Sukelluslääketieteestä yleiset UKK

Be aware of the side effects of taking alfuzosin. Antihypertensive effects such as dizziness and postural hypotension are known to occur. These same undesired effects in water are counteracted by the centralization of the blood circulation due to the disappearance of the gravitational effect, but it is important to warn you of this possibility in order to prevent pre- and post-dive injuries and to minimize diagnostic confusion with DCS in the event of symptoms at the end of the dive. I would therefore advise you to resume diving very gradually to check for any adverse effects in the water, initially at very shallow depths, staying within recreational limits.

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Medications and Fitness to Dive

It is essential to take into account the energy consumption to be sustained and the timing of food intake according to the dives. The following is a correct dietary pattern, designed to support and nourish the diver on his/her diving days:

• Breakfast, characterized by adequate energy intake and high nutritional quality. Take care not to overload your digestive system (avoid cow’s milk and packaged sweets). A good example is a crunchy muesli mix (oat and barley flakes, berries, 15g mixed seeds) and vegetable milk.
• A second breakfast and afternoon snack for recovery after immersion: sourdough, wholemeal, or 5-grain bread plus tahini with malt/honey or avocado cream or oil and tomato. For rehydration: a mix of fruit and vegetables with ginger;
• For lunch: cereals such as pasta, rice, spelt, couscous, quinoa, etc., in appropriate quantities and seasoned with vegetable sauces, followed or preceded by vegetable juices with chia seeds.
• For dinner: choose a protein-based meal with side dishes. To rebuild muscle glycogen: an adequate amount of cereals, i.e., meat, fish, legumes, eggs, accompanied by bread, rice, couscous, salads, and vegetables.
• Hydration: it is important, so drink water between the dives.

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Nutrition for scuba diving: practical advice to enjoy your dives!

Raynaud’s Syndrome decreases effective blood flow to the extremities, most significantly fingers and toes; this results in cold, pale fingers and toes, followed by pain and redness in these areas as blood flow returns. The underlying problem is constriction of the blood vessels in response to cold, stress or some other phenomenon supplying these areas. Symptoms are often mild. Raynaud’s phenomenon may occur as an isolated problem, but it is more often associated with autoimmune and connective tissue disorders such as scleroderma, rheumatoid arthritis and lupus. Raynaud’s Syndrome poses a threat to a diver who is so severely affected that he/she may lose function or dexterity in the hands and fingers during the dive. If coldness is a trigger that causes symptoms in the individual, immersion in cold water will likely do the same. These individuals should avoid diving in water cold enough to elicit symptoms in an ungloved hand. The pain may be sufficiently significant that, for all practical purposes, the diver will not be able to use his/her hands. Less severely affected individuals may be able to function adequately in the water. Calcium channel blockers may be prescribed for individuals with severe symptoms; lightheadedness when going from a sitting or supine position to standing may be a significant side effect.

Psoriatic arthritis is a chronic inflammatory disease of the musculoskeletal system and could itself be a contraindication to diving if not well compensated/controlled, as it makes the body susceptible to decompression stress. In addition, the use of Methotrexate could put your student at further risk because of its side effects, which include pulmonary toxicity and myelotoxicity. It is therefore imperative that you have your student’s fitness to dive assessed by a specialist in diving and hyperbaric medicine in consultation with the rheumatologist.

The clinical manifestations of the disease can also vary greatly from person to person; for example, some patients suffer more from the cutaneous manifestations of the disease (typical desquamative lesions and scabs), while others suffer from the arthritic type (joint and girdle pain). Over the course of a lifetime, the disease itself can vary, alternating between flares and periods of ‘quiescence’.

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Medications and Fitness to Dive

Ear, nose and Throat (ENT) surgeons trained in diving medicine differ in their opinions regarding the wisdom of diving after a stapedectomy, which is a surgery to treat hearing loss by replacing the stapes bone in the middle ear with a prosthesis. Limited studies have described small numbers of people diving after stapedectomies. The results from these samples indicate that the subjects are not at an increased risk of injury when compared to the control groups of divers, provided they can safely equalize their ears and sinuses with the changes on ambient pressure. With that said, the consequences of failure to equalise can be greater for those who have undergone stapedectomy procedures. The inability to equalize the middle ear space effectively, or an attempt to do so too forcefully, may dislocate the prosthetic stapes. Dislocation can be corrected only in surgery and may result in permanent hearing loss. Diving after a stapedectomy also carries the risk that the desolation of the prosthesis may damage the round or oval window of the cochlea. Such an injury can permanently affect both hearing and balance. Again, it is not that the risk of injury is necessarily greater than that faced by other divers, but rather that there are greater consequences in the event of an injury. Before deciding to pursue or return to diving, it is clearly in your best interest to candidly review your fitness to dive with a doctor and make a brutally honest risk versus benefit analysis based on the information available.