Ask new scuba divers about the bends and they’re likely to mumble something about bubbles in the bloodstream and pain in the elbow or shoulder. Few have a good understanding of the problem and most pursue a blissful conviction that a couple of hours in a recompression chamber will cure any bends problem. This nonchalant attitude toward the diver’s most deadly disease could cost native divers their lives.

To be perfectly frank, today’s diver is not taking the problem of bends seriously enough. Some scuba instructors treat the subject of bends too lightly, in an effort to keep the “fun” in their scuba training. They may be doing their students a disservice by not providing a clear picture of the problem. Students end up viewing bends with ignorant cockiness and little knowledge of its true destructive powers.

It is this article’s opinion that bends should be declared Public Enemy Number 1 to divers and treated with as much concern as cancer, a heart attack or other serious medical problems.

The diver's most deadly disease

Let’s take a moment to dispel some of the current myths about bends by offering a few key facts every scuba diver should know before entering the water:

Bends can kill – Bends is neither a simple nor minor medical problem. Bends can kill a diver, in spite of first aid and chamber treatment. A number of divers have died from bends hits and this number is growing because the sport is growing. The reasons for bends deaths vary from shock to neurological damage.

Severe hits strike at random – One of the major misconceptions is that serious bends cases result from only deep, long dives. This is not true. A serious bends hit can result from even the smallest infraction of the decompression tables. Quite often, the diver making a medium depth dive gets a worse hit than the diver making a really deep one. The key to this puzzle lies in where the bubble happens to pop up. A hit in the knee or elbow can result in just localized pain, but a hit in the spine or central nervous system can cause paralysis or other kinds of severe damage. It’s like a game of Russian Roulette – not even an expert diving doctor can predict where the bubble is going to pop up.

The chamber is not a cure-all – Many divers are under the illusion that the recompression chamber can quickly cure any and all cases of bends. Nothing could be farther from the truth. The chamber is not a miracle machine. Many divers come out of the chamber in just as much pain as when they entered. This is often because the victim was not transported to the chamber soon enough for effective treatment or because the initial damage was so massive that full recovery is hopeless. Residual effects from a bends hit are common and it takes victims years to fully recover – if ever.

Not all bends symptoms are clear-cut – Most divers expect a case of bends to be preceded by those classic symptoms stated in all textbooks – sharp pains in the elbow, shoulder, knee or other joint. Unfortunately, bends symptoms are not always so clear-cut. A pain in the elbow may never occur. Instead, there may be dizziness, or nausea, or paralysis, or itching of the skin, or a dozen other more subtle signs. Some victims simply pass out after surfacing. Any strange feelings or neurological disorders after a dive should be immediately suspect.

If you think the above information is intended to shock you, you’re right. Bends is a serious danger to anyone diving deeper than 33 feet and the risk increases with repetitive dives.

The best way to protect yourself from the dangers of the bends is to take steps to avoid getting hit in the first place. Here’s a checklist which may help.

  • Always dive well within the no decompression limits.
  • Keep a careful check on your depth and bottom time.
  • Ascend slowly, well within the 60 foot per minute rate.
  • Take a five minute decompression stop at 10 feet just to be safe.
  • Be cautious on repetitive dives.
  • Figure your decompression limits to the next greater depth and next longer bottom time.
  • Check yourself for bends symptoms after the dive. Don’t be shy about telling your dive buddies you’re feeling strange.
  • If you suspect you have a bends hit, get to a recompression chamber fast.

Perhaps the most effective weapon in the sport diver’s war against bends is a thorough knowledge of the subject and a healthy respect for it. New books on decompression sickness abound. They are available from the certification agencies and various other sources. If you want to learn more about this physiological phenomenon, I suggest you pick up a copy of one of these. The best way to handle the bends, however, is to avoid them – by cautious diving.

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