BPPV new diver

[tridacna]

I have an OW student (64F) with a history of BPPV. First diagnosed about a year ago. Severe symptoms - seen in ER; treated with meclizine and anti-emetics. Two minor episodes in past six months. None as severe as initial one.

Her GP has okayed her to dive. I’m curious to hear what MDs here think about taking her UW. I have to admit that I’m more than a tad nervous. Course in 3 weeks.

 

[tridacna]

@doctormike or @Duke Dive Medicine Any input?

 

[Living4Experiences]

I've had infrequent BPPV for 15 years, never while diving and not severe. I went to physical therapy with an ear/balance provider and learned how to self treat when an episode occurs using the Epley maneuver. Medication doesn't get rid of it, and by the time the meds start to work, the episode would be over because it only lasts a couple of minutes. I'm not a doctor, just speaking from experience. I'm interested to hear what our dive docs have to say.

 

[dmaziuk]

Among other claimed benefits, this is supposed to help get the crystals in place:

 

[Duke Dive Medicine]

@doctormike or @Duke Dive Medicine Any input?

That's a good question. I'd be curious to know how the otoliths would act in a low-gravity environment. I think you're right to be concerned since a recurrence in a new diver could be panic-inducing. I'll defer to @doctormike for a concrete answer.

 

[-JD-]

That's a good question. I'd be curious to know how the otoliths would act in a low-gravity environment. I think you're right to be concerned since a recurrence in a new diver could be panic-inducing. I'll defer to @doctormike for a concrete answer.

The gravitational force acting in the ear while submerged is (roughly) the same as sea level on dry land.
In the water the gravitational force (down) on the diver is counteracted by the buoyant force of the water (upward - magnitude of the displaced water) resulting in (ideally) balance forces and neutral buoyancy which feels somewhat like low gravity, but down still feels like down.

 

[crofrog]

The gravitational force acting in the ear while submerged is (roughly) the same as sea level on dry land.
In the water the gravitational force (down) on the divers is counteracted by the buoyant force of the water (upward - magnitude of the displaced water) resulting in (ideally) balance forces and neutral buoyancy which feels somewhat like low gravity, but down still feels like down.

Where did you do your fellowship in otolaryngology?

 

[-JD-]

Where did you do your fellowship in otolaryngology?

Not in any way implying that I did.


But Gravity (the acceleration vector) at the Earth's surface (sea-level nominal - depths of bare-human diving are insignificant) is essentially the same all over in any meduim. Neutral in the water or flying in a plane does not mean that gravity has changed compared to being on dry land - only the type of force balancing gravity (assuming steady state depth\elevation\altitude.)
Even free-falling near the surface, which, like being in water, can be described as weightless, is not gravitly-less.

 

[Duke Dive Medicine]

The gravitational force acting in the ear while submerged is (roughly) the same as sea level on dry land.
In the water the gravitational force (down) on the diver is counteracted by the buoyant force of the water (upward - magnitude of the displaced water) resulting in (ideally) balance forces and neutral buoyancy which feels somewhat like low gravity, but down still feels like down.

That makes sense. They're already in a liquid in the inner ear so they wouldn't act any differently in an immersed individual.

 

[tridacna]

Where’s @doctormike ?