Arachnid Encounter

A spider bite put me in DAN's web of care.

It started so festive: A bunch of dive buddies from the Laguna Sea Dwellers dive club all traveling to Australia for a week of diving the Coral Sea on Mike Ball's Spoilsport liveaboard. Arriving in Cairns a couple of days early to shed our jet lag and see the sights, we took in the very picturesque Skyrail Rainforest Cableway gondola tour in Kuranda.

In the Kuranda Rainforest outside of Cairns, the author backed
into a copse of trees. The spider bite was dismissed as a foliage
brush but became a frightening health hazard the next day when
the author was underwater in the Coral Sea.
It was all quite interesting to see the dense vegetation and mature hardwood hammock, but on the way back down the mountain to Cairns I stopped at the halfway tower station for a final scenic overlook. That's all I wanted, one last look. One giant tree caught my eye, looking for all the world like a massive No. 2 pencil, complete with yellow bark. It was so tall I backed away from the groomed areas by the gondola and into the bush, just to get a better view of the canopy. I was wearing shorts and felt something brush my leg, but I really didn't think anything of it. After drinking in the view until I'd had my fill, we boarded the bus for the four-hour ride from Cairns to Townsville.

We boarded the Spoilsport and had the typical briefing, dinner and a few welcome drinks before we all drifted off to our cabins to catch some shuteye; we had a 1 a.m. departure time for the long overnight crossing to the Coral Sea. By the time we reached our destination my leg was itching somewhat, but after a few dives in the Coral Sea, I was on such sensory overload from the underwater world, it was a small distraction I hardly noticed until the third dive, when my whole world turned upside down.

I was about 10 minutes into the dive, cruising a massive bommie at 70 feet, when suddenly it was like a giant hand gripped my thigh and squeezed all the tissue down into my knee. I know that sounds pretty weird, but that's exactly the sensation I experienced; then my heart started racing, and I was nauseous. Underwater was clearly not the best place to be at that moment. I signaled my buddy, and together we ascended to the boat's safety bar, where I did my obligatory off-gas time. But once I got back on the boat, things started to get rather dire in a hurry.

My leg was killing me, and just removing my wetsuit was about all I could do. My knee was already swollen to the size of a softball, and blisters were starting to form on the skin. I'd been a paramedic for seven years, so self-examination of medical matters is something that comes naturally; but this was a new one to me, and I still hadn't connected any dots to understand why I was in such distress. By 6 p.m. I was begging the captain for something to drain my knee; the pain was excruciating. The pus socket was the size of a golf ball, and the knee had grown to the size of a football. I knew I was in trouble, and when the captain called Townsville Hospital with my vitals, they concurred.

About the only spit of sand where the hospital could dispatch a helicopter was Flinders Reef, and even that was at the very edge of their fuel limits for safe pick-up and return. We made a plan for first light the following morning, but that meant I still had to get through the night. So we took a 20-gauge needle and evacuated the infection. I have to say it provided some pretty blessed relief, but I was nowhere near cured. When morning came, I was bundled on the boat's dinghy and taken to the "island" of crushed coral that was, at most, 3 feet above sea level.

The funnel web spider is regarded as one of the most dangerous spiders in the world; in Australia, 13 deaths have been attributed to their bites. Typically, symptoms following a bite is fairly rapid but was delayed in this case.
Right on time, the RACQ CQ Rescue (Central Queensland air rescue) helicopter dropped from the sky, and as the medics loaded me onto the stretcher, one leaned down and said, "Oy, mate, I reckon you got a little spider bite … classic symptoms. In these parts, probably a funnel web spider."

It was a psychological relief to know what was wrong with me, but physically I was still a mess. I was comforted to know medical professionals were on the case and I was en route to a hospital, but I got an even greater sense of security when the medic filling out my accident report was actually using a form from Divers Alert Network®. All of a sudden, it wasn't quite so scary and foreign to me.

The flight back to Townsville was 80 minutes, and despite receiving three bags of IV solution on the way, I was delirious by the time we arrived at the hospital. I wasn't aware of them doing it, but somehow the medical staff took blood and did all the admitting procedures; incredibly, within 30 minutes of contacting the U.S. Centers for Disease Control and Prevention in Georgia, they knew my full medical history. It turned out I was extraordinarily lucky, first because the health care in Australia is so very good, but also because the hospital in Townsville was responsible for maintaining supplies of funnel web spider antivenin for the entire Pacific region. If I'd suffered the same spider bite in Papua New Guinea, they would have had to scramble a jet to fly the antivenin to me, but by a great stroke of luck I was receiving treatment where it was actually kept in storage.

While I was in the hospital, the guy in the next bed moaned in pain for 48 hours straight. It turned out he'd been in the outback, at a posh resort near Ayers Rock, and had simply bent down to pick up his morning paper. A brown snake he never even saw struck him in the shoulder, and for that he nearly died. Gratefully, the hospital pulled him through, too, but that's how fast things can happen. It can be on land or it can be underwater, but far away from home a good insurance card (or two) may be your best friend.

I had a Kaiser health maintenance organization (HMO) plan for my primary insurance and the DAN Preferred plan for my secondary policy, so there was never a moment's doubt from anyone involved (including me) that I was fully insured. Admittedly, it wasn't my primary concern when I needed treatment; all that mattered at that point was relieving the pain and ensuring I pulled through. But when the danger passed and the reality of paying for medical treatment set in, knowing I was fully insured became of paramount importance. The cost of the helicopter rescue alone was $12,000; added to that was what became an ordeal of surgery, five days in the Townsville hospital's intensive care ward, and another four days of medical care in Cairns, where I'd been transported to rendezvous with my dive buddies. (They'd continued the trip at my insistence and had a wonderful time diving the Coral Sea without me.)

This incident took place in 2006, and I still suffer effects from the spider bite. I find I limp at times, and I know my body paid a price surviving the venom from the tiny, potentially lethal arachnid. There isn't much I can do about that except endure. But I am alive and grateful for it — thanks to a chain of care that started with an attentive boat crew and the amazing health-care professionals I met on a remote spit of land in the middle of the Coral Sea. It continued with the peace of mind that helped me heal; I incurred no expense at all for the accident evacuation or treatment, with the exception of a $25 service fee from the hospital in Cairns. If I learned anything at all from this ordeal, it's that international health coverage from an insurance provider, plus DAN membership and a dive accident insurance plan, are absolutely essential when traveling to any remote location. Australia offers world-class medical care, but part of its charm is the remote adventures it offers. When I think of those adventures and all the other places I've gone, and then I consider the things that could have gone wrong, I'm glad I have DAN there, waiting to help, to cover contingencies and extend their web of service.

Medic's Perspective
Though DAN was not involved in this case in the usual form of a call to the DAN Emergency Hotline, it is a wonderful illustration of how an integral aspect of DAN's history and future is professional collaboration. The vision to foster and support international DAN offices (IDAN) as regional centers of diving medicine expertise began decades ago and continues today. The latest step in our expansion of network partners comes not with the addition of new DAN offices, but with our multicenter approach. By forming close bonds with the University of California at San Diego's and the University of Pennsylvania's hyperbaric medicine departments, we have found additional ways to include world leaders in diving medicine and expand the resources available to the diving community. The importance of this network is evidenced by the care our members receive around the world — the result of partnerships formed over the span of our 30 years.

—Nick Bird, DAN chief medical officer

© Alert Diver — Fall 2010