Coumadin & Scuba

[Scubapro146]

Dear Dr. Deco and anyone who can help.

I have heard mixed reviews about Diving and Coumadin.

Is it safe? I never get nosebleeds. (Knock on wood)


Tanks.

 

[shakeybrainsurgeon]

The main risks of Coumadin are GI bleeds, excessive bleeding from wounds and higher risk of spontaneous or traumatic intracerebral or subdural hemorrhages. For young people with no brain atrophy, spontaneous intracranial bleeding is uncommon, and GI bleeding has nothing to do with scuba.

Thus, the chief things to avoid are head trauma and lacerations, neither common in scuba, I would presume. Penetration wreck diving might carry some risk of being cut, but that's about it. If a diver is cautious, taking care not to fall on slippery, heaving boat decks, staying away from jagged wrecks, watching so the tank doesn't slam you in the occiput during the giant stride, I don't see a problem.

This isn't to be taken as advice in lieu of consulting your personal physician. Given your age, I presume you take Coumadin for a valve replacement and so may need a higher INR than someone taking it for phlebitis or vascular disease. Does your INR run high and how often is it checked???

 

[DandyDon]

Here's my thread from a year ago on the subject: here. As you'll see there, I was certainly not the first to dive on it. No problems.

 

[DocVikingo]

Hi Scubapro146,

Indeed there are some serious considerations in diving while on anticoagulation.

While the risk of spontaneous bleeding, blunt trauma and similar events during diving is generally relatively small, if such does occur the consequences can be quite grave.

Moreover, divers are prone to barotrauma of air-containing spaces within the body (middle ears, sinuses, lungs, gut) and relatively slight barotrauma can cause significant bleeding even in the normal diver. Coumadin unquestionably would aggravate the situation. Also, some have speculated that anticoagulants may worsen the effects of spinal DCI.

Finally, there is the issue of why one is on an anticoagulant and implications of that disease process for safe scuba.

You might find the following UKSDM standards informative:

General- anticoagulation
http://www.uksdmc.co.uk/standards/Standards- anticoagulants.htm

Helpful?

This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice to you or any other individual and should not be construed as such.

Regards,

DocVikingo

 

[rawls]

Finally, there is the issue of why one is on an anticoagulant and implications of that disease process for safe scuba.

Excellent point!

 

[DandyDon]

Quote: Originally Posted by DocVikingo
Finally, there is the issue of why one is on an anticoagulant and implications of that disease process for safe scuba.

Excellent point!

Yep. I skipped over that in part because of my qualifications to ask & understand: close to none. We are very fortunate to have diving, medical professionals post when they can here.