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Central Nervous System - Injury

Dr Jules Eden, dive medicine specialist and founder of e-med, answers divers' questions - as published in Sport Diver magazine:
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Q - I am proposing to go on a diving holiday, but wanted to ensure that I am medically fit enough to go, and wondered if you can help?

I had a pneumothorax as the result of a fractured rib, two years ago. I am fully recovered now. Do you foresee any problems?

I had a seizure, also at this time, due to a head trauma. This seizure occurred whilst unconscious. I have had none since, and have been declared medically fit to drive. I do not take any medication. Are there any problems with this too?

Finally, I sustained some fractures in my pelvis and upper left arm. Both have healed and I have no problems.

Am I medically fit enough to go diving?????

Thank you very much for your time.

A - There are 3 issues here to deal with:

As your punctured lung or pneumothorax was as a result of injury, rather than being spontaneous, it is more likely that you will be fit enough to dive.

You still need to have your chest examined by a qualified diving physician, and our regulations also call for a CT scan of your chest to make sure that all is well now before we can recommend you dive again.

Your seizure is less of a problem. In normal cases of head injury the length of any amnesia or presence of a seizure will decide the lay off from diving time. You have been fine for the last 2 years with no problems , so I think that this shouldn't be a problem to you.

Finally the fractures you sustained are of relevance only if they stop you from kitting up on a RIB, or mean that you would not be able to look after your buddy if they had a problem. The other thing to have checked by your diving doc is if there is any residual problems left by the injury which could be mistaken for a bend, by this I mean areas of numbness or joint pain in your pelvis or upper left arm .It's best to have these documented now, so you are not incorrectly diagnosed as bent in the future. So, if the chest CT is fine look forward to getting wet!

Q - I am a PADI Open Water diver I qualified three years ago. I 'm 44 years old and I am thinking of going for the Advance Certificate now that I've been diving a while and have a little more experience (30 Dives).

I had a central herniated disc S1/L5 and 18 months ago I underwent a Circumferential fusion S1/L5. I had a SPECT Scan in December 99 which indicating that the fusion had successful taken.

With this condition, do you think I can continue to dive?

A - The only real problem you face having had a fusion of these 2 vertebrae in your lower back is to do with tanks and weights.

Because your scan shows the 2 bones have successfully joined you shouldn't get any problems with your disc herniating out anymore.

This would have caused problems with diving if left untreated, but that is obviously OK now.

However after any op in that area you may get the odd niggling pain and weakness there. So you need to be sure you can carry your tanks well enough, especially on long walks to a shore entry. I think it would also be wise to carry any weights in your BCD pockets as a traditional weight belt would hang down right over where you had the fusion and may exacerbate any remaining problems.

On a different note, I am glad you are thinking of doing your Advanced Cert. As a diver myself, it wasn't until I did that course that I really felt comfortable and relaxed underwater which then confers as safer diving.

(other dive medical questions)


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