Question about diving impact on existing conditions

[boulderjohn]

I am posting this on behalf of someone else, specifically a diver who had started divemaster training with our shop this year. I had very few interactions with him during this process; I only participated in his training a couple of times when he assisted me on training dives, so I barely know him. He is a young man--I did not look at his papers, but I would guess he is in his later 30s. His training officially ended last week when he suffered a stroke.

I learned that he had not been diving for 5-6 years before he decided to get back into it seriously, taking the Rescue Diver and then DM classes. He had stopped diving because of a series of transient ischemic attacks (TIAs). He had been trouble free during those years, and he decided it was OK to start diving again. His doctor agreed and signed his medical release.

After his stroke, he told his primary DM instructor that he couldn't understand it. He had been trouble free for years, but once he returned to diving, he started having trouble again. He said this last year was his worst year since he had stopped diving. (No one apparently knew he was having any health issues during training; I certainly didn't.)

So he is looking at the chronology of his history (TIAs followed by years of no diving and no symptoms followed by a return to diving and a return of symptoms) and wondering if there is a possible connection. Could diving be at least partially a cause for his problem with TIAs?

 

[John A Lewis]

As a stroke survivor, I'm take a flyer here.

There's no way to be sure. Strokes hit people of all ages, genders and backgrounds. The causes are varied, but some of the more common things associated with it are high blood pressure, diabetes, and smoking. Was your friend checked out by a doctor prior to taking up scuba again--or did he jump right back into training?

My own attack probably was from untreated high blood pressure; invisible, silent and very nearly fatal--yet completely treatable had I been paying attention. You don't feel that anything is wrong, until it is. Could your friend have been experiencing the same?

 

[boulderjohn]

Was your friend checked out by a doctor prior to taking up scuba again--or did he jump right back into training?

He had a doctor's OK, and his primary instructor knew about it. He had apparently quizzed him carefully about that doctor's OK, because he was surprised he got it.

 

[DocVikingo]

Hey John,

About 1 in 3 people who have had a TIA will eventually have a stroke. Additionally, vigorous exercise like fighting a high current, lifting heavy objects like scuba tanks, and positive pressure equalizing techniques such as the Valsalva maneuver increase arterial pressure in the head and thereby may increase the likelihood of a hemorrhage.

My belief is that a diver with a history of TIA should avoid the above as well as any actions that may result in a carotid artery embolism, such as entries that may cause any direct impact to the neck area & movements as hyperextension of the neck as part of clearing maneuvers or looking up or around by twisting the head rather than by positioning the eyes by whole body movements.

Cheers,

DocV

 

[Duke Dive Medicine]

After his stroke, he told his primary DM instructor that he couldn't understand it. He had been trouble free for years, but once he returned to diving, he started having trouble again. He said this last year was his worst year since he had stopped diving. (No one apparently knew he was having any health issues during training; I certainly didn't.)

So he is looking at the chronology of his history (TIAs followed by years of no diving and no symptoms followed by a return to diving and a return of symptoms) and wondering if there is a possible connection. Could diving be at least partially a cause for his problem with TIAs?

John, does this mean that his TIAs reoccurred after he began diving again and were followed by the stroke? Without a detailed medical history and exam it would be difficult to answer this question.

Best regards,
DDM