ISSUE 24 ARCHIVE - BANGED UP ABROAD

Anna

I am a PADI Divemaster, I trained in a few locations, a lot in Plymouth, a bit Wales, but most of my training has been in Egypt. I went to to university in Exeter so visited Plymouth a lot to dive.

I have been on a live aboard in the Red Sea, we left from Hurghada and followed the southern route. The issue occurred when we were diving Daedalus reef; where you get all the schooling hammerheads and thresher sharks. Really good diving. Fourth dive on Daedalus Last dive of the day diving on Nitrox 29%.

Entered the water on a negative entry, I was kicking straight down and reached about 7/8m and my reg was being strange, and I found myself sucking in water. I probably should have used my octopus but I did not. I came to the surface to resolve it. I was only down for about twenty seconds and sorted it out there. After that I went back down but I found my ears were being a bit funny and I started to feel like I was having a bit of panic attack. This was unusual for me as I have never found myself having this unease on a dive. I am always really chilled.

I continued the dive as normal but I still felt a bit funny, not normal.

At the end of the dive I had lots of air left, and I just wanted to get out, which was questioned by the guide, not understanding the fact that I had 110 bar and I wanted out. You know when you're just a bit done. So I surfaced as normal and completed a normal safety stop. I was explaining all of this when I got back on the boat, and when I looked down, and a rash had come up along my chest. I thought 'I've got bloody stung', but as we all examined it, we realised my skin felt a bit spongey and just weird. I thought to myself 'that's not quite right.' Then I got on the boat and went on oxygen. When I went on the o2, the rash was going down with it, but it felt a bit weird. I felt a bit odd, a surreal experience. Like I feel now, a bit out of the ordinary. Seemed like a little bit of fuss and you don't realise what is going on.

I'd describe it more as you don't really know what is going on rather than denial. And nobody really knew on the boat; everyone had an opinion about it, but no-one really knew. I thought this was very interesting as everyone on the boat was an instructor or a Divemaster, so highly qualified divers. None of us, including the guides knew what we were looking for.

Other than the rash on my arms, I presented a rash on my tummy too. There was a tingling on my hands up to wrists and I was tired. Really tired. I was staying downstairs and I was watching a DVD on the sofa dozing off, and I just kept falling asleep. I didn't really pay much attention. I just thought I felt exhausted from the dive.

I didn't do the dive in the evening, but the symptoms had resolved themselves. By the next day I was feeling pretty fine. Then the rash on my arm had come right down, so it wasn't red anymore and my stomach rash was coming down too. I thought to myself that this isn't anything. And so I went out and dived again. On the next dives it came back up *laughs out loud*. I did two dives and then I looked and saw the rash had come up again in the same place.

I thought to myself 'oh dear.' So I went back on the oxygen. Some people were being very sarcastic, which was not the best help having not had any clear advice before then. People always have opinions they don't really know either. You would expect more knowledge from trained instructors and guides. The issue was largely that in a time of need, I was surrounded by other divers who had essentially no knowledge of what I was experiencing. Plus I was in the middle of the sea, with no one else to help. Not constructive.

What I really wanted to know was where the doctor was. The key issue upon arriving on land was where the location of a trusted doctor connected to a hyperbaric chamber was. This was the information that nobody seemed to have and as I knew something wasn't quite right I decided to take myself to the doctor despite the fact that no-one could direct me.

None of the boat crew knew, the girl who was running the trip was none the wiser and the only beacon of shining light to defer the impending doom was one of the guides on the boat eventually 'remembered' something about a military operation in Hurghada. I ended calling DAN and having another odd conversation. Very friendly, but she was just going through all the symptoms of DCI, on my on an international call rate, when all I wanted was an address. They were very informative, but I just needed an answer.

The reality was setting in a bit and there was no internet for me to google. Things were getting a bit scary. I eventually got the address and sent a text to the military chamber, close to Hurghada. The accident happened on the Wednesday; I didn't get to a chamber until the Friday.

When I got to the chamber, it was very different. It's not the same as here at LDC; this place was amazingly well equipped and very organised. First off, there was a language issue. It took the young doctor ten mins to work out that I had been diving. But as soon as he clocked there was an issue, he went off and retrieved a more senior doctor. Both men were very nice.

We went through the examination, and then my friend had to go off to a pharmacy to go and get medication for me. It seemed weird that these drugs were not available in the hospital. They prescribed Clexane, vitamin b12 (which I hadn't had a test to see if I needed), and aspirin. According to Dr. Mark, they are used for blood thinning. They favour that type of intervention before they compress you.

The chamber treatment had to be paid in dollars before I was compressed. This was an issue as nowhere dispensed dollars out of the ATM, and it was Friday afternoon by this time. They would not accept Egyptian pounds. In the end they allowed me in the chamber for compression therapy, but my friend had to put down his passport as collateral while he was out hunting for cash.

I had to fill out a bit of paperwork, passport details etc. When I went into the chamber I had no idea what was going on as the language barrier meant the briefing was non existent. But by this time I was relieved that there was a resolve.

No-one explained that it was going to be so loud. Your ears are going to pop, and you're going to be sweating loads. The chamber at LCD is cold, whereas in Egypt it was like sitting in a sauna. You don't wear scrubs, you wear the clothes you are in. I started scratching and itching. I didn't know if it was the rash or if I was experiencing prickly heat reaction while I was in the chamber. It was a low level chamber on the first day, so I was laying on my back and the roof was just above me in a cocoon. I found it a bit claustrophobic.

You have got this kind of fighter pilot mask on your face. There was an attendant looking after me, and he was lovely. The first treatment was 2 hours on the Friday night, and then the same on the Saturday. It was a sitting up chamber on the second treatment, but it was still hot.

The attendant was miming for me to equalise at the beginning, so I figured out pretty quickly when we started descending that you needed to equalise many more times in the dry chamber than when you are descending in water. Nowadays, when you don't really understand something then you just YouTube it and get it explained for you. As there was no internet, I really felt like I was going about it in the dark. I wouldn't recommend that.

After the second session, I had another injection of one of the weird and wonderful things they had prescribed. They really hurt. In fact I tried to run away before they injected me again but I got to the gate and they called me back. We had a debrief then and he explained it would be fine to fly that same evening and I would need another couple of sessions when I arrived back in the UK. He then went on to explain how to take the medication that I was heading home with. I flew that night and arrived in UK at about 1am on Sunday.

On the plane, the symptoms were non existent. The flight was horrible because I had a horrible case of food poisoning. The whole boat had been struck down on the last day, so I wasn't even thinking about he DCI. A great end to the trip... However, the food before that had been really amazing. Great company to travel with and lovely boat.

I contacted LDC about 3pm on the Sunday, and the nurse booked me in to come in the next morning. All I did was google decompression chambers in London, and saw the 24 hour line.

The experience here has been exceptional, from start to finish. You can't fault it. It is incredible that the NHS offer this service completely free without any waiting time. Everyone is so friendly, going out of their way to be helpful. The crew in Egypt were great and kind, and hopefully this incident raised their awareness of the symptoms of DCI for future cases.