Scary after dive experience?

[holmboy]

Perhaps I can help with DAN's explanation of subcutaneous emphysema.

Pulmonary barotrauma is caused by expanding air trapped in the pulmonary system - particularly the lungs. The result is lung overexpansion which causes the alveoli to rupture and allow air to escape into the surrounding tissues. The gas may find its way into the space between the lungs called the mediastinum, which results in a condition called mediastinal emphysema. The gas in the mediastinum may also rise into the neck where it becomes subcutaneous emphysema. Signs and symptoms of subcutaneous emphysema may include "crackling" skin such as you described, breathing difficulties, swelling in the neck, voice changes, and difficulty in swallowing.

You first noticed a problem during ascent, which matches the assumption that you experienced a lung overexpansion injury. The cause of the air trapping isn't obvious from your description of the event, was there anything going on during your ascent which may have caused you to hold your breath inadvertently? It is also possible that small airways in your lungs became blocked for some reason resulting in the overexpansion of alveoli beyond the blockage. Ascent rate can also be a factor, but given that the event occurred during ascent I would think that the equalization technique used is not unless you were pressurizing your ears during the ascent for some reason...

Headache is not listed as a symptom of subcutaneous emphysema, but it is a symptom of DCS/AGE. AGE in particular is quite possible if you did in fact suffer a lung expansion injury, though if you did have an embolism I would think that you would likely have additional symptoms.

I would strongly recommend that you follow DAN's suggestion to be examined by a doctor trained in dive medicine.

FYI - my background: NAUI Divemaster, no formal medical training.