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Let's Work Using Symptoms Instead

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Let's Work Using Symptoms Instead

Post Number:#1  Postby SeaDemon » Sun Jun 03, 2007 7:03 am

Previously, all questions have been posed based on diagnosed illnesses. The common questions related to diving illnesses have mostly been asked.

So, now let's work on symptoms that are uncommon instead.

A diver, previously known to be fine, is on a 2D/1N dive trip.  His dive profile for the first day of diving are as follows:

Dive One

Depth 1: 30m for 12 minutes. Ascent rate to next depth: 18m/min
Depth 2: 24m for 08 minutes. Ascent rate to next depth: 18m/min
Depth 3: 18m for 10 minutes. Ascent rate to next depth: 18m/min
Depth 4: 05m for 03 minutes. Ascent rate to surface: 18m/min
Surface interval time to next dive: 45 minutes

Dive Two

Depth 1: 30m for 15 minutes. Ascent rate to next depth: 18m/min
Depth 2: 22m for 12 minutes. Ascent rate to next depth: 18m/min
Depth 3: 16m for 10 minutes. Ascent rate to next depth: 18m/min
Depth 4: 05m for 03 minutes. Ascent rate to surface: 18m/min
Surface interval time to next dive: 50 minutes

Dive Three

Depth 1: 30m for 14 minutes. Ascent rate to next depth: 18m/min
Depth 2: 20m for 16 minutes. Ascent rate to next depth: 18m/min
Depth 3: 15m for 10 minutes. Ascent rate to next depth: 18m/min
Depth 4: 05m for 03 minutes. Ascent rate to surface: 18m/min
End of dives

An hour or so after the dive, he coughs uncontrollably, and feels the urge to pass motion.  There is presence of blood in the stools. He shows no typical DCS/DCI-related symptoms.

Keeping this to the scope of diving, what could be the problem with this diver?
SeaDemon
 
Topic author

Re: Let's Work Using Symptoms Instead

Post Number:#2  Postby GOD » Sun Jun 03, 2007 2:42 pm

:o
GOD
 
Topic author

Re: Let's Work Using Symptoms Instead

Post Number:#3  Postby SeaDemon » Sun Jun 03, 2007 5:10 pm

;D ;D ;D ;D ;D Where's Divedoc?
SeaDemon
 
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Re: Let's Work Using Symptoms Instead

Post Number:#4  Postby divedoc » Sun Jun 03, 2007 9:28 pm

I'm still around, thanx for asking...

Y on earth laa u like to torment me with all these questions??? Frankly speaking, i don't think the scenario u gave has anything do with diving illness.

Furthermore, providing the dive profile alone isn't sufficient enuff for any doctor to determine the illness that this particular diver is having. What type of gas is he using (compressed air, Nitrox, Heliox, Trimix, etc...), could very well explain the emergence of symptoms immediately after diving, with the assumption that he has not fully off-gassed yet!

I like to quote my Professor in med school, who used to say, "Common illnesses come commonly, and uncommon illnesses come uncommonly." Gastrointestinal barotrauma comes to mind when u mention that this diver feels the urge to pass motion, and when he does, it's streaked with blood. An ascent rate of 18m/min is usually a standard ascend rate, but do keep in mind that diver may have skipped his breath at depth, causing visceral barotrauma, and possibly pulmonary over-inflation syndrome (pneumothorax, subcutaneous emphysema, mediastinal emphysema, CAGE[worst case scenario]), causing the cough to be prominent.

Hope that answers your urge to ask questions...
divedoc
 
Topic author

Re: Let's Work Using Symptoms Instead

Post Number:#5  Postby zzz » Sun Jun 03, 2007 9:37 pm

hehehe.... thanks for the answer divedoc. I was thinking in the same line but wasn't sure whether there is documented visceral barotrauma..

Ahh... Continuing Medical Education ... can get CME points tak??? ;D ;D ;D
Last edited by divedoc on Sun Jun 03, 2007 9:45 pm, edited 1 time in total.
zzz
 
Topic author

Re: Let's Work Using Symptoms Instead

Post Number:#6  Postby divedoc » Sun Jun 03, 2007 9:46 pm

hehehe.... thanks for the answer divedoc. I was thinking in the same line but wasn't sure whether there is documented visceral barotrauma..

Ahh... Continuing Medical Education ... can get CME points tak??? ;D ;D ;D


CME?? I doubt very much...CMD (Continuous Medical Dyseducation) maybe lah, hehehe...
divedoc
 
Topic author

Re: Let's Work Using Symptoms Instead

Post Number:#7  Postby SeaDemon » Mon Jun 04, 2007 2:38 am

I'm still around, thanx for asking...

Y on earth laa u like to torment me with all these questions??? Frankly speaking, i don't think the scenario u gave has anything do with diving illness.

Furthermore, providing the dive profile alone isn't sufficient enuff for any doctor to determine the illness that this particular diver is having. What type of gas is he using (compressed air, Nitrox, Heliox, Trimix, etc...), could very well explain the emergence of symptoms immediately after diving, with the assumption that he has not fully off-gassed yet!

I like to quote my Professor in med school, who used to say, "Common illnesses come commonly, and uncommon illnesses come uncommonly." [highlight]Gastrointestinal barotrauma comes to mind when u mention that this diver feels the urge to pass motion, and when he does, it's streaked with blood. An ascent rate of 18m/min is usually a standard ascend rate, but do keep in mind that diver may have skipped his breath at depth, causing visceral barotrauma, and possibly pulmonary over-inflation syndrome (pneumothorax, subcutaneous emphysema, mediastinal emphysema, CAGE[worst case scenario]), causing the cough to be prominent.[/highlight]

Hope that answers your urge to ask questions...


Hehehe...correct assumptions.  Gastrointestinal barotrauma is somewhat uncommon, though not to be ruled out.  Thank you for asnwering, and hope that forumers who read this, do read this answer by Divedoc thoroughly.

My bad for not specifying the type of gas the diver may have been breating, but you get these symptoms in recreational divers whom have gotten complacent when it comes to lessons learnt during OWD.

Was just keeping you on your toes la...been a while since anyone's posted anything in this thread. ;D
SeaDemon
 
Topic author

Re: Let's Work Using Symptoms Instead

Post Number:#8  Postby SeaDemon » Mon Jun 04, 2007 2:40 am

hehehe.... thanks for the answer divedoc. I was thinking in the same line but wasn't sure whether there is documented visceral barotrauma..

Ahh... Continuing Medical Education ... can get CME points tak??? ;D ;D ;D


Ahahaha...stay put cutting bones and prescribing Paracetamol and LMS to amputees. Soft tissue injury.  ;D
SeaDemon
 
Topic author

Re: Let's Work Using Symptoms Instead

Post Number:#9  Postby zzz » Mon Jun 04, 2007 6:14 am



Ahahaha...stay put cutting bones and prescribing Paracetamol and LMS to amputees. Soft tissue injury.  ;D


>:( >:(

Cannot know more meh

What if divedov not around....aha then you know..... ;)
zzz
 
Topic author

Re: Let's Work Using Symptoms Instead

Post Number:#10  Postby SeaDemon » Mon Jun 04, 2007 12:15 pm



Ahahaha...stay put cutting bones and prescribing Paracetamol and LMS to amputees. Soft tissue injury.  ;D


>:( >:(

Cannot know more meh

What if divedov not around....aha then you know..... ;)


I can answer some of the stuff on his behalf  ;D
SeaDemon
 
Topic author

Re: Let's Work Using Symptoms Instead

Post Number:#11  Postby divedoc » Thu Jun 07, 2007 7:55 pm



Ahahaha...stay put cutting bones and prescribing Paracetamol and LMS to amputees. Soft tissue injury.  ;D


>:( >:(

Cannot know more meh

What if divedov not around....aha then you know..... ;)


I can answer some of the stuff on his behalf  ;D


Eh, don't la like that, SD!!! I'm counting on zzz to answer ur ever-so-inquisitive mind whenever i'm not around. And so far, there are SOOOOOOO many forumers with "MBBS" around lah!!! Difficult to distinguish which one is genuine!!!

Please, i would like to advise our dear forumers, please do not give ill-advice to our friends. You may not realise it and think of it as a joke, but it could possibly do more harm rather than good! If ur advice is evidence-based, by all means, post it!! Do not post any "ajaran sesat" answers in any Dive Medicine and Fitness threads. And i think (SD would agree with me on this) that we have covered almost all of the common diving illnesses, so for any of you wanting to start a thread based on your queries, please refer to earlier threads (in case the answer you need may be just available there without you having to ask again).

TQ.
divedoc
 
Topic author

Re: Let's Work Using Symptoms Instead

Post Number:#12  Postby SeaDemon » Fri Jun 08, 2007 1:41 am

MBBS...is that the one near the Stadium Negara? Eh, that one is MBS. ;D

I agree. We have covered most of the important topics on dive-related illnesses. Maybe one of those peculiar ones may surface from time to time...like the egg-shell skull theory  ;)
SeaDemon
 
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