MEDICAL FAQs

QUESTION

ANSWER

There's 2 ways of doing a hysterectomy.

Vaginally where the surgeons go via that route, or abdominally where they go through a bikini line incision on your lower abdomen.

The advantage of the first method is that it does not involve cutting through your abdominal muscles. And so your over all recovery time is quicker as you can lift, strain and heave sooner. This naturally will benefit the diver as they rig up on a busy RIB.

I normally suggest that 6 weeks is a reasonable time to wait post-op before diving again.

But if it the first time for you and you are doing the OWC at their pool in Chiswick then a couple of weeks should be fine for the simple pool work and theory. Leave it another 3-4 weeks though before doing your 4 open water dives.

37 is quite young for this sort of op and it may be worth considering the implications of your condition that warrants this on diving.
If it for uncontrolled heavy periods, then that's fine. However if it's for any sort of tumour then we may need a rethink.

QUESTION

ANSWER

My advice with this situation is pretty much standard. When you are fit enough to hump a bag of fertilizer from the car to the garden then you are fit enough to dive.

An incision has been made through your abdominal wall muscles to get at your uterus. Like any op of this category we say a good 8 weeks or more should be enough time for recovery. Some things delay recovery like post op infection or if you have any other illnesses that slow healing.

I would wait until the season starts, let's say the end of April, i.e. 3 months and you should be fine by then.

One thing on the Scapa trip. Do make sure you are dive fit and it's not the first dive after a lay off. The chamber up there is reporting more and more cases, so make sure a 40metre, low viz dive is like falling off a log for you before you go.

QUESTION

ANSWER

Recovery from this sort of operation to full preop ability usually takes up to one month. The operation she has had has no real effects on diving, so I suggest she wait until she is fully able to act as a good buddy and be strong enough to help you if you get into any trouble. This also includes her strength in carrying her tanks and rigging up in difficult conditions. Anyway by now she should be fine to dive.

QUESTION

ANSWER

Your friend is right. You suffer from what we call cystitis, which is where bacteria that normally inhabit your lower gastrointestinal tract can find their way to your bladder and multiply causing you the symptoms of pain on urination, increased frequency of urination and often an odd odour to your urine. The reason that women get it far more frequently than men is due to the length of their urethra. This is the tube that takes the urine from the bladder to the outside world, which in men is considerably longer than in women. So because of this bacteria can easily find their way up to the bladder and so cause the problem.

When you are back home the fact is that if the problem didn't get any better with the over the counter remedies you can quickly see your doctor who can prescribe you the antibiotics needed. But of course on safari you may be a long way from medical help and if left untreated the real problems can set in.

Leading into the bladder from the kidneys is another tube called the ureter, and in some cases the bacteria can ascend this tube and cause a full on kidney infection. This would lead to a severe fever, vomiting and pain in your lower back at the side of the infection. This can sometimes lead to dehydration, delirium and hospitalisation.

What I suggest is that you take your usual remedies with you, and if you get symptoms of cystitis then you should try these for a day. If there is no improvement after this then you need to really increase your fluid consumption to about 5 litres a day, especially as you will be in a hot climate and will be dehydrating at a faster rate than at home and you should start the antibiotics immediately.

There are several you can take, and currently I would suggest either trimethoprim 200mg twice a day for 3 days or cephalexin 250mg twice a day for the same time. The strongest and widest spectrum antibiotic is called ciprofloxacin and is taken at a dose of 100mg twice daily for 3 days as well.

If you are going for a long time I recommend you get hold of 2 courses of one of the first 2 and one course of the ciprofloxacin for your medical bag.

To prevent it occurring in the first place, always drink plenty of fluids, especially cranberry juice, make sure you wipe your bottom from front to back after going to the toilet and try to pass urine as soon as you can after intercourse as this can also aid the passage of bacteria up to the bladder.

On a final note, if you are suffering cystitis that often then you should make sure that your doctor has screened you for diabetes as this can make you prone to these recurrent infections.

QUESTION

ANSWER

And you call it a restroom. Doesn't sound like a place of rest to me, but the torture chamber for double-bottom disasters.

First the good news, none of your problems is a bar to diving. Depth, saltwater and neoprene are all OK as long as you have a sturdy pair of knickers.

But at the very least you could have a urine infection in the front and a bleeding pile at the back. Let's not go into the worst case scenario. You won't sleep.

Get yourself to a doc, who will examine you appropriately and hopefully nail it with tablets and cream.

Tell your partner to get checked as well.

QUESTION

ANSWER

I think if they have dived into you 4 times to frazzle the little bits of uterine tissue lying outside the womb, that causes endometriosis, and your little scamp of a child has been using you as a trampoline, then best to leave it for 6 weeks. I know this may be ultra-conservative, but it's no mean thing having this sort of op. glady we men will never suffer this problem, but basically, the womb lining somehow gets out of the uterus and into the fallopian tubes, the abdominal cavity and even into the uterine muscle too. Then each time you have a period, the hormones make this tissue expand as well, and get bloody, causing monthly agonizing pain. Thank the Lord for Y chromosomes. But its gone now for you. However 4 entries through the abdo wall with the scope can make healing less quick.

So leave it 6 weeks to be sure. The bleeding is due to the coil. Mirena is a progesterone covered coil, and this hormone can cause abnormal bleeding for a few weeks after it has been fitted, but all will be OK for when you first sign up for your Open Water.

QUESTION

ANSWER

"Referee, I hope your mother has an ovarian cyst the size of a grapefruit". One of the better insults I have heard at Stamford Bridge in the last few years. So, Mrs Collina, listen up. It is fine, as long as they are not prone to something called torsion. That's where they twist on their own axis and cause a lot of tummy pain. If this happened underwater it could be an issue.

But I assume the gynaes would have removed them by now if this was the case. So dive on, as these fluid filled lovelies won't compress or burst with pressure.

QUESTION

ANSWER

I think- no I’m sure this is the op where they pop the steel tube through your tummy button. Then whiz a fibre optic scope through that to look at your fallopian tubes. Then a whole bunch of blue dye is pumped up through the cervix, and is expected to be viewed passing from the ends of the fallopian tubes. Ergo, your tubes are fine, and there shouldn’t be a problem getting pregnant.

No dye seen and it’s a blockage. IVF all round then, and I bet you wished you had taken some zithromax to clear up the Chlamydia in your teens.

Good luck anyway, and give it 4 weeks before diving, as a rough rule of thumb.

QUESTION

ANSWER

Acronym city here…

GA= general anaesthetic.

CIN= cervical intraepithelial neoplasia.

LLETZ= laser loop errrr, forgot the rest, but it is removing the bad cells with a laser gizmo. Like Connery Bond on the table in Goldfinger.

UBE= unnecessary breast examination. Thought I would chuck that one in there.

A1W= answer, I week is ok for you.

QUESTION

ANSWER

The last time I witnessed the admonishment of a uterus was as a lowly junior doctor on Birth Suite. The poor owner of this wayward womb was suffering regular contractions with a closed cervix, akin to trying to squeeze toothpaste out of a tube with the lid shut. The consultant on call, a fiery sort with the bedside manner of a vexed Vinnie Jones, stormed in, examined the patient, and said in a full Scots brogue: “you have a lovely cervix, my dear, but an extremely naughty uterus”. Incensed, she delivered soon afterwards, but it’s not a technique that I’ve seen since.

I don't see a problem with some well earned recuperative swimming, as long as your wound is healed over and your blood tests (particularly your haemoglobin) show that you're not anaemic. With surgery of this kind (which is pretty major) I normally suggest a post-op layoff of 6-8 weeks to allow the tissues to develop reasonable strength before diving, but swimming should put a lot less strain on things, so the 4 weeks you have given it should be enough.

QUESTION

ANSWER

It’s extremely unlikely that you’ll encounter any problems with the IUD whilst diving. Most are small, solid structures that are snugly situated in the womb, protected from any harmful effects of external water pressure. Sometimes they do lead to increases in amount and length of menstrual flow, which might prove less than ideal on a liveaboard with one tiny toilet and 20 hairy male divers. But newer types such as the intra-uterine system (IUS) tend to diminish flow so it’s probably wise to discuss the various options with your GP before plumping for one. There’s no available evidence on whether pressure affects the release of hormones from the contraceptive implant, but there’s no theoretical reason why it should.