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Scuba Forum / General / July 2006micro invasive lung operation of bulla
Hi, Has anybody of you heard of a possibility or real case, where somebody had a small ( ca. 1/2") bubble near one lung's center, and had it successfully removed? Seems like I have such, and it is a contraindication to diving. Seems strange with my 1500 dives on the belt. Still I had a series of minor events ( a bit of post dive coughing), but also an accident 2 weeks ago which nearly killed me. Serious lung edema, very bad oxygen loading of blood. They rescued and hely-lifted me the very evening into the Kiel Marine Naval Medical Institute, and from there to the Universities ICU, where I was artificially breathed with oxygen and PEEP. Coughed all night, said my watchdog. Was released the after the next day, apparently not only fully recovered, but feeling _really_ well. No doubt, wonder what they put into my central venous plug. Main cause probably was my elevated blood pressure, which may have caused a swelling and collapse of the alveolar bed. Aggravating factors... hard breathing reg, tight shoulderstraps of Long John, tight crotchstrap, intermittent bouancy exercise ( from 17m up to 6m, down again), considerable current, about one knot, from the side, fighting to keep the the bearing and true COG. Conclusion: Listen to your body. You don't realize deteriorizing conditions, like you get accustomed to brake pad or clutch wear on your car. Had my lungs tested yesterday. Same performance as ten years ago. Feeling well with a new life. greets, all, Matthias > Hi, > Has anybody of you heard of a possibility or real case, where somebody [quoted text clipped - 34 lines] > > Matthias Matthias, What you have is known as a pneumothorax. Air gets in between the pleural sac which envelopes the lungs in the thoracic cavity. This is a very dangerous and painful (from what I have been told from someone had was thus afflicted), condition. Often this is caused by some penetrating injury but there are times when it just happens for no reason. This is known as a spontaneous pneumothorax. My concern with you continuing to dive without medical clearance would be the air at depth becoming trapped in the pleural space and then expanding, significantly worsening your condition. Before I went back in the water to depth, I would absolutely want a medical opinion from a pulmonary specialist, especially one with some knowledge of hyperbaric medicine or at least have them coordinate with DAN. Andy Andy, >> Hi, >> Has anybody of you heard of a possibility or real case, where somebody [quoted text clipped - 40 lines] > very dangerous and painful (from what I have been told from someone had > was thus afflicted), condition. Nothing like that. The bulla, or airfilled cystis, is completely surrounded by lung tissue, and nowhere near the pleural sac. The event wasn't painful as such, it was just the terrible coughing and feeling of getting no oxygen, 250 m from shore. I do not know wether this bulla may have a delayed responded to ambient pressure changes, thus creating local zones of different pressures, eventually triggering the edema, which was very clearly to be seen on the lung's CT. > Often this is caused by some penetrating injury but there are times when > it just happens for no reason. This is known as a spontaneous > pneumothorax. I am too old to fit in spontanous pneu statistics. But what worries me, is the amount of acid gasses my VW T4 TurboDiesel expels. It is very irritant to the lungs. I have this car since 2004, and in the same year my GF suffered from a lung edema in diving as well, after we had driven 15000 km through Spain, France, Italy. > My concern with you continuing to dive without medical clearance would > be the air at depth becoming trapped in the pleural space and then > expanding, significantly worsening your condition. > Before I went back in the water to depth, I would absolutely want a > medical opinion from a pulmonary specialist, especially one with some > knowledge of hyperbaric medicine or at least have them coordinate with DAN. Absolutely. Even if this is only a by-product of a good CT. What I'd want, is to know, wether it is ventilated well enough to follow ambient pressure changes, or can be made to do so. Be it in an operation, eventuallly laser or electrocoagulation. Matthias > Andy, > [quoted text clipped - 52 lines] > eventually triggering the edema, which was very clearly to be seen on > the lung's CT. OK...my bad. From your description, it sounded like a pneumothorax >> Often this is caused by some penetrating injury but there are times >> when it just happens for no reason. This is known as a spontaneous [quoted text clipped - 6 lines] > lung edema in diving as well, after we had driven 15000 km through > Spain, France, Italy. I would not think this to be a factor unless you did a considerable amount of idling, such as in heavy stop & go traffic where it could be blown back into the passenger compartment, or the exhaust is configured in so a way as to not get it away from the passenger compartment adequately. Have you checked the integrity of the exhaust system? I would have thought you would get more exhaust from the vehicle(s) in front of you than from your own. >> My concern with you continuing to dive without medical clearance would >> be the air at depth becoming trapped in the pleural space and then [quoted text clipped - 10 lines] > > Matthias We do agree on this. Whether its a pneumothorax or other, the ambient pressure change is still a concern. If it will ventilate both ways you may be able to dive (up to your physician). If it has a little flap or some other type of occluding tissue acting as a 1-way valve, it would certainly need to be corrected. I hope it is a simple fix for you. Andy >> But what worries me, is the amount of acid gasses my VW T4 TurboDiesel >> expels. It is very irritant to the lungs. [quoted text clipped - 9 lines] > I would have thought you would get more exhaust from the vehicle(s) in > front of you than from your own. Quite right... Still, when my workshop was unable to do something about it, a friend looked at the rear door, whichs swings vertically, and found out that the closing loop-strap was so long that it interfered with the door's rubber seal. We shortened it, which made things better. Still, when idling, windows open, you feel it. I saw other cars (turbo-diesels with particle filter) expel the same irritating gas, or vapours. It smells like sulfuric dioxide, or trichlorethylen subjected to ultraviolett light. Wonder what it is. Matthias >>> But what worries me, is the amount of acid gasses my VW T4 >>> TurboDiesel expels. It is very irritant to the lungs. [quoted text clipped - 25 lines] > > Wonder what it is. I would be afraid to render a guess. Chemistry is not my strong point. However, if you could lay your hands on a portable CO monitor, that may give you an indication as to the intensity of what you are getting in your passenger compartment. You mention sulfuric dioxide. I guess that may be some by-product of the type of fuel you are using. May be the same in the US or because of the makeup of the fuel we might not have that. Most common byproduct of car exhaust I am familiar with is CO. My point in measuring the CO is that if you are getting substantial levels of CO, you would be getting substantial levels of everything else associated with burning whatever type of fuel you use. If you are getting substantial CO in your passenger compartment, that would certainly be something I would want fixed, since CO exposure is cumulative. FWIW, a local college (about 15 miles from me), apparently had some sort of CO issue in one of their dorms. 100+ people were taken to the Emergency Room. One died, at least one was in critical condition. >>>> But what worries me, is the amount of acid gasses my VW T4 >>>> TurboDiesel expels. It is very irritant to the lungs. [quoted text clipped - 32 lines] > > You mention sulfuric dioxide. Because I know it's scent from childhood... mixing black powder.. > I guess that may be some by-product of > the type of fuel you are using. May be the same in the US or because of > the makeup of the fuel we might not have that. Most common byproduct of > car exhaust I am familiar with is CO. Normally sulfur should not be any more an ingredient of diesel fuel. Still there may be other components, like nitrous oxides, and oil residues altered in the combustion process. > My point in measuring the CO is that if you are getting substantial > levels of CO, you would be getting substantial levels of everything else > associated with burning whatever type of fuel you use. While I think CO is not a part of it ( having normally 99% oxygen saturation ), your point is well taken. I could still run against a wall ;-) when recalling how a missed a Draeger AirLab on Ebay... > If you are getting substantial CO in your passenger compartment, that > would certainly be something I would want fixed, since CO exposure is > cumulative. This has to be fixed, some way or other, definitely. I am a bit suspicious about what happens in the particle filter, which is an ultra-fine linearly sructured honeycomb of ceramics. Gets quite hot there. Right place for anything chemical to crack up there. > FWIW, a local college (about 15 miles from me), apparently had some sort > of CO issue in one of their dorms. 100+ people were taken to the > Emergency Room. One died, at least one was in critical condition. Phew! Sounds bad...Overload in the Emergency... Matthias >>>>> But what worries me, is the amount of acid gasses my VW T4 >>>>> TurboDiesel expels. It is very irritant to the lungs. [quoted text clipped - 43 lines] > Still there may be other components, like nitrous oxides, and oil > residues altered in the combustion process. I know all to well what diesel smells like in the US but European blends may be different and have some different components. >> My point in measuring the CO is that if you are getting substantial >> levels of CO, you would be getting substantial levels of everything [quoted text clipped - 3 lines] > saturation ), your point is well taken. I could still run against a wall > ;-) when recalling how a missed a Draeger AirLab on Ebay... Oh well....there will probably be more. You mention your O2 sats. I guess that would have to be monitored almost on a continuing basis. While CO does have an affinity for your red blood cells and lingers quite awhile, it will eventually purge itself. So if you had your O2 sats monitored on only an occasional basis, that might not be a very good baseline to rely on. >> If you are getting substantial CO in your passenger compartment, that >> would certainly be something I would want fixed, since CO exposure is [quoted text clipped - 4 lines] > is an ultra-fine linearly sructured honeycomb of ceramics. Gets quite > hot there. Right place for anything chemical to crack up there. I am guessing what you are calling a particle filter is what we refer to as a catalytic converter. I didn't realize diesels had catalytic converters. I know gas powered cars in the US do. >> FWIW, a local college (about 15 miles from me), apparently had some >> sort of CO issue in one of their dorms. 100+ people were taken to the >> Emergency Room. One died, at least one was in critical condition. > > Phew! Sounds bad...Overload in the Emergency... Quite correct. However, the local hospitals had a mass casualty plan which they implemented. The local fire, ems and hospitals got high praise from those who were exposed. The vast majority were monitored for a few hours and released. Andy >> This has to be fixed, some way or other, definitely. >> I am a bit suspicious about what happens in the particle filter, which [quoted text clipped - 4 lines] > as a catalytic converter. I didn't realize diesels had catalytic > converters. I know gas powered cars in the US do. I believe it is different. It is a ceramic "honeycomb" structure consisting of a multitude of parallel microtubes. Their walls are so fine that you overlook them when looking straight through, only thing you notice is that all you see is blurred by diffraction. It is meant to filter out diesel combustion dust, or at least modify the size of the particles blown out. They are thinking about real catalytic filters for diesels here, but these require some active heating, afaik. Matthias >>> This has to be fixed, some way or other, definitely. >>> I am a bit suspicious about what happens in the particle filter, [quoted text clipped - 15 lines] > They are thinking about real catalytic filters for diesels here, but > these require some active heating, afaik. Perhaps. Just your description matches the catalytic converters in the US. I know the catalytic converters get quite hot also and there have been cases where cars have pulled off the road into a grassy area and it ended up setting the grass on fire. >>>> This has to be fixed, some way or other, definitely. >>>> I am a bit suspicious about what happens in the particle filter, [quoted text clipped - 20 lines] >been cases where cars have pulled off the road into a grassy area and it >ended up setting the grass on fire. The new VW TDIs have a particulate trap. No great plume of black smoke on take-off. And once the turbo spins up, they can really fly.  Signaturedillon JAFO >>> But what worries me, is the amount of acid gasses my VW T4 >>> TurboDiesel expels. It is very irritant to the lungs. [quoted text clipped - 27 lines] > > Matthias Switch to biodiesel or Waste Veggie Oil (WVO) blends. Signature“TANSTAAFL” ”it’s better to die on your feet than live on your knees” ____________________________________________________________________________ "A prudent man foresees the difficulties ahead and prepares for them; The simpleton goes blindly on and suffers the consequences." - Proverbs 22:3 >>>> But what worries me, is the amount of acid gasses my VW T4 >>>> TurboDiesel expels. It is very irritant to the lungs. [quoted text clipped - 29 lines] >> > Switch to biodiesel or Waste Veggie Oil (WVO) blends. Then his car will smell like a big bag of French Fries. >>>>> But what worries me, is the amount of acid gasses my VW T4 >>>>> TurboDiesel expels. It is very irritant to the lungs. [quoted text clipped - 31 lines] > > Then his car will smell like a big bag of French Fries. less CO and hydrocarbons. It's less bad for you. Signature“TANSTAAFL” ”it’s better to die on your feet than live on your knees” ____________________________________________________________________________ "A prudent man foresees the difficulties ahead and prepares for them; The simpleton goes blindly on and suffers the consequences." - Proverbs 22:3 >>>> But what worries me, is the amount of acid gasses my VW T4 >>>> TurboDiesel expels. It is very irritant to the lungs. [quoted text clipped - 29 lines] >> > Switch to biodiesel or Waste Veggie Oil (WVO) blends. I did once, the smell goes away. But in cold weather, the engine is a bit rough. They say, engines don't last that long with it. At least the direct injection high power ones. I also thought about switching to unprocessed veggie oil. It is on the big run with trucks here. But you need a separate tank for the warmup and shutdown times of the engine with diesel, and a heater for the crude stuff. Matthias >>>>> But what worries me, is the amount of acid gasses my VW T4 >>>>> TurboDiesel expels. It is very irritant to the lungs. [quoted text clipped - 31 lines] > > I did once, the smell goes away. So most of what you are smelling is sulfur. Very little sulfur in biodiesel. But in cold weather, the engine is a > bit rough. They say, engines don't last that long with it. At least the > direct injection high power ones. > I also thought about switching to unprocessed veggie oil. It is on the > big run with trucks here. > But you need a separate tank for the warmup and shutdown times of the > engine with diesel, and a heater for the crude stuff. I use WVO/diesel blends in the summer, but straight diesel in the winter. If you have the space to do the blending, it saves big money. > Matthias Signature“TANSTAAFL” ”it’s better to die on your feet than live on your knees” ____________________________________________________________________________ "A prudent man foresees the difficulties ahead and prepares for them; The simpleton goes blindly on and suffers the consequences." - Proverbs 22:3 > >>> But what worries me, is the amount of acid gasses my VW T4 > >>> TurboDiesel expels. It is very irritant to the lungs. [quoted text clipped - 29 lines] > > > Switch to biodiesel or Waste Veggie Oil (WVO) blends. I got stuck behind a veggie oil powered car once in traffic. By the time I could get away from it, I had to stop at the next McDonalds and I bought 5 large orders of fries. When we get 20 or 30 thousand of those on the road, I'll have to put a microwave in the car so I can heat up a snack on the drive home from work! > Hi, > Has anybody of you heard of a possibility or real case, > where somebody had a small ( ca. 1/2") bubble near one > lung's center, and had it successfully removed? Man. I will forward this to several people, but I suggest you contact Dr. Kay via e-mail; http://faculty.washington.edu/ekay/ > Hi, > Has anybody of you heard of a possibility or real case, where somebody had [quoted text clipped - 34 lines] > > Matthias You have come to the right place to have your questions resolved. Never mind doctors and all that bullshit. I highly recommend some serious repeatative deep diving to cure what ails you. Get back in the water ASAP and quit whinning like a pussy. |
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