Aspirin and diving

[Wendryn]

Hello!

I have a question I haven't been able to find an answer for.

I know aspirin works as an anti-coagulant, presumably by thinning the blood (although I'm not sure about that part). I was wondering if this would have any effect on the formation of bubbles after a dive.

I often end up a little achy after a dive, presumably from lugging tanks and equipment before the dive. Is the any minor pain medication that would be ok to take after diving? I know the limitations about alcohol and hot baths and such, but I haven't seen anything about mild painkillers.

Thank you!

--Wendryn

 

[Dr Deco]

Hi Wendryn:

Many divers have taken aspirin following a dive for about 2 decades. There does not appear to be any problem with this.

It is true that it might mask very mild DCS, but that probably would not be recognized by a diver anyway. There is no way known [currently] to treat a sprain and not mask DCS.

Dr Deco :doctor:

 

[Frank O]

There was an interesting article in the New York Times yesterday on the effectiveness of non-steroidal anti-inflammatories such as aspirin or ibuprofen to treat different kinds of injuries and pain:

http://www.nytimes.com/2003/09/22/health/menshealth/22GOWE.html

(This link will probably require registration, and it may not work after a few days.)

The bottom line is that they seem to be effective with acute, immediate pain (you bonk your head on a tank, it hurts right now). But there seems to be question about whether they work as well with "delayed-onset muscle soreness" (you go diving on Saturday, and the next day or the day after that you wake up sore all over).

 

[dlegros]

There was a thread about NSAIDs (Diclofenac specifically) over on the DiverNet forums a little while ago. A concern raised was that the anti-platelet effects of NSAIDs could complicate a CNS bend - any thoughts?

Dom

 

[DandyDon]

I like to take a couple before I Go Dancin' or before a day of Diving for the same reasons - old knees with cowboy injuries. Otherwise, they ache in gentle finning, much less boot-skootin.

The DAN med-tech I spoke with advised that there was no known problem with what I was doing, and I'm sure that it helps with my out of shape body doing more than it's used to. (I'm trying to follow Dr.Deco suggestions and take my weights and tank off before boarding, but the boat mates aren't too receptive!)

The DAN med-tech also added that in theroy currently being explored by DAN, they thought the thinning of the blood would make Nitrogen bubbles less of a threat, reducing the liklihood of DCS. Makes sense: thinner liquids moving around a bubble in a tube would flow better than thicker fluids.

don :hi:

 

[drbill]

Hey there Don! I too take aspirin (every other day) but for an alleged stroke nearly 20 years ago. I've always assumed there might be benefits in my diving as well. Of course my blood does tend to thin a bit just before a full moon (when I replenish my supply).

Dr. "Fangilio" Bill

 

[dlegros]

Thanks for the info guys.

The original post from DiverNet is here.

I agree with the idea that blood that has been 'thinned' should be less problematic from a DCS point of view, and DAN are always reliable for info.

At least these discussions are helping to keep my brain ticking over on nights

Dom :nurse:

 

[Wendryn]

Thank you for all of the information!

I was specifically wondering if the reduced pressure of blood on the bubbles due to aspirin thinning the blood might let the bubbles expand, but it sounds like that is not an issue.

Nice to know I can get rid of some of the aches - I'm just starting to get into doubles, which isn't exactly a light set of gear. :mouth:

-Wendryn

 

[kelpdiver]

As was pointed out, aspirin and other NSAID's decrease/prevent platelets from clumping together, starting clot formation. Aspirin's effects are permanent (platelets live ~10 days in the blood, meaning about 10% turnover/d) which is why aspirin can be given every other day to prevent clots; diclofenac, and the many other non aspirin NSAIDs affect the platelets only as long as the drug is in the system--8 or so hours for ibuprofen, greater than 24 hrs for piroxicam, most others in between.
That said, Aspirin doesn't "thin" the blood per se, it only prevents the "thickness" that occurs with clotting. (And the pressure on bubbles is hydrostatic related to depth, not because blood is "thick" or "thin"). As the inflammatory effects of bubbles in vessels may lead to platelet aggregation, aspirin may help prevent some of the effects of DCS.
HOWEVER...in actual and experimental DCS, where bubbles form directly within the spinal cord, these areas have been noted to become hemorrhagic (i.e., bleed), which would make DCS worse, and moreso if the blood doesn't clot normally. This was seen quite clearly on slides of post-mortem specimens I just saw at a DAN conference. Thus there wasn't a lot of enthusiasm for recommending Aspirin as a DCS preventive. Yes it might help prevent some manifestations of DCS, but it might make some (especially serious CNS DCS) worse.
After diving, especially if several hours have passed without obvious DCS, aspirin and NSAIDs would seem generally safe.

As usual, this is meant as a general discussion, not specific medical advice, nor is a doctor-patient relationship implied.

 

[WaterDawg]

Good info everyone. I too was wondering about the surface tension of thinned blood, but I did suspect that it wasent really thined per se. Thank you, lets hear more.