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Record 53 hour session in hyperbaric chamber saves diver’s life

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Hyperbaric Chamber

Thanks to some quick thinking by doctors and a handy US Navy Diving manual, a recent record breaking long-haul stay in a hyperbaric chamber saved the life of a Michigan diver…

“What I was worried about the most was holding my breath if I panicked,” said 64-year-old Begnoche, as holding your breath while ascending rapidly could cause a fatal lung embolism. “Panic is what really kills people.”

Last month Begnoche and other volunteers dived a shipwreck to capture footage off the coast of Grand Marais, Michigan. After he was pulled onto the boat, he started feeling prickly sensations in his body and he lost control of his arms and legs. His rapid ascent caused nitrogen bubbles to form in his bloodstream, cutting off blood to his spinal cord and other parts of his body.

Hyperbaric ChamberHis decompression sickness was so severe that saving Begnoche required a helicopter rescue to Marquette, Michigan and then a low-altitude flight to Hennepin County Medical Center in Minneapolis, where doctors tried a rare treatment protocol which they found in the U.S. Navy’s Diving Manual.

Along with a nurse, Begnoche spent a record 53 hours in HCMC’s hyperbaric chamber to give his body a chance to slowly clear out the damaging nitrogen bubbles.

“It’s really rare to have to do that protocol for a couple of reasons,” said Dr. Chris Logue, medical director of HCMC’s center for hyperbaric medicine. “One is that most people die. They never make it to treatment.”

Begnoche was like a “human soda bottle” that had been shaken up, Logue said, and caregivers needed to figure out how to deflate the bubbles.

Most of the time, HCMC’s hyperbaric chamber simulates a depth pressure of 45 feet to 60 feet below the surface and promotes healing by creating an oxygen-rich environment for patients suffering severe wounds or conditions such as anemia or carbon monoxide poisoning.

In this instance, Logue needed to simulate a depth of 165 feet — only 10 feet above the chamber’s maximum limit — to mimic Begnoche’s actual dive depth. That would drive the nitrogen in his body from bubbles into a solution and allow it to escape his body slowly and safely.

That’s what would have happened naturally if Begnoche ascended slowly from the lake as planned, with three or four decompression stops on the way to the surface.

Nurse Kimberlee Nerling, who was in the chamber with Begnoche the entire time, said she noticed immediate movement in the man’s arms when the chamber reached its maximum depth.

Begnoche has since regained control of his arms, and concerns about his lung functioning are over. But the semi-retired environmental manager and university lecturer can’t walk or move his legs yet.

Hyperbaric ChamberHe is receiving additional daily treatments in the hyperbaric chamber in the hopes that they will stimulate healing and reduce inflammation in his spinal cord. Whether he will make a full recovery is, as yet, uncertain.

“It’s such a rare event, it’s impossible to tell,” Logue said. “What we’ve gained back, I’m thrilled about.”

Begnoche, who lives in Michigan, watched films during his two-plus days in the chamber. He struggled to sleep and replayed how the dive went wrong in his mind.

Loaded with underwater lighting and a video camera to examine the recently discovered Nelson, a three-masted schooner that sank off the coast of Grand Marais, Michigan in 1899, Begnoche had neglected to put on a weight that would have otherwise controlled his ascent. The project was part of his work with the Great Lakes Shipwreck Museum.

Given the amount of oxygen in his tank, he had only 20 minutes to spend by the ship. At 19 minutes, just to play it safe, he started to rise and pointed the video camera back down at the ship on the lake’s floor. That’s when he noticed how rapidly he rose past another diver.

With 40 years of experience and numerous deep-water dives, Begnoche knew he couldn’t stop his momentum.

“I was doing everything I could do to push any air out of the suit or any buoyancy devices that I had,” he said, but with the pressure decreasing and the gasses in his suit and his body expanding, it was “like a self-fulfilling prophecy.”

When he reached the surface, Begnoche immediately submerged a few feet to try to decompress and then returned to the boat when his oxygen tank was nearly empty. A Coast Guard helicopter was dispatched along with a boat.

Flying Begnoche to Minneapolis was complicated, because a high-altitude flight would have worsened his decompression sickness. So the pilot was ordered to keep the plane below 800 feet.

Having never spent more than three hours in the hyperbaric chamber before, nurse Nerling was in for an unusual shift. The 53 hours in the chamber was necessary for her as well. Bringing them out of a simulated depth of 165 feet any faster would have caused her to suffer decompression sickness.

So Nerling made sure her daughter could stay with her father and grabbed a textbook she needed to study for an upcoming nurse practitioner exam.

“It’s just me and you,” she told Begnoche in the chamber.

Once the air pressure in the chamber rose back to a simulated depth of 60 feet, additional caregivers were allowed in so that Nerling could rest.

Begnoche said he is grateful for the help he received in the lake, for the national Divers Alert Network that assessed his injuries and referred him to HCMC, and for the proximity of the hyperbaric chamber in Minneapolis.

He hopes that continued hyperbaric treatments along with physical therapy will help him regain strength, but he’s also worried. In the water, his expertise helped him focus and stay calm. In the hospital, he is burdened with the knowledge of just how devastating a rapid ascent can be to the body.

“It’s scary,” he said, “especially when you know what’s going on and what could have happened”

Source: www.startribune.com

Photos: Renee Jones Schneider

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New academic study to confirm rehabilitative benefits of Scuba Diving

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A new study into Scuba Diving Rehabilitation Charity Deptherapy’s approach to supporting Armed Forces veterans with psychological injuries such as Post-traumatic Stress Disorder (PTSD) through the medium of scuba diving has been carried out by Petra Walker in conjunction with Hanna Kampman of the Posttraumatic Growth Research Unit at the University of East London.

This study, which used Interpretive Phenomenological Analysis (IPA), demonstrates that scuba diving has rehabilitation benefits beyond those found in other forms of sporting rehabilitation exercise.

IPA is a qualitative methodology that examines the experiences of participants and has been used in previous studies of Posttraumatic Growth (PTG) in para-athletes.

Petra is an experienced diver herself and was exploring the wellbeing aspects of scuba diving as part of her Masters in Applied Positive Psychology and Coaching Psychology when she came across a previous study on Deptherapy. Past studies have mainly focused on the medical aspects of diving, so the opportunity to examine the mental health side of rehabilitative scuba diving was impossible to ignore.

The full study is currently embargoed until it is published at a future date in an academic journal, but it follows similar academic research into the work of Deptherapy by the University of Sheffield Medical School (2018) and the University of Nottingham (2019).

Richard Cullen, Chairman of Deptherapy commented: “This evidence-based study demonstrates yet again the value of scuba diving and, in particular, the support provided by Deptherapy to severely traumatised people within the Armed Forces community. We await the publication of the detailed findings which we anticipate will be of considerable interest to all organisations who seek to assist in the rehabilitation of veterans through sporting activity, as well as the Scuba Diving world.”

Team Deptherapy returned to the UK last week from their first training expedition since the start of the COVID-19 Pandemic. A small group of six veterans travelled with the Deptherapy Instructor Team to the charity’s international base at Roots Red Sea to undertake practical Scuba Diving training in the clear, warm waters of the Red Sea.

Joining Team Deptherapy for the first time was 20 year old paraplegic Corey Goodson who had this to say: “I have been made aware of a new academic study about the benefits of Deptherapy. Last week I learned to scuba dive properly with Deptherapy, a huge achievement for someone with paraplegia. Deptherapy doesn’t judge your injury, whether that be physical or psychological; it looks beyond, and it sees the person inside. That person is who they work with, and the Deptherapy programme encourages you to see your fellow beneficiaries in the same light. More important than the sense of achievement during the training, was the support, care, encouragement and love the team showed me. I have found a new family in Deptherapy. I am home now but the support, friendship and banter continue; it is motivating and empowering, it gives me a deep sense of wellness and worth. I look forward to continuing my rehabilitative journey with Deptherapy.”

For more information about the work of Deptherapy and Deptherapy Education visit www.deptherapy.co.uk.

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Deptherapy returns to its Roots – Part 6

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Join Richard Cullen from Deptherapy for part 6 of his Blog about the charity’s recent expedition to Roots Red Sea, El Quseir, Egypt.

Thursday has dawned and it is down to the House Reef with an outgoing tide that is approaching slack so we can get in the water straight away.   Lots of chat about last night’s RAID O2 Provider session with Moudi.  Oatsie is talking about sidemounts and marine biology, Swars is looking forward to his first sidemount session this afternoon.

Moudi is supported by Oatsie this morning and doing some more skill work with Keiron.

Moudi running the guys through the RAID O2 Administrator Course

Corey was asking last night about what it is like at 30 metres, so I have decided that with Michael and Swars we will take him to 30 metres.  We are going to run a narcosis exercise so out comes the slate with the numbers 1 – 25 randomly placed in squares.  Corey’s task, in the dive centre, is as quickly as possible to touch each number in sequence.  He does it pretty quickly and Michael briefs him that he will need to do the same exercise at 30 metres.

Michael briefs the dive and we set off down the beach.  Corey has improved beyond measure and he is becoming a pleasure to dive with.  So we are off to follow the South reef to 30 metres where we will complete the second part of the exercise.

At 30 metres Michael hands Corey the slate; there is a considerable difference in the time to complete the exercise at the surface and at 30 metres.  There are lots of mitigating factors in how quickly you can identify the numbers and explaining a slower time at 30 metres than at the surface does not mean an individual is suffering from narcosis.  Identifying random numbers, if you run the exercise at the surface, several times with an individual over a number of hours can result in wide variations in the time taken to complete the exercise.

We finish the dive with Corey smiling from ear to ear and we have a discussion about depth and air consumption.  The second dive of the morning is a fun dive, then it is lunch in the beach restaurant.  After the burgers I am sure we will need to look at our weighting before the afternoon’s dive.

We will need to look at weighting after this lunch!

Corey and Keiron have got into the habit of recording their dives online using the RAID online log book which is a tremendous facility and as the instructor I can access that data.

Moudi and Keiron are going for a fun dive as are Corey, Oatsie, Michael and myself. Swars is getting kitted up for the first experience of sidemount with Guy Henderson.

Swars getting to grips with his sidemount cylinders

People often look at the relationships that exist between the dive team and our beneficiaries and try to extrapolate a similar relationship to disabled students they might have.  Our relationships are built up over a period of time, in some cases over many years.  We also provide 24/7 support and have chat groups etc on social media; we also meet up socially when we can.  It is somewhat different than a individual coming in to a dive centre and saying ‘I want to dive’. Your relationship is likely to be the same as any other student, you will teach them, they might stay with the dive centre or like many that will go on holiday to do some diving, you might never see them again.

Our main aim is to create a family atmosphere for our programme members, one where they feel secure and they are able to discuss freely with the team and fellow beneficiaries their feelings and needs.

Few dive centres are charities, and owners might want to consider costs of running a course for someone with a disability that might take more than the standard four pool sessions etc.  You may find the number of sessions and the staffing levels have to increase.  Many dive centres, because of their size and turnover are exempt from providing accessibility.  How will this affect someone who is a wheelchair user?  Can they gain access to the dive centre, the classroom, the toilet?  What are the changing facilities, can they get wheelchair access to the pool?

Lots of things to think about.

Roots’ beautiful reef

The reef is beautiful, so much aquatic life and the corals look splendid, especially the pinnacles.

A good day’s diving, Swars has really enjoyed his sidemount.

Lovely way to relax in the evening with the Roots BBQ, a fitting end to a great day.

Last day tomorrow and our final blog!


Find out more about the work of Deptherapy and Deptherapy Education at www.deptherapy.co.uk

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