How to prevent the bends

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WHAT ARE “THE BENDS”?

Picture this. You are just about to emerge from the depths of the sea during a dive when suddenly, your whole body starts to ache. Well, you just got the bends. Either you can start praying that someone comes to your aid, or you can use a couple of tips to prevent it from taking hold. Read on for our tips on how to prevent the bends. If you’re wondering why is decompression sickness called the bends, we cover that too!

Also known as decompression sickness (DSC), the bends refer to a condition that is caused when there is a rapid decrease in air and water pressure around you. It is a common ailment among skydivers and deep-sea divers, but it is also fairly common in airline passengers during high altitude air travel. 

WHY IS DECOMPRESSION SICKNESS CALLED THE BENDS?

So, why is decompression sickness called the bends? Because of the joint pain that is associated with the condition. 

Here is how it works. When you dive with compressed air, you are not only breathing in oxygen in, you are also taking in nitrogen with it. While our body uses up the former, it allows the latter to dissolve in our bloodstream where it remains during the entire dive.

The trouble starts when you start to ascend. As you swim back up to the surface from the deep, the pressure of the water around you starts to decrease. Now, if you swim up too fast, your body does not have time to clear all of the nitrogen that is lying latent in your bloodstream.

When this happens, those nitrogen bubbles get between the joints making your bones ache. The most affected joints, in this case, include the ones in the shoulders, knees, elbows, and ankles. The pain intensity can vary depending on the extent of the DSC – you can either feel a slow and dull ache or crippling pain that makes you double over.

What happens in the body is quite similar to what happens when you open a carbonated drink. When you flip the top, you decrease the pressure that surrounds the drink in the can. This causes a rapid release of gas which comes out in the form of bubbles. Imagine those bubbles forming inside your body, blocking normal blood flow and rupturing blood vessels. That’s how serious this condition can get.  

DSC SYMPTOMS

The symptoms of DSC differ depending on where the nitrogen bubbles form in the body. Divers who experience the bends can complain of:

• Headaches
• Unusual fatigue
• Weakness
• Paralysis
• Breathing issues
• Vertigo
• Nausea 
• Tingling in arms and legs

If the condition is serious, the diver may also go into shock, fall unconscious, experience paralysis or worse. Death is imminent if the diver does not receive appropriate medical aid within time. 50% of divers generally develop DSC symptoms in the first hour after they diver while most experience it within 6 hours after it or within 24 hours.

Exceptions exist for divers who travelled via aircraft or who traversed through a mountain prior to the dive. Under those conditions, the low pressure can still trigger the bends even after 24 hours have passed after a dive. In other words, it is not a good idea to fly within 24 hours of a deep sea dive.

High-risk Divers

If you are susceptible to the bends, prevention is better than cure. That way, you won’t find yourself paralysed underwater with the water adding more pressure to your already pressurized blood vessels. So if you have any of these issues, you should probably stick to land for some time:

• You are older than 30.
• You have heart muscle birth defects such as ventricular septal defect.
• You have a history of heart disease or a current hearth condition.
• You smoke and drink alcohol frequently.
• You get tired easily
• You have injuries
• You have a lung disease 

Out of all of these, individuals who have heart defects (such as a hole in the heart) are highly susceptible to decompression disease. Since the nitrogen bubbles pressurize the blood in the body, they can actually cause the blood to re-circulate into the arteries without picking up the oxygen your body needs on the way. The result? You organs fail to receive the amount of oxygen they need to function optimally. A hole in the heart can also allow a large bubble to circulate in the arteries which can lead to a stroke – underwater. 

Similarly, individuals who have lung issues may have air pockets that have thin walls. The reason they can’t breathe properly is that when they exhale, the pockets empty too quickly. When this happens underwater, the air in the air pockets can expand fast enough to rupture it leading to a collapsed lung.  

How to Prevent the Bends?

The good news is that you can avoid the bends if you dive smartly. Here is a basic checklist you can follow:

• Dive within your physical limits.
• Take a safety stop after every 5 meters for 3 minutes to allow the nitrogen to leave your bloodstream.
• Avoid strenuous activity.
• Avoid a rapid ascent. Do not lose your weight belt or do anything that can make you rise rapidly to the surface.
• Avoid exercise 12 hours before a dive.
• Don’t fly immediately after a dive.
• Breathe normally during a dive.
• Make sure you are hydrated before a dive.
• Don’t drink alcohol before or after a dive.
• Don’t dive if you have a hangover.

How to Treat the Bends?

Diving back to the depths and coming back up again but this time slowly will not fix DSC. Irrespective of the severity of the sickness or pain you are feeling, you should be treated in a hyperbaric chamber. Re-compression may even make things worse. In some cases, oxygen can be administered to reduce symptoms. If you feel better after inhaling oxygen, the treatment should be continued till all signs disappear, and a doctor gives you the all clear.

Depending on the severity of the condition, you may be asked to stay out of the water for a couple of days or a couple of weeks. Make sure that the dive boat you are on is equipped with an oxygen kit and someone who is trained to use it. 

PREVENTION IS BETTER THAN CURE…

So you see, having some knowledge of how to prevent the bends is very valuable. Remember, diving puts us in an abnormal atmosphere and you must take care to ensure your body adjusting to the levels you’re at slowly.