Somewhat experienced 37-year-old white male diver, overweight and only
mildly in shape, but very, very handsome, on a remote multiday liveaboard
dive trip, begins his first dive of the third day after sitting out the
morning dive due to sinus/nasal congestion and a possible but undiagnosed
hangover.  Occasional smoker and drinker, both vices were eagerly pursued
the previous night.  Congestion is appeased with Claritin, 12-hour Sudafed,
and a few snorts of Afrin.  No other medications present.

Water is 82 degrees at surface, a bit chillier at depth.  Diver is warm, if
not too warm, in a 5mm farmer john wetsuit.  He is carrying bulky video
housing/light on the dive in an attempt to film big sharks.  Profile
involves a free descent to 65 fsw in challenging current and surge, then to
hold onto rocks for duration of dive.  Diver, somewhat new to his heavy
video system, is bounced around at depth while trying to hang on with one
hand, film with the other, dodge vicious maneating sea urchins and the
occasional large shark, and all the while maintain vigilance over his novice
buddy.  Diver sucks his tank down in record time and after only 25 minutes
(he did have a short fill to begin with, after all) is down to 1,000 psi.
Still breathing hard, he signals the DM to watch over his buddy and begins
his ascent.

He maintains contact with the rock until about 40', where severe vertigo and
accompanying nausea start to set in, worsened by the expanding bubbles of
four or so divers below.  At that point, the surge caused by waves crashing
into the surface portion of the rock require the diver to swim away from the
rock into the blue so that the dinghy can safely pick him up.  He does so,
quickly losing sight of the rock and any other divers in the dwindling 20-30
visibility, and the vertigo and nausea worsen.  Vomiting through his
regulator while trying to maintain a safe rate of ascent, he manages to get
the best hammerhead footage he's collected all week, but it's so bad by the
time he gets to 15' that, with the additional recollection that this is the
site where two divers off the same liveaboard were lost (and never found)
back in late 2003, he surfaces after less than a one minute safety stop.
Diver was breathing 32% nitrox.

On the surface, and now in 8-10' swells, diver weakly extends a hand into
the air while continuing to violently vomit through his regulator, hoping
that he won't inhale any of the foul bilious venom, wishing he had eaten
breakfast that morning or at least had something in his stomach besides two
shots of oily boat espresso, and praying that the dinghy driver would spot
him before he had to deploy a safety sausage, EPIRB, or even be lost at sea.
After several tense minutes, the dinghy driver appears, circles around,
grabs the weakly extended camera, and lowers the ladder, grabbing proferred
fins, and assisting the ill diver as he climbs up the ladder, clambors
aboard the craft, doffs his BC and tank, and immediately leans over the
other side of the boat to, you guessed it: vomit some more.

Dinghy driver offers vomiting diver a cup of water which is initially
refused, then accepted, then regurgitated over the side.  After a few more
minutes, additional divers appear on the surface to be collected by the
dinghy and as they slowly climb aboard, the looks of pity or perhaps smirks
are clearly visible on their faces.  A few begin to offer sympathy but then
rapidly recoil as the diver resumes his violent intestinal purge.
Eventually diver is out of ammunition, and takes a seat on the gunwale,
taking deep breaths and trying to keep his eyes on the ever-bouncing horizon
as he attempts to rein in the intense nausea.

As the remainder of the divers finish climbing on and taking their seats,
perhaps 20 minutes after the time the diver first broke the surface, he
notices a slight tingling in his fingers and hands.  At first attributing
the tingling to the tightness of his wetsuit or his gloves, the diver first
tries to ignore the symptom, but can't help but get worried when it starts
to grow into a strong sensation, similar to an electrical impulse.  The
tingling continues to grow until the diver can no longer move his fingers,
and then he watches helplessly as his hands start to involuntarily contract
into claw-like appendages.  At this point, the diver finally speaks of his
condition aloud, and catches himself slurring his words as if he were drunk.
The realization sets in . . .  He asks for oxygen, and repeats his request a
bit louder so someone will hear.

The dinghy driver quickly abandons his post at the ladder and reaches for
the DAN O2 kit.  He sets up the cylinder and mask, but is having trouble
deciding how to turn it on.  The affected diver, himself a certified O2
provider, can barely talk at this point as the tingling has set into his
lips, and his hands are certainly useless for the purpose.  Fortunately,
sitting next to him is an experienced surgical nurse who knows her way
around an oxygen tank and she gets the oxygen flowing, the mask strap over
the diver's head, and gets other divers to assist her in positioning the
diver on his left side stretched awkwardly across the bottom of the crowded
dinghy.  Finally the DM climbs aboard and quickly takes over the situation,
questioning the dinghy driver and other divers, checking the oxygen flow,
and comforting the scared diver.   The dinghy makes the 10-minute journey
back to the liveaboard, the diver is helped to his feet, and assisted off
the dinghy, where he is laid down on the dive deck, oxygen bottles are
swapped, and his buddy helps remove his wetsuit.  Soon, the DM helps him
inside the salon, lays him down on the couch, and brings him more water to
drink.

Meanwhile, the oxygen seems to be working miracles.  The symptoms are
quickly resolving, to the point that after 15 total minutes on oxygen, the
diver's hands unclench and the tingling subsides.  The diver speaks and
notices no recurrence of the slurring.  After another 15 minutes of slow
breathing, the tingling subsides completely and the diver is urged to take
an oxygen break.  The symptoms fail to resume, yet the diver follows up his
20 minute oxygen break with a second 20 minute session on the mask before
deciding that he's cured for good, at which point he has a slice of pizza.

Worried about making future dives on the trip, and having the same worry
strongly communicated to him by the boat captain, the DM, and the trip
organizer, diver mentally prepares himself for spending the remainder of his
vacation topside.  He consults with two doctors aboard the vessel who doubt
that the incident was due to DCS, but the diver is puzzled by their
explanation and remains firmly of the belief that he got bent.  The next
morning, he invests a few minutes of expensive satellite phone minutes on a
call to DAN, where after a quick description of the symptoms, the DAN
consultant gives a confident and definite diagnosis of the divers ailment.
Confident in DAN's wisdom, and this now being his third confirming opinion,
the divers speaks with the DM and boat captain after they return from the
first morning dive and gets cleared to dive the next dive.  A bit of vertigo
ensues on the diver's next dive after reaching the 90' plateau via a mooring
line, but the diver holds onto the rocky plateau rim until the vertigo
subsides in about 10 minutes, and then the diver continues on to make the
remainder of the dives of the trip without incident, but for a painful
reverse block on the very last dive of of the trip because his damn cold
never goes away.

Which alphabetic condition did this diver suffer from?

a) TVA

b) CVA

c) Acute HVS

d) Mild DCS

e) DTs

f) All of the above

g) None of the above

First six correct answers win a can of beer.  Shipping and handling fees may
apply.  Cheating incurs optional corkage fee.