Issue 5 Dive Docs Go Mad in Graz from the Archives of the London Diver Magazine

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7 November 2024

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	ISSUE 5 ARCHIVE - DIVE DOCS GO MAD IN GRAZ Or How Your Dive Doc Gets to Know Their Stuff EUBS Conference, Graz, Austria. THE clever diving medical meeting of the year... The next time you interact with your local dive doc, be it a phone call, or you've sent a rather odd looking bloke to get passed as fit (you even might want to discuss a bend, or which recreational drug you can get away with 20 minutes before you dive) remember one thing and remember it well: All this clever stuff doesn't just roll off our tongues. We have to go a learning once in a while. And this year finds us all in the Austrian mountains with the European Underwater Baromedical Society. So let's get a little insight into the life of a "Hyperbaric Physician" from a secret diary found under a chair at the end of the meeting.
	Wednesday I hate Stansted. I hate Ryanair. In fact the only thing I hate more than those two is Sharm airport with a five hour delay. But there, you have at least been diving. At Stansted you have to mix it with Essex's finest and only have Dunkin Bloody Donuts to get coffee from. And Ryanair? You'll be having to pay extra to wear shoes next. Just publish the final price you lot, not hooking me in then stripping my wallet bare later. Ah well, at least it's sunny here and the pilot says it's even hotter in Austria. I can't see many dive docs on the flight, but there does feel the ominous presence of those in search of Nazi war memorabilia.
	We are staying at a hotel picked at random from the web. Well, when I say random, the stars did have something to do with it. As all those executive travel mags keep telling us, if you slum it in a 2 or 3 star hotel, you do take an almighty risk with the minibar. 4 stars doesn't guarantee you all the channels on the telly, so you really have to go for the big 5. Here you certainly get towel origami from the maid and that caring gentle knock on the door just as you are on the bidet asking whether you need your bed turning down. "Can you come back later, I'm just washing my arse" echo all the cries down the corridor. The Grand Hotel Wiesler has all that and more. Windows big enough to accommodate 3 smokers hanging out for that illicit fag as well as a complimentary apple. Perfecto. My travel companion is another dive doc, I shall call him the Shamen of the Deep. Today is registration day. All that means is, you go and get a rucksack full of goodies as well as the list of lectures that are so gonna clever-me-up this week. But problem – the venue is miles from the hotel, so what is the point really of going that far for something I can get tomorrow. "Ah", says Shamen, "it has the info of where tonight's welcome bash is being held" – I had forgotten to print it off the web before going. We could be wandering the streets of Graz blind in the search of a free drink. No worries though, there's free internet in the hotel reception. Well, there was until the fire alarm went off and all the power shut down automatically just as I got onto the terminal (if you ever want to totally stress out a hotel receptionist, just ask them how long they think the web will be down as they are frantically searching a plan of the hotel to see which guest is in flames).
	A quick call to base in London solves the problem. 7pm at the Burg in Graz is the venue for our welcome from the Mayor of Styria. That's the part of Austria where we are and not to be mixed up with Stygia. That's something to do with the River Styx, the Ancient Greek death river. Shamen finds it first on the map – right at the top of a sodding mountain in the middle of town. "Let's walk up the 4000 metres", he says. It's OK for him. He does marathons. I eat them. We walked up. And I have to admit, the thought that I might just have my first heart attack really did arise. It is a sad point in life when a colleague is subtly trying to take your pulse when you have to stop for a fag break after the thousandth step. But with all that exercise, I reckon it unclogged me coronaries and I made it all the way without recourse to the Shamen's emergency aspirin.
	We were, however, about to be disappointed. The restaurant denied all knowledge of a boozy do for doctors. The Burg was in fact back down the mountain. "Arsenholz", as they say here. This was the Schlossburg, the venue for tomorrow night's piss-up. We made it a few minutes late. And in typical metronomic Austrian style, the speech had started bang on time and we had missed the major part of the glad handing. Anyway, let's see who is here this year. And like a scene out of the classic youth violence film "The Warriors" we have the Croats in one corner. Outside smoking on the balcony, the Greek massive are running with the Dutch boys. French mixing it with Saffies as the Turks look on. "Russians to the left of me, Germans to the right. Here I am stuck in the middle with you", I sing to the Shamen.
Here we made first contact, the sweetest Professor of Dive Medicine around. She runs the Moscow chambers. There are 50 there and 1,500 in Russia alone. They can probably add a few more when Georgia is theirs. The stuff they treat out there with success makes our hyperbaric industry look backward: MS, rheumatoid arthritis, stroke, acute heart attack. Fascinating. And all paid for by the state. Now there's a generous oligarchy. She was surprised to find out that we would also like to trial treatments for those sort of illnesses, but our hands are tied by government red tape and the double edged sword of "Evidence Based Medicine". My rant with EBM is that for every trial to actually prove whether a drug or treatment works, there's another trial that may cast some doubt. So in the end, a doctors hunch is worthless as we have to wait for defacto 110% proof, that can take years. Patients suffer in the end as a doctor who knows hyperbaric oxygen will benefit an off beat case can't back it up with reams of evidence where thousands of patients have been "double-blind-random-controlled-trialled". Shamen and I decide Graz needs drinking dry. Well I did actually. Shamen is more responsible than that and probably has a marathon next week. I have a light jog to Asda planned for November. Back to the room – oh joy – an origami towel swan and another complimentary apple. They must be in season. Thursday Let the games begin. Hang on what's this? Why are there two mop haired musicians on the stage playing jazz guitar. I thought we had a lecture on DCS in rats. They are still playing 5 minutes later. "Gettoff", I mumble, give us the Powerpoint slides of bar charts and dead rodents. They finish playing and our Austrian host for today explains that jazz is a Graz tradition. Yeah right. And so is the digeridoo in Peckham mate. The conference kicks off with "Technical application of hyperbaric chamber providing pig experiments in Prague". Not only is this grammatically incorrect but they have seriously made a pig shaped chamber. Those crazy Czechs. They also made a smaller one to put rats in as well. Since when did pigs dive anyway? This should remind all us divers that a lot of what we know about DCS is based on the deaths of pigs, rats, sheep and goats. I guess it's God's punishment for making them so stupid. Today's lectures are about other uses for a diving chamber. One such is for treating carbon monoxide poisoning. In London we may see one or two cases of this a year. A Spanish doctor tells us Barcelona's figures – 160 cases a year. 160!! Just what are they doing there in España? Considering the major cause of this is a dodgy boiler, then they must have the worst plumbers in the world there. Or all our crap ones emigrated south to wreak havoc amongst the Catalans.
There's a nice lecture from a pretty Turkish doctor about weaver fish injuries. Poor lass is a bit nervous though and talks too quickly, with the highest pitched voice I have heard today. She must be on hippie-trimix... helium/oxygen and speed. It is a long, long day. Shamen and I have sat through 30 – 40 lectures. But we are cleverer by a long way. The best talk was by Dr Wolf, yes, he of Gladiators fame I think. Sinus surgery in divers, that's his thing. All in glorious Technicolor, we see how he probes and scrapes until the sinus and noses of problem divers become wide open alleys. Equalization made super easy. It could also be a cure for a Brummie accent as well. Shamen wants to walk back to the hotel. I am too lazy so we get a taxi. The driver is a huge fan of Graz's number one son, none other than the Governator of California himself. Arnie was born here. The town's football stadium used to be named after him. The cabbie was still annoyed though. Graz's liberals had The Schwarzenegger Stadium renamed as Arnie supports the death penalty in the USA. Somewhat ironic methinks when you consider the first ever stadium was the Colosseum in Rome. Tonight's entertainment is "The Gala dinner above Graz" – where we wandered to yesterday. High up atop the mountain in town. We get the lift this time. 30 seconds to the top and no chest pain. Before the grub, which I assume will be veal and apple based, our hosts give us a slide show on the history of the city. Here's the stats: Graz is the second biggest Austrian town; It's based in the south and was bombed heavily during the war. "But the Allies were kind and did not bomb the Old Town" our host almost wept. I felt that the Brits, Aussies and Americans here should have been given a big round of applause. The musicians sparked up more Austrian Jazz and yes, there was yodelling as well. Bed late. Origami towel giraffe. More apples. Friday Oh for f**' sake, you can't put THAT on a slide this early in the morning – Fournier's Gangrene. The worst thing that can happen to a man. A gangrene that starts in the perineum and basically destroys the penis and testicles. Slowly and agonizingly you watch as bacteria chew away your jewels. There is a cure. Hyperbaric oxygen. Thanks to the divers in the UK, there are enough pots around that can treat this emasculating illness. The lecturer has kept his worst slide as the last. Shamen has gone green. The wimmin in the audience grin. At last, divey stuff. Some French doc has researched the positive effects of having a sauna before you dive. Apparently it wards off the bends. Can't see how, what with the dehydration that is going to happen as well. And practically speaking, even if it were true, are we all really going to rush into a sauna before putting on a wetsuit? Best stick to Nitrox.
Now this is interesting. The Norse reckon that the lack of DCS in some divers with shit profiles might be due to the banging they get on the RIB on the way to the dive site. The vibration causes little bubble nuclei to be stripped off the blood vessel's walls, so decreasing the chances of larger bubble formation. They trial it by getting divers to stand on a vibrating platform before a provocative tank dive. And lo... less microbubbles after that. So, today I have learned that I should have a vibro-sauna next time I pop up to Stoney. Perhaps they should install one there. By the end of Day 2, it's the little things that can make all the difference. On the plus side, free Red Bull and rocket fuel coffee. On the negative side, the tea is awful here. "Euroblend" they call it. Letting Europeans blend tea is like letting Austrians loose on jazz. They do the mags better than the music. Shamen hates the chairs we have to sit on. All wiry and minimalist. He is shifting from buttock to buttock to prevent pressure sores. Tonight's fest is a "South Styrian supper and wine tasting". Two hours away by bus. Shamen and I take a raincheck and go large in town. At last he is drinking properly. Just got to get him smoking next. Towel antelope. An orange. Saturday We are hungover. It must have been those funny cocktails that tasted of Tizer. A local specialty we were informed. Today is Dr Adel day. The big man is in town with a talk on the perils and pitfalls of tech diving. This is a good talk. All new stuff, hot from his data banks. 7% of all dives in Sharm are tech. 56% of all DCI is from those dives. So you can see why he is concerned. Half of them aren't or can't get insurance. The reasons for all this death and disaster? In Dr Johnston's words "the triumph of hope over experience". One techie saw him, Adel realised he wasn't fit or competent and refused to sign him off. So he saw another doc and lied to get a sign off. He died the next day after cocking up a gas switch at depth. Hmmm. I went for a walk around town later. A bunch of earingedtattooed yoof were drinking cans by a fountain. As I strolled past trying to look away they all said "Hello". Even the chavs here are polite. Bed early for us, it's the big DAN day tomorrow and we have to have brains like sponges.
I think it's a wolf. Banana. Sunday Divers Alert Network are hosting the big hitters of dive medicine today. And at last we have really relevant cutting edge information. Well, that's what I hope anyway. Bruce Bienke kicks off, with how bubbles are formed and his theory on deep stops in technical diving. However, his talk is a bit too technical and I miss his point. The next speaker makes things a bit plainer. Here's how to deep-stop: Take half the max depth of your dive and put in a stop for 1 – 4 minutes at that level. Super simple. So if you've gotten to 34 metres, do a 17 metre 2 minute stop as well as the safety stop and you shouldn't end up in a chamber. Phil Bryson's on too, with his "Women and Diving" talk. Apparently the third week of the menstrual period is the safest for the dive chicks out there. Just after ovulation. Safe for diving, not for getting up the duff. What the Lord giveth he taketh away. And don't dive if you are pregnant, but if you have by accident then there's no evidence for foetal malformation. I knew that already. Next up is a Belgian doc on "Children in Diving". Shamen is a bit concerned that Belgians are allowed near kids still. What depths at what ages, as well as what safety precautions the nippers need? I have my own opinions here and they are based on what would happen in an emergency. I would hate to see a ten year old have to help Dad out of the briny, so personally feel kids should wait until their teens to dive. But hey, that's just me and I don't make the rules. The DAN talks also cover asthma, flying and diving and more bubble theories. In all, a good day. At the end of the conference the Austrians have made the biggest cake-in-the-shape-of-a-dive-chamber I have ever seen. About 10 feet across. It gets photographed more than eaten. So that's it. It's all over. That's how we get to know our stuff and impart that knowledge onto you, dear diver. Despite the crap chairs, Shamen and I have become institutionalized here and are a tad sad to go. Our last night is spent in the part of town called "Glockenspiel" where we have become addicted to Austrian red wine and veal. We would buy lederhosen too but they are over 800 euros a pop. Seriously.
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