Thursday, July 07, 2005

Questions and Answers

Age of air in my tank

This may be a stupid question, I have not used my equipment for almost 7 years. I only use it in my work which is residential swimming pools. My last VIP was 7/98. My tank is still full, is this air still good and/or should I have it VIP and refilled? Will the tank need to be Hydro’d since it has been so long?
Second question is the regulator, again not used for 7yrs. “Scuba Pro” Should this also be checked out may it need to be re-built. Again, This is for leak checks in pools of no more than 10ft. and I have not had to need to use this equipment for all these years.

Please advise.

Answer by Stephen Barsky

Hello:

Dr. Campbell asked me to respond to your questions. I would recommend that you have the tank drained, inspected internally, hydroed and refilled. There is probably nothing wrong with it, however, if there is active corrosion in the tank, this can deplete the oxygen inside the cylinder, which could be a problem.

Tanks must be hydrostatically tested every five years, so your cylinder is definitely out of hydro. Your regulator should also be serviced. Depending on how and where you stored your regulator, the o-rings may be very dry and/or cracked. This would cause the regulator to not perform properly. While you're at it, you should have your BC inspected as well.

You'll be a lot more comfortable using your gear if you know it has been serviced and everything is operating correctly.

-- Regards,
Steve Barsky
Marine Marketing & Consulting/Hammerhead Press

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Stingray Injury

I was stung by a stingray ten days ago in the gulf of mexico. I was treated with tetanus and medicine for shock and allergy. Since then it seemed to be fine. The puncture wound is in the bottom of my foot.

Yesterday I noticed some localized swelling. Almost like a hematoma or abcess? Like a grape size, harder. When I walk on it it feels like I'm walking on a grape or rock. At the time it was done the medical clinic was not sure if the barb had come out or not. What should I do now?

Answer:

It is entirely possible that you have a portion of the barb or some of the proteinaceous substance surrounding the barb still in your foot. Sometimes this will not show up on x-ray and other diagnostic procedures are required.

There might be the need for surgical debridement of the wound, if this has not been done before now.

See my web site information about this at http://scuba-doc.com//hzrdmrnlf.html and at this site http://www.emedicine.com/aaem/topic421.htm .

Hope this is helpful!

scubadoc
Diving Medicine Online
http://scuba-doc.com/

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Pulmonary barotrauma, cerebral embolism in Marfan's patient

My son has recently had a gas embolism to the brain following a shallow (<15m dive). He is a master diver, and has dived over 50 dives. We were in Zanzibar - on his first dive he experienced visual disturbances which he thought was salt in his contact lenses. The second dive 45 minutes later he experienced severe weakness and surfaced early. The next day he had two wonderful perfect dives. Day 3 upon surfacing, he experienced pain in his thighs with pins and needles and tingling in his arms. Upon surfacing he appeared comatose although he says he could hear what people were saying. His pupils were pinprick and he was basically paralysed (flaccid). My other son who is a newly qualified doctor was his buddy and adminstered 100% oxygen with rebreather immediately. He had three tanks of oxygen all in all. We returned to South Africa three days later where he saw Dr. Frans Cronje an expert in South Africa, who realised that he must have had some pulmonary baratrauma. He found on ct scan that he had various bullae in his lungs due to the fact that he has marfans syndrome. We realise that he has had a close shave with death and that diving is now contra indicated. However, your articles suggest removal of the bullae. Is this the treatment of choice in your country. Many thanks.

Answer:

Hello:

The advice that you have received from Dr. Cronje is absolutely correct and further diving is contraindicated in your son. Inherited bullae or blebs [as is the case with Marfan's Syndrome] are located in both lungs and surgery would be difficult if not impossible to remove all of the enlarged and partially blocked air spaces.

Bullae can be removed and often are removed in countries all over the world - not just the USA. This is done to prevent pneumothorax [collapse] of the lung but not to allow resumption of diving. However, persons with a need to resume diving as a livelihood and who can be shown not to have air trapping have been able to resume diving after successful surgery.

Again, I completely agree with Dr. Cronje that your son would be at great risk for another episode of arterial gas embolism with any further diving. In addition, he may also be at risk for bleb rupture with coughing, sneezing, or any procedure that requires the closure of the glottis and straining. Even mountain climbing and air travel might be considered as offering an increased risk of bleb rupture.

One final caveat - his cerebral embolism has left scarring with loss of neurons. Further diving with the risk of decompression illness or emboli might add to this damage.There are numerous links to pulmonary barotrauma on our web site, including one on Marfan's Syndrome.
http://www.scuba-doc.com/mrfnsynd.html
http://www.scuba-doc.com/spntpnu.htm

I hope this has been helpful!

Ernie Campbell, MD
'Scubadoc's Diving Medicine'
http://scuba-doc.com/

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