It's Clearing, Somewhat

After carefully reading lots of information about the circumstances leading up to my hospitalization I think I understand what happened.

There's no doubt that the diving incident brought some other circumstances to the forefront. However it appears the primary cause for kidney failure was extremely low blood pressure aggravated by the extreme diving conditions.

I was originally prescribed 10mg of Lisinopril which after a month or so was bumped to 20mg. This got my blood pressure to about 120/80 and seemed to work well. After a few months I had adjusted nicely to it. Initially, the Lisinopril slowed my heart rate and really limited my cycling activities.

If you can't get your heart rate up, you can't pump enough blood to keep the muscles going. It can be very frustrating at times. With this dosage it appeared my days of cycling would be limited to longer slower rides. Of course this is good for my general health but gone was my limited ability to try and climb big hills at a snappy pace or try to hold my place in a very brisk paceline.

On top of this I had recently been prescribed .4mg of Tamsulosin, better known by its popular name Flomax. Hey, I'm getting older and it's not easy to "hold it" as long as I could years ago. However, Tamsulosin also lowers your blood pressure.

The last bit of this was my weight. During 2012 I slowly gained some weight that I finally committed to losing. By the time Saturday the 16th rolled around I had lost ten pounds and had another ten to go. However, this also served to lower my blood pressure, although this is good. Very good.

The combination of two medications and the weight loss had probably lowered my blood pressure to the low side of acceptable numbers, 110/65 at rest. Nothing to be concerned about at all. However, throw in the extreme conditions of a failed dive computer on a deep dive which caused a decompression violation and an exceedingly difficult swim back to shore and you have the ingredients for disaster.

Not having a backup computer or set of gauges was the final straw when my primary computer failed. Of course, things like this should not fail. Period.

The final chapter is the return of the failed computer to Sherwood. Fortunately their headquarters is just a few miles from home so when I called them and sent them the dive data they immediately offered to replace the unit; after all it was still in warranty. When I arrived to do the switch the person that facilitated the exchange said "Yeah, I've seen this before."

YEAH, I'VE SEEN THIS BEFORE???" You're kidding aren't you. Just like that nonchalantly saying you're not the first one to almost die because of this problem.

So I have a new Sherwood Wisdom and I am honestly pondering whether I should pursue a legal solution. I've still got tingling in my lower extremities, gave up a week of work and possibly worst of all, I have that uneasy feeling about trusting my new Sherwood Wisdom. What would you do?

The Storm Continues

I'm backing up a bit to Saturday afternoon to interject that at this point after coming out of the water I had no urge to urinate even though I hadn't done so for hours. In fact for the rest of Saturday I didn't urinate even though I made efforts to drink lots of water.

Sunday morning I still didn't feel a need to urinate. After finishing the 90 minute hyperbaric chamber session Sunday morning, I was checked for neurological disorders and everything seemed fine. Again it was stressed to take if easy for at least a few days, no strenuous exercising for two weeks and no diving or extreme activities for a month.

However later Sunday evening I just wasn't feeling like myself. For whatever reason I decided to take my blood pressure with my machine that I've compared to the doctor's and it passes with flying colors.

My blood pressure was 75/52 and I still hadn't peed a drop. Wow! I knew I relaxed most of the day but obviously that was way too low. So Monday morning I took my blood pressure and it was 72/48 and I finally urinated a couple of ounces.

I could barely feel a pulse on my wrists so I had to resort to reading my pulse on my carotid artery, the large artery going up your neck. Even there the pulse was nothing to brag about but at least readable. I got an 89 which is quite high for being first thing in the morning when my normal resting rate is about 60.

At this point I weighed myself and from Saturday at 6AM to Monday 7AM I gained 10 pounds! My ankles, legs, wrists and hands were not swollen at all. However my "love handles" now looked like water balloons filled to the point of exploding. I had already called in to work to take Monday off, which would normally be a busy day since it was President's Day.

So I called my regular doctor who said be there at 11:30AM. She confirmed my extremely low blood pressure and after a few minutes sent me to Hoag Hospital. She called ahead so they were ready to help me when I got there. I felt very special.

The battery of tests began. A telling number was my creatinine level which back in September 2012 was 1.2 (acceptable range is .7 to 1.2), it was also 1.2 on Saturday when I first went to the emergency room and now it was at 3.0. My kidneys had stopped functioning!

I was admitted to the hospital and the tests continued. Intravenous liquids, albumin via IV, antibiotics via IV, blood work, you name it. Before I continue on I have to say Hoag Hospital is the hospital to be in if you must be in a hospital. Everyone, at all levels of responsibility was friendly, they enjoyed their work and it showed.

By Monday evening my kidneys started coming back to life. I was able to urinate more than a couple of ounces at a time and my blood pressure was starting to normalize though it was still low. I had to get up twice during the night because now I was urinating like a russian race horse but that was a good thing. The testing continued as Tuesday slowly rolled along. More blood work and yet more blood work. My arms probably have more prick marks than Lance Armstrong's. The news was very satisfying. My creatinine level dropped consistently until the last test around 1pm showed it had dropped from 3.0 to 1.6.

When the doctor in charge walked in and said everything looked great and they wanted to observe me for one more day I was quite emphatic that all I could see them doing was forcing fluids into me which I was prepared to do at home. He didn't disagree so he went to consult with a few other doctors and the nurses and came back to announce I could go home. Eureka! As soon as I got home, I promptly stepped on the scale to realize that over the course of three and a half days I had gained 15 pounds. I look like a water logged loaf of bread so somehow I need to continue consuming almost a gallon of water a day AND lose water weight. This is not going to be easy.

The Perfect Storm is over but now I have to figure out what made this perfect storm of circumstances lead to my to my kidney failure. It's starting to clear, soon we'll understand.

The Perfect Storm

I've decided to call yesterday's dive at Redondo Beach The Perfect Storm. A series of event contributed to near disaster. First the things that contributed to the making of the storm:

1) I was significantly dehydrated, I realized that just before the dive I was quite thirsty so I downed a 16oz water and went for a dive. I should have had a lot more because now over 24 hours later I still have only peed about 2oz even though I've been drinking water like a fiend, though I really can't identify why I was so dehydrated to begin with.

2) The other person that was supposed to show up didn't so I went solo. This was a mistake even though I dive solo fairly often. And yet I have to say that not having a buddy might have helped me on my return navigation but other than that I think I did the best that could be done under the circumstances.

3) The entire dive was spent kicking and kicking, pretty hard and consistent. First I had to get to my planned depth of 150' and then when things went wrong I had to kick back pretty aggressively also.

4) When I decided to abort my dive I turned around and took a heading of about 70 coming back because I had gone out at about 250. For whatever reason I drifted quite a distance from the stairs almost into the boat lanes in front of the pier. It was a very long swim back to the stairs.

5) Although I hate to admit it, all of this was exacerbated by my age. Although I'm in very good shape, I just can't do the things I used to do.

6) I once again had a failure of a Wisdom computer. See the screen shot of the dive profile.

Now the details:

I entered the water with 7 or 8 students along with Becky Anderson and her assistant. We kicked out to just beyond the end of the pier where she once again discussed the dive plan. When it was time to drop none of the students dropped right away, probably being concerned that someone else would have a problem and making sure they didn't go down alone. I've seen it before. Anyways, I waited a bit and saw two people start to release their BC air so I went down and landed at about 56 feet. I waited and waited, probably two or three minutes and decided to continue my dive. Obviously someone at the surface was having some issues.

Soft silty sand, no signs of life, so I headed at about 250 as had been recommended. Finally at almost 80' I saw one tiny fish. At 100' a dead shark of some sort. Look at this ugly thing and the silt on it. I didn't even try to get closer since I was on a plan to get to 150ft.

I finally saw 150' and still nothing to look at so I decided to go another 10'. I gave two kicks looked at my gauge and it said 220ft! All the indicators were blinking like crazy and I realized the computer was probably failing. So I turned around still with about 1600psi in the tank and headed back without any dilly dallying. The computer now was showing 50ft but I knew I was a lot deeper than that. So I kept on kicking and kicking. Of course it got lighter and lighter above but the couple of times I looked up I couldn't tell how far it was to the surface.

Eventually I got to 500psi and started getting a bit anxious. When I got to 350psi I decided it would be better to come up alive with the bends than never come up at all so I slowly headed for the surface. Ends up I was probably at about 30-40ft. I really wish I had known that since I could have stayed still on the bottom for at least 5 minutes and that would have tremendously minimized my DCS.

When I got to shore I walked out of the water and completely totally exhausted I said a thank you and rested for a few minutes. It took what seemed like forever to get my gear off since I couldn't even stand at that point. After that struggle I took all my equipment except tank and BC and walked up the steps where I met Gaille. She could tell immediately there was a problem and went to get one of the other guys to help me with my tank and BC.

I sat down while gasping for air, drank two bottles of water and gathered my wits about me. When I stood up to go to the car I had a tremendous tingling sensation in both lower legs and I had trouble walking. After more rest at the car and talking about it I realized my legs were better but now I had a huge headache at the very top of my head. I said to Gaille that I should go to the hospital and luckily Becky suggested Long Beach since it has a hyperbaric chamber. So she drove me there and Gaille followed.

On the way I call DAN and informed them of my situation.Dan is amazing! They called the hospital, alerted them to my condition and were very efficient. The RN at the hyperbaric chamber called me to inform me they were ready for me and wanted to know how far away I was.

I ended up spending two hours in the chamber and went back for another 1 1/2 hours this morning.

My muscles ache like crazy and the doctor says I will have symptoms for a few days so take it easy.

Thanks, actually a million thanks to the people that helped me through a very tough day. Becky Anderson, Eric Aubort, the nurses and doctors at Long Beach Memorial Hospital and especially Gaille Mintz.

I'm one lucky guy!