hemodialysis and diving

[pacificgal]

None of my doctors have been willing to give me a clearance to dive with the bovine A/V loop I have in my forearm. I have asked my Nephrologist, my GP and my physical rehab doctor, and none of them are willing to say it's OK to dive with it, but can't tell me that I can't dive with it. They just don't know how diving would affect it.
I can't say that I would quit diving if they told me I couldn't dive with it, but I would appreciate knowing the risks that are involved if I continue to dive. I know that with a I/J catheter I can't dive (or get wet) and with peritoneal dialysis I can't dive, which is why I chose hemodialysis in the first place.
I want to take an AOW course within the next month to become a better diver, been planning this for 8 months now, and the planned dive is to a depth of 120 fsw, I need to know if this is a risk not worth taking.
Is anyone familiar with hemodialysis patients and diving that might be able to shed some light on the subject? I hesitate to see a diving doctor expressly for this purpose, my medical bills are already quite high and I doubt medical insurance would cover such a visit.
Thanks!

 

[DesertEagle]

I think you should call Divers Alert Network and speak to a physician there.

 

[pacificgal]

Thanks, I just called them. They were very nice, but stated that my doctor should call them and talk to one of their physicians, which I don't think is very likely to happen. They did say that the hydrostatic pressure as a result of being underwater wouldn't be a problem, a tight-fitting wetsuit could be, though.
Yet another reason a dry suit may be a great idea (once I get the hospital bills paid off).

 

[DocVikingo]

Hi Pacificgal,

Obviously there are issues with diving while on hemodialysis, but I can tell you there are folks who manage them. This recent article sums up the concerns quite well:

Are There Risks for Diving while on Dialysis?
http://tenfootstop.blogspot.com/2006/04/are-there-risks-for-diving-while-on_21.html

You also may wish to contact the Handicapped Scuba Association International http://www.hsascuba.com/ and the American Association of Kidney Patients http://www.aakp.org/ to get their take on the matter. HSAI is a mighty impressive organization.

You are correct that your health insurer will not reimburse expenses for seeking medical clearance to dive. As such, it may come down to your paying out of pocket to consult with a physician who understands the fluid and electrolyte shifts, cardiovascular alterations and other changes brought on by scuba. You may find it money well spent.

Best of luck and keep us posted on how matters resolve. It helps us learn.

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

Regards,

DocVikingo

 

[pacificgal]

Thank you DocVikingo for the links and your input. I can see that it's not an easy question. My fluid intake isn't restricted because I still produce urine, so I am not so concerned about dehydration, however, upon checking my hemoglobin levels from my last labs, they were 11.6 where the article says if it's below 12 I shouldn't dive. I thought my biggest problem was this graft and not having pressure on it, now I see that it is probably the least of my issues. Do you believe that I can find a diving MD that can answer that specific a problem, or do I need to find one that would specialize in nephrology too? If I have to spend the money out of pocket, I want to be somewhat sure he/she can give me an informed decision. I will also contact the people at the other two links you recommended, and see if they can offer a recommendation on a physician in my area that can help me.
Thanks again!

 

[DocVikingo]

Hi Pacificgirl,

Given that you seem to be progressing smoothly with hemodialysis, it probably is not absolutely necessary that you locate a nephrologist with a diving medicine background, although that would be the ideal. A properly trained internist or family medicine practitioner should be able to get the job done. So should a specialist in hyperbaric medicine.

While their referral base often is quite thin, especially outside of major metropolitan areas, it can't hurt to contact DAN [(919) 684-2948 (Mon thru Fri, 9AM-5PM EST)] to see who they may have in San Jose and environs. Given your proximity to the greater Bay Area, you should be able to locate a qualified individual.

Dr. Paul Cianci, who does both internal and hyperbaric medicine in the Bay Area, would also be a good contact. He can be reached by calling (510) 235-3483.

This should get you rolling. If things bog down, feel free to return to the forum for additional suggestions.

Regards,

DocVikingo

 

[sleepr]

Any further info Pacific gal? I know this thread is old but I dug it up. My GF has just been told she will be on dialysis till we can find a kidney. We are newly certified and just had to cancel our first cruise and first caribbean dives because her doctor advised against travel until we got things sorted out. Her kidney failure is due to diabetes so I know we will face an uphill battle getting in the water but were hoping for light at the end of the tunnel. May have brand new regs and computer for sale!