Kidney stones and Dive Physical

[EnvironmentalDiver]

I've been reading the threads about kidney stones and have a question along those lines.

I have reacurrent stones. I've lost count after 30 or so. The problem is not going away, but I have learned to deal with it. Does anyone have info on how the AAUS or NOAA view that condition? I would like to volunteer dive at my local aquarium, but understand that the physical is in-depth as required by the AAUS. When I answer yes to the question "have you ever had blood in your urine?" does that mean that i cannot dive? I would also like to volunteer dive with NOAA at Greys Reef, (the team ocean program) again when I answer yes to the question "have you ever had a kidney stone?" will they not let me dive? My concern is these organizations may take the same stance as the US Coast Guard, who would not let me join the reserves because of my condition.

Now you may be wondering what this fool is doing diving while being a kidney stone machine. It has been my experience that if I emerse my kidney under water the pain will stop. Instantly!!! I can be in the middle of a "on my knees, get the gun and kill me please" attack and if I can crawl into a tub of water; instant cure. Here's another question. Anyone ever had the same experience? Has anyone ever had a kidney stone attack at depth?

FYI: If you sleep as many nights in the tub as I have you will start to look this way too. My avatar should be a raisen

 

[orion612004]

I cant see them not allowing you to dive. Having kidney stones does not affect diving, it is the incapacitation due to the pain. However you are unlikely to be incapacitated underwater because the amount of time spent underwater in short comparatively. My recommendation is to see a doctor/physician that has knowledge with dive medicine. He may clear you for diving with some restrictions such as depth and refrain from doing complex dives (technical diving). If you are more comfortable with your doctor have him call the DAN hotline and talk to a member of the medical staff.

 

[DocVikingo]

Hi EnvironmentalDiver,

Disclosing medical conditions such as a history of blood in the urine or kidney stones does not automatically mean you will not be allowed dive. What it does mean is you'll likely have to obtain written medical clearance for SCUBA and submit it to any training agency, dive op or volunteer dive program involved.

Also be sure you report and understand the effects of any medications you may taking for the condition. For example, it would be unwise to dive while using narcotic medication for kidney stone-related pain.

Based on what's been reported here, I suspect you will receive medical clearance. Of course either you or your physician can discuss the matter with DAN Scuba Diving Medical Services.

When diving, make sure to stay very well hydrated and alert to any developing renal problems.

As regards the US Coast Guard denying you entrance into their reserves program v medical requirements for safe SCUBA, these of course are quite different situations. There's a big difference between being medically combat ready and medically suitable for occasional recreational diving.

Best of luck.

Regards,

DocVikingo

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.

 

[TSandM]

Doc Vikingo, I think the OP was specifically asking about scientific diving. I know there are different standards for that, as compared with pure recreational diving, but I'm unsure what they are. The OP might consider contacting Thalassamania, who was very heavily involved with the AAUS. He might have specific information about their medical clearance policies.

 

[EnvironmentalDiver]

Thanks for your interest, and taking the time to post!

TSandM is right, the standards for "scientific diving" are what I'm concerned about. I have already a copy of the dive physical from NOAA. It does ask some detailed questions, and I was told by the program official that once completed it would be sent to NOAA's medical board for review. I have to admit that if I were in their shoes, I might have reservations about allowing a volunteer to dive with the potential risk. I can see both sides of the coin.

I handle my situation like this: First it's my life, and I fully accept the risks, and consequences of my actions. However with exprerience comes understanding, If I felt as if I might have an attack I would not go. I also have a high tolerance for pain, I feel confident that if said attack should occur at depth I could make a controlled accent and terminate the dive. The only question for me is whether or not I would feel kidney stone pain at depth?

I noticed that Thalassamania was involved with the AAUS, I will try to bring his attention to this string, if I can figure out how! I'm new at this message board stuff.

 

[Thalassamania]

I have never heard of kidney stones being a contraindication to diving. That's not to say that in a severe case a doctor might not decide to make it an issue, that could happen with any abnormality.

 

[cutlass]

...
Now you may be wondering what this fool is doing diving while being a kidney stone machine. It has been my experience that if I emerse my kidney under water the pain will stop. Instantly!!! I can be in the middle of a "on my knees, get the gun and kill me please" attack and if I can crawl into a tub of water; instant cure. Here's another question. Anyone ever had the same experience? Has anyone ever had a kidney stone attack at depth?

FYI: If you sleep as many nights in the tub as I have you will start to look this way too. My avatar should be a raisen

Pain from stones in the ureters (draining the kidneys into the bladder) is typically sharp, coming in waves (colicky) corresponding to the normal peristaltic contractions of the ureters. Since the pain is typically attributed to mechanical irritation during involuntary muscular activity, it's not clear to me how being suspended in water would provide relief; I've certainly never come across a related citation. But if I had to guess, I'd say that it might be related to part of the diving reflex; i.e. internal organ suspension is interpreted as hypervolemia, provoking a diuretic reaction which also affects ureteral motility. That is, the need to drain higher kidney output results in (higher frequency and) amplitude smoothing of the ureteral contractions; i.e. bolus pumping gives way to a smoother, less pulsed flow. This may reduce the irritation and hasten passage of a stone.

Take note that even if this is true, there's no guarantee that it will always work. I hope you're being checked, or have been checked, as to why you're a stone machine. Risking the ability to pee is not a good thing.

 

[EnvironmentalDiver]

cutlass

Thanks for your imput! My urologist would concur with you. However we still can't find a way to stop stone production. My wife is in the medical field, and she has sugested seeing a nefrologist, perhaps that will be the next step. (Please note my spelling sucks!)

 

[DocVikingo]

Doc Vikingo, I think the OP was specifically asking about scientific diving. I know there are different standards for that, as compared with pure recreational diving, but I'm unsure what they are.

Good point, although the basic bottom line remains the same.

I hereby strike the (in)appropriate segments from my post (#3) above and amend my opening paragraph to read: “Disclosing medical conditions such as a history of blood in the urine or kidney stones does not automatically mean you will not be allowed to become an NOAA or AAUS certified diver. What it does mean is you'll have to obtain acceptable written medical clearance prior to being considered. Be aware that NOAA and AAUS medical standards, and particularly the former, are more extensive and detailed than those of the standard PADI/RSTC Medical History used for recreational diving.

Here are the NOAA medical standards --> NOAA Diving - Medical Criteria & Requirements

Here are AAUS medical standards --> http://data.memberclicks.com/site/aaus/AAUS_Nov_2006.pdf (See Appendices 1-3)

Regards,

DocVikingo

 

[EnvironmentalDiver]

Thanks everyone for all the great advice and info. There is so much about diving that I want to learn and do, my interests lie beyond recreational diving, and I would be disapointed if my situation would not allow me to continue in those endevors. So again thanks from a humble diver who hopes to be able to give something back to the marine environment, that so many take for granted.