As a result of latest discussion I decided to do this sticky which has the most questions and answers on women diving and health issues.
The source of the article:
http://www.diversalertnetwork.org/medical/articles/article.asp?articleid=9
Diving Medicine Articles
DAN Explores Fitness and Diving Issues for Women
By Donna M. Uguccioni, M.S., DAN Associate Medical Director Dr. Richard Moon, and Dr. Maida Beth Taylor
Breast Cancer, Cancer and Surgery
The Condition: Tumors in the breasts are not uncommon, especially after age 30. Tumors may be cancerous (malignant) or non-cancerous (benign). Approximately one in nine women will develop breast cancer. Early detection can be made with regular, manual self-examinations of the breasts, but not all tumors can be detected in this manner. Mammography (X-ray of the breast) can detect tumors that manual examination cannot. The American Cancer Society recommends the following:
Women 20 years of age and older should perform breast self-examination every month.
Women ages 20-39 should have a physical examination of the breast every three years, performed by a healthcare professional such as a physician, physician assistant, nurse or nurse practitioner.
Women 40 and older should have a physical examination of the breast every year, performed by a healthcare professional such as a physician, physician assistant, nurse or nurse practitioner.
Women 40 and older should have a mammogram every year.
Tumors are often removed surgically and treatment of malignant tumors may involve surgery, radiotherapy, chemotherapy - or a combination of two or three of these procedures.
Both chemotherapy and radiotherapy can have toxic effects on the lung, surrounding tissue and body cells that have a rapid growth cycle such as blood cells.
Fitness and Diving Issues: Cytotoxic drugs (chemotherapy) and radiation therapy can have unpleasant side effects such as nausea and vomiting, and a prolonged course of therapy can result in greatly decreased energy levels. This makes diving while experiencing such side effects inadvisable. Radiation and some chemotherapeutic drugs can cause pulmonary toxicity.
An evaluation to establish the safety of a return to diving should include an assessment of the lung to ensure that damage likely to predispose the diver to pulmonary barotrauma (arterial gas embolism, pneumothorax or pneumomediastinum) is not present.
Finally, before diving, healing must have occurred, and the surgeon must be satisfied that immersion in salt water will not contribute to wound infection. Strength, general fitness and well-being should be back to normal. The risk of infection, which may have increased temporarily during chemotherapy or radiotherapy, should have returned to normal levels.
Ovarian Tumor
The Condition: Ovarian tumors may be malignant (cancerous) or benign (non-cancerous). Tumors may be solid or a hollow sac (cysts). Cysts are sometimes filled with fluid and usually are the non-cancerous form of an ovarian tumor. Ovarian tumors are not all that uncommon and, if identified early, they can be removed surgically or with radiation treatments.
Fitness and Diving Issues: With respect to diving, the major issues are the effects on the body from the surgery and/or radiation/chemotherapy treatments (See the section above on "Breast Cancer and Cancer in Women").
Pregnancy
Description of Condition: Having a developing embryo or fetus in the body. Duration of pregnancy from conception to delivery is approximately 266 days/9 months.
Fitness and Diving Issue: There is little scientific data available regarding diving while pregnant. Much of the available evidence is anecdotal. Laboratory studies are confined to animal research and the results are conflicting. Some retrospective survey type questionnaires have been performed but are limited by data interpretation.
An issue to keep in mind is the risk of decompression illness to the mother due to the physiological changes which occur while pregnant. During pregnancy, maternal body fluid distribution is altered, and this redistribution decreases the exchange of dissolved gases in the central circulation. Theoretically, this fluid may be a site of nitrogen retention. Fluid retention during pregnancy may also cause nasopharyngeal swelling, which can lead to nose and ear stuffiness. In regards to diving, these may increase a pregnant woman's risk of ear or sinus squeezes. Pregnant women experiencing morning sickness, which could then couple with motion sickness from a rocking boat, may have to deal with nausea and vomiting during a dive. This is an unpleasant experience and could lead to more serious problems if the diver panics.
Due to the limited data available and the uncertainty of the effects of diving on a fetus, diving represents an increased exposure for the risk of injury during pregnancy. There's a baseline incidence of injury including cases of decompression illness in diving. One must consider the effects on the fetus if the mother must undergo recompression treatment.
Additional Considerations: This is a summary of the available studies of diving during pregnancy:
Diving and Pregnancy Outcome
Bangasser Survey 1978 - no increase defects
Bolton Survey 1980 - 109 women who dived prior to pregnancy, 69 stopped when pregnant higher rate of defects in groups who continued including two major cardiac anomalies multiple hemivertabrae, absent hand, VSD, coarctation, pyloric stenosis, birthmark - no major defects in group that stopped (but no higher than the general population and may be influenced by recall bias)
Turner Case Report 1982
twenty dives in 15 days, days post LMP 40-50
most less than 60 ft., three dives 100 ft., one 110 - one rather rapid ascent from 60 ft., three dives 100 ft., one 110 - one rather rapid ascent from 60 ft.
Sudafed also taken
multiple anomalies
head circumference normal, development normal, karyotype, EMG, muscle biopsy normal
mechanism of DCS injury - fetal embolism or bubbling.
Please remember that one anecdotal report does not create a syndrome or disease
Fife Survey 1991 -- 1,037 female divers -- only 1.4 percent dived while pregnant
Animal studies of DCS during pregnancy also have noted increases in cardiac malformations. If a woman dives inadvertently before pregnancy is diagnosed during the first trimester of pregnancy, acknowledging that a very limited amount of literature and experience exists, I suggest getting a second trimester ultrasound (sonogram) with emphasis on limb and spinal development and with good detailing of the cardiac structures and the configuration of the great vessels around the heart -- aorta, pulmonary arteries, etc.
Return to Diving After Giving Birth
The Condition: Diving, like any other sport, requires a certain degree of conditioning and fitness. Divers who want to return to diving postpartum (after having a child) should follow the guidelines suggested for other sports and activities.
Fitness and Diving Issues: After a vaginal delivery, women can usually resume light to moderate activity within one to three weeks. This depends of several factors: prior level of conditioning; exercise and conditioning during pregnancy; pregnancy-related complications; postpartum fatigue; and anemia, if any. Women who have exercise regimens prior to pregnancy and birth generally resume exercise programs and sports participation in earnest at three to four weeks after giving birth.
Obstetricians generally recommend avoiding sexual intercourse and immersion for 21 days postpartum. This allows the cervix to close, decreasing the risk of introducing infection into the genital tract. A good rule of thumb is to wait four weeks after delivery before returning to diving.
After a cesarean delivery (often called a C-section, made via a surgical incision through the walls of the abdomen and uterus), wound-healing has to be included in the equation. Most obstetricians advise waiting at least four to six weeks after this kind of delivery before resuming full activity. Given the need to regain some measure of lost conditioning, coupled with wound healing, and the significant weight-bearing load of carrying dive gear, it's advisable to wait at least eight weeks after a C-section before returning to diving.
Any moderate or severe medical complication of pregnancy - such as twins, pre-term labor, hypertension or diabetes - may further delay return to diving. Prolonged bed rest in these cases may have led to profound deconditioning and loss of aerobic capacity and muscle mass. For women who have had deliveries with medical complications, a medical screening and clearance are advisable before they return to diving.
Additional Information: Caring for a newborn may interfere with a woman's attempts to recover her strength and stamina. Newborn care, characterized by poor sleep and fatigue, is a rigorous and demanding time in life.
The source of the article:
http://www.diversalertnetwork.org/medical/articles/article.asp?articleid=9
Diving Medicine Articles
DAN Explores Fitness and Diving Issues for Women
By Donna M. Uguccioni, M.S., DAN Associate Medical Director Dr. Richard Moon, and Dr. Maida Beth Taylor
Breast Cancer, Cancer and Surgery
The Condition: Tumors in the breasts are not uncommon, especially after age 30. Tumors may be cancerous (malignant) or non-cancerous (benign). Approximately one in nine women will develop breast cancer. Early detection can be made with regular, manual self-examinations of the breasts, but not all tumors can be detected in this manner. Mammography (X-ray of the breast) can detect tumors that manual examination cannot. The American Cancer Society recommends the following:
Women 20 years of age and older should perform breast self-examination every month.
Women ages 20-39 should have a physical examination of the breast every three years, performed by a healthcare professional such as a physician, physician assistant, nurse or nurse practitioner.
Women 40 and older should have a physical examination of the breast every year, performed by a healthcare professional such as a physician, physician assistant, nurse or nurse practitioner.
Women 40 and older should have a mammogram every year.
Tumors are often removed surgically and treatment of malignant tumors may involve surgery, radiotherapy, chemotherapy - or a combination of two or three of these procedures.
Both chemotherapy and radiotherapy can have toxic effects on the lung, surrounding tissue and body cells that have a rapid growth cycle such as blood cells.
Fitness and Diving Issues: Cytotoxic drugs (chemotherapy) and radiation therapy can have unpleasant side effects such as nausea and vomiting, and a prolonged course of therapy can result in greatly decreased energy levels. This makes diving while experiencing such side effects inadvisable. Radiation and some chemotherapeutic drugs can cause pulmonary toxicity.
An evaluation to establish the safety of a return to diving should include an assessment of the lung to ensure that damage likely to predispose the diver to pulmonary barotrauma (arterial gas embolism, pneumothorax or pneumomediastinum) is not present.
Finally, before diving, healing must have occurred, and the surgeon must be satisfied that immersion in salt water will not contribute to wound infection. Strength, general fitness and well-being should be back to normal. The risk of infection, which may have increased temporarily during chemotherapy or radiotherapy, should have returned to normal levels.
Ovarian Tumor
The Condition: Ovarian tumors may be malignant (cancerous) or benign (non-cancerous). Tumors may be solid or a hollow sac (cysts). Cysts are sometimes filled with fluid and usually are the non-cancerous form of an ovarian tumor. Ovarian tumors are not all that uncommon and, if identified early, they can be removed surgically or with radiation treatments.
Fitness and Diving Issues: With respect to diving, the major issues are the effects on the body from the surgery and/or radiation/chemotherapy treatments (See the section above on "Breast Cancer and Cancer in Women").
Pregnancy
Description of Condition: Having a developing embryo or fetus in the body. Duration of pregnancy from conception to delivery is approximately 266 days/9 months.
Fitness and Diving Issue: There is little scientific data available regarding diving while pregnant. Much of the available evidence is anecdotal. Laboratory studies are confined to animal research and the results are conflicting. Some retrospective survey type questionnaires have been performed but are limited by data interpretation.
An issue to keep in mind is the risk of decompression illness to the mother due to the physiological changes which occur while pregnant. During pregnancy, maternal body fluid distribution is altered, and this redistribution decreases the exchange of dissolved gases in the central circulation. Theoretically, this fluid may be a site of nitrogen retention. Fluid retention during pregnancy may also cause nasopharyngeal swelling, which can lead to nose and ear stuffiness. In regards to diving, these may increase a pregnant woman's risk of ear or sinus squeezes. Pregnant women experiencing morning sickness, which could then couple with motion sickness from a rocking boat, may have to deal with nausea and vomiting during a dive. This is an unpleasant experience and could lead to more serious problems if the diver panics.
Due to the limited data available and the uncertainty of the effects of diving on a fetus, diving represents an increased exposure for the risk of injury during pregnancy. There's a baseline incidence of injury including cases of decompression illness in diving. One must consider the effects on the fetus if the mother must undergo recompression treatment.
Additional Considerations: This is a summary of the available studies of diving during pregnancy:
Diving and Pregnancy Outcome
Bangasser Survey 1978 - no increase defects
Bolton Survey 1980 - 109 women who dived prior to pregnancy, 69 stopped when pregnant higher rate of defects in groups who continued including two major cardiac anomalies multiple hemivertabrae, absent hand, VSD, coarctation, pyloric stenosis, birthmark - no major defects in group that stopped (but no higher than the general population and may be influenced by recall bias)
Turner Case Report 1982
twenty dives in 15 days, days post LMP 40-50
most less than 60 ft., three dives 100 ft., one 110 - one rather rapid ascent from 60 ft., three dives 100 ft., one 110 - one rather rapid ascent from 60 ft.
Sudafed also taken
multiple anomalies
head circumference normal, development normal, karyotype, EMG, muscle biopsy normal
mechanism of DCS injury - fetal embolism or bubbling.
Please remember that one anecdotal report does not create a syndrome or disease
Fife Survey 1991 -- 1,037 female divers -- only 1.4 percent dived while pregnant
Animal studies of DCS during pregnancy also have noted increases in cardiac malformations. If a woman dives inadvertently before pregnancy is diagnosed during the first trimester of pregnancy, acknowledging that a very limited amount of literature and experience exists, I suggest getting a second trimester ultrasound (sonogram) with emphasis on limb and spinal development and with good detailing of the cardiac structures and the configuration of the great vessels around the heart -- aorta, pulmonary arteries, etc.
Return to Diving After Giving Birth
The Condition: Diving, like any other sport, requires a certain degree of conditioning and fitness. Divers who want to return to diving postpartum (after having a child) should follow the guidelines suggested for other sports and activities.
Fitness and Diving Issues: After a vaginal delivery, women can usually resume light to moderate activity within one to three weeks. This depends of several factors: prior level of conditioning; exercise and conditioning during pregnancy; pregnancy-related complications; postpartum fatigue; and anemia, if any. Women who have exercise regimens prior to pregnancy and birth generally resume exercise programs and sports participation in earnest at three to four weeks after giving birth.
Obstetricians generally recommend avoiding sexual intercourse and immersion for 21 days postpartum. This allows the cervix to close, decreasing the risk of introducing infection into the genital tract. A good rule of thumb is to wait four weeks after delivery before returning to diving.
After a cesarean delivery (often called a C-section, made via a surgical incision through the walls of the abdomen and uterus), wound-healing has to be included in the equation. Most obstetricians advise waiting at least four to six weeks after this kind of delivery before resuming full activity. Given the need to regain some measure of lost conditioning, coupled with wound healing, and the significant weight-bearing load of carrying dive gear, it's advisable to wait at least eight weeks after a C-section before returning to diving.
Any moderate or severe medical complication of pregnancy - such as twins, pre-term labor, hypertension or diabetes - may further delay return to diving. Prolonged bed rest in these cases may have led to profound deconditioning and loss of aerobic capacity and muscle mass. For women who have had deliveries with medical complications, a medical screening and clearance are advisable before they return to diving.
Additional Information: Caring for a newborn may interfere with a woman's attempts to recover her strength and stamina. Newborn care, characterized by poor sleep and fatigue, is a rigorous and demanding time in life.
