This is a very serious condition - usually, though not always, associated with diver error. The most common symptoms are unusual fatigue or weakness; skin itch; pain in the arms, legs (joints or mid-limb) or torso; dizziness and vertigo; local numbness, tingling or paralysis; and shortness of breath. Signs may also include a blotchy skin rash, a tendency to favour an arm or a leg, staggering, coughing spasms, collapse or unconsciousness. These symptoms and signs can occur individually, or a number of them can appear at one time.
The most common causes of decompression sickness (or 'the bends' as it is commonly known) are diving too deep, staying at depth for too long, or ascending too quickly. This results in nitrogen coming out of solution in the blood and forming bubbles, most commonly in the bones and particularly in the joints or in weak spots such as healed fracture sites.
Other factors contributing to decompression sickness include excess body fat; heavy exertion prior to, during and after diving; injuries and
'Be aware that underwater conditions vary significantly from one site to another.'
'Visitors must do their best to ensure that their activities don't spoil the experience of those who will come in the future.'
illness; dehydration; alcohol; cold water, hot showers or baths after diving; carbon dioxide increase (eg through smoking); and age.
Avoid flying after diving, as it causes nitrogen to come out of the blood even faster than it would at sea level. No resort in the Maldives will allow you to dive less than 24 hours before a flight. Low-altitude flights, like a seaplane transfer to the airport, may be just as dangerous because the aircraft are not pressurised. There are various opinions about the risks and the time required to minimise them - a lot depends on the frequency, depth and duration of dives over several days before the flight. Seek the advice of an instructor when planning the dives during the final few days of your stay, and try to finish up with shallow dives.
Even if you take all the necessary precautions, there is no guarantee that you will not be hit by the bends. It's a diver's responsibility to be aware of their own condition, and that of their diving buddy, after a dive.
The only treatment for decompression sickness is to put the patient into a recompression chamber. That puts a person back under pressure similar to that of the depth at which they were diving so nitrogen bubbles can be reabsorbed. The time required in the chamber is usually three to eight hours. The treatment is usually effective, with the main problem being caused by delay in getting the patient to the chamber. If you think that you, or anyone else you are diving with, are suffering from the bends, get to a recompression chamber as soon as possible; there are two in the Maldives, at Bandos and Kuramathi resorts.
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