Diving with multiple sclerosis

[Markos Valsamis]

Hi all, I have been reading with interest some relatively conflicting/vague information about multiple sclerosis and diving. I suspect it is vague due to a weak evidence base to support any decision making, but I am interested to know if anyone is aware of any sources/information about the rationale behind the concern when diving with MS- is the concern about worsening the MS symptoms or is the concern about the dive itself? Is there any understanding of the physiology that underlies any association?

 

[Marie13]

I know someone with MS who was authorized by his doctor to dive. He did fine with the pool dives, but when it came time for the OW dives, the instructor/dive shop would not allow him to dive. This happened years before I met him, so I’m not sure how advanced his MS was at the time. I wasn’t told exactly why he wasn’t allowed to finish the course, except that they were worried about problems during the dive from his MS.

You should probably contact DAN. There’s also a group for disabled divers based in the US called Diveheart. They might be able to provide some info, as well.

 

[Markos Valsamis]

I know someone with MS who was authorized by his doctor to dive. He did fine with the pool dives, but when it came time for the OW dives, the instructor/dive shop would not allow him to dive. This happened years before I met him, so I’m not sure how advanced his MS was at the time. I wasn’t told exactly why he wasn’t allowed to finish the course, except that they were worried about problems during the dive from his MS.

You should probably contact DAN. There’s also a group for disabled divers based in the US called Diveheart. They might be able to provide some info, as well.

Thanks for your input. I do not have MS myself, I am a doctor (though without diving medicine expertise) and am just curious!

 

[John C. Ratliff]

Thanks for your input. I do not have MS myself, I am a doctor (though without diving medicine expertise) and am just curious!

Since you are a doctor, you know that MS is a disease of the brain. As such, symptoms appear to vary. I am not a doctor, but have a MSPH degree in industrial hygiene, and am a former NAUI Instructior (#2710). It appears that no one is looking to answer your question, so I’ll attempt to (with the knowledge that I am not an expert at all).

First, since it is a neurological disease, diving can be a problem. Divers normally have to hold a mouthpiece in their mouth to survive. People with MS may have a problem with that if something happens when underwater.

Second, there appears to be a link to the immune system, and divers are exposed to water with a lot of “stuff” in it, and also things like cuts and scraps of the skin which could lead to infections.

Third, breathing is essential to human life, and underwater, breathing becomes an art. If MS interferes with breathing it may lead to a fatal situation.

Now saying that, I can see benefits to people with MS being underwater. I would caution that a full-face mask be used, so that holding a mouthpiece is not required. Also, simply being underwater with the lack of gravity could be very beneficial to people with MS. Because of the problems of MS, the dive needs to be in a confined area, probably a pool, with very close monitoring by one or two (preferably two) assistant divers. If the diver with MS has problems walking, then a lift needs to be available for entry and exit.

I hope this helps, but again, I’m no expert, and this is just “top of my head” thoughts about diving with MS. I would encourage you to get in touch with both DAN and Dive Heart too, for their thoughts.

Multiple sclerosis - Wikipedia

en.wikipedia.org

SeaRat

 

[Duke Dive Medicine]

Hi all, I have been reading with interest some relatively conflicting/vague information about multiple sclerosis and diving. I suspect it is vague due to a weak evidence base to support any decision making, but I am interested to know if anyone is aware of any sources/information about the rationale behind the concern when diving with MS- is the concern about worsening the MS symptoms or is the concern about the dive itself? Is there any understanding of the physiology that underlies any association?

Hello Dr. Valsamis,

To my knowledge, there's nothing about the pathophysiology of multiple sclerosis that suggests that it could be aggravated by diving. When Duke was researching hyperbaric oxygen therapy for MS, the control group that received the sham treatment showed no decrement.

Since the presentation of MS varies so widely, fitness to dive in individuals with MS would have to be assessed on an individual basis and could change over time based on the course of the disease.

Best regards,
DDM

 

[leadduck]

note that it's not only the illness itself but also side effects of medication that can make diving unsafe. We had a fatal accident in a nearby lake in 2014 where a diver told her buddies she wants to return, swam back alone, fell unconscious and drowned in shallow waters only 30ft from shore. Rumor (!) had it that they found MS medication in her hotel room and she hadn't told her buddies that she was on meds.

 

[P-Dog]

As someone with Multiple Sclerosis - I'll chime in. I started diving in 1991 and have never had an issue. The doctor thinks it's great for me as water therapy/exercise is recommended.

MS treatments have greatly improved over the past 20 years and it is possible to control nearly all of the symptoms. The only time I would NOT dive is if I were having an exacerbation. That being said, if I were having an exacerbation, I'd be bedridden, blind, and unable to function. Diving would not be on my mind.

 

[P-Dog]

note that it's not only the illness itself but also side effects of medication that can make diving unsafe. We had a fatal accident in a nearby lake in 2014 where a diver told her buddies she wants to return, swam back alone, fell unconscious and drowned in shallow waters only 30ft from shore. Rumor (!) had it that they found MS medication in her hotel room and she hadn't told her buddies that she was on meds.

Falling randomly unconscious is not a symptom of MS. So, although a rumor speculated that she had MS medications in her room, it is distinctly possible that it was not the cause of her unconsciousness.