MEDICAL FAQs

QUESTION

ANSWER

Dear wife, yes I agree they can be expensive! Atenolol is a beta blocker and as I have pointed out before in previous issues this drug has a risk of causing a build up of fluid in the lungs if she were to exercise more than she was used to. This is called "pulmonary oedema" and results when the heart, which is slowed by the medication, not coping with the amount of blood returning to it, which then oozes out of the capillaries of the lungs into the tissues of the lungs itself. You can recognise someone with this as they are classically short of breath and cough up frothy blood stained sputum rather like the head of a glass of strawberry Cresta if you can remember popular 1970's soft drinks. Atenolol is the most commonly used of the antihypertensives as its cheap and pretty effective, but I've got to advise that she try a non beta blocker, and the best of these for a diver is probably Losartan. So try to get her medication switched afore she goes.

Now the question of what best to keep the flies off. Traditionally one of the Vitamin B subtypes, either B1, B6 or B12 works to keep off mosquitoes rather than flies, but to tell the truth I'm not sure which one it is exactly. But by no means is this to be relied on instead of antimalarials if that occurs where you are. I think the theory is that it makes the skin smell bad to these bugs and wards them off like garlic is also supposed to. But flies are a different matter, bigger and bolder. I guess the key is not to smell like what flies like, or make someone else an attractive proposition. I'll leave that to you! Your shots seem fine as long as its Hep A you've had. As for health tips…plenty.

The most important is to stay well hydrated as this is the biggest contributor to DCS in divers out there. This includes not getting diarrhoea, so watch what you eat there.

Remember the sunscreen and from my experience never be the first to get rigged up before a dive if there's a real slowcoach, standing in 35 degree heat with a wetsuit on for 20 minutes if someone's still in the loo can exhaust you to the point of collapse.

Enjoy the trip.

QUESTION

ANSWER

The guidelines are fairly straightforward as regards high blood pressure and diving. In the UK if you are an established diver, with a BP of under 160/100 you are allowed to dive, but if you are new to the sport and you have a BP of over 150/90 then you need to see a medical referee before you are allowed to dive.

Now before you get too worried you need to understand something. The pressure that your doctor checks is a variable thing. It may be high when he or she checks it, but it may be low later when you are at home. So in my practise I never go on a single reading that I take. I always suggest that a patient with borderline high BP either buys a machine to check it themselves at home on a regular basis which I think is a far more accurate way, or even better, has a 24 hour BP monitor. This gives the most accurate reading for your BP and quite often shows that it was normal anyway.

However, if it is raised enough to stop you diving then hypertension is very easy to treat and can be under control within a week or two with a choice of medication that won't interfere with diving.

So, get it properly checked firstly and then get it controlled and you can be diving sooner than you think.

QUESTION

ANSWER

So diving makes you less stressed, and the problem was stress in the first place. Sounds like we need to re-open Mr Cousteau’s Sudanese underwater world for you. Your BP is actually OK to dive with, anything below 150/100 in an existing diver can be considered fine. If you are going to go onto meds, my recommendation is any drug ending in “-sartan”.

QUESTION

ANSWER

This is going to get more and more common, as NHS GP’s are paid to put people onto these sort of meds at the soonest instance. 250 G’s a year!! They’re having a laugh, and it’s our taxes. And they whinge about over-work. Try running a proper business, I say.

Anyways, as long as you are not a coronary risk, and it sounds you are not, then you are fine to dive.

QUESTION

ANSWER

I’m trying to get my head round this. Your boss is in Hawaii, needs a medical question answered, and instead of asking the dive shops dive doc, calls you. I hope you don’t have to wipe her…you know what I mean!

Anyways up, she will need to get seen before diving, to check what the hypertension has done to her, but the good news is that the meds she is taking are the best with diving. So she should be ok to learn. Hey, you could even do her PADI exam for her too.

QUESTION

ANSWER

I think we can work round this one, before it gets in to “Carry On” proportions of comedy as you try to hide the secret as he walks into a docs office with pictures of divers everywhere. If it was just high cholesterol, then this has never stopped anyone form diving. But he will need a medical. I suggest remotely certing him for the pool and theory, but before the open water dives, where he would have clicked by then, seeing me. Of course there are no guarantees he will pass the medical, but you get a feel for people and he should be OK.

QUESTION

ANSWER

Whooa, this sounds like quite a side effect, and I hope you have gotten rid of it by now, if not, go see your regular GP for an immediate assessment of your blood pressure. When you up a dose like that there are chances it can drop your BP too much, hence nausea and dizzy. And strange feelings on one side of your face really need a neurological assessment, to make sure there’s no strokey sort of things going on. So, assuming this is still present, do NOT dive.

If it does settle and it’s simply a transient problem with the dose increase and now gone, this is how you dive. High blood pressure does need to be assessed by a dive doc before diving. You need an ECG to make sure there’s no damage to the heart, and a general once over. But these meds are dive friendly, few side effects like the dreaded beta blockers or diuretics. I reckon your chances are good, as long as all this side effect malarky has gone for good.