MEDICAL FAQs

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ANSWER

I have given this a lot of thought. Consulted some of the wisest sages that have learnt the arts of Hippocrates. And all we can come up with is a guess.
If all is OK on the dive. Up from your safety stop. With your head bobbing above the water. But then you paint the deck as you pull yourself up, the only thing it could be is an increase in intra-abdominal pressure brought on by the exertion of hauling yourself up kitted still.

On your next boat dive here are my tips.

Don’t eat for at least 2 hours before you dive so your stomach is empty.

Remove your weight belt before getting onto the boat.

Remove your BC and tank and let the boat meister haul them up for you.

This should work but if not then I suggest you either get the same guy to gently lift you onto the vessel, or tape a sick bag onto your face so you have your hands free to hold a mop and bucket of water if it blows.

QUESTION

ANSWER

Thanks for explaining the acronym as to tell the truth I have never heard of it before. Likewise anything Swedish and adjustable could easily be assumed to affect the bedroom rather than the stomach. But I think I'm right in assuming it's a band that is put around the stomach to squeeze it smaller so you need less food to feel full. Hence the weight loss. And as you lose weight I assume it can be either relaxed or tightened to help you further.

So what about diving with it?

As it is not air filled that's fine. The only real issue is does if cause any reflux of gastric contents back up the oesophagus. If it does because it's too tight or you are trying to get too much food in you for your new stomach width then that is a real problem. Acid regurgitation with a reg in your mouth can be fatal. On dry land you can retch merrily away to get spit the acid out, or even rush to the pharmacy to get the Gaviscon. However down with the fish there is a chance that you can inhale the acid, go into a paroxysm of coughing. Reg comes out. You drown.

Only you know if you get any reflux. If you do, don't dive until the band is off. If you really don't then I hope you enjoy your trip to Egypt. Mind you, with some of the local delicacies I've seen out there you don't need an operation to put you of eating.

QUESTION

ANSWER

Heartburn or reflux oesophagitis is one of those highlighted things on the PADI med dec form. The danger here is, that if it is uncontrolled, good old gastric acid can spill up into your oesophagus on a dive, into your throat and either come out as a vomit through your reg, or more lethally, be re-inhaled. This will cause a spasm in your breathing tubes, laryngospasm, it's known as. If you get this underwater, your next sight will not be a little wrass but the Grim Reaper himself.

The reason you may get this diving is because of your body position and your gear. A horizontal dive position with a tight BCD and weight belt can squeeze your abdomen forcing up the acid.

So if that is the issue, then consider an integrated weight belt or a larger BCD.

However, as you are getting it so regularly I suggest you see your GP and consider a course of omeprazole to really knock the problem on the head. This is an antacid that is better at long term prevention of gastric acid problems. If this does not help then it's a gastroscopy for you. That's a 50 cm flexible tube they shove down your oesophagus to have a look at what lies within.

Not a lot of fun but better than having a chunder at 30 metres.

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ANSWER

This is pretty serious stuff. Varicies, or oesophageal varicies as they are known in long hand, are blood filled swellings in the oesophagus caused by problem with the vasculature in that area. The issue here is that they can bleed at any point, sometimes disastrously. In your case they have done that and you inhaled the blood at depth. Lucky to be alive, and I guess this is a testament to your "sang froid" underwater.

Now imagine if you were DM'ing and it happened again. You would be putting not only your, but your other divers' lives at risk. So it's no diving for you I am afraid.

What the hospital considers small and not worth operating on though needs another look. If diving is your life and you want to continue, then you need to find out why you have varicies and if they could fix them with a guarantee you will not bleed again. If they can do this, then you may well be able to dive and DM in the future.

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Not really with the peripheral neuropathy. This illness where nerves in the periphery stop doing what they are supposed to do can be a real pain, as I am sure you know. But the deal with diving is that as long as you have sufficient strength there to fin, haul out a buddy or get back on the boat then that should be OK. It is worth seeing a dive doc to get passed as fit, as well as getting a neurological mapping of your deficit. Numbness and pins and needles are classic bends symptoms, so you need to have a good idea of what's going on baseline, as it could save 5 hours in a chamber if you had a problematic ascent and an over zealous doctor.

The Barrett's though is an issue. This is caused by hyperacidity in the oesophagus, and needs the antacids to prevent pain and burning in this tube. As long as it does not affect your diving, causing reflux or pain when you are horizontal, then cool. If you are a gastric belchy sort of diver then there could be a risk of an acid vomit on a dive, so get that all checked out when the doc is stroking your tootsies with cotton wool before jabbing a pin into big toe.

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ANSWER

Firstly, congratulations on that huge initial weight loss, impressive indeed. For those in the dark, gastric banding is one of a big range of “anti-obesity” procedures performed these days. Notable luminaries who have undergone the operation include Sharon Osbourne and Anne Diamond. It involves putting an inflatable device around the top part of the stomach via keyhole surgery. This “band” creates a small pouch above it, which therefore fills quickly and produces a “full” sensation, while also slowing down the passage of food through the rest of the stomach. In theory this means the wearer feels full more easily, eats less, and loses weight. The tightness of the band can be varied by injecting or withdrawing saline from it, until a happy medium is found. Very clever stuff.

There are one or two issues with bands and diving however. There is a particular side effect charmingly referred to as “PB’ing” – Productive Burping – which can result in regurgitation of food from the upper pouch. Similarly, reflux of acid stomach contents can be a problem, especially if they come up into the mouth – a misplaced retch or cough could lead to a dropped regulator and inhalation of water. But in the absence of these hitches and as long as there is no gas trapping, there is no reason you shouldn’t dive afterwards.

QUESTION

ANSWER

Don’t panic, this is actually quite a common complaint and thankfully it’s unlikely to terminate your diving career prematurely. These are the typical symptoms of gastro-oesophageal reflux disease (GORD), which are often exacerbated by diving. Think of your stomach as a bottle filled with acid, and your oesophagus (food pipe) the long neck of the bottle. Normally a handy little sphincter stops acid entering the oesophagus, but in some situations (for example lying down, or being horizontal in the water) the acid refluxes through it, up the long neck of the bottle, and causes your typical heartburn and nausea. Pretty unpleasant during a dive. The risk factors for GORD are numerous: certain foods (fatty or spicy stuff, chocolate, caffeine, citrus fruits), certain drugs (nicotine, alcohol, anti-inflammatories), obesity, advancing age and tight clothing are those most prevalent in the diving community. If any of these apply then address them. Luckily there are also plenty of medicines to help. Some coat the lining of the oesophagus, others stop the acid secretion from the stomach, and sometimes a course of “triple therapy” will eradicate pesky bacteria that can contribute to the symptoms. So before your next dive ask your GP to give your gullet the once-over.

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I think I can. Gastric bypass surgery has been around for nearly 50 years, so surgeons are well aware of the possible complications of the procedure. The pleasant-sounding “dumping syndrome” is the most troublesome – cold sweats, butterflies, bloating and diarrhoea after eating (particularly whilst watching any form of reality TV). Small meals low in sugar are the order of the day (which is the whole point). On the whole results are good and weight loss sustained. A newer surgical approach is to wrap a band around the stomach, the size of which can be adjusted by injecting or removing saline through a port placed under the skin. This can be done via keyhole surgery (“laparoscopically”) and is hence commonly called a “lap band”. In Europe we are also blessed with the similar variant “Swedish adjustable gastric band”. Aren’t we lucky people? One charming complication of this procedure is Productive Burping, the regurgitation of swallowed food. Slower eating and more thorough mastication normally sort this out. Ascent from a dive can cause some acid reflux which might be an issue with either of these procedures, but this can usually be treated with antacids or similar drugs. Air trapping is unlikely as the gut is still “open” at either end for the important release of expanding gases. So assuming you have none of the above problems, go dive.