A Day in the Chamber and I Wasn’t Bent

While recently aboard the Cayman Aggressor, I dived four times a day using nitrox, well within the limits to avoid DCS. Lying in bed the night before my last full day of diving, I had light vertigo whenever I rolled over on my left side. I dismissed this as being caused by the rocking boat, fatigue, or ear infection. I tried to ignore it, feeling it would eventually go away.

My last full day of diving went without a hitch, but I still had some vertigo when lying on my left side. The next day, we I planned to make the two offered dives before we headed to port, but halfway through the first, I looked down between my legs and vertigo hit me. It quickly passed, but I figured that I had better get back to the boat and pack my gear.

When we reached port, the captain suggested that I visit the Cayman Clinic, which has a couple of doctors who specialize in diving medicine. I figured I probably had an ear infection and would get an antibiotic, and all would be well. The doctor gave me the equivalent of a field sobriety test, which I failed. She then told me that there were several things that could cause my condition, one of which was an inner ear DCS hit. She suggested a five-hour treatment in the hyperbaric chamber. I was shocked, but felt it would be a wise course of action, so at 3:00 in the afternoon on Friday, I headed over.

I thought that I would just sit in the chamber for the five hours, maybe read a book, and catch a nap. Was I mistaken? I did not realize that I would have to breathe oxygen through a mask for 20-minute intervals, with only a five-minute break between. I also did not realize that someone must be with you at all times, which turned out to be in one-hour shifts by five different people, all volunteers.

I got through the process with the admirable help of the volunteers. Getting in and out of the chamber took an additional 30 minutes for them, and each had dropped what they were doing to help out on a Friday afternoon. I told them to talk about anything, just tell me whatever you want, life story, your pets, your last trip, anything, just keep the boredom down for us both.

When the treatment was over, I went back to the boat and went to bed. The next morning, I went to the clinic for a follow-up. Dr. Hobday did the same sobriety tests with me, and I failed again. She had me lie on an examination table, slightly tilted down, and turn my head to the left. Vertigo hit me like a brick. She then told me that I had a condition called benign postural vertigo. It is more likely to occur in older people (I am 52) and is caused by the inner ear not "bouncing back" well after one moves into an unfamiliar posture. It seems that my enjoyment of weightlessness underwater usually involves hanging upside down, looking under ledges, doing barrel rolls, etc., but this wreaked havoc on the balancing mechanisms in my inner ear.

She described a few exercises and told me to do them until my vertigo went away. After doing them three times a day for a day-and-a-half, my vertigo disappeared completely.

I wanted to share this experience with Undercurrent subscribers for several reasons: 1) Stay well within the limits to avoid DCS, because going into the hyperbaric chamber, even in the best of circumstances, is extremely uncomfortable and really boring. 2) Be sensible about your positioning in the water, especially if you're older than 40, because your inner ear does not bounce back like it did when you were a kid on a trampoline. 3) The doctors at the Cayman Clinic are topnotch, and I didn't have to wait long to be seen. They took my DAN insurance card and handled everything, not one dime out of pocket. 4) And finally, the volunteers who operate and maintain this facility are great people who deserve my gratitude.

- Paul McFall (Cumming, GA)

Dr. Jim Chimiak, MD, Medical Director, DAN, commented: "Always report vertigo to your divemaster when it first occurs. Prompt first aid and medical treatment may be indicated. There are medical conditions that present in a similar fashion to DCS and can make diagnosis difficult, especially if following a dive. It is sometimes prudent to proceed with recompression therapy when there is significant doubt."