My DCS Hit
- Thread starter DSix36
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broncobowsher
Member
I don't think even the moderator want's to wade through all this garbage to pick out the good stuff.
Exactly it has become click bait.It's on the other side of the central median but we just have to slow down for a look
As painful as these discussions have become, I still feel strongly that we as a diving community have benefited from the discourse. I for one, have gained a much greater insight into the nuances of the various deco models, how they are structured and the methodology behind them by reading about them here on this forum. As a moderation team, we have decided to let the discussion continue. Coincidentally, the deco discussions have by far been the most read discussions in the history of the forum. I have to believe it is primarily because people find them beneficial and not just because they enjoy a good cat fight.
Simon Mitchell
Well-Known Member
All of those papers demonstrate either increased decompression stress or actual decompression sickness in humans when profiles emphasising deep stops are compared with alternative profiles of the same length but with the stops distributed shallower. I cannot understand how you can possibly fail to see that they support my position. My "position" in fact, is a careful articulation of exactly what has been found in those studies and subsequent evaluation of their results.
What planet are you on Ross? Consider the following....
David Doolette, arguably the world's leading decompression modeller, has agreed with me on these forums.
Neal Pollock, another prominent decompression scientist, has agreed with me on these forums.
Andrew Fock, a prominent Australian diving physician, published early suspicions about bubble models in technical decompression diving in a peer reviewed medical journal article [1] long before I ever started discussing the issue.
David and I have published interpretations of many of the issues we debate with you in a recent peer reviewed scientific journal article [2].
My colleagues published the studies I cited in support of my position (see earlier posts) in peer reviewed journals.
Do you seriously think that in my position I could leave a trail of inaccurate information all over the internet without some sort of push back from my colleagues?
By "valid science" you mean your opinion and uneducated interpretations. Come on Ross, you demand peer review and support of me.... why not live up to the high standards you demand of others and get your beliefs on these matters peer reviewed and published if you believe them to be correct. Until then, why should anyone even begin to contemplate the validity of your "science". Indeed, you are so easily proven wrong on so many things that you state categorically (see below for example) that it would be unwise for anyone to believe anything you say without some sort of external corroboration.
My interpretations of intra- and extravascular bubble growth and the role of VGE in DCS (that you refer to as "deceptions and lies") have been published in the most recent chapters on pathophysiology of decompression sickness in the world's 3 most prominent diving medicine textbooks [3-5], and the most influential general medicine textbook [6]. It is inconceivable that I would be invited to write these chapters if my interpretations of the pathophysiology were considered incorrect (let alone "deceptions and lies") by my peers. Your claim that I have this wrong or misrepresent accepted paradigms is nothing short of bizarre.
This is delusional nonsense as has been pointed out to you many times before. You simply don't understand what is meant by a "rate". The numbers of cases have decreased, but we have published evidence that this, at least in part, is a consequence of less diving activity [7] and other influences such as less frequent recompression for mild cases [8]. Moreover, the vast majority of the global population to which the declining case number statistics apply are scuba air divers who have never heard of VPM. Your attempt to draw relevance of globally declining DCS cases to use of VPM demonstrates your poor understanding of the relevant issues.
Every time you say this, someone points out that Don's decompression was not confluent with the views I have expressed on the most rational interpretation of the current evidence. But you keep ignoring this.
Leaving that aside, someone is certain to get sick doing EXACTLY what I have suggested, but so what? A single case, or two cases or whatever doesn't "test" anything. The real question is what happens if you compare the two strategies over a large number of standardised dives. And every time scientists have done that to date the approach that emphasises deep stops produces more decompression stress.
I think this amply demonstrates what an unpleasant vindictive individual you are, and how low you will go just to try to win an argument on the internet. And you keep ignoring the question that has been asked many times: based on the logic you are applying here, should you be blamed for all those divers who have gotten sick using VPM?
Actually Ross, since you have raised it, I think it is you who is a "bully on a campaign". Its just that the bully has finally encountered someone who will stand up to him, and he doesn't like it. I remember during the 2000s you used to rule the roost on decompression matters on the internet and you would very quickly and angrily shout down anyone who disagreed with you. They even had a term for it: "Ross-Rage". I generally ignored you because you were espousing things that I basically agreed with; that is until the NEDU study came along and you kicked off this process that is still going. Like many accusations you make, I think you need to take a good look in the mirror on this one.
Simon M
References:
1. FOCK A. Deep decompression stops. Diving Hyperbaric Med 2007;37(3):125-32.
2. DOOLETTE DJ, MITCHELL SJ. Recreational technical diving part 2. Decompression from deep technical dives. Diving Hyperb Med 43, 96-104, 2013
3. MITCHELL SJ. Decompression sickness: pathophysiology. In: EDMONDS C, BENNETT MH, LIPPMANN J, MITCHELL SJ. Diving and Subaquatic Medicine (5th ed). Florida, USA, Taylor and Francis, 125-140, 2015
4. FRANCIS TJR, MITCHELL SJ. Pathophysiology of decompression sickness. In: Bove AA (Ed). Bove and Davis’ Diving Medicine (4th ed). London, Saunders Publishing, 165-184, 2004
5. FRANCIS TJR, MITCHELL SJ. The pathophysiology of decompression sickness. In: Brubakk AO, Neuman TS (Eds). Bennett and Elliott’s Physiology and Medicine of Diving (5th ed). London, Harcourt Publishers, 530-556, 2003
6. BENNETT MH, MITCHELL SJ. Hyperbaric and Diving Medicine. In: Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson JL, Loscalzo J (eds). Harrison’s Principles of Internal Medicine (19th ed). McGraw – Hill, Chapt e477: 2015
7. HAAS RM, HANNAM JA, SAMES C, SCHMIDT R, TYSON A, FRANCOMBE M, RICHARDSON D, MITCHELL SJ. Decompression illness in divers treated in Auckland, New Zealand 1996-2013. Diving Hyperbaric Med, 44, 20-25, 2014
8. MITCHELL SJ, BENNETT MH, BRYSON P, BUTLER FK, DOOLETTE DJ, HOLM JR, KOT J, LAFERE P. Pre-hospital management of decompression illness: expert review of key principles and controversies. Diving Hyperbaric Med. 48, 45-55, 2018. doi.10.28920/dhm48.1.45-55.
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In the matter of your anti-deep stop campaign.... and your self proclaimed body of evidence.... You quote those papers out of context. You make invalid re-interpretations of them. You draw invalid conclusions from them... You ignore the fact that your assumptions are easily proven invalid and wrong.
Your assumptions have not been put to peer review.
You make the assertion that they are scientists, so therefore your re-interpreted assumptions must be right.
You fabricate the context of VGE, intravascular and extravascular micro-bubbles.
All because you need to prop up and create a fallacy argument.
YOUR new decompression ideas ... don't seem to work.
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But maybe we need special exception rules just for Simon.
.
Your assumptions have not been put to peer review.
You make the assertion that they are scientists, so therefore your re-interpreted assumptions must be right.
You fabricate the context of VGE, intravascular and extravascular micro-bubbles.
All because you need to prop up and create a fallacy argument.
YOUR new decompression ideas ... don't seem to work.
****************
But maybe we need special exception rules just for Simon.
.
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Simon - arguing with Ross is like playing chess with a pigeon (it’s not mine and goes along lines of: The pigeon doesn’t understand rules, knocks all the peices over, struts around with chest pumped up like he’s won and then takes a dump on the board),
Please just ignore him, use your valuable time somewhere else and don’t keep responding - nobody believes his information anyway
Please just ignore him, use your valuable time somewhere else and don’t keep responding - nobody believes his information anyway
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UWSojourner
Active Member
The problem with the "just ignore him" strategy is he'll keep peppering these forums with his views of decompression. If he goes unopposed, then it simply looks to newer participants like he knows what he's talking about.
These discussions are like cleaning a room with a loose monkey throwing his feces around. Glad Dr. Mitchell's been kind enough to join the cleanup crew.
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Simon Mitchell
Well-Known Member
Hi Bobjr,
That's pretty funny! You are right of course, but the problem is that so is UWSojourner. Forums are where many technical divers come for their information, and the potential for disinformation to spread if someone is determined to spread it is immense. Especially if the commentator is perceived as credible. The fact that Ross has written an excellent software platform for VPM (and other models) has always afforded him a degree of credibility. Indeed, I am sure that many readers automatically assume he had some sort of role in conceiving the model. He didn't of course, and the truth is that his knowledge of the physiology and pathophysiology of decompression is limited. But he is a skilled confabulator, and it is usually hard to see through the authoritative language. This is why UWSojourner is correct. If left to his own devices, Ross could have a substantial influence on thinking amongst technical divers. Most of my colleagues won't go near the internet for exactly the reasons you see playing out on this thread, but because I am very connected to both the technical diving community and to actively researching the pathophysiological challenges of our sport I cannot stand by and see purposive spread of misinformation in my area of interest.
Unfortunately, Ross's involvement in the deep stops saga has created an exaggerated polarization on the issue. If he had not refused to accept what the published evidence is showing then the conclusion at this point in time would be a reasoned interpretation; that the deepest stops prescribed by bubble models are deeper than required for optimal decompression in dives of the same length. That message is actually modest in its intent. It doesn't say that you should not use bubble models if you find the theory attractive, or that you should absolutely not use bubble model deep stops (especially if you compensate for them at the shallow end of the decompression and / or back off them a bit). Unfortunately, years of bitter meandering debate have created a sense that you either love deep stops or consider them complete sh1t. The latter is not my view. Stops have got to start somewhere. Every decompression must have its deepest stop. My intent throughout this has been to try to derive a sensible response to the current evidence. Ross's has been to defend bubble models at all costs, mainly by attacking the published work of my colleagues, and in the absence of any published evidence supporting his defence. A relatively small degree of sensible compromise could have avoided all of this.
Simon M
"refused to accept what the published evidence is showing then the conclusion at this point in time would be a reasoned interpretation;"
What a delusional person you are. So wrapped up in your own self importance.
Your self proclaimed collection of supporting "evidence" (you mean studies), does not support your cause or assumptions. In fact science proves your assumptions are wrong. Your interpretation is wrong.
The consequence of your faulty interpretations - i.e. your defective "new, more efficient" deco method, does not work.
You have broken deep decompression, and have fixed nothing. How many more people will get seriously injured (like Don here) following your advise?
.
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silent running
Member
Ross, if you were serious about disputing Simon's opinions you would not persist in name calling and sensational accusations. Pick one thing he has supposedly misrepresented, challenge him and stick to the point. If you have read the literature and understand it, it should be realtivively easy to raise doubt about a particular principle you disagree with him on. Not thoroughly engaging with him on specifics makes you look less knowledgeable and less honest in your motives. Whether you like it or not, his knowledge base is very substantial and it's not enough just to say he's wrong, you need to be specific and pointed in your criticism. You're not arguing about whether the Stones are better than the Beatles, this is serious stuff and you ought to have more courage in your convictions than to resort to personal attacks. Again, it just makes you look bad to anyone but the newest among us.
Continuing on this path is certainly risky for many reasons, so do us and yourself a favor and change your tact.
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silent running
Member
Hello Simon, to change the subject somewhat, do you or anybody else in in the scientific/medical fields know why saturation diving decompression is successful with rates of very slow ascent and deep stops, yet with no apparent additional penalties for their additional ongassing during those deeper stages and stops? Is this only physiologically possible because they reach total saturation during their stay on the bottom as the baseline? If so why does this one fact so greatly influence every other aspect of gas exchange back into the bloodstream on ascent? Or is it simply the extreme slowness of the ascent that prevents tissue injury and counter diffusion? I think I've asked this before but maybe not the right way? If so please forgive me, sometimes it takes awhile for things to sink in...
The literature on saturation diving decompression procedures I've read states it's main objective is controlling bubble growth. And that was how RGBM was sold to me during my NAUI trimix class. Obviously during the chamber ride to the surface they can control and monitor all sorts of things that a CCR diver cannot. But still, why are the results of deco models used in CCR diving apparently less successful than those of saturation diving, which is so much more extreme physiologically than a bounce down to 150m? Where/what is the disconnect and why haven't we learned more about deco from commercial diving?
The literature on saturation diving decompression procedures I've read states it's main objective is controlling bubble growth. And that was how RGBM was sold to me during my NAUI trimix class. Obviously during the chamber ride to the surface they can control and monitor all sorts of things that a CCR diver cannot. But still, why are the results of deco models used in CCR diving apparently less successful than those of saturation diving, which is so much more extreme physiologically than a bounce down to 150m? Where/what is the disconnect and why haven't we learned more about deco from commercial diving?
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Hi Silent,
As I said before, We have done all those nice points of argument before. Some of these arguments are now 5 years old. We have all been through each paper in detail, and I (and sometimes joined by others), have shown quite conclusively, the mistakes and errors in Simon's arguments. No-one has successfully challenged the points I made... And what happened in those discussions? Simon is already committed to a view point, so he never concedes anything. He bullies anyone else conflicting arguments out of the way, and is quite viscous in the way he does that. People notice that and instead just let him have his way. i.e. a bully. Then the fanboys arrive, many of who are primed up with bullet point lists of arguments, and stomp the conversation into the ground. Simon gets his desired change though, based on a fait accompli.
Silent, you want to do all that again?
****
No one has made a valid opposing point or found fault in the the cause I described to Don's dive here. This dive contains the very essence of all of Simon's "new, more efficient" deco method, and his defective interpretations and invalid assumptions of the science.
.
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silent running
Member
Hi Ross, to begin at the end of your post, we have the man himself, Don, right here in this thread to ask the question: "Why did you plan and dive 60/90 to 600'?" There is literally no need to bring Simon into it or presume anything until Don has answered the question. My guess is that as with any self possessed person exercising their free will, the decision was based on his extensive deco experience and his personal tolerance for risks, which are multiple on such big dives. Surely you don't regard someone as honest and forthright as Don as anybody's fool?
Regarding what you or others have "shown" in your questioning of the various studies Simon refers to, if any of these challenges were substantial, there would be more people chiming in, right? There would be an actual debate, even amongst "fan boys". It all seems very one sided to me, and nobody other than you alleges Simon to be a bully. He seems positively civilized to me considering the accusations you make.
There is so much yet to be learned, please find a better way to bring your knowledge and opinion to bear. There is too much at stake to make this personal or petty. You definitely have a contribution to make, so figure out how to do it without denigrating smart, committed people like Simon. Never mind all the other people from his discipline who are scared off by such extreme contention...
While Don may have planned 60/90 and had that set in his computer, his computer does some inbuilt rounding up and it's quite excessive at times. This stems back to the VR3 days, where those computers did some big rounding up too, so other computers followed suit. The real diveplan he followed was a 60/70..... You can use MultiDeco to re-plan a dive overlaying the computer print out, and find out what you really did.
Your other points have been answered numerous times. His unwavering conviction to a clearly faulty premise, is his problem.
.
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Simon Mitchell
Well-Known Member
As Silent Running implied, your claims about which of us has the greatest predisposition to "viscous" bullying is open to considerable debate. But seriously, Ross, This is just a rationalisation for failing to convince anyone of your theories over many years now. If you believe the process you articulate has resulted in unjust rejection of your ideas, why don't you provide links to the threads where you believe it to have happened. People can read them, and form their own opinions whether you are right or not.
Multiple people on this thread have told you that you cannot draw conclusions about the veracity of an approach to decompression based on one dive. But you have just ignored that.
This whole thing is ridiculous. Hundreds of divers have been bent using all sorts of decompression approaches all over the world - deep stops, shallow stops, no stops, you name it. The only way to sort out which approach is most effective is to perform proper studies, and all such studies conducted to date contradict your views. Yet here you are trying to sell the notion that the entire issue can be judged on the basis on one adverse outcome in a dive that did not incorporate bubble model deep stops, whilst ignoring all those divers who have been injured diving the way you believe is best.
Multiple people on this thread have told you that Don's decompression was not confluent with what I have described as a sensible response to the current state of the evidence. But you have just ignored that.
Multiple people of this thread have also asked you if, based on the logic you are applying, you should be blamed for every case of decompression sickness that has occurred in divers using VPM or other deep stops approaches. But you have just ignored that.
Silent Running said:
Thank you. Ross's latest strategy appears to be to categorically announce that he is right, and completely ignore evidence to the contrary even if it is overwhelming. It is a waste of time debating him.
Silent Running said:
Thank you, from me and on behalf of the many people on these forums who Ross insults by implying they are incapable of independent thought.
Silent Running said:
Thank you. I pointed this out to Ross, but he ignored it. "Bully" seems to be his current favourite word, and he has always been incapable of reflecting on the fact that almost all of his numerous accusations are uncannily autobiographical. Ross-Rage is never far from the surface.
Simon M
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coo roo-c'too-coo
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