Wednesday 19 May 2010
Thursday 10 September 2009
A rough guide to Hyperbaric Oxygen Therapy
The chamber is just a small room in which air can be compressed to a pressure greater than normal. If you have been in an airplane, then you have already been in a hyperbaric chamber. The chamber has port holes and a comfortable bench to lie down on.
What is hyperbaric oxygen therapy ?
We normally take in 21% of oxygen from the air that we breath. By putting the patient into the higher than normal pressure then giving them 100% oxygen, the beneficial effects of oxygen is greatly increased. It’s a painless procedure which can for example, reduce the size of the bubbles of nitrogen in the body and in doing so the damage to the tissues is decreased, reducing the pain and improving micro circulation. The hyperbaric oxygen that is dissolved in the plasma, helps to restore the damaged tissue. The subsequent reduction in swelling further improves circulation in the damaged areas. So in the case of a stubborn wound which refuses to heal because of poor circulation hyperbaric oxygen can increase microscopic blood vessel growth and improve the ability of white blood cells to fight off infection.
Why have I been referred to the hyperbaric chamber?
There are two main reasons why you may have been sent to the chamber.
Decompression Illness (the bends).
This is where excess nitrogen bubbles have been trapped in the body, causing DCI.
DCS type 1. Joint pain & skin bends only. Caused by the physical effect of the bubbles and immune reaction on the tissues.
DCS type 2. Typically due to bubbles in the nerve tissue of the spinal cord or brain, causing a wide range of neurological problems including, but not limited to:
Ÿ Numbness and tingling in the limbs particularly in the fingers and toes.
Ÿ Limb weakness or paralysis
Ÿ Back or torso pain.
Ÿ Urinary retention (cannot pee).
Ÿ Lack of balance, poor gait and poor co-ordination.
Ÿ Extreme fatigue.
Wound Healing.
You may have a wound that is not responding to antibiotics and you may suffer from poor circulation. This can be helped by hyperbaric oxygen as it forces oxygen to those tissues which have been damaged, encourages blood vessels to grow, which will promote and accelerate healing.
What should I expect when I arrive?
When you arrive you will introduces to our staff and then you will asked to sign a consent form for your hyperbaric treatment. You also need to provide some form payment, which is usually a DAN insurance card or a credit card. You will be supplied with suitable clothing, and be asked if you have anything flammable like lipstick or vaseline in your pockets. Because hyperbaric oxygen therapy requires 100% oxygen, any form of smoking material, electrical appliances, lighters, books and magazines are prohibited. If you watch is not used for diving, then you should leave it with a friend or family member.
We will give you an oxygen mask, to try on your face so that it’s comfortable for you. You will also be asked to describe your symptoms before you go into the chamber and during treatment so we can monitor your progress. Our staff will be with you throughout the treatment so feel free to ask any questions.
How will it feel?
For the first 10 minutes or so the chamber will be quite hot and noisy, but it will get cooler and quieter once we have reached the required pressure. If it gets too cold, you can have a blanket, or if the noise is too much for you, then let the attendant know that’s with you.
You will feel the pressure change in your ears, just like in an airplane. If you have problems equalizing your ears, or feel any discomfort, you should tell your attendant immediately. You will be given an oxygen mask to put on and encouraged to breath deeply. The remainder of the treatment should be relaxing, you will occasionally be asked to remove the oxygen mask for an air break, and take in fluids. Non greasy foods are allowed in the chamber like fruit or granola bars; ask the staff if you are not sure. If you need to go to the bathroom there is a bed pan and male urinal under the bed. The attendant will move into the outer lock and the TV monitors switched off for privacy. You are encouraged not to “hold on” as this can cause great discomfort, especially on the ascent.
How long will the treatment last?
If you have been diagnosed with DCS then the treatment should take about 5 hours however this will depend on your progress and what the doctor who admitted you decides. Once you have had a treatment, you will then need to go back to the doctor to be evaluated. The doctor may send you home, or may recommend more treatments.
Wound healing treatments tend to last 2 hours but often multiple treatments of 20 or more are required. These tend to be scheduled either in the morning 6 – 8am or afternoons 4-6pm.
Family members and friends are welcome to come along in the first instance, however we find that after the treatment has started many leave and return near the end of the treatment.
What if I am a smoker?
To get the most from your hyperbaric oxygen therapy, you are encouraged not to smoke as this causes the blood vessels to constrict which in turn decreases blood and oxygen supply to the tissues, this negates the effects of hyperbaric oxygen.
Where can I find out more information.
The Divers Alert Network. Website http://www.diversalertnetwork.org
Hyperbaric Medicine at Duke University. http://hyperbaric.mc.duke.edu/index.htm
Or call DAN +1 919 – 684 - 4326
Tuesday 23 June 2009
Caribbean championships Barbados 2009
I dont think the Bajans realised what had happened since we scraped a win from them in the 7s in the Bahamas and they beat us once For sure, we were a different team out there on Sunday June 21st.
We played like were drilled to play, with the forwards making penetrating runs for 2 to 3 phases before giving it out to the backs. Olive made some really god runs and intercepted one ball for an easy try. Loletta also did some good strong running and she also scored.
I came on in the second half to replace Caroline and had a good game, doing what i do best, scrapping for the ball, and stealing it...we lost a little strucuture in the second half as we allowed ourselves to play to the ability of the bajans, who were, by now, bickering amongst themselves. This is always a good sign! Karen Hart and Jess had outstanding runs as did Jo Zeigler who put in some monster tackles. the referee was shit!missing alot of hands in the ruck and not stopping the game in time fo (potential) injuries.
Rowena desprately wanted to score a try herself, she went to take the ball over but was stopped a foot short, I was supporting her and was about to take the ball out and put it down, when Lisa said "I have it" she took it from me and moved it 6 inches to score the try! Of course the team took the mick out of her..saying once again she has stolen the try from Sharon...Lisa rang Mick and told him
, which was just as well becuase
Rowena, eventually scored a try in the last 5 minutes , which was just as well because we would never have heard the last of it!
We had won, and the pressure was off! We were all ecstatic. Ypu would not believe the relief and for the next 5 hours the game was all we talked about, and the piss taken out of everybody at some stage or another!
We lounged by the pool, drank beers and I made some Martinins whilst we all waited to have the compulsory ice bath..then it was off for a lovely meal followed by dirty dancing at McBrides in St lawrence Gap. What a great day!
Wednesday 10 June 2009
In the news.Cayman net News. Tuesday June 9thhttp://www.radiocayman.gov.ky/servlet/page?_pageid=1816&_dad=portal30&_schema=PORTAL30&_mode=3&p_thi_id=1
09/06/2009
The recent appearance of the beautiful, but dangerous Indo-Pacific Red Lionfish in our waters has united Cayman's divers and marine conservationists in their efforts to preserve our treasured marine environment. A recent example of this union was a generous donation of specialized equipment to the Central Caribbean Marine Institute (CCMI) by the not-for-profit dive club, The Cayman Islands Divers - BSAC # 360."Thanks to the generous contribution of this specialized equipment from Cayman Islands Divers, CCMI is properly equipped to do our part in helping to control the population of lionfish here in the waters of the Cayman Islands." Commented Claire Dell from CCMI's Little Cayman Research Centre
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Wednesday 29 April 2009
In the last few months individual lionfish (Pterois volitans) have been spotted in and around the dive sites of Grand Cayman. First spotted in Little Cayman, in March 2008, since then a multitude of reports have come in.
A Lionfish captured at Eden Rock dive site. Grand Cayman. (Chris Burrowswood)
They may look pretty but in actual fact their presence on here on our reefs could mean the total devastation of the reef fish populations over a very short period of time. In fact in the Bahamas the lionfish reduced the number of native fish by 79% over a 5 week period[1]. These fish have voracious appetites, picking juvenile fish at will that have not evolved any natural survival instincts against them. In many areas it is thought that the whole coral reef community may be decimated as a result of lionfish predation.
Photo of invasive and non invasive areas (taken from Florida Museum of natural History website).
Lionfish are native of the Red Sea and Indo – Pacific regions. This covers most of Western Australia, New Zealand, Malaysia, Japan and throughout Micronesia.
Photo of invasive areas
(ref NOAA)
The first documented sight of lionfish on this side of the Atlantic was in Florida in the late 1990s, but since then they have spread rapidly down the eastern sea board and are now been caught as far as Haiti and Puerto Rica.
Lionfish like to be in warm marine tropical waters like the Red Sea, they have been found in depths of up to 400ft, but are usually seen from 80 to 200ft. They don’t mind what type of habitat they live in. It could be either coral reef, or hard pan. The author has also seen them around and in wrecks. They tend to like overhead areas like caves, so you have to look up rather than down !. Lionfish hide in crevices during the night, coming out to hunt in the morning.
Lionfish are conspicuous predators, slow moving, they seem to glide along the reef without a care. Like “boys in the hood” The spines are not used for killing but for cornering their prey. The bright colours; dorsal, anal and pectoral spines ward off potential predators, and as a consequence they tend to be the top fish in the food chain, indeed even the nurse sharks don’t like them and spit them out when they have been fed them.
Lionfish had thought to be brought into Caribbean waters in the ballast of cargo ships however; studies have shown this to be erroneous. It is now known that most of the lionfish in our waters now came from just 8 fish (1 male and 7 females!) that were accidentally released in Biscayne Bay, Florida when an private aquarium broke during Hurricane Andrew in 1992. However since then it’s thought that other private aquarists have released fish into the water, probably by flushing them down the toilet.
So what can be done about this invasion? The answer is that we cannot possibly stop the lionfish now that they are in our waters. Scientists have had very little base line information to go on since there was never a problem in their native habitat, where the ecosystem has remained in balance for hundreds of years with the lionfish a part of it. It’s only now that information is being gathered in order to understand the nature of these creatures.
The news is not good for the native fish, the bottom line is that these fish reach sexual maturity very quickly and breed all year around. The female release two egg masses that are then fertilized by the male. These float rise to the surface when, after a few days the larvae become free floating. The larval stage lasts between 25 to 40 days, enough time for them to reach far on the Yucatan and Caribbean currents [2]
In order to control and manage the invasion a culling program has been introduced here in Cayman as well as in Bermuda and the Bahamas. In Cayman the Department of the Environment (DOE) invited, first local dive masters and later the general public, to a presentation given by a NOAA/REEF/USGS representative. The talk was aimed at educating local dive operators and showing them the best (tried and tested) technique for capturing the lionfish. Spear fishing had been tried but the most effective way is by using two nets and then, carefully grabbing the body using spine resistant gloves, and putting them into a clear dry bag. (see photo)
The lionfish are then collected by the DOE, the gill filaments are removed for DNA testing and their biological data collected.
There have been many workshops all around the Caribbean to facilitate early detection and a rapid response to this threat; licenses have been issued to those people who attended the talk as local marine laws prohibit the taking of any marine organisms from protected waters.
These programs represent the front line in the defense against invasive species and the work of organizations such as REEF have been incremental in finding; not just lionfish but other invasive fish around the world.
At the time of writing this article some 60 lionfish have been captured in Cayman waters and over a hundred have been reported. However, as is often the case, for every one lionfish seen there are many not seen lurking in cracks and crevices ready to ambush defenseless species of fish that have never seen the like of these in their existence. They have no chance, adaptation and evolution takes hundreds of years and by then it will be too late for this population. All we can do is, like King Canute, try and hold back the tide.
Acknowledgements
Photos : Chris Burrowswood
NOAA
Bradley Johnson, Department of the Environment. Cayman Islands
REEF
[1] Albins MA, Hixon MA. (2008) Invasive Indo – Pacific lionfish Pterois volitans reduce recruitment of Atlantci coral – reef fishes. Mar Ecol Prog Ser Vol 367:233.
[2] Morris et al (2008) Biology and Ecology of the Invasive Lionfish, Pterois miles and Pterois volitans. Proceedings of the 61st Gulf and Caribbean Fisheries Institute. Nov 10-14.
