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  • Writer's pictureDrew McArthur

Cover Your Ass!

The recompression chamber at the Cayman Islands Hospital
The recompression chamber at the Cayman Islands Hospital. Not the best end to your dive trip.

During my time spent as a diver so far, I have unfortunately witnessed quite a few cases of Decompression Sickness (DCS.) Something I have noticed that appears to be common for pretty much all of these incidents is that as soon as the first signs and symptoms appear, the initial reaction from the victim is almost always denial. To me, I think this exposes an interesting point of view that most divers have which is that DCS is so unlikely that for them to get bent just couldn’t be possible. I also believe it’s the same thinking that leads many divers to dispel the need to get appropriate dive insurance. The sad reality is that each year untold amounts of divers end up in the chamber where they can run up tens of thousands of dollars worth of treatment without having the means to pay for it. A dive vacation is supposed to be a fun experience where fond memories are made but as many have discovered, if things don’t go to plan then the penalty could be extreme. With this in mind, in my position as a divemaster I often wonder why so many people dive with without good insurance?

I recently met a lady who had what is referred to as an “unexplained hit”. An unexplained hit would be described as someone who gets bent on a dive where nothing out of the ordinary occurred and not only did everything go to the plan of staying within safe limits, there was nothing untoward in the condition of the diver or the environment that day that might contribute towards DCS.

About an hour after her dive she noticed a series of rashes across her stomach which is a classic sign of DCS. True to form she couldn’t possibly imagine that it was anything to do with the dives she had done that day so thought nothing of it until the pains started. In spite of being 20 minutes away from a medical facility with a hyperbaric chamber it was approximately five hours after the onset of signs and symptoms before she went to get it checked out.

Many chambers run costs in the region of $1,000 USD per hour and the common starting point for a chamber ride is five hours but the bill doesn’t end there. For this lady, one treatment of five hours was enough but many cases may require two or three spells in the chamber at around five hours a time, you can see how the vacation budget would get blown out of the water pretty quickly.

A DCS patient, prior to admission to the recompression chamber. Used with patient permission.

Although the lady in this anecdote only needed one ride, the chamber wasn’t the only item on the bill. The medical grade oxygen needed to be covered along with a series of care, consultations, scans and eventually a night in hospital to be monitored. The final bill came in a little under $10,000US and unfortunately her travel insurance would not cover anything to do with extreme sports which believe it or not, diving is considered to be.

A surprise $10K sting at the end of a vacation is a bummer indeed but unbelievably, there was more to come for our unfortunate diver. After the spell in the chamber, the lady just wanted to go home and try to recuperate but due to the treatment and the nature of her condition, she was prohibited from flying for 72 hours. The flying restriction meant that on top of all the medical bills, she had to find the means to extend her stay for another three days before she was approved for air travel.

I have noticed that a scary amount of people happily drop thousands of dollars to go on dive vacations but fail to invest $30 for the basic dive cover through the Divers Alert Network (DAN). Of course most of the time everything goes absolutely fine but the very real possibility that anyone on a boat may one day have the misfortune to get bent is absolutely real. I keep wondering why so many people get caught out and based on conversations with those who have, I have found a few Repeat offenders that seem to come up time and again. Below are the most common five objections I have heard to buying insurance with a couple of thoughts as to how I would respond to those.

I follow the rules so shouldn’t get bent

On a small island you're likely to know everyone. Serena (top) is the chamber attendant, caring for her friend who was suffering from DCS. Used with patient permission.

Of course it makes sense to follow the rules such as ascent speeds, safety stops, NDLs etc in order to make your dives as safe as possible. The lady in the story above however is just one example of a perfectly fit and well diver who took a DCS hit after having done nothing wrong on her dive. With regards to assuming that everything will be fine if you obey your dive computer, consider that it is not hard wired into your body and does not monitor your physiological reaction to what you are doing underwater. The computer will work on a theoretical calculation that should indeed work well for most dives and most people but it does not take into consideration any changes in the person or on the dive as a whole that could increase the susceptibility of getting bent. Unexplained hits are a thing.

I’m much healthier and fitter than other divers so should be fine

There is no telling how one persons body responds to gas super saturation in the tissues compared to another’s. It is generally agreed that being in good shape i.e. strong cardio vascular system and not overweight will improve a divers chance of staying safe but there are other things at play. You may be fitter in terms of cardiovascular health but what about predisposing medical conditions? Have you been checked for a PFO? This considerably increases the chanced of DCS but is just one condition that does so. There are so many aspects of dive physiology that remain a mystery and not even the young fit diver is exempt from risk.

I don’t dive enough to need it

It only takes one dive to get bent and it doesn’t have to be on a dive vacation. Of course the numbers dictate that the more you dive the more likely you are to take a hit but that doesn’t mean that people who dive a few times a year are not open to the possibility either. If you only dive at home then be sure to check your regular health insurance and see what the small print says about coverage for dive injuries and illnesses. If you are planning a dive overseas then doing so without dive insurance is playing with fire.

I can’t afford it.

….seriously? You can afford your Open Water course, equipment purchase or rental, a charter boat dive travel and so on but you can’t afford $30 to cover your ass if you get bent? Can you afford the $10K if it goes wrong? I don’t usually recommend that people dive less but if money is the barrier then just do one dive less a year and put the money that you saved from that towards the cost of coverage. Should you ever get bent then you’ll find that having insurance to cover the costs of it will mean that you’ll be able to get way more dives in throughout the year than if you are in ten thousand dollars worth of debt.

Lack of understanding

DCS is a complicated beast. Many divers have a very basic understanding of the concept but unfortunately manage to retain a lot of false information. In truth, there is much about the condition that even the world’s leading researchers on the topic don’t yet understand. When someone gets bent there may never be a clear reason as to how it happened and that makes it hard for others to learn from. While you are reading up on the subject to get a solid understanding of the basics, why not save yourself some time and just get online first to buy some dive insurance?

The intention of this blog isn’t to try to scare people out of the water I am just trying to raise awareness of a risk that we all assume when dive. As I mentioned at the beginning of the article, I have first hand seen people fall foul of this and find themselves in the whole for obscene amounts of money. Statistically you are unlikely to get bent but the condition is still a very real possibility and isn’t always caused by doing something wrong on a dive like ascending too fast or missing a safety stop.

DAN cardiologist Dr Douglas Ebersole has a very nice way of looking at the condition which is to refer to it as a sporting injury. You wouldn’t think it that strange if a basketball player tore an ACL, in the same vein DCS is a potential injury that divers are exposed to.

The good news is that most people who I know that have been bent in the past have recovered and been signed off for diving again usually six weeks after the accident. Nobody wants to get bent and it isn’t nice to think about it but it is far better to have cover and never need it than to need it and not have cover. My advice to all divers is to get online, go to and buy at least the most basic plan. After that just keep on having fun underwater.

Safe diving everybody!

P.S. I don’t make commission on selling DAN insurance!


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