(The following article is presented as a means to explain Abysmal Diving’s
background thought on adding the Deepstop option to the current version of Abyss.)
The Importance of Deep Safety Stops: Rethinking Ascent Patterns From Decompression Dives.
By Richard L. Pyle.
Before I begin, let's make something perfectly clear: I am a fish-nerd (i.e., an
ichthyologist). For the purposes of this commentary, that means two things. First, it
means that I have spent a lot of time underwater. Second, although I am I biologist and
understand quite a bit about animal physiology, I am not an expert in decompression
physiology. Keep these two things in mind when you read what I have to say.
Back before the concept of "technical diving" existed, I used to do more dives
to depths of 180-220 fsw than I care to remember. Because of the tremendous sample size of
dives, I eventually began to notice a few patterns. Quite frequently after these dives, I
would feel some level of fatigue or malaise. It was clear that these post-dive symptoms
had more to do with inert-gas loading than with physical exertion or thermal exposure,
because the symptoms would generally be much more severe after spending less than an hour
in the water for a 200-foot dive than they would after spending 4 to 6 hours at much
shallower depths.
The interesting thing was that these symptoms were not terribly consistent. Sometimes I
hardly felt any symptoms at all. At other times I would be so sleepy after a dive that I
would find it difficult to stay awake on the drive home. I tried to correlate the severity
of symptoms with a wide variety of factors, such as the magnitude of the exposure, the
amount of extra time I spent on the 10-foot decompression stop, the strength of the
current, the clarity of the water, water temperature, how much sleep I had the night
before, level of dehydration ...you name it...but none of these obvious factors seemed to
have anything to do with it. Finally I figured out what it was - fish! Yup, that's
right...on dives when I collected fish, I had hardly any post-dive fatigue. On dives when
I did not catch anything, the symptoms would tend to be quite strong. I was actually quite
amazed by how consistent this correlation was.
The problem, though, was that it didn't make any sense. Why would these symptoms have
anything to do with catching fish? In fact, I would expect more severe symptoms after
fish-collecting dives because my level of exertion while on the bottom during those dives
tended to be greater (chasing fish isn't always easy). There was one other difference,
though. You see, most fishes have a gas-filled internal organ called a
"swimbladder" - basically a fish buoyancy compensator. If a fish is brought
straight to the surface from 200 feet, its swimbladder would expand to about seven times
its original size and crush the other organs. Because I generally wanted to keep the
fishes I collected alive, I would need to stop at some point during the ascent and
temporarily insert a hypodermic needle into their swimbladders, venting off the excess
gas. Typically, the depth at which I needed to do this was much deeper than my first
required decompression stop. For example, on an average 200-foot dive, my first
decompression stop would usually be somewhere in the neighborhood of 50 feet, but the
depth I needed to stop for the fish would be around 125 feet. So, whenever I collected
fish, my ascent profile would include an extra 2-3 minute stop much deeper than my first
"required" decompression stop. Unfortunately, this didn't make any sense either.
When you think only in terms of dissolved gas tensions in blood and tissues (as virtually
all decompression algorithms in use today do), you would expect more decompression
problems with the included deep stops because more time is spent at a greater depth.
As someone who tends to have more faith in what actually happens in the real world than
what should happen according to the theoretical world, I decided to start including the
deep stops on all of my decompression dives, whether or not I collected fish. Guess what?
My symptoms of fatigue virtually disappeared altogether! It was nothing short of amazing!
I mean I actually started getting some work done during the afternoons and evenings of
days when I did a morning deep dive. I started telling people about my amazing discovery,
but was invariably met with skepticism, and sometimes stern lectures from
"experts" about how this must be wrong. "Obviously," they would tell
me, "you should get out of deep water as quickly as possible to minimize additional
gas loading." Not being a person who enjoys confrontation, I kept quiet about my
practice of including these "deep decompression stops". As the years passed, I
became more and more convinced of the value of these deep stops for reducing the
probability of DCI. In all cases where I had some sort of post-dive symptoms, ranging from
fatigue to shoulder pain to quadriplegia in one case, it was on a dive where I omitted the
deep decompression stops.
As a scientist by profession, I feel a need to understand mechanisms underlying observed
phenomena. Consequently, I was always bothered by the apparent paradox of my decompression
profiles. Then I saw a presentation by Dr. David Yount at the 1989 meeting of the American
Academy of Underwater Sciences (AAUS). For those of you who don't know who he is, Dr.
Yount is a professor of physics at the University of Hawaii, and one of the creators of
the "Varying-Permeability Model" (VPM) of decompression calculation. This model
takes into account the presence of "micronuclei" (gas-phase bubbles in blood and
tissues) and factors that cause these bubbles to grow or shrink during decompression. The
upshot is that the VPM calls for initial decompression stops that are much deeper than
those suggested by neo-Haldanian (i.e., "compartment-based") decompression
models. It finally started to make sense to me. (For a good overview of the VPM, read
Chapter 6 of Best Publishing's Hyperbaric Medicine and Physiology; Yount, 1988.)
Since you already know I am not an expert in diving physiology, let me explain what I
believe is going on in terms that educated divers should be able to understand. First,
most readers should be aware that intravascular bubbles are routinely detected after the
majority of dives - even "no decompression" dives. The bubbles are there - they
just don't always lead to DCI symptoms. Now; most deep decompression dives conducted by
"technical" divers (as opposed to commercial or military divers) are very-much
sub- saturation dives. In other words, they have relatively short bottom-times (I would
consider 2 hours at 300 feet a "short" bottom time in this context). Depending
on the depth and duration of the dive, and the mixtures used, there is usually a
relatively long ascent "stretch" (or "pull") between the bottom and
the first decompression stop as calculated by any theoretical compartment-based model. The
shorter the bottom time, the greater this ascent stretch is. Conventional mentality holds
that you should "get the hell out of deep water" as quickly as possible to
minimize additional gas loading. Many people even believe that you should use faster
ascent rates during the deeper portions of the ascent. The point is, divers are routinely
making ascents with relatively dramatic drops in ambient pressure in relatively short
periods of time - just so they can "get the hell out of deep water".
This, I believe, is where the problem is. Maybe it has to do with the time required for
blood to pass all the way through a typical diver's circulatory system. Perhaps it has to
do with tiny bubbles being formed as blood passes through valves in the heart, and growing
large due to gas diffusion from the surrounding blood. Whatever the physiological basis, I
believe that bubbles are being formed and/or are encouraged to grow in size during the
initial non-stop ascent from depth. I've learned a lot about bubble physics over the last
year, more than I want to relate here - I'll leave that for someone who really understands
the subject. For now, suffice it to say that whether or not a bubble will shrink or grow
depends on many complex factors, including the size of the bubble at any given moment.
Smaller bubbles are more apt to shrink during decompression; larger bubbles are more apt
to grow and possibly lead to DCI. Thus, to minimize the probability of DCI, it is
important to keep the size of the bubbles small. Relatively rapid ascents from deep water
to the first required decompression stop do not help to keep bubbles small! By slowing the
initial ascent to the first decompression stop, (e.g., by the inclusion of one or more
deep decompression stops), perhaps the bubbles are kept small enough that they continue to
shrink during the remainder of the decompression stops.
If there is any truth to this, I suspect that the enormous variability in incidence of DCI
has more to do with the pattern of ascent from the bottom to the first decompression stop,
than it has to do with the remainder of the decompression profile. DCI is an
extraordinarily complex phenomenon - more complex than even the most advanced diving
physiologists have been able to elucidate. The unfortunate thing is that we will likely
never understand it entirely, largely because our bodies are incredibly chaotic
environments, and that level of chaos will hinder any attempts to make predictions about
how to avoid DCI. But I think that we, as sub-saturation decompression divers, can
significantly reduce the probability of getting bent if we alter the way we make our
initial ascent from depth.
Some of you may now be thinking "But he said he's not an expert in diving physiology
- why should I believe him?" If you are thinking this, then good - that's exactly
what I want you to think because you shouldn't trust just me. So, why don't you dig up
your September '95 issue of DeepTech (Issue 3) and read Bruce Weinke's article? I know it
covers some pretty sophisticated stuff, but you should keep re- reading it until you do
understand it. Why don't you call up aquaCorps and order audio tape number 9 ("Bubble
Decompression Strategies") from the tek.95 conference, and listen to Eric Maiken
explain a few things about gas physics that you probably didn't know before. While you're
at it, why don't you order the audio tape from the "Understanding Trimix Tables"
session at the recent tek.96 conference? You can listen to Andre Galerne (arguably the
"father of trimix") talk about how the incidence of DCI was reduced dramatically
when they included an extra deep decompression stop over and above what was required by
the tables. On the same tape you can listen to Jean-Pierre Imbert of COMEX (the French
commercial diving operation which conducts some of the world's deepest dives) talk about a
whole new way of looking at decompression profiles which includes initial stops that are
much deeper than what most tables call for. Why don't you ask George Irvine what he meant
when he said he includes "three or four short deep stops into the plan prior to using
the first stop recommended by each of the [decompression] programs" in the January,
'96 issue of DeepTech (Issue 4)? If that's not enough, then check out Dr. Peter Bennett's
editorial in the January/February 1996 Alert Diver magazine; he's talking about basically
the same thing in the context of recreational diving. If you really want to read an
eye-opening article, see if you can find the report on the habits of diving fishermen in
the Torres Strait by LeMessurier and Hills (listed in the References section at the end of
this article). The lists goes on and on. The point is, I don't seem to be the only one
advocating deep decompression stops.
Are you still skeptical? Let me ask you this: Do you believe that so-called "safety
stops" after so-called "no- decompression" dives are useful in reducing
probability of DCI? If not, then you should take a look at the statistics compiled by
Diver's Alert Network. If so, then you are already doing "deep stops" on your
"no-decompression" dives. If it makes you feel better, then call the extra deep
decompression stops "deep safety stops" which you do before you ascend to your
first "required" decompression stop. Think about it this way: Your first
"required" decompression stop is functionally equivalent to the surface on a
dive that is taken to the absolute maximum limit of the "no-decompression"
bottom time. Wouldn't you think that "safety stops" on
"no-decompression" dives would be most important after a dive made all the way
to the "no- decompression" limit?
Some of you may be thinking, "I already make safety stops on my decompression dives -
I always stop 10 or 20 feet deeper than my first required stop." While this is a step
in the right direction, it is not what I am talking about here. "Why not?", you
ask, "I do my safety stops on no-decompression dives at 20 feet. Why shouldn't I do
my deep safety stops 20 feet below my first required ceiling?" I'll tell you why -
because the safety stops have to do with preventing bubble growth, and bubble growth is in
part a function of a change in ambient pressure, not a function of linear feet. Suppose
that, after a dive to 75 feet, you make a safety stop at 20 feet. Well, the ambient
pressure at sea level is 1 ATA. The ambient pressure at 75 feet is about 3.3 ATA. The
ambient pressure at your 20-foot safety stop is 1.6 ATA - which represents roughly the
midpoint in pressure between 3.3 ATA and 1 ATA. Now, suppose you're on a dive to 200 feet
(about 7 ATA) and your first required decompression stop is 50 feet (about 2.5 ATA). The
ambient pressure midpoint between these two depths is 4.75 ATA, or a little less than 125
feet. Thus, on this dive you would want to make your deep safety stop at about 125 feet -
exactly the depth I used to stop to stick a hypodermic needle in my little fishies.
But of course, the physics and physiology are much more complex than this. It may be that
ambient pressure mid- points are not the ideal depth for safety-stops - in fact, I can
tell you with near certainty that they are not. From what I understand of bubble-based
decompression models, initial decompression stops should be a function of absolute ambient
pressure changes, rather than proportional ambient pressure changes, and thus should be
even deeper than the ambient pressure mid-point for most of our decompression dives.
Unfortunately, I seriously doubt that decompression computers will begin incorporating
bubble-based decompression algorithms, at least not in their complete form. Until then, we
decompression divers need a simpler method - a rule of thumb to follow that doesn't
require the processing power of an electronic computer. Perhaps the ideal method would be
simply to slow down the ascent rate during the deep portion of the ascent. Unfortunately,
this is rather difficult to do - especially in open water. Instead, I think you should
include one or more discrete, short-duration stops to break up those long ascents. Whether
or not it is physiologically correct, you should think of them as pit-stops to allow your
body to "catch up" with the changing ambient pressure.
Here is my method for incorporating deep safety stops:
1) Calculate a decompression profile for the dive you wish to do, using whatever software
you normally use.
2) Take the distance between the bottom portion of the dive (at the time you begin your
ascent) and the first "required" decompression stop, and find the midpoint. You
can use the ambient pressure midpoint if you want, but for most dives in the
"technical" diving range, the linear distance midpoint will be close enough and
is easier to calculate. This depth will be your first deep safety stop, and the stop
should be about 2-3 minutes in duration.
3) Re-calculate the decompression profile by including the deep safety stop in the profile
(most software will allow for multi-level profile calculations).
4) If the distance between your first deep safety stop and your first "required"
stop is greater than 30 feet, then add a second deep safety stop at the midpoint between
the first deep safety stop and the first required stop.
5) Repeat as necessary until there is less than 30 feet between your last deep safety stop
and the first required safety stop.
For example, suppose you want to do a trimix dive to 300 feet, and your desktop software
says that your first "required" decompression stop is 100 feet. You should
recalculate the profile by adding short 2-minute) stops at 200 feet, 150 feet, and 125
feet. Of course, since your computer software assumes that you are still on-gassing during
these stops, the rest of the calculated decompression time will be slightly longer than it
would have been if you did not include the stops. However, in my experience and apparently
in the experience of many others, the reduction in probability of DCI will far outweigh
the costs of doing the extra hang time. In fact, I'd be willing to wager that the
advantages of deep safety stops are so large that you could actually reduce the total
decompression time (by doing shorter shallow stops) and still have a lower probability of
getting bent - but until someone can provide more evidence to support that contention, you
should definitely play it safe and do the extra decompression time. One final point. As
anyone who reads my posts on the Internet diving forums already knows, I am a strong
advocate of personal responsibility in diving. If you choose to follow my suggestions and
include deep safety stops on your decompression dives, then that's swell. If you decide to
continue following your computer-generated decompression profiles, that's fine too. But
whatever you do, you are completely and entirely responsible for whatever happens to you
underwater! You are a terrestrial mammal for crying out loud - you have no business going
underwater in the first place. If you cannot accept the responsibility, then stay out of
the water. If you get bent after a dive on which you have included deep safety stops by my
suggested method, then it was your own fault for being stupid enough to listen to
decompression advice from a fish nerd!
References:
Bennett, P.B. 1996. Rate of ascent revisited. Alert Diver, January/February 1996: 2.
Hamilton, B. and G. Irvine. 1996. A hard look at decompression software.
DeepTech, No. 4 (January 1996): 19- 23
LeMessurier, D.H. and B.A. Hills. 1965. Decompression sickness: A thermodynamic approach
arising from a study of Torres Strait diving techniques. Scientific Results of Marine
Biological Research. Nr. 48:
Essays in Marine Physiology, OSLO Universitetsforlaget: 54-84.
Weenie, B. 1995. The reduced gradient bubble model and phase mechanics.
DeepTech, No. 3 (September 1995): 29-37.
Yount, D.E. 1988. Chapter 6. Theoretical considerations of Safe
Decompression. In: Hyperbaric Medicine and Physiology (Y-C Lin and A.K.C. Niu, eds.), Best
Publishing Co., San Pedro, pp. 69-97.
I would like to thank Eric Maiken for explaining bubble physics to me and for adding some
theoretical foundation to my silly ideas.