Scuba Diver Australasia + Ocean Planet
Experiencing Lymphatic DCS
Text and Images by Lior Carmeli
When a diver begins to suffer from extreme fatigue, achy joints, and confusion, divers may recognise these as signs of decompression sickness (DCS).
However, there are also numerous uncommon symptoms and these are often associated with lesser-known forms of DCS. Because the most common symptoms represent only a partial list of potential complications, this can lead to a misdiagnosis and delays in treatment. When a diving accident occurs, DAN can be instrumental in facilitating medical care.
Kelly, a Master Scuba Diver Trainer with more than 500 lifetime dives, had taken months to prepare for her technical sidemount diving certification. She was ready to tackle the classroom portion of her course, manage multiple gas cylinders and complete 12-dives in six days.
The course started in shallow water, with dives becoming progressively deeper and longer. Kelly’s overall approach was cautious. She had experienced skin DCS the previous year, and she wanted to follow her decompression stops exactly as her latemodel, multi-gas dive computer prescribed.
First, she completed two dives to nine metres on air and then three nitrox dives to 27 metres. After one dive, Kelly had a small problem while exiting the water – rough seas jostled her and she collided with the ladder. For the next two dives,
Kelly introduced 100 percent oxygen as her decompression gas. These dives were to 29 metres for 42 minutes and then to 36 metres for 67 minutes.
Now more than halfway through her dives, Kelly noticed her left bicep was sore and the skin felt taut and warm.
She assumed the injury came from her collision with the ladder and, unphased, kept diving.
But the pain worsened and spread to her left breast. The working hypothesis among those on the dive boat was that Kelly had suffered a haematoma on her left bicep. However, the lack of bruising to the area contradicted that assessment.
Four days had passed since symptom onset, and the symptoms were worsening – her fingers were tingling, her chest was tight, and her vision was becoming impaired. The boat crew decided to transport Kelly back to shore and take her to the nearest medical facility while her partner called the DAN Emergency Hotline.
Once the DAN medic heard Kelly’s symptoms, they became concerned about the possibility of inert gas bubbles in Kelly’s lymphatic system, creating a build-up of lymph fluid in her upper arms and chest, known as lymphatic DCS.
At the hospital, Kelly was directed to the nearby hyperbaric chamber for treatment. When she arrived at the chamber, she relayed the information she received from DAN about lymphatic DCS, and that helped inform her treatments.
Lung barotrauma was ruled out and Kelly was wheeled into a hyperbaric chamber to undergo a five-hour U.S. Navy Treatment Table 6. Kelly was eventually discharged and her symptoms diminished as she continued recovery at home.
Kelly’s obscure symptoms were consistent with lymphatic DCS, but that’s a manifestation of DCS that is not well known. Her dives were long and deep but did not violate her planned depth/time profile.
Fortunately, DAN knew what to do.
The DAN medic’s knowledge and quick thinking gave Kelly’s doctors a starting point. DAN helps take the guesswork out of emergency logistics.
24/7 DAN Emergency Hotline +1 919 684 9111
No matter where we are from, a lot of us are taught to fear sharks. I created Sharks4Kids because I believe kids can change the world. They give me hope and they inspire me. I have dived all over the world and have seen majestic mantas and delicate nudibranchs. I have danced with wild dolphins and have been in awe of 10 great hammerheads. I have to say, though, that some of the most amazing moments have been seeing kids experience the ocean for the first time.
Through our Sharks4Kids outreach programmes, we take students to The Bahamas on field trips to see sharks and rays. Despite living on an island, many of these students do not know how to swim or have never been on a boat. When we first arrive at the stingray encounter, a lot of the students are nervous to get off the boat. This shallow beach area allows students to enter and exit the water as they wish. Slowly but surely, they move into the water and begin to snorkel. They are amazed to see the underwater world, a first for almost all of them. They giggle and screech through their snorkels and it’s really beautiful to watch.
One particular day I noticed a student who hadn’t entered the water yet.
She remained standing in the shallows watching. I offered my hand and together we moved to deeper water. We swam among the nurse sharks and southern stingrays. Her tight grip on my hand began to ease. I looked over and she had the biggest smile on her face. She had found joy in the ocean. Seeing fear slip away and become fascination is one of the most remarkable and rewarding experiences. These students carry with them a personal story of sharks and the oceans. This experience creates a connection that is critical for conservation. We need people to care and seeing the ocean first-hand is, in my opinion, the best way to create understanding and empathy.
We’ve seen so many students go from being afraid to not wanting to get out of the water. I am constantly reminded of how powerful creating your own ocean story can be. I am so lucky to make these moments possible and then to witness them.
These students carry with them a personal story of sharks and the oceans. This experience creates a connection that is critical for conservation. We need people to care and seeing the ocean first-hand is, in my opinion, the best way to create understanding and empathy
Starting with only a diving mask and snorkelling gear, I am now a certified scuba diver. As an SSI Junior Open
Water Diver, I learned how to control my buoyancy and the physical implications underwater. I also learnt how to save and support colleagues underwater during a crisis.
As a young diver, it was interesting to learn about the ocean and explore a new world. One person in particular who inspires me is Jay Moriarty; his passion for the sea and the way he thinks about the ocean and respects it – his attitude inspires me to become a part of the ocean.
Initially, it was stressful getting into diving because I didn’t know how my body would cope or what would happen when I encountered different sea creatures. At the beginning, I felt the pressure in my ears and nose but I quickly learned how to manage it.
I find the underwater world fascinating. It is so interesting to discover new types of animals that you never see outside the water. It is exciting to see vast changes underwater during night and day.
I find the underwater world fascinating. It is so interesting to discover new types of animals that you never see outside the water
On night dives, you can find different types of animals compared to dives in the daytime. Another thing that fascinates me underwater are the various colourful reflections that are different and unique.
One of my strangest experiences underwater was when I dived a sunken battleship. A dive buddy pointed out a spot on the ship and as I got closer, I noticed a hidden creature with long antennas on top of its head!
Wrecks are some of my favourite dive sites, as these are the only places where you can experience such unique historical monuments. I also love diving with animals and observing their relationships with the ocean. Swimming with dolphins was particularly captivating – an experience I will never forget. SDAA