Urea cycle disorder and Diving

[Scuba_Vince]

I signed me up for a open water course, but I have a question I wonder if anyone heard about it. I might have a very slight form of a urea cycle disorder, this means in
cases of extreme stress or dyhydration I might pass out. It only happend once in 26 years. Would it still be safe to dive for me

Vince

 

[DocVikingo]

Hi Vince,

A few inquiries:

1. When did the solitary event of passing out occur?
2. Has the diagnosis of urea cycle disorder been definitively made? Has urinalysis revealed abnormal metabolites or blood assay shown abnormal ammonia or amino acid levels?
3. Do you currently have any signs or symptoms of the disorder?
4. Are you on a special diet or taking any supplements/medications designed to control the condition?
5. Do you have any other medical/psychiatric disorders?

Regards,

DocVikingo

 

[Scuba_Vince]

In respond of your questions DocVikingo


1 The event took place last june in Paris.

2 No the diagnosis has not been made definifitively. the doctor thinks I have a very slight form of it. They did found a higher than normal ammonia level in my blood after I passed out.

3 No I have no symptoms

4 No I dont take any supplements or medication

5 Yes i have a kidney disease called chronic glomerunephritis, ( but have permission to dive from the doctor )


Vince

 

[DocVikingo]

Hi Vince,

From a diagnostic standpoint, it appears as though things are bit up in the air at the moment.

Passing out can have all manner of causes. Sometimes persons pass out on only a single occasion and the cause never is identified. Or, it can be the result of unusual stress, dehydration or similar conditions that are not expected to recur.

Moreover, it is possible for chronic "glomerunephritis" (severity not otherwise specified) to in some manner be related to elevated blood ammonia levels, but unrelated to episodes of loss of consciousness. One would want to have a baseline measure of such ammonia levels against which to compare that obtained just after an event of loss of consciousness. An assay of relevant amino acids and enzymes also would be useful.

In any event, a fairly recent incident of unexplained loss of consciousness is quite worrisome as such an event well could prove fatal underwater. It clearly is in the diver's best interests to be confident that it will not recur.

If it is determined that extreme stress or dehydration contributed to the episode, then avoiding stressful diving conditions and taking vigorous efforts to stay fully hydrated seem well advised.

Given that no cause is found despite a comprehensive work up, it would be prudent for the diver to wait a fainting-free year, then seek medical clearance, preferably from a diving medicine physician.

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.

Regards,

DocVikingo