Ptsd & scuba

[Mothball]

Hey all! I've always been a safe, conservative diver, but I have voluntarily stopped diving/divemastering for the past two years because I was diagnosed with post traumic stress disorder stemming from a tour in the Middle East during Operation Desert Storm. My main problem was insomnia, which lead me to be generally aggrevated and so on... So my private and VA physicians prescribed some meds that really do help me in daily life. The problem is that I don't know what these meds would do at higher partial pressures.

I was wondering if there are any Veterans out there who have been diagnosed with PTSD willing divulge any personal findings about diving and their meds, specifically CNS depressants such as muscle relaxers and mood stablizers.

My physicians don't know (or won't say) how these meds would act at higher partial pressures. The most that a DAN physician would say, is that it would cause a narcosis at a shallower depth, and that there have been no studies done with these meds at depth.

Any furthur insights would be greatly appreciated.

Thanx, Dave

 

[scubajcf]

Call DAN.
DAN Divers Alert Network
Thanks for your service. Feel better soon.

 

[NadMat]

Call DAN.
DAN Divers Alert Network
Thanks for your service. Feel better soon.

Did you even read his post? He already indicated that he had contacted DAN

 

[DocVikingo]

Did you even read his post? He already indicated that he had contacted DAN

Appears not, eh, NadMat?

Sadly, the reflex action of those who don't really read or understand questions posted to the Diving Medicine and DrDeco forums often is, "CALL DAN."


Regards,

DocVikingo

 

[don Francisco]

As a starting point, get the specific names and dosages of what you're taking, and research their actions and side effects. Start by pressing your doc for more info, ask the pharmasist, and finally do an internet search on these meds, and learn all you can about them.

You may not get specific dive related info, but may find they're similar to others about which more is known. Also discuss with your doc your desire to continue diving, and that it might be therapeutic for you. Ask whether modifying the dosage might be workable or helpful in your case.

After you've learned all that you can, you can decide if diving is out, or if you can work out an action plan that involves some diving, maybe with restrictions. Good luck, and BTW thanks for your service in Desert Storm. dF

 

[Mothball]

All great advice don. I have been doing some research on the web and will continue to do so, but I never thought about talking to a pharmacist before - I know a few and will question them.

As of yesterday, I visited with my 12th doctor. When questioned about diving, he listened to my concern and brief explanation of what happens physiologicly to the human body at depth. He smiled and said he didn't know of such occurances. He went on to say that he had no reason to think that meds should stop me from diving. This is the basic answer that I keep running into when speaking with non-diving physicians.

Anyway, on a brighter note... Because I have learned these CNS depressants seem to have a strong tendency to cause a narcosis rather than an oxygen toxicity problem, I have been thinking of a possible training program. The program would start with 4-6, 30-45 minute pool sessions where my wife and I can see how I react in shallow water. If all is well, then I'll work on proper weighting and bouyancy control, do a full review of all 18 demonstration skills and all emergency procedures. Then, if all is still well, I might consider entering our favorite training site where there is a very gradual slope to 25', and see how I do. After that, there is line available that drops down to 42' that I can consider trying.

Another idea I have is, barring the possibility of an oxygen hit, I'll ask some trimix instructors about the possibility of using a hyperoxic trimix (something like 26/20 - 30/30 maybe) at recreational depths with idea being, to take as much nitrogen out of the mix without increasing the risk of an oxygen hit (which still looms in my mind). I think SSI was offering a "recreational trimix" course about the time I stopped diving. Anyway, I'm just thinking...

Any further thoughts, ideas or chastizements are still appreciated...

Semper Fi, Dave

 

[don Francisco]

Dave, you're taking the right approach; slow and cautious.

Continue to get as much info about the drugs and their side effects, however you could consider your docs answer a qualified yes. Usually the docs err on the side of caution, so even if it's only unawareness, there weren't any obvious contra-indications. I don't believe in asking DAN blanket questions, but possibly if told your specific meds they might know of specific contra-indications, or can refer you to a source.

Meanwhile going back to the pool and getting your self ready to dive, and reviewing your skills can't hurt. Likewise testing your limits in controlled conditions makes sense. The thing is to be self aware and honest with yourself about things like narcosis, and not so driven to dive that you wish your problems, if any, away.

It could be that you can work yourself up to diving in the 50-70 foot range, which opens up many of the best diving sites. Until you're fully confident of being OK, make sure you dive with a skilled, attentive buddy, tuned in to your possible problems. Regarding your CNS concerns, I'm no expert, but to my knowlwdge, it tends to be stimulants, and not depressants, that raise oxygen sensitivity, so you probably won't need to fool with mixed gasses, but don't base your decision on my opinion, check that out thoroughly.

The other area of concern may be your reactions to sudden stress or problems. The PTSD might may make you over-reactive, while the meds might make you sluggish, or cloud your thinking. There's no way to know for sure, so take it slow.

The bright side is that I've known others with PTSD symptoms, who with time and more joy in their lives have moved past their problems and weaned off the meds. The diving may actually be theraputic, but good luck getting the VA to pay for it.

best wishes
francis

 

[Mothball]

Well said Francis.

I did give DAN the full list of my meds, and they said three are CNS depressants and warned me of the narcosis factor. I'll probably compose another question or maybe rephrase the question to DAN as they come to mind as learn more - that's the source of my skeptizism from the non-diving docs, but you're also correct in pointing out that I might be reading too much into their answers.

I'll go ahead and tell of a seemingly "inert" situation that is a source of my malfunction and list the meds in question. Normally, the M 60 machinegun is deployed as a crew-served weapon (usually by three Marines, at that time). Well, the situation dictated that I had to carry and operate the whole system by myself for four days straight (which was unusual, but we were at the front line of the combat zone) about 200m from my buddies who I had to protect. I'll be honest and say that nothing bad happened, in fact all of us came home in tact. My attitude in that situation was that "no one was going to get hurt or die because I was too lazy to stay awake and alert" - I would not live with myself if something like that would have occurred because of my "laziness". What I didn't realize for 13 years is that I came home and never relinguished that responsibility, basically there was never an end to my shift, so to speak. So, I would just stay awake for days and sometimes weeks at a time just thinking that everything was normal, although I was beat to he11. working 7 days a week, many times 10-16 hours a day for about twelve years. I filled my free time with riding my motorcycle around all night (not causing any trouble, just riding around), parked it, got something to eat, read a book, watched the news, took a shower and went back to work. If I happened to have a day off (or acted "sick") I would either skydive or SCUBA dive. Well, I finally began to weaken and wear out, and I finally went to the VA, and thankfully they listened to me, and it was obvious to me that they knew I was being honest and sincere, and they could tell that I was definately not kidding around by asking for help, and they provided the help that I asked for, and actually provided me with more help that I didn't know I was in need of. Overall, I feel that VA has treated me very well and more than fairly. The three meds in question that I take are for sleep but are also used for more severe malfunctions.

Lexapro (10mg) for general depression

Alprazolam (1mg) for anxiety and to stop racing thoughts to aid in achieving restful sleep

Flexeril (10mg) as a muscle relaxer to aid in achieving restful sleep and to ease any physical reactions to any nightmares, etc.

As I understand from all the doctors and others I spoken to, all of the meds are at an extremely low dose, but they do the job and I generally feel a lot better than before.

I'm right with you as far as a good dive buddy is concerned. My hope and goal is to push the envelope so slowly that things will not get out hand.

As far as reactions under stress, you bring up a good point. I think I might amend my training program to include the 18 demonstration skills and emergency procedures at 5' intervals to 25' or so, since we'll be in fresh water and viz is usually unlimited (at first anyway). I think that would be a good "honesty check" for me. I think another good "check" would be to time myself, say, removing the unit and replacing it in the pool and then time myself at 25'.

Thanx for tyoing back,

Semper Fi, Dave

 

[Mothball]

Well, I heard back from the DAN dive physician. He explained all of the factors that I should consider, and I've decided that the risk is too great for me right now. I'll abstain from diving for the near to mid-range future.

Thanx for reading and typing back folks,

Blue water wishes, Semper Fi, Dave

 

[do it easy]

I'm sad to hear you won't be diving just yet. Thanks for posting about your PTSD and thank you for your service and sacrifice.