Medical FAQs

Here's a list compiled over the years of commonly asked questions. The list was created by DAN MDs and represent specific, evidence-based recommendations our member should take into consideration.

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I've recently been diagnosed with Raynaud's Syndrome. I'm an avid diver. Can I continue diving?
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.

Is it possible to dive after having suffered a stroke?
Stroke, or loss of blood supply to the brain, causes damage to part of the brain, or bleeding from a blood vessel in the brain, which results in similar injury. Strokes vary in severity and the resulting disability depends on the size and location of the event.
  1. Most strokes occur in older people. The stroke itself identifies the person as one who has advanced arterial disease, thus a higher expectation of further stroke or heart attack.
     
  2. The extent of disability caused by the stroke (e.g., paralysis, vision loss) may determine fitness to dive.
     
  3. Vigorous exercise, lifting heavy weights and using the Valsalva method for ear-clearing when diving all increase arterial pressure in the head and may increase the likelihood of a recurrent hemorrhage.
     
  4. While diving in itself entails exposure to elevated partial pressures and elevated hydrostatic pressure, it does not cause stroke.
     
  5. There is certainly increased risk in diving for someone who has experienced a stroke. Exceptional circumstances may exist, such as cerebral hemorrhage in a young person in whom the faulty artery has been repaired with little persisting damage.
    This type of recovery may permit a return to diving, with small risk. Each instance, however, requires a case-by-case decision, made with the advice of the treating physician, family and diving partners. Consulting a neurologist familiar with diving medicine is also advisable.
     
  6. There is a similar concern for significant residual symptoms, as with post brain tumor surgery.
I was diagnosed with an ailment called Arteritis Temporalis 10 months ago and was treated with a high dose of Prednisone (or cortisone) (60mg/day). The dosage of prednisone is being diminished each month. Now it is down to 15 mg/day and I am feeling OK. Is this a contraindication for recreational diving? Should I restrict my dives to 20-meter maximum?
For what concerns recreational scuba diving, not much is known about the interaction of cortisone, giant-cell arteritis (also known as temporal arteritis) and diving. In such cases it is wise to be prudent.

I do not think major problems are to be expected, but believe that limiting the depth and dive times are wise decisions.