Unbending the bends

Sometime before dawn this morning, we took our oldest son to the airport. He's bound for the Caribbean for a pre-orientation trip for college (learning to sail with a team of other freshmen). They will get the chance to do a little snorkeling, but when his dad asked him about whether or not they'd be doing any scuba diving, he replied enigmatically,"There is no hyperbaric chamber in the Virgin Islands. They'd have to fly you to Puerto Rico, I guess."

My first response was to wonder how they would do that, given that most aircraft are pressurized to something around 10,000 to 15,000 feet, which would certainly exacerbate the bends - the outgassing of nitrogen from the blood, which can cause embolisms (blockages) in your blood vessels and painful swelling in your joints.

Henry's law governs the amount of gas dissolved in a liquid: the amount of dissolved gas depends on the external pressure of the gas. For example as the pressure of carbon dixoide increases, so does the amount of dissolved carbon dioxide. Some portion of that dissolved CO₂ turns into carbonic acid (H₂CO₃), and lowers the pH, which gives soda water it's characteristic bite. It also means that acidification of the ocean is a risk of fossil fuel burning, and the resultant carbon dioxide in the atmosphere. Climate deniers will say that there is no data linking CO₂ levels with changes in the ocean pH, suggesting it's because the oceans aren't plain water, and that this will complicate the chemistry. True. But your blood is pretty chemically complicated, and this is essentially the system that is used to control your blood's pH.

So why would flying make the bends worse? As the external pressure of nitrogen falls with altitude, more nitrogren comes out of solution in your blood stream and joints. Neither are places where you want more bubbles. If possible, victims of the bends are evacuated on planes that can be pressurized to lower altitudes (an expensive proposition, and one often not covered by travel insurance).

Bariatric chambers allow the external pressure to be increased, and then slowly decreased to prevent the formation of large bubbles. It can take several "dives" to assuage the symptoms. I sat with my mother while she underwent treatment in a hyperbaric chamber, it's not for those with claustrophobia is all I will say.

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Photo is from Wikimedia.