Coumadin and diving?

[zeN||]

Since embolism is one of the more serious traumas associated with diving, I am curious if any of the docs suggests antocoagulant therapy may in fact be beneficial zeN

 

[Saturation]

zeN|| once bubbled...
Since embolism is one of the more serious traumas associated with diving, I am curious if any of the docs suggests antocoagulant therapy may in fact be beneficial zeN

Hi Z:

Coumadin is used in emboli caused by blood clots, that of diving is caused by a bubble of gas.

Antiinflammatory agents [motrin, aspirin or hydrocortisone] are controversial during the bends, and generally not recommended.

Taking aspirin while on coumadin, and thus inhibiting the platelets, is relatively contraindicated, it can make one bleed profusely.

 

[Aeolus]

Saturation once bubbled...
http://www.lifescan.com/company/press/prharmony_launch.html

The jury's still out on that one, but its promising. I am constantly annoyed by coumadin adjustment, its something that, like insulin, should be taught to patients.

I have looked into this a little and the cost is prohibitive for a decent machine. =-)

 

[zeN||]

Dr. Saturation, thank you, I was not aware that gas embolism was the only type associated with dive injuries zeN

 

[DocVikingo]

Actually, I do believe that your inquiry bears a bit more discussion.

I'm leaving the office now, so perhaps tonight.

Best regards.

DocVikingo

 

[Saturation]

zeN|| once bubbled...
Dr. Saturation, thank you, I was not aware that gas embolism was the only type associated with dive injuries zeN

Hi Z,

Its the most common type. You could stroke from exertion [while diving but it could happen with exercise or sex] if one has other diseases that are worsened by exertion such as hardened arteries or aneurysms of the vessels of the brain. When a normal person 'strokes' during a dive its mostly cerebral arterial gas embolism, i.e., CAGE.

 

[lragsac]

Aeolus once bubbled...


I have looked into this a little and the cost is prohibitive for a decent machine. =-)

This is unfortunate. I own a home monitoring device, distributed by Quality Assurance Services, and it cost around $1,000. But if you are going to be on Coumadin for the rest of your life, as I am, it's worth considering. Presently, I don't use my home machine, because I have an HMO that makes it very convenient for me to test at the lab whenever I want. The thing that keeps me from doing home monitoring is the cost of supplies. At $10 a test, I have little incentive to use it. And, of course, my HMO won't cover the cost of supplies.

 

[miguel sanz]

I don´t think there is much scientific demonstration about the good or bad effects of oral anticoagulants in prevention or treatment of gas emboli (I didn´t have time to chek it on medline, there may be some animal models) but eventhough the gas emboli causes later a blood clot it also causes local tissue lessions that may bleed. Anticoagulants would probably reduce the clot formation around the gas emboli but the bleeding risk would be to high and the patient may need invasive procedures wich would need the coagulation systeme to be normal.
About the INR self- control machines, as I said it´s expensive but it may be cheaper in other countries + it will get cheaper + it depends on how long you´ll be on coumadine (for 6 months it´sobviouslly not worth it, but if it´s life long treatment and your young...)+ how much costs a life, or a paralised life? It´s demonstrated that self control is better (less bleeding and less clot complications), there are basically two problems, 1 the price (national or private inssurances won´t pay for it by now) and 2 the doctors who live of monitoring INR don´t want to lose it. There is a third problem but I don´t think it applies for divers, it´s about the mental capacity to self manage INR (obviouslly, self it´s not alone, there are teams who will councel you)
Best regards to all those anticoagulated divers out there.

 

[zeN||]

Thanxs DocViking ~Z