Can I Dive With.......

Reprinted from Scuba Diving:::::

Dive doctors and operators have long lowered their own risk by limiting yours when certain medical conditions enter the picture. Asthma? Sorry, no dice … or dives. Ditto for diabetes, heart disease and other conditions that increase the odds of something going wrong down below.

But the tide is slowly turning. For more than two decades, the Divers Alert Network has compiled information on divers from around the globe, many who continued diving despite disqualifying diseases. Likewise, dive doctors and scientists like those belonging to the Undersea & Hyperbaric Medical Society (UHMS) have conducted their own studies.

"When we first started devising prescriptive guidelines for who was fit to dive and who wasn't, we didn't have hard data, so all the axioms were based on theoretical risk," says Edmond Kay, M.D., a diving medical officer at Seattle's University of Washington. "We now have facts and figures." He has studied dive fitness for the past 20 years, and in that time, he has seen a lot of changes in the way medical professionals approach diving with certain conditions. "The thinking has turned from 'If you have this disease, you can't dive' to 'If you have this disease, you must be able to manage the symptoms, and then you may be fit to dive.'"

Kay helps us explain the newest approaches for managing some of the most common dive disqualifiers.

Diagnosis: Asthma

Back in the day, if you mentioned asthma to a dive instructor, you'd likely hear a firm "No, you can't dive." The disease affects those all-important diving organs, the airways, making them inflamed and susceptible to irritation. At its worst, asthma attacks tighten the muscles around your airway and constrict airflow to the point where you can barely breathe. Therein lies the risk. A number of factors inherent to diving can trigger an attack, including exercise and breathing cold and/or dry air, and an underwater attack can easily escalate to panic and drowning. Doctors theorized that this narrowing of the airways could also trap breathing gas in the lungs, which could expand before it could be exhaled during ascents, causing lung-expansion injuries. However, data presented during a 1995 international asthma symposium sponsored by UHMS showed no increased risk for lung injuries among asthmatic divers.

Diving with asthma: Anyone with severe asthma — meaning they have daily, chronic symptoms — should not dive. If your asthma is mild, intermittent and controllable, you may get clearance if you can show that you're functionally normal — that you manage it with medication to the point that exercise and typical asthma triggers don't cause an incident.

Today, DAN estimates about 4 to 5 percent of the diving population has asthma. To see if you qualify, take an airway challenge — a test where you exercise at increasing intensity on a treadmill, while a doctor measures your airflow to ensure you're stable even during vigorous exertion. You'll also need to show stability when exposed to triggers like cold, dry air, which is what you breathe from a scuba tank, Kay says.

Talk to your doctor about dive-friendly medications. Aminophylline, an older oral medication that opens air passages in the lungs, not only dilates the smooth muscles of the airways but also the arteries in the lungs, which decreases your lungs' ability to filter bubbles and increases your risk for DCS. Newer medicines, bronchodilators like Albuterol for example, can relax the airways for four to six hours and haven't been found to dilate the arteries in the lungs, Kay says.

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Kathy Dowsett
www.kirkscubagear.com

Ask an Expert: Should Divers Reveal Their Medications?

Is the average dive professional really qualified to safeguard — never mind interpret — your personal medical history?

By Larry Lozuk

Several years ago while managing an IT project at a large health-care provider, I witnessed my team lead being a perfect gentleman.

As we returned from lunch, he held the door open for a woman who happened to be walking into the building just as we were. She introduced herself as the facility’s compliance director for the Health Insurance Portability and Accountability Act (or HIPAA), requested his badge, and asked that he accompany her.

His seemingly innocuous act of chivalry had violated a security regulation, by passing the badge-reading system and potentially allowing someone unauthorized through an employee entrance. This led to hours of retraining for the entire team, once again covering the complex tangle of rules around security and privacy of medical records. The work we were doing was only tangentially related to health care, yet we were subject to the same confidentiality and security policies as the medical professionals who dealt directly with patient-health information.

In the scuba industry, we aren’t interested in the health of our customers, or what medication they might be taking. Really, we just want them to have a good time and then go home as healthy as they were when they came in.

However, by demanding and storing medical histories and medication lists, we willingly put ourselves in the same position as doctors’ offices, clinics and hospitals. We assume the responsibility to safeguard our customers’ medical information that, improperly disclosed, can affect their credit, their livelihoods and their lives.

We should all cringe to think of what is stored in those unlocked filing cabinets at countless dive shops across the world.

We also open ourselves up to liability by assuming the mantle of experts. While I can teach you all of the nuances of buoyancy, trim and different types of fins, I haven’t the slightest idea what drugs interact badly with one another, or with increased partial pressure of nitrogen or oxygen. Yet when I request a list of your medications, you probably have the expectation that I’m doing so for a reason, ostensibly to see if you have any conditions that are incompatible with scuba diving.

Would you be disappointed if I disclosed that I don’t even recognize any of the medication names?

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Kathy Dowsett

www.kirkscubagear.com

Volunteering in film re-enacting fatal shark attack a solemn memory of Shark Week for BadDiverBill

BadDiversTV is behind Bill Hill now but his love for scuba remains and two new passions -- music and promoting causes -- have been added.

When a funding deal fell through for BadDiverBill’s Quest, which was to find the most interesting DIVE sites, Dive buddies and DIVE bars, Hill's pseudonym of BadDiverBill was set aside, along with his trademark "adult beverages," hat and sunglasses. They're gone, but not forgotten. If the opportunity arose, says Bill, "BadDiverBill would don his hat and sunglasses and make a cocktail." However, BadDiversTV.com exists online forever.

Still, the character he created is not what drives him now. Instead, it's his growing awareness of causes that have become important to him, namely, protecting the ocean and supporting an orphanage in Honduras. He came face to face with both causes through diving and is expressing them with music.

The song "Weightless," for which he wrote the lyrics, embraces the magic of both diving and its medium, the sea. A portion of the song’s downloads will go to The Ocean Conservancy.

It was his passion for diving that took Bill Hill to Honduras, but it was the needs of an orphanage in that country that captured his heart. He has made nine trips there, combining diving and helping out at the orphanage. There, he met Paola, a young girl who was abandoned by her mother. She is still in school there.

Hill was inspired by her and decided to make a little video and write a song about her, which he called Pequena Rosa (Little Rose).

"Dancing was her thing. She dances to forget about things. All the girls take care of each other," says Hill, who wrote all the lyrics for the song on the flight from El Salvador back home to Los Angeles. "I look forward to dancing with her to this song."

HIs friend, musician Jeff Alan Ross, wrote the music. Some of the proceeds from the song will go to the orphanage.
On the flight home, Hill came up with another idea that he called "Your cause, your anthem," which is to help others promote their cause.

Back in the water, August is the month of Shark Week, in which Hill served as a safety diver for a movie to re-enact the death in May of 2008 of a 66-year-old diver who was attacked by a Great White just north of San Diego. The shark was estimated to be about 12 to 17 feet in length. To illustrate the damage to the diver’s legs by the attack, the filmmakers wanted to cut up the legs of the wetsuit the actor playing the deceased man would wear. In choosing a wetsuit to destroy, they were looking for the one that was in the worst shape, with the promise that the donor could buy a new wetsuit at cost. They chose BadDiverBill’s wetsuit.

Bill was one of three safety divers on the "Body Glove" boat owned by Bob and Pattie Meistrell. Bob and his late twin brother, Bill, had been innovators of wet suits. "I was honoured and privileged to be on the Body Glove boat when he was the captain.

"One day we were shooting the actor stuff of them swimming when he (the victim) was hit, the panicking and the swimmers coming to the rescue. A lot of my job was just being behind the camera man about 15 feet down, or on the boat with no scuba gear."

Hill remembers "the kind of respectful feeling on the boat" because they were re-enacting a man's death.
He was told his job was finished for the day so he took off his gear. Then they decided to take one more shot on the other side of the boat. The actress swam quickly to the side where the shooting was to be, but the older actor portraying the victim of the shark attack seemed to be struggling in the water. He kept going under the surface in his attempt to get to the other side of the boat, the challenge made more difficult by wearing BadDiverBill’s damaged wetsuit. Knowing the actor had been in the water all day and was probably tired, Hill dove in, grabbed him and took him to the other side.

Another chapter had been written in the evolution of BadDiverBill.

Copyright Kathy Dowsett

www.kirkscubagear.com