Advice, Support and a Lifeline

One of the major concerns with remote dive travel is the distance from a hyperbaric facility. Photo by Julika Kennaway

A few years ago I traveled from Cape Town, South Africa, to North Sulawesi, Indonesia, to pursue my dream of seeing miniscule seahorses and to recover from the past trauma of a car accident. My eight dives over five days were easy and shallow with slow ascents, plenty of safety stops and a maximum depth of 65 feet. Each dive had been on air, and I experienced no problems except for feeling cold and developing a strange tingling in my left foot.

Two days after my last dive, I flew to a remote island in West Papua. I was not feeling well before the flight and had developed a sore throat and slight squeeze in my lungs. While in the air, the tingling in my left foot got worse and spread to my left hand. The tingling worried me; with a heavy heart I knew I should stop diving. I was not convinced that my symptoms were due to another cause and was not willing to risk possible decompression sickness (DCS) going untreated.

There was no phone reception at my location, so I waded through the sea to another part of the island and then climbed a three-story bamboo tower to get a signal. I contacted my mother, a general practitioner, who admitted that many general practitioners have little or no knowledge of dive medicine.

It is important to have a communications plan in place, take seriously any symptoms of possible DCS or other dive injuries, and call the DAN emergency hotline if you need assistance.

Even though I wasn’t a DAN® member, I texted and emailed with my partner back in South Africa to see if DAN would give me advice. Within seconds of getting phone service again, I was talking to a doctor trained in dive medicine, and I got advice, support and a lifeline.

After I told the DAN doctor about my dive activity from the previous week, he concluded that my symptoms indicated possible DCS. He advocated for my immediate evacuation to a recompression chamber.

When I called my insurance company in Johannesburg, South Africa, the representative wondered if DCS was contagious, asked how I could climb a tower with this “sickness” and began making plans to get a doctor to visit me in about a week. They clearly had no idea what DCS is and that time is a vital factor. I was at a location where only one boat a week went to and from the island. DAN fully understood the urgency and stepped in to help me.

DAN logged all my correspondence and calls, mapped the island’s exact position and activated an emergency evacuation plan. DAN medical staff facilitated my transportation to definitive medical care and assisted me with the information I needed to make the important choice to be promptly evacuated to Singapore, where the Republic of Singapore Navy chamber was operational and available for my recompression treatment. While my symptoms worsened on the way, I was confident and able to rely on the plan DAN put in place to ensure I arrived safely.

A few hours after landing in Singapore, I arrived late at night at the recompression chamber at the superb Tan Tock Seng Hospital, which DAN had recommended and vetted. The hyperbaric facility team was waiting for me and provided me with recompression treatment.

From across the world, DAN constantly assisted me throughout the entire ordeal from the moment I contacted them. When I arrived home, the DAN doctor saw me in person to follow up about my DCS. DAN’s effort to help a nonmember was impressive and appreciated, but unfortunately I could not take advantage of member benefits such as dive accident and travel coverage, which would have been helpful. I will never do another dive trip without DAN.

Lessons Learned

  • DCS does not always present in a typical manner, and symptoms can vary from person to person. Like me, you may not have joint pain or rashes.
  • Sit out a dive if you’re not feeling 100 percent. I was cold and fatigued during my last few dives; while I can’t say for certain those factors predisposed me to DCS, they certainly didn’t help.
  • When you travel to remote locations to dive, be sure you have a plan to ensure you have sufficient communications capabilities. I had to make an effort to get in contact with someone who could give me a proper diagnosis and assist me in getting medical care. Had my DCS been severe enough to prevent me from getting to a location with a cellular signal to make a call, my outcome may have been worse.
  • Take your symptoms seriously even if others don’t. Then get professional advice with a doctor trained in dive medicine, even if it means consulting someone who is far away. The DAN emergency hotline is available any time, day or night.
  • Not all doctors are familiar with DCS. If in doubt, call DAN.
  • Many travel insurance companies won’t understand the urgency of dive-related symptoms and may not have fast access to anyone who is qualified in dive medicine.
  • Travel insurance companies may have foreign offices — such as in Indonesia and Singapore — who act on their behalf, but each representative must get authorizations from the head office, in this case in Johannesburg, which can cause huge delays. In a time-sensitive scenario, any kind of delay can put the outcome in doubt, especially when it’s already necessary to travel to receive treatment.

With DAN there are no delays: Activation and decisions in an emergency are immediate. Thank you, DAN. I won’t ever forget your help.

© Alert Diver — Q4 Fall 2019