Trust Your Gut… My Experience with Skin Decompression Sickness

Posted: Apr 4, 2017

diver KateI am not a "thrill" diver. AT ALL. I love to dive, but I am the drop in, look around, float around and take some pictures kind of diver. That makes me happy. I don't push limits, I don't push tanks, I dive my computers without messing with settings. I am a true recreational diver.

The shore diving in January had been AWFUL...and for the whole month I only had four dives. Not nearly enough for living on Maui, let alone for someone who works at Maui Dreams Dive Co. and gets to (has to!) hear about everyone else's cool critter sightings all day long, so I was thrilled to be able to get on the Maui Diamond II for some very much needed ocean therapy. I had friends and colleagues diving with me and the day was bright yet very windy, so a Molokini trip was out of the question.

I broke out my 5 mil suit, the one I only wear on boat dives because of the weight I have to carry to sink the darn thing. All my other equipment was the same. My main computer is a Suunto D4i and my back up is a Suunto Zoop that is part of my gauge console.

We suited up, dropped in and found beautiful water! I dove with two friends and it was a very normal dive: 68 minutes, max depth 57 feet. All within limits of both of my computers. There was little current, great vis, and yep, a good dive was had by all.

After a 72 minute surface interval (there WERE whales to watch you know), we dropped into our second site.

It was pretty much the same profile: 68 minutes of bottom time with 54 feet at max depth. This dive was also well within the limits of my computers. My profile matched my dive buddy's. Everything was calm. All was right.

We had nudibranchs, frog fish, mating octopus, devil scorpionfish - it was a good day!

Typical Dive Critters

I left the boat at 11:30 and headed home to clean gear and have lunch. Then, less than two hours later, my skin began to itch. More of a burn than an itch. At first, I didn't think much of it...just kind of rubbed my belly...and moved to the couch. I napped for a few minutes, but awoke and the itching was still there.

Then I looked in the mirror.

My mid-section was red. Not crazy beet-red, but red and spreading around to my back.

I had never had anything like this happen to me ever so I ran through a mental check list. New detergent? No. New soap or shampoo? No. Eaten anything strange? No.

It suddenly got brighter in the room... as the ligh-bulb switched on.

I had gone diving.

It hit me hard. I knew what was happening but did a quick search to confirm my suspicions; I was having symptoms of Decompression Sickness (DCS).

I chose the "phone a friend" option and my friend told me to immediately call DAN (1 919 684 9111).

DAN (Divers Alert Network) is a service and supplemental insurance where you can seek advice in these situations. Best of all, if you are traveling to exotic and or remote locations, DAN can help you get answers you need regarding symptoms. If you need evacuating, they help with that and help cover the costs.

Go put DAN in your phone right now. I will wait...OH! You don't HAVE DAN...I will really wait while you go online and GET DAN!

I spoke with Frances who asked me about my symptoms and dive profile and quizzed me a bit. I emailed her a picture of my belly (NOT attractive, but I was not really caring at this point, but the one in this blog is from the skin bends website). It was not long before I was told to go the hospital and also to get on oxygen as soon as I could.

Once again my "phone a friend" was on the job! Since I am lucky enough to work AT a dive shop, there was plenty of oxygen available. We have O2 kits for our dive guides and we have a kit for the shop and they are assembled, full, and ready to go at all times. Never did I imagine that I would be on the receiving end of this though!

Before I left the house, I downloaded and took pictures of my dive profiles. I was not sure when I would be home or who would want the information. I also wore my dive computer so we had access to it in the ER. I grabbed my phone charger because, yes, I was not sure what my timing was going to be.

By 3:00, I was in the car on the way to the hospital breathing O2 set at 15. During the 30 or so minute drive we chatted. I was feeling fine...just itchy...and a wee bit scared.

It was a little funny entering the ER with my own oxygen cylinder. I got a couple looks, but I was very glad to have it!

Thankfully, a quiet day meant I was triaged, processed and in a room within about 70 minutes of leaving my house.

By the time I was in a bed, the rash had all but dissipated. Being put on O2 made ALL the difference! The doctor could not see my rash but took my word, looked at my pictures, and we worked from there.

Blood was taken and blood pressure checked (THAT was through the roof due to nerves!) and I was given IV fluids.

skin bends

After speaking with the nurses and doctor and giving a dive history, we were left to ourselves for a bit.

I was quite happy when my doctor reappeared to let me know he spoke with the only emergency doctor that deals with DCS in ALL of the Hawaiian Islands. His name is Davut Savaser.

I was told I blew my limits (did not) and the doc on Oahu said computers could be wrong (two of them?). I was a little less than happy with this piece of news from a non-diver.

THEN, I got an email from Dr Savaser! He asked for my pictures and he asked that I call him. He gave me his personal cell number, so I did. Over the phone, he was more relenting on the "you dived too long" theory.

We discussed my symptoms. Rash, itch...but really, nothing else. No joint aches. No confusion. Nothing! He urged me to travel to Oahu to be evaluated by his team and be put in "the chamber" to make sure I was okay.

I declined. I felt more than fine by now. He told me I would have a neurological test by the Maui team and I made sure I had it before being released. I passed it with no problem.

My official diagnosis was "Level 1 DCS" or "Skin Bends", the lowest level of DCS while still having DCS.

After five hours in the emergency room and six hours total on oxygen, I was released.

So off we went, healthy and cleared, but really no answers to questions I had.

What had I done wrong? DID I do anything wrong? What could I have done differently? How will this affect my diving in the future?

Here are a few of the answers.

Nothing. I did nothing wrong. Basically, it can come down to "S**t happens." Yes, that's the official word on it.

Differently? Well, these dives were like at least 100 others I have had, so I'm not sure what I could have done differently, but I do know what I did before I moved forward.

I was checked out before I went back in the water. Dr. Savaser and my primary care physician recommended a four-week diving hiatus. Four weeks (DURING WHALE SEASON!! ARGH). BUT, I did as advised.

As to what I will do going forward?

I will make sure I am super hydrated before I dive. I tend to not like to drink much the mornings I dive because, well, I "don't do that and I don't lie about it" ☺

Right now, I'm kinda over "being the best breather". I don't HAVE to breath the tank or be the longest in the water. If I miss something, it is going to have to be okay.

I will use Nitrox on my boat dives. These tend to go deeper, so it's the safe play.

I will be conservative in my dive profiles.

All of the above I can and will do.

Be aware of your body. Listen to your gut. Don't dismiss symptoms.

While I was well within limits, I leave you with this, as was said to me: Computers don't get DCS...divers get DCS.

Aloha, Kate

p.s. Have you ever experienced skin bends or any other variety of DCS? If so, I'd love to hear from you; feel free to post in the comments section.


Are you a human? If so, please enter the text displayed in the following image

Jan Hendrix
November 24, 2019 @ 10:04 am

Kate, this happened to me, on an easy dive where I knew I had done nothing out of bounds. Turns out I had a PFO (the hole between the 2 heart chambers that allows blood to bypass the lungs never closed up after I was born, so it's considered a birth defect). About 25% of the population has this. I know another gal who got serious DCS, she was paralyzed for about 1 year, and she found out she had this. The test is called a 'bubble echo' - a sonogram that checks for the PFO action, done by a cardiologist here on Maui. The PFO is invoked by doing the Valsalva (sinus clearing technique), so if you have it and it isn't fixed, you could get another DCS hit and maybe a more serious one on any dive you do...

Mary Raker
July 29, 2017 @ 8:50 am

I'm a diver, and I'm terrified of the DCS (even though I've never gotten it). I decided to do a school project on it, and I used your blog as one of my main resources. It was very helpful and informative. I didn't realize you could get skin decompression sickness till I read this. Thank you for sharing your experience.

Mary Raker
July 29, 2017 @ 6:35 am

I'm a diver, and I'm terrified of the DCS (even though I've never gotten it). I decided to do a school project on it, and I used your blog as one of my main resources. It was very helpful and informative. I didn't realize you could get skin decompression sickness till I read this. Thank you for sharing your experience.

June 29, 2017 @ 11:52 am

Glad it worked out, and the advice is good. I'm also thrilled you were able to dive again. I was on a liveaboard in Malaysia last year when a relatively new diver suffered from DCI following a very mild profile. She was taken to Singapore for treatment where she was diagnosed with a PFO and told not to dive again unless and until she had it repaired. I am curious about something though. I know staying hydrated is consistent advice, and is good advice. However my check of the literature continues to yield no evidence that it actually reduces DCI propensity. Other than being common sense, has any good scientific evidence emerged on this point?

Myron Bloom
April 28, 2017 @ 8:05 am

Tight suit, creases, cold skin, bent joints, dehydration all contribute to skin hits by inhibiting circulation and out gassing

April 8, 2017 @ 3:48 pm

So relieved to hear you're ok and took action Kate. Happy recovery in the next few weeks and hope you're back in the ocean soon. Take good care

April 6, 2017 @ 12:15 pm

Aloha, Kate. Thanks for sharing your story. A good reminder that s*it happens and it's good to not ignore symptoms and have DAN insurance!

April 5, 2017 @ 5:01 pm

It is so important to listen to your body especially when you have been diving. During my vacation here on Maui in the summer of 2013 I experienced what I now know was skin bends. I ignored the symptoms. A month later while doing the deep dive specialty I took a huge DCS hit that landed me in a chamber and the ICU. If it hadn't been for my instructor having O2 with him my outcome may have been different. I was found to have a PFO and luckily when I moved over here I was able to have it repaired. So glad you were ok and thanks for the great blog.

April 5, 2017 @ 2:54 pm

Aloha all! Thanks for the well wishes and it all turned out great. The doctors said being well hydrated is a way to prevent...but like I said...I HATED drinking water before diving. I do now! The head on the MDII and I are good friends now!

April 5, 2017 @ 2:30 pm

Drink lots of water and pee freely. I always enjoy a brief (and urgent) swim after surfacing from a dive, where I can strip my wetsuit down and 'float on it' shall we say. Bottom line - drink drink drink! Water, that is.

April 5, 2017 @ 1:37 pm

Kate, thank you so much for doing this blog. It's a good read because of all the experiences you had, from not knowing what was going on, to acting quickly once you figured it out. Calling DAN for advice is something that's helped me on several occasions and not always for questions about myself. I have another friend who experienced skin bends a couple of times, but didn't get treatment the first time because they didn't know that's what it was. The rash can be very mild looking and resolve quickly like yours did. Like you said, "Listen to your gut"!

Tanya Sisson
April 5, 2017 @ 11:51 am

So glad you were okay Kate and that we got to dive with you and Corey when we were there in February. Great article :)

Mary Pat Gibson
April 5, 2017 @ 10:24 am

Wow Kate - so glad you are all right. So, did the doctors say hydration would help? I guess our bodies react differently depending on so many factors that day or week. Just glad you are OK. Sending Aloha from Canada!