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Duke University Medical Center
VOLUME 24, NUMBER 35
SEPTEMBER 2,1977
DURHAM, NORTH CAROLINA
Man Walks from Chamber, out of Nightmare
By David Williamson
On Sunday, Aug. 14, a routine
shell collecting dive in the Gulf of
Mexico turned into a nightmare for
industrial chemist Thomas G. Floyd
that could have left him forever
paralyzed from the waist down.
But a low altitude airlift to Durham
through thunderstorms late that
night for unique emergency
treatment at the medical center
spared his legs and probably
lengthened his life at the same time.
The treatment, which involved
holding three men at four times
normal atmospheric pressure for
more than six days, may be good
news for future diving accident
victims, according to Dr. John Miller
who headed the international team
that cared for Floyd.
Couldn't Move Legs
The patient, still recovering here
from his aquatic misadventure, said
that his back began to hurt 10
minutes after returning to the surface
from an 80-foot dive near his home
in the Florida panhandle town of Ft.
Walton. By the time he and his
friends returned to shore, he couldn't
move his legs at all.
Miller said he and his colleagues
believe Floyd suffered a slight tear in
one of his lungs that released air into
his blood stream. A bubble then
lodged'in his spinal cord, cutting off
its blood supply and creating what
doctors call an air embolism.
"I have a pretty good idea what
was going on at the time, and I have
to admit I was scared," said the
40-year-old chemist, who is also an
experienced diving instructor. "I
lead an active life, and it's hard for
me to keep still. Before the accident, I
was running four to five miles every
day at lunch."
Eliminating Bubbles
His friends rushed him to a local
hospital where the decision was
made to fly him to Gainesville, Fla.,
for treatment in a one-man
hyperbaric chamber at the
University of Florida's J. HiUs Miller
Health Center. Air embolism and
decompression sickness resulting
from diving are treated in hyperbaric
chambers, where high air or oxygen
pressure simulating depths beneath
the sea can eliminate bubbles in the
blood stream.
"At Gainesville, Mr. Floyd was
treated in accordance with the U.S.
Navy Diving Manual, apparently
with some relief, but five minutes
after surfacing, he collapsed again
and was worse," Miller said.
"Doctors there were reluctant to
continue because their chamber only
has a pressure capability of 66 feet.
"They called me at 12:15 a.m. on
Aug. 15 and made arrangements to
have him transferred to EHike where
our charnbers have a 1,000-foot
pressure capability."
Accompanied by a physician and
nurse fromTlorida, Floyd was flown
through a line of thunderstorms at
only 1,200 feet altitude. Higher
elevations would have caused the air
bubble in his spine to expand even
more.
(Continued on page 3)
Program Makes Learning
Breast Self-Exam Easier
By William Erwin
Women in North Carolina are
going to find it easier than ever to
leam how to check their breasts for
possible cancer signs.
The state's public health
departments are sending 300 public
health nurses to Duke to practice'
REUNION WITHOUT PRESSURE—A drama of sorts came to a
happy conclusion here last week as diving accident victim
Thomas G. Floyd successfully emerged from six days of
treatment in the hyperbaric chamber. Dr. Jens Grimstad of the
Norwegian Diving Institute and technician Joseph Sandy
remained with the patient for the entire "dive" as high
pressures dissolved an air bubble in his spine. Shown together
in the chamber on the day before his release from the hospital
were, from left to right, Floyd, Sandy, Grimstad and Dr. John
Miller, an assistant professor of anesthesiology who headed
the international team that cared for Floyd. (Photo by Jim
Wallace)
teaching breast self-examination.
When all the nurses are trained three
years from now, a woman anywhere
in the state can arrange for a free
demonstration of the method by
calling her local health department.
Women in some counties can do so
already.
Self-examination involves
watching for unusual changes in the
breasts and feeling with th'e'
fingertips for suspicious lumps. If a
woman finds a lump, four times out
of five it will not be cancerous. But
only a physician can tell for sure.
If the lump does turn up
cancerous, then the sfooner the
woman has gone to the doctor, the
better off she will be.
Benefits Rural Women
Rural women stand to benefit most
as a result of the training program,
said Dr. Josephine Newell,
coordinator of the Breast Cancer
Detection Demonstration Project at
Duke where the nurses are learning
Most women visiting public health
clinics in North Carolina live in rural
areas, she said.
No matter where women live,
they're going to have more peace of
mind after a graduate of the course
teaches them, said Don Batts
manager of the state Division of
Health Services Cancer Detection
Program.
The nurses teach by examining
women themselves, Batts explained
So women taught by the specially
trained nurses are "going to be more
sure that if something is there, the
nurse is going to discover it," he
said. If a public health nurse
happens to find a suspicious lump or
other sign during the teaching
session, she refers the woman to a
physician.
The state Cancer Detection
Program paid for a training building
at the project site. The National
Cdncer Institute is providing the
money for training expenses.
With Achial Patients
Public health nurses spend two
(Continued on page 2)