Aspirin and Diving

[ArcticDiver]

All threads on DCS need to be read in the context that no one KNOWS what causes DCS. There are many studies and scientific theories. Many of these have even been demonstrated at cellular level; but not as applied to the human body. Over time the dive industry has developed algorithms and procedures that have, for the most part, proven to result in divers not being hurt with DCS. But, exactly why this is so remains a mystery.

That is why terms like "conservative diving", or "aggressive diving" are just about devoid of actual as differentiated from psychological meaning.

Now, then, just because we don't know what causes DCS should we throw up our hands and disregard the practices that have become standard in the industry? No, just because a person does not know doesn't mean that there are demonstrated practices that can diminish the likelyhood of DCS occuring.

SCUBA is not a cut and dried activity. There are no guarantees. Each dive is in a very real way an experiment with accompanying risks. Following accepted practices minimizes the risks, but does not eliminate them.

But, while this is so a quick reference to DAN information tells us that for all the publicity about DCS it remains a rare event. One is much more likely to be hurt with DCI or some other trauma or disease than DCS.

 

[speedhound]

Interesting thread. While learning to dive in the US (and then diving with YMCA) we were told that aspirin could help with "blood thinning", and could (legal-ese apart) be offered to someone that was thinking they could/would get a DCS hit as a precaution/first aid measure.

I've sinced moved back to the UK (diving with BSAC), I've been told the taking or offering of aspirin before/during/after a DCS hit should be avoided as it could mask developing symptoms of DCS. The masking of early/developing symptoms is something that I hadn't thought about.

Personally I try to stay hydrated (I usually bring extra water bottles for the boat/team too). On dive trips I take aspirin for any aches and pains (tennis elbow is a drag), that I would normally take paracetamol/ acetomenophine for.

 

[pescador775]

I came down with severe pain and paralysis of the lower right side which lasted for about 1/2 hour. It stopped after I dosed myself with water and aspirin. I felt so good by the time we docked at Cat Cay that I told the people in Miami to "hold the helo". However, after hitting the sack, by the wee hours of the morning, once again, I could not move my right leg but there was no pain, just profound numbness and some other weird symptoms associated with paralysis of the lower body. They launched the helo. I recieved hyperbaric oxygen therapy for five days and gradually got better. One of the physicians (hospital, not chamber) had ordered a walker but I eventually left with a cane and a limp. Personally, I think that time and aspirin plus some other stuff like omega 3 fatty acids which I had secreted in my luggage helped more than the oxygen (yeah, I know, blah, blah). After passage of several years, the occasional regressive symptoms like pins/needles and weakness faded. I still dive and take aspirin (regularly now), a half pill. I cut the pill in half, not to put too fine a point to it.

Five years ago, there was a show and tell describing how aspirin aggravated bleeding caused by bends. I think the experiment was inappropriate and exaggerated the findings. Any idiot knows that aspirin aggravates bleeding and if a person is bent bad enough where bleeding is a threat, he is probably dead anyway.

When a bubble blocks a capillary feeding nerves in the spine it should be eliminated as soon as possible by one means or another. It can be reduced or made more slippery by hydration, and by preventing any accompanying "aggregation" (how erudite of me) Furthermore, it is essential that inflammation and swelling be treated immediately, IMO. Aspirin is quite effective in this instance.

 

[DandyDon]

"I felt so good by the time we docked at Cat Cay that I told the people in Miami to 'hold the helo'."
That sounds like a good lesson in the dangers of dive injury denial - self medicating during paralysis...?

 

[OH-JJ]

I came down with severe pain and paralysis of the lower right side which lasted for about 1/2 hour. It stopped after I dosed myself with water and aspirin. I felt so good by the time we docked at Cat Cay that I told the people in Miami to "hold the helo". However, after hitting the sack, by the wee hours of the morning, once again, I could not move my right leg but there was no pain, just profound numbness and some other weird symptoms associated with paralysis of the lower body. They launched the helo. I recieved hyperbaric oxygen therapy for five days and gradually got better. One of the physicians (hospital, not chamber) had ordered a walker but I eventually left with a cane and a limp. Personally, I think that time and aspirin plus some other stuff like omega 3 fatty acids which I had secreted in my luggage helped more than the oxygen (yeah, I know, blah, blah). After passage of several years, the occasional regressive symptoms like pins/needles and weakness faded. I still dive and take aspirin (regularly now), a half pill. I cut the pill in half, not to put too fine a point to it.

Five years ago, there was a show and tell describing how aspirin aggravated bleeding caused by bends. I think the experiment was inappropriate and exaggerated the findings. Any idiot knows that aspirin aggravates bleeding and if a person is bent bad enough where bleeding is a threat, he is probably dead anyway.

When a bubble blocks a capillary feeding nerves in the spine it should be eliminated as soon as possible by one means or another. It can be reduced or made more slippery by hydration, and by preventing any accompanying "aggregation" (how erudite of me) Furthermore, it is essential that inflammation and swelling be treated immediately, IMO. Aspirin is quite effective in this instance.

First off I agree with you. However I must correct you about the bleeding part.

My Main Dive buddy and close friend was a Commercial diver. after a a 300+ dive gone bad, ( thought he lost one if his men and went looking for him and sent the bell up.) He hit the surface and was foaming blood from the gums. they threw him in the chamber on the platform, blew him down to the max, ( I think around 150fsw,) then flew him to a bigger chamber. he survived, but it was because of the chamber. and Yes he was on Asiprin, before he left the bell.

Needless to say he tells it better, and he highly recommends against getting bent. but, the point is don't worry about bleeding and such, worry about how quickly you can get to a chamber. As DandyDon has in his footer, do you have DAN programmed into your phone?

 

[cutlass]

Offhand, I'd say that the theoretical benefit of aspirin in DCS is its anticoagulant properties. Micro-bubbles provoke an immune response which includes platelets attaching to such bubbles*. This might aggravate DSC risk or severity. But as debersole pointed out earlier, this theoretical benefit of aspirin is unproven.

*"The Clotting System" section discussion in this article

 

[super7]

However, there is conjecture (not good clinical data) that the inflammation caused by DCS could result in platelet aggregation as a byproduct and this aggregation could cause blockage of blood vessels. That is why it is being studied.

Thanks Debersole. I was focused on the "blood thinning" part that I left out the factor of inflammation. Very important, and as mentioned, inflammation serves a vital role in all kinds of vessel occlusive diseases.

However, there is insufficient data at the present time to recommend aspirin to prevent DCS.

Designing an RCT for DCS might be difficult, don't you think?

thanks for the heads up.

My pleasure!

 

[Dr. Doug Ebersole]

Yeah, I don't think the NIH has any plans for a randomized double-blind placebo controlled trial of aspirin versus placebo in recreational scuba divers looking at reducing the incident of DCS. After all, the incidence of DCS is extemely low in the general diving population. The statistics to show a difference in aspirin vs. placebo with such a small incidence would take something like a few million participants !!!!! However, my point was that while lots of therapies in medicine SOUND like good ideas -- when they are studied, the results turn out to be exactly the opposite of what the "experts" thought they would be. Just a word of caution! Personally, I don't take aspirin even for my deep technical rebreather dives. I just hydrate, hydrate, hydrate ... and don't push my computer or deco tables. So far, so good. I just hope my luck continues to hold.

 

[TSandM]

The Rubicon Research Repository is a good place to look for answers to questions like this. I did a cursory search, and came up with a few papers, of which THIS one seems the best. There are many problems involved in assessing whether aspirin prophyaxes against DCS, among them the low incidence and unpredictability of DCS in recreational divers and the fact that animal models are done in chambers, which may not be completely analogous to the physiology of immersion. Given those factors, and that aspirin is long since off patent and widely prescribed for cardiac prophylaxis, I don't see any reasonable likelihood of anyone funding an extensive study to evaluate ASA as a prophylactic agent for divers.

 

[DandyDon]

So what's the best guess? Keep taking one 325 a day like I do everyday....?