Diving with a mild bleeding disorder

[Duke Dive Medicine]

@tbone1004 makes a fair point about the animal research. Many times the researchers will purposely omit significant amounts of decompression in the study animals to look at some of the more far-out effects and I think that punctate hemorrhages on the spinal cord probably fall into that category, though omitted decompression and severe sudden-onset spinal cord DCS are not unheard of. It's about evaluating the risks in your own individual diving habits, weighing the possibility that a mildly hypocoagulable state could *potentially* aggravate DCS if you do get hit, and then mitigating the risks to the best of your ability. A lot of holes would have to line up in the Swiss cheese, so to speak, but then again we wouldn't know about things like spinal cord DCS in humans if it didn't happen. I'm hesitant to second-guess a physician who has evaluated you in person and I don't encourage doctor-shopping, so to speak, but @tbone1004's situation is a nice case study of the more descriptive approach to fitness to dive that the field is moving toward. You may be able to find someone near you with a similar approach.

 

[1000rosie]

Thanks for the info @Duke Dive Medicine. To summarise; that study looked at the changes caused by neurological DCS in an animal model. Have there been any studies looking at:

• The impact of impaired clotting on these changes in an animal model eg using anticoagulant drugs, gene knockout or similar
• Any epidemiological studies on humans and the impact of bleeding disorders/symptoms on adverse outcomes from neurological DCS like long term neurodisability?

I know from the study you’ve cited and others that I’ve found eg about increased platelet consumption in DCS that it’s a theoretical risk. I was just being a bit provocative and checking...

Actually, I hate doctor shopping too. I understand that it must be really difficult with DCS at it seems like exact mechanism is unknown, it can occur within safe dive limits and the effects can be lasting and awful. However, I’d also like to move beyond very a proscriptive approach to risk as it’s not what I’m used to when participating in other higher risk sports. Personally, I don’t find it helpful and it seems a bit parentalistic. Thanks for your assistance!

 

[1000rosie]

couldn’t resist!

 

[Duke Dive Medicine]

Thanks for the info @Duke Dive Medicine. To summarise; that study looked at the changes caused by neurological DCS in an animal model. Have there been any studies looking at:

• The impact of impaired clotting on these changes in an animal model eg using anticoagulant drugs, gene knockout or similar
• Any epidemiological studies on humans and the impact of bleeding disorders/symptoms on adverse outcomes from neurological DCS like long term neurodisability?

I know from the study you’ve cited and others that I’ve found eg about increased platelet consumption in DCS that it’s a theoretical risk. I was just being a bit provocative and checking...

Actually, I hate doctor shopping too. I understand that it must be really difficult with DCS at it seems like exact mechanism is unknown, it can occur within safe dive limits and the effects can be lasting and awful. However, I’d also like to move beyond very a proscriptive approach to risk as it’s not what I’m used to when participating in other higher risk sports. Personally, I don’t find it helpful and it seems a bit parentalistic. Thanks for your assistance!

Hi @1000rosie ,

I'm not aware of any studies that look specifically at clotting disorders/dyscrasias and diving.

I can see where it might feel paternalistic and I'm glad to see you for advocating for yourself and looking beyond the box.

Best regards,
DDM