- Messages
- 5,721
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Let's look at them:
1. "I agree it's nice to know and report the results from studies, but in my book if a finding comes out of a published study it isn't infallible. Personally, before I would accept something published as "true" I would have to study the methodology used in a published study myself (even in a refereed journal), and then wait for other independent studies to validate the first study."
I concur that this is a wise approach, as would most anyone who appreciates the nature of research & progress in science.
However, this does not obviate the fact that your anecdotal self-report on a single dive while on a single antibiotic does not compellingly support your initial contentions, i.e., that the side effects of antibiotics as a class bode poorly for narcosis, and are counterindicated in the face of elevated partial pressures of oxygen.
Say another diver dives a profile & gas similar to yours on a similar dose of Cipro for a similar infection. His unsubstantiated self-report is that he experienced no narcosis. Would you accept this as a reasonable basis for asserting in a public forum that antibiotics as a class pose no risk for narcosis or ox-tox?
2. "I made clear that my comments about my experience were anecdotal and would hope people would consider them according to whatever their personal criteria are for assimilating such information -- certainly within that spectrum is to disregard them, which is fine. Most of this board is anecdotal as near as I can tell. I still find it useful."
You surely did, although under the circumstances it would have been rather unconvincing to attempt to present them as anything other than purely subjective.
I will not differ with the statement regarding the anecdotal nature of much of "the board" as a whole. I will, however, contend that the professional advice put forward under the Dive Medicine section of the board is not mostly anecdotal. It is largely based on what the science of medicine knows about a topic. As to the "usefulness" of the more anecdotal material here, I would argue that it varies from the useful to the dangerous.
Furthermore, I think it is improper to imply that the Diving Medicine and other board sections, say the Travel/Locations area, are equivalently appropriate forums for opinion based solely on subjective experience. The advice provided here bears directly on health & medical welfare, and should be held to a higher standard.
3. "As a class, antibiotics are extremely heterogenous (sic) in their composition."
I couldn't agree more, and therefore can't understand why in your previous posts you unconditionally generalized from your single experience with one specific compound, Cipro, to the entire universe of antibiotics.
4. "Side effects from antibiotics are all over the map, and include in some cases drowsiness."
You are quite correct. However, for the only antibiotic about which you have spoken from personal experience, Cipro, drowsiness is not a side effect in any real sense.
It is reported in LESS THAN 1 percent of individuals taking the medication. As someone who puts himself forward as savvy in interpreting research & understanding drug effects/side effects, certainly you appreciate it is extremely difficult to cogently argue that this is anything but "noise."
5. "Drowsiness is in my limited exposure to dive medicine is what gets pinpointed most often as enhancing the effects of narcosis, especially in combination with seasickness preventatives."
Indeed, seasickness medications as a class are notorious for causing drowsiness, although I fail to see the relevance of this remark as antibiotics as class are not.
Go to the PDR and read up on variety of seasickness meds & antibiotics. Warnings about drowsiness are rampant & heavily emphasized in the former as a class, but not in the latter as a class.
6. "Cipro is a potent inhibitor of Cytochrome P450 1A2. This enzyme is responsible for metabolism of caffeine."
I see little purpose in pursuing the caffeine matter. It seems quite unnecessary from the standpoint of providing the initial poster with a straightforward & easily comprehensible answer. It branches off into what are essentially mixed gas & deep air issues, and wanda has simply inquired about her upcoming in-pool scuba class.
In addition, your suppositions about the possibly additive effects of caffeine & increased partial pressures of oxygen in causing increased CNS stimulation in humans is exactly that--utter theorizing.
I would note that the only science cited on this issue thus far used a lower mammalian form, rendering it of limited application to humans, but it reported that caffeine reduced the effect of CNS oxygen toxicity.
I can see no point in placing a whole class of very useful medications into question for scuba just because they can adversely interact with an unnecessary & volitionally used stimulant.
In concluding this point, I'll quote BillP, who said: "But then any concern about that effect should prompt a warning about taking too much caffeine and diving, or about combining excessive caffeine use with Cipro use- not a warning that antibiotics increase the effects of narcosis," and myself who said: "And, in any event, this state of affairs is not the fault of the antibiotic; it's the untoward result of taking two drugs [Cipro & caffeine], one of which is not necessary to the health & welfare of the individual."
I believe that these statements make a lot of sense.
7. You told people to check out medications on "dry ground" before they take them when diving.
A capital suggestion, indeed. However, I don't see how this would this assist them in determining what effect the drug might have on dive-related nitrogen narcosis & increased partial pressures of oxygen, which were your specific focus in prior posts.
Undoubtedly we could quibble about aspects of all of the above. However, I would assert that taken in the aggregate they do not support your initial blanket statements about the effects on scuba of antibiotics as a class, nor about Cipro in particular. IMHO, you have not adduced the science or medicine to underpin your speculation.
As final point, in my view your debating of this matter has become increasingly specious & intellectually dishonest. This serves no one well.
But, as Dennis Miller is wont to say at the conclusion of his marvelous "rants": "Of course that's just my opinion, I could be wrong."
Peace.
DocVikingo
1. "I agree it's nice to know and report the results from studies, but in my book if a finding comes out of a published study it isn't infallible. Personally, before I would accept something published as "true" I would have to study the methodology used in a published study myself (even in a refereed journal), and then wait for other independent studies to validate the first study."
I concur that this is a wise approach, as would most anyone who appreciates the nature of research & progress in science.
However, this does not obviate the fact that your anecdotal self-report on a single dive while on a single antibiotic does not compellingly support your initial contentions, i.e., that the side effects of antibiotics as a class bode poorly for narcosis, and are counterindicated in the face of elevated partial pressures of oxygen.
Say another diver dives a profile & gas similar to yours on a similar dose of Cipro for a similar infection. His unsubstantiated self-report is that he experienced no narcosis. Would you accept this as a reasonable basis for asserting in a public forum that antibiotics as a class pose no risk for narcosis or ox-tox?
2. "I made clear that my comments about my experience were anecdotal and would hope people would consider them according to whatever their personal criteria are for assimilating such information -- certainly within that spectrum is to disregard them, which is fine. Most of this board is anecdotal as near as I can tell. I still find it useful."
You surely did, although under the circumstances it would have been rather unconvincing to attempt to present them as anything other than purely subjective.
I will not differ with the statement regarding the anecdotal nature of much of "the board" as a whole. I will, however, contend that the professional advice put forward under the Dive Medicine section of the board is not mostly anecdotal. It is largely based on what the science of medicine knows about a topic. As to the "usefulness" of the more anecdotal material here, I would argue that it varies from the useful to the dangerous.
Furthermore, I think it is improper to imply that the Diving Medicine and other board sections, say the Travel/Locations area, are equivalently appropriate forums for opinion based solely on subjective experience. The advice provided here bears directly on health & medical welfare, and should be held to a higher standard.
3. "As a class, antibiotics are extremely heterogenous (sic) in their composition."
I couldn't agree more, and therefore can't understand why in your previous posts you unconditionally generalized from your single experience with one specific compound, Cipro, to the entire universe of antibiotics.
4. "Side effects from antibiotics are all over the map, and include in some cases drowsiness."
You are quite correct. However, for the only antibiotic about which you have spoken from personal experience, Cipro, drowsiness is not a side effect in any real sense.
It is reported in LESS THAN 1 percent of individuals taking the medication. As someone who puts himself forward as savvy in interpreting research & understanding drug effects/side effects, certainly you appreciate it is extremely difficult to cogently argue that this is anything but "noise."
5. "Drowsiness is in my limited exposure to dive medicine is what gets pinpointed most often as enhancing the effects of narcosis, especially in combination with seasickness preventatives."
Indeed, seasickness medications as a class are notorious for causing drowsiness, although I fail to see the relevance of this remark as antibiotics as class are not.
Go to the PDR and read up on variety of seasickness meds & antibiotics. Warnings about drowsiness are rampant & heavily emphasized in the former as a class, but not in the latter as a class.
6. "Cipro is a potent inhibitor of Cytochrome P450 1A2. This enzyme is responsible for metabolism of caffeine."
I see little purpose in pursuing the caffeine matter. It seems quite unnecessary from the standpoint of providing the initial poster with a straightforward & easily comprehensible answer. It branches off into what are essentially mixed gas & deep air issues, and wanda has simply inquired about her upcoming in-pool scuba class.
In addition, your suppositions about the possibly additive effects of caffeine & increased partial pressures of oxygen in causing increased CNS stimulation in humans is exactly that--utter theorizing.
I would note that the only science cited on this issue thus far used a lower mammalian form, rendering it of limited application to humans, but it reported that caffeine reduced the effect of CNS oxygen toxicity.
I can see no point in placing a whole class of very useful medications into question for scuba just because they can adversely interact with an unnecessary & volitionally used stimulant.
In concluding this point, I'll quote BillP, who said: "But then any concern about that effect should prompt a warning about taking too much caffeine and diving, or about combining excessive caffeine use with Cipro use- not a warning that antibiotics increase the effects of narcosis," and myself who said: "And, in any event, this state of affairs is not the fault of the antibiotic; it's the untoward result of taking two drugs [Cipro & caffeine], one of which is not necessary to the health & welfare of the individual."
I believe that these statements make a lot of sense.
7. You told people to check out medications on "dry ground" before they take them when diving.
A capital suggestion, indeed. However, I don't see how this would this assist them in determining what effect the drug might have on dive-related nitrogen narcosis & increased partial pressures of oxygen, which were your specific focus in prior posts.
Undoubtedly we could quibble about aspects of all of the above. However, I would assert that taken in the aggregate they do not support your initial blanket statements about the effects on scuba of antibiotics as a class, nor about Cipro in particular. IMHO, you have not adduced the science or medicine to underpin your speculation.
As final point, in my view your debating of this matter has become increasingly specious & intellectually dishonest. This serves no one well.
But, as Dennis Miller is wont to say at the conclusion of his marvelous "rants": "Of course that's just my opinion, I could be wrong."
Peace.
DocVikingo
