Sauna for Sadists
On the last day of a recent dive holiday on the island of Malapascua, in the heart of Philippines, I got bent. I didn't come up too fast, I didn't stay underwater too long, I hadn't been out drinking the previous night. Why did it happen at all?
The day before, I'd dived twice. Once to see the thresher sharks that the island is famous for, once to a Japanese wreck sunk by US bombers during WWII. The second dive was a real challenge; a swim through 10 metres of strong current to get down to the site. I held onto my stomach (I get seasick in the bath) and went for it. That night I was tired - really tired. I was in bed by 8.30, completely tanked out.
Next morning we dived the shark reef again. We didn't see any Threshers until right at the end of the dive, and we stayed two or three minutes longer than we ought to have done; it was, after all, the last dive of my trip. My guide's computer said we were fine, but a more recent model belonging to one of our party - an extremely experienced Dutch diver called Ger - warned that we'd gone into what's known as decompression time. This meant making a 'safety stop' during our return to the surface, a pause between 3 and 6 metres to allow our bodies to rid themselves of the excess nitrogen they'd absorbed. No problem - we always did one of these anyway, on every dive, just to be safe. But the sea above us was rough, and during the stop I felt a little queasy. I held onto the anchor rope, which was a mistake - as the boat bounced up and down on the waves, it bounced me with along it. Without realising it, I was being shaken like a can of Fanta.
We returned to the island, had breakfast, then I went back to my hut and lay down to read. After a couple of hours, my hand went numb. Bad pins and needles. Thinking it was probably the seasickness tablet I'd taken, I worked my fingers until sensation returned. This it did. I went back to my book. Then my leg went numb too. And stayed numb. I walked around a bit. No change. I walked down the beach to the dive shop. I felt tired. I lay down. My leg continued to tingle.
I decided to tell Ger. He'd know if it was DCS. It was the first day of his holiday and I didn't want to bother him, but now I was becoming genuinely concerned. He quickly examined me. I had some loss of power down my left side, nystagmus (rapid, involuntary movements) in my right eye and debilitated hearing in my right ear. No doubt about it. It was DCS. One way or another tiny nitrogen bubbles had formed in the nerves of my lower arms and left leg. The only way to get rid of them was to climb inside a hyperbaric chamber, pressurise my body so that the nitrogen could be reabsorbed back into my blood, and use oxygen to try and flush it from my system.
The first thing was to get me breathing pure oxygen right away, which helps contain and allay the onset of symptoms, though on its own it can't cure the condition. The second was to get me to the nearest hyperbaric chamber, about 70 miles away in Cebu City. Not sure if my insurance would stretch to a helicopter (it turns out it would have done), we organised a car and a boat. Another mistake - seventy miles is a long way by road in the Philippines. The journey took us close to five hours.
Going through the chamber was not a pleasant experience. Imagine. You've had no food for twelve hours. You've been travelling all day. You're scared and exhausted, and you're now going to spend the next five hours in a sauna. But this isn't a normal sauna. This is a special sauna, a sauna for sadists, with lots of special sadist rules.
1) In this sauna you have to lie down, but you're not allowed to sleep, however tired you may feel.
2) You have to breathe oxygen through a mask for long stretches, however much your lungs scream out with exhaustion and pain.
3) After a while the sauna will change from a sauna into a fridge as the pressure is halved, but someone will have removed the extra clothes you took in with you without telling you, so now you'll be really cold.
4) To make sure you stay awake and breathe properly the Philippine equivalent of a US Navy Seal, built like a gorilla and wearing only a thong, will go in with you, to prod you every five minutes and mumble vaguely homoerotic threats at you in Tagalog.
5) On the karaoke system that happens to be installed just outside someone will play 'Only Yesterday' by the Carpenters several times in its entirety.
After three hours of this I no longer had any idea who, what or where I was. After five, I had the answer: I was Karen Carpenter.
Eight days later, back in London, I went to see Dr. John King, a leading dive medicine specialist. The fatigue I'd experienced after the wreck dive? It had probably been DCS, right there already, which the poor safety stop the next day then exacerbated. I'd made matters worse by delaying reporting my symptoms and not taking a helicopter. The four hours I'd been made to wait, for no apparent reason, before getting into the chamber hadn't helped either. And I should have been put through it at least twice. Because as it turned out I was far from okay.
Despite six more trips through a hyperbaric chamber in St. John's Wood, I'm left with some minor nerve damage to my left hand. It still tingles, a condition it'll might take my body up to 18 months to correct. And it's still not absolutely clear what the cause of the DCS was. Was it, in fact, a poor safety stop? Did we just dive too close to the limits? Was I dehydrated? Did I hyperventilate while battling that strong current? Did the seasickness tablets I was taking make me more susceptible? Am I just prone to DCS anyway? According to Dr. King, it was all of these. I'd always thought you needed to do something stupid and extreme to get DCS, like shooting up quickly from depth, or flying right after a dive. But it turns out it can creep up on you slowly, a slow amalgamation of minor oversights or mistakes. If you're planning a dive trip this summer, be warned - and be careful.
- The Observer, July 2002