Delays in treatment, and flying prematurely, can both result in a worsening of symptoms and/or decrease the benefits of subsequent treatments. Had she remained longer in the Maldives (with or without further care) she may not have required further treatment on returning home.
Bottom line: think about how much DAN AP Membership could save you!
In next week’s blog post we will discuss the issue of flying after diving and DAN’s recommended guidelines for divers.