The Bends: What Every Diver (and Traveler) Should Know About Decompression Sickness

Have you ever dreamed of diving in the Nusa Penida and see Manta or Mola-mola fish? or exploring shipwrecks in Amed?

Bali is a diver’s paradise—until something goes wrong…

Many tourists don’t realize that one of the biggest risks in scuba diving: Decompression sickness (DCS), or the bends

This can happen even on a "simple" dive. It happens to beginners, tourists, and even experienced instructors. And yes—it happens in Bali.

For example, in James Cameron’s movie The Abyss, a team of underwater workers face extreme pressure while working deep in the ocean. The film is science fiction —like breathing a special liquid to avoid decompression—but it highlights the real risks of diving too deep or too fast. This movie not medically accurate, but it shows how dangerous diving. It’s no joke! You don’t need to be thousands of meters deep dive like in this movie. Standard depth dive in Bali is enough to cause DCS.

Let’s take a look at what decompression sickness is, how it happens, and how to stay safe.

What Is Decompression Sickness (a.k.a. “The Bends”)?

When you dive deep underwater, your body absorbs extra nitrogen from the air you breathe through your tank. The deeper and longer you stay, the more nitrogen builds up in your tissues.

If you swim up to the surface too fast, that nitrogen can form bubbles

Think about a sealed bag of chips.
When you take it up a mountain or on a plane, it looks like it might explode—because the air inside expands when there’s less pressure outside.

Now imagine the opposite: if you took that same bag deep underwater. As you go deeper, the pressure increases, and the bag shrinks because the air inside gets compressed.

Your body acts a bit like that bag of chips when you go diving.

As you go deeper, the pressure increases and your body soaks up more nitrogen from the air you breathe. That’s normal. But if you swim up to the surface too fast, the pressure drops quickly—and all that nitrogen inside your body expands into bubbles.

Those bubbles can cause pain, dizziness, breathing problems, and other serious health issues. That’s what we call decompression sickness, or the bends.

What Does It Feel Like?

The symptoms can vary a lot. Some people just feel really tired or achy. Others may feel:

• Tingling, numbness, weakness, or even trouble walking, especially in your legs or back
• Extreme fatigue

• Dizziness or confusion,
• Blurry vision, seeing spots, or feeling “out of it”

• Hearing issues, hearing ringing in your ears
• Vomiting
• Numbness or tingling
• Trouble breathing: Feeling short of breath or chest pain
• A rash or itching

In severe cases, it can lead to paralysis or even death.

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Real-Life Tragedy from Padangbai

In September 2024, Dr. Wong Yu Yi, a 48-year-old Singaporean doctor and experienced diver with approximately 100 dives, tragically lost her life after a dive at Padangbai. During a 20-meter dive, she signaled for help and was brought to the surface but lost consciousness. Despite immediate medical attention, she was declared dead on arrival at the clinic. An autopsy confirmed decompression sickness as the cause of death .

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It’s example of the worst case.

That’s why it’s important to take it seriously, even if you just feel a little “off” after a dive.

You should also think about everal factors contribute to the risk of DCS to occur:

• Currents are strong, especially around Nusa Penida. Divers may go deeper or ascend faster than they should.
• Tourists are often on tight schedules, trying to fit in dives the same day as travel or flying too soon after diving.
• Beginners may not know the rules, or trust instructors too much without understanding the risks.

Even in calm places like Amed, doing multiple dives in one day or diving too deep can put you at risk.

• Strong Currents: Sites like Nusa Penida are known for unpredictable currents, which can lead to rapid ascents.
• Tight Schedules: Tourists often plan dives close to flight times, not allowing adequate surface intervals.
• Lack of Awareness: Some divers may not fully understand or adhere to safety protocols.

How to Avoid DCS

• Stay in shape for diving: Keep active, train regularly, and eat well. A healthy body handles pressure changes better underwater.
• Never dive alone: Always use the buddy system—two is safer than one.

• Ascend slowly. Follow your dive guide’s instructions.
• Take safety stops—pausing at shallow depths lets your body release nitrogen safely.
• Know your limits: Only dive in conditions you're comfortable and experienced in—don’t take risks with unfamiliar sites
• Drink plenty of water—dehydration can make things worse.

• Tell your dive instructor if you’re tired, sick, or have any health conditions.
• Don't push your limits—skip that second or third dive if you’re feeling off.
• Wait at least 18–24 hours before flying after diving (longer if you did multiple or deep dives). Flying too soon can trigger decompression sickness!
• Know where the nearest hyperbaric chamber

• Know where the nearest emergency help

Diving in Bali is unforgettable experiences, but safety should always be priority. The ocean feels endless. But the ocean doesn’t forgive carelessness. Everyone can suffered from decompression sickness.

So enjoy your time underwater. If something doesn’t feel right after a dive, let’s seek help as soon as possible. Nusa Medica Clinic open 24/7 and provide emergency treatment for decompression sickness. We also provide evacuation to recommended hyperbaric chamber.(*)

Source:

• Auerbach, P. S., Cushing, T. A., & Harris, N. S. (Eds.). 2016. Auerbach's Wilderness Medicine (7th ed.). Elsevier.
• Jon Dallimore, Sarah R. Anderson, Jon Dallimore, Chris Imray, Chris Johnson, James Moore and Shane Winser (eds.). 2023. Oxford University Press Oxford Handbook of Expedition and Wilderness Medicine (3rd Edition)
• Indonesia Expat. 2017. The Bends Cause of Death in Bali Tourist Dive Death: Husband. https://indonesiaexpat.id/news/bali-tourist-death/

Writer: dr. Almira Talitha Ulima - General Practitioner Nusa Medica Clinic Pecatu