Diving with an Arteriovenous fistula

[The_Ghost]

Due to my bad luck I have a fistual in my left arm surgically created for hemodialysis treatments. My surgeon said after about 10 weeks I could dive with it so long as I don't restrict my left arm by like wearing anything too tight. Also I was the first person to ever ask her that question. Which makes me a little nervous.

I have heard of people diving after receiving a transplant which is fine, but I was hoping that I wouldn't have to give up diving for a few years untill that time that I get a transplant.

You guys ever hear about people diving just fine with a fistula and if I was to come to say your place to want to either get a new cert or go on a dive trip what would be a good recommendation of what types of paperwork to have on me. I figure it would be good to have an ok of some kind of a doctor on my next dive trip, but just want to make sure I cover all my bases.


thanks.

 

[TSandM]

The fistula is not a problem, so long as you don't put anything constrictive over it.

However, there is a potential issue about the kidney failure itself. If you do not make urine, then you are dependent on your dialysis to control your blood volume. If you are on the edge of being overloaded, and you dive and centralize your blood volume as being underwater makes us do, you run the risk of going into congestive failure. On the other hand, if they dry you out so you can dive for a weekend, you may run a higher risk of DCS.

If you still make urine but don't clear your toxins, the issue is much easier to manage.

 

[The_Ghost]

well currently im not on dialysis YET, but thats good information to know also.

stupid question: no wet then over the fistula then I take it or at least a really tight one?

 

[TSandM]

What you don't want is to block the flow of blood through the fistula so it clots. If you had a true AV fistula made (no artificial conduit) then it has to do what we call "maturing", which means that the venous side has to dilate and accept increasing flow. When it is young, it is much more susceptible to clotting. Gortex grafts are more resistant to compression, but have other clotting and infection issues in the long run.

Once the fistula is nicely dilated up (very visible) it should be okay to wear a wetsuit, as long as it isn't really tight in the arms.

 

[The_Ghost]

ok sounds good, just need to wait for it to mature then. Not sure what to do once I get on dialysis, might just have to put my diving on hold for a couple years.

thanks for the help.

 

[TSandM]

Again, as long as you are making urine, so your volume status isn't terribly tenuous, you should be able to dive. I had a friend who successfully dove for over two years while on dialysis. You have to be a bit careful on your dive scheduling, because late in the afternoon of the day before you dialyze probably isn't a great time to dive. But it is possible with careful attention.